Building Blocks December 2012 Cover

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A SPECIAL NEEDS MAGAZINE

EARLY INTERVENTION Where it All Begins…

Page 40

A Life of Autism Page 46

Services in Israel Page 20

Dentistry for Special Needs Page 58

December 2012

“I realized how bleak my future really was” Page 28

A Supplement of the


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December 2012

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December 2012


CONTENTS DECEMBER 2012

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FAMILY

INTRODUCTION

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“Little Miracles” Rabbi Yaakov Klass

9 10

31

No Two are Alike BB Digest

10

A ISSUES & ANSWERS

12 14

The League of the Physically Handicapped

16

Patient Centered Medical Home

17

38

Golda Turner

20

Avigael (Stephanie) Saucier Wodinsky, Ph.D.

41

Services Out of New York?

23

Direct Care Counselors

24

Coping with the Death of a Chronically Ill Child

26

How to Advocate Effectively

Barry Katz

27

Teaching Adolescents Indepedence

20

42

Lisa R. Silvey

Why Does Early Intervention Work?

Dana Ledereich, MA, OT/L

40 40 41 42 44

DIAGNOSIS A Life with Autism

22

Yaakov Kornreich

46 48

24

46 50

Autism News and Updates

48

Understanding PANDAS

51

Dr. Joshua Weinstein

Melanie Kwestel

Shoni Eidlisz, LMSW

Proposed Changes to Early Intervention The History of Early Intervention

17

Sandy Eller

Chaim Wakslak, PhD

38

Mori Sokal

Linda Farkas

Special Needs Services in Israel

22

The Montessori Method

Stephen Glicksman, PhD

We Could Do Better

Steve K. Walz

36

Establishing Eligibility for Early Intervention Services

Dr. Peter Della Bella and Carolyn Driscoll, LMSW

Tzivy Reiter, LCSW

Charter School for Jewish Educational Needs?

A Source of Hope

FAMILY

18

35

EARLY INTERVENTION

Deborah Berman, LCSW

The Impact of Disabilities on Marriage

28-

EDUCATION

Rabbi Dr. Mordechai Salfer, PhD

Q&

Preparing for The Unexpected

Family Forum

Susan K. Schulman, MD

Seizure Disorders: Causes and Treatment Rachel Wizenfeld December 2012

52 5


CONTENTS DECEMBER 2012

CONTINUED

TREATMENT

70 PRODUCT REVIEWS

54

Does Movement Matter?

55

The Art of Play

56

Are Primitive Reflexes Affecting Me?

58

Dentistry

59

Guide Dogs

60 62-

FES and Dropfoot

67

Paul Stadler, MS OTR/L

68-

Book Reviews

74-

54

Avrohom Adler, LCSW

73

77

RESOURCES DIRECTORY

Paul Stadler, MS OTR/L

Dr. Chrystalla Orthodoxou

Product Reviews

58

Directory Listings

7899

100

BULLETIN BOARD 100-

Faith Fogelman

103

Herschel Sauber

? ASK THE EXPERT

66

101

RECRUITMENT 104105

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Chaya Ilene Klass ilene@buildingblocksmagazine.com Bracha Holczer bholczer@aol.com Breindy Rosenblatt brosenblatt@auditoryoral.org Yitty Rimmer

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Chaya Ilene Klass ilene@buildingblocksmagazine.com Shoni Eidlisz, Rabbi Yaakov Klass, Abe Kopolovich, Melanie Kwestel, Brocha Holczer, Dana Ledereich, Tzivy Ross Reiter, Breindy Rosenblatt, Juby Shapiro, Paul Stadler, Jared Wasserman, Rifky Weinberger

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Alana White lanala8@gmail.com For questions and comments or to order extra copies contact us at: buildingblocks@jewishpress.com or 718.330.1100 x352.

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Building Blocks Magazine published in collaboration with the Jewish Press. Reproduction in whole or in part in any form without prior written permission from the publisher is prohibited. The publisher reserves the right to edit all articles for clarity, space and relevance. Building Blocks Magazine assumes no responsibility for the content of advertisements. The views and opinions expressed in this article are those of the authors and do not necessarily reflect the opinion of Building Blocks Magazine or the Jewish Press.

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December 2012


December 2012

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INTRODUCTION “Little Miracles”

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ith the festival of Chanukah just passing us by, it is important that we reflect on its enduring message and its impact on our lives. The Talmud (Shabbos 21b) and Megillat Chashmonaim [the Hasmonean Scroll] relate the events that led to the festival of Chanukah, which we celebrate for eight days commencing with the 25th day of Kislev. The Jewish people in their own land [of Israel] were ruled over by the Syrian-Greeks, who subjugated them by enacting harsh edicts, all of which were intended to eradicate their Jewish belief and the practice of G-d’s commandments. Finally, when the edicts were unbearable, there arose a small courageous group of men, the

Maccabees, under the leadership of Matisyahu, son of Yochanan Kohen Gadol – the high priest of the House of Hasmoneans and waged battle with their oppressors. Miraculously G-d enabled this small band to overpower the more numerous enemy. When they entered the defiled Temple to cleanse it and rededicate it, they sought to kindle the Candelabrum – Menorah, but all the oil was defiled save for one small flask which was intact and bore the seal of the kohen gadol. They took of that oil and kindled the candelabrum and it proved sufficient for eight days [nights] of light. In order to commemorate and publicize this great event, the sages decreed the annual celebration of Chanukah with the light-

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dEvElopmEntal SpEcialiStS in Education, SpEEch & fEEding, occupational and phYSical thErapY and counSEling aBa, muSic thErapY, nEw SEnSorY room, adaptivE computErS, full timE nurSE, parEnt workShopS

ing of candles, and the recitation of praises – Hallel – to G-d. Thus the essence of this festival and its mitzvot – commandments are “pirsumei nissa – the publicizing of the miracle.

By Rabbi Yaakov Klass

ror, with the end result benefiting not only those with whom they relate on a continual basis but often far beyond. It is all due to publicizing successes in the classroom – the

“Educator and parent alike must publicize their “little miracles,” as inconsequential as they may seem…” Now we may ask does this festival come and then disappear until the next year with little or no impact on our lives? Or is there a deeper message, one that relates to the quality of life of each and every one of us. Indeed the concept of pirsumei nissa has greater relevance when we acknowledge that all that transpires in this world is due to our Ultimate Benefactor – G-d. It is due to this that we are required to publicize all the munificent good that He does. When dealing with the children that we are blessed with, we find that every child’s learning ability, whether it be those who have special needs or even those who are typical, is different, as our Sages (Midrash Tanchoma, Parashat Pinchas chap. 9) tell us: “One who sees multitudes of His people [600,000 or more] recites, “Blessed are You… the Knower of secrets.” Why because only G-d can fashion something, over and over again, and each of his creations is unique in appearance. And just as their appearances are one unlike the next, so too is their power of understanding. Each has unique intelligence and different means of comprehension. Yet, we find that educators are constantly pursuing new utilities, tools and techniques for the sake of imparting youngsters with knowledge and skills. Much is developed through trial and er-

laboratory of knowledge, via lectures at conferences, via print, via video, and other means of communication, that greater numbers of young people have benefited in acquiring skills, previously assumed to be beyond their reach. Yet an equally important source for enhancing the comprehension skills of students, both typical and Special Needs, is the parent. Every time a conscientious parent studies with his/her child and constructs a new portal that breaks through the child’s learning blockage, what results is a new and unique work of art. These portals at times are vividly perceived as little miracles, when little Avrumy can suddenly “read, write, or do ‘ritmetic.’ Imagine if that new technique that offered one parent great success was made available to another parent, who otherwise, in the midst of a harrowing and unsuccessful battle with his child, would throw up his hands and concedes defeat. Indeed, educator and parent alike must publicize their “little miracles,” as inconsequential as they may seem, in the spirit of “pirsumei nissa.” In that way, we may all share and benefit from each others miracles. Rabbi Yaakov Klass, rav of Congregation K’hal Bnei Matisyahu in Flatbush, Brooklyn, is Torah Editor of The Jewish Press. He can be contacted at yklass@jewishpress.com.


INTRODUCTION

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Editor’s Introduction: No Two Are Alike

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ne of the recurring themes in this issue of Building Blocks is the concept that each of our children with Special Needs is first, and foremost an individual. One way of understanding the mission of all of us who serve as care givers, therapist or advocates for these children, is allowing them to transcend their disability to the extent possible so that their unique character can come through, and to enable them to achieve their individual goals and potentials. The same is true for our parents and care givers. Each of them is faced with unique challenges, requiring infinite patience, determination and courage. For

parents, it means reconfiguring their expectations and overcoming their disappointment, while maintaining their focus on their other children and their spouse. They must enable their family to continue to function and fulfill the needs of all of its members, while they serve as a primary care giver and advocate for their child with Special Needs. There is the role of the professional care giver who, in some ways, has undertaken the greatest mission of all by voluntarily taking on the challenge of trying to help a child with Special Needs overcome their disabilities. It is one thing to step up when the challenge is thrust upon you. It is

something else to seek it out and make helping the child of stranger into your calling in life. Finally, there are the lessons to be learned from the high functioning individuals with Special Needs who have broken through their obstacles to lead meaningful and rewarding lives on their own terms. They are living proof that they can do more much than just function on a minimal level. They are proof that individuals with Special Needs can and do have dreams and ambitions of their own. Given sufficient support and opportunities, some of them can become productive, creative individu-

Sun., Feb. 10th at 11 am Mon., Feb. 11th at 7:30 pm

Tues., Feb. 12th at 8:00 pm

als, with their own unique and valuable contributions to make to the larger society. The Jewish tradition also teaches us the intrinsic value of the lives of lower functioning individuals who will never be able to live independently or make their marks in the outside world. Their unfathomable courage in the face of their disabilities, their amazing capacity to return the love lavished upon them by their care givers, and their ability to awe us with their determination to achieve the goals which they have set for themselves, no matter how large or small, leaves us all enriched and inspired.

From the Editors

Tues., Feb. 5th at 7:30 pm

December 2012

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INTRODUCTION By Yaakov Kornreich

Digest Special Needs Redefined in DSM-V

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fter a dozen years of research and internal debate, the American Psychiatric Association has finalized the fifth and latest edition of its Diagnostic and Statistical Manual of Mental Disorders, known far and wide by its acronym as the DSM-V, to serve as the new “bible” of the mental health field. Its listings define what is or is not a recognized developmental disorder, both for the purposes of qualifying for government ser-

vices and, to a lesser extent, reimbursement by insurance coverage. The new DSM-V will become available in May, 2013, and replace the most recent edition which was published in 2000. Its major changes include the elimination of Asperger’s Syndrome as a separate disorder, and its inclusion as part of the autism spectrum disorder (ASD). The autism spectrum will also now include two other disorders which had previously been list-

ed separately, childhood disintegrative disorder and pervasive development disorder. Another significant decision by the authors of the DSM-V was to retain the separate listing from dyslexia, which will retain its status as a recognized learning disorder. This edition of the DSMV contains many significant changes which will impact other mental health fields. The definitions of substance abuse and substance dependence have been

combined. Bereavement for the death of a loved one will now be recognized as trigger for a diagnosis of depression. Several new categories, such as sensory processing disorder, were proposed but not accepted for official recognition by the authors of the DSM-V. Other conditions, such as Internet gaming abuse suicidal behavior, and deliberate self injury, were designated for further research for possible inclusion in future editions.

Highest Achievers Being Handicapped by Classroom Norms

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ccording to presentations at the November conference of the National Association for Gifted Children (NAGC), the tendency of the traditional educational system to teach for the “average” student, has stifled the achievement of many of our most talented children. Like children with learning disabilities, gifted children in mainstream learning environments are often misidentified by teachers, neglected in the classroom and emotionally isolated from their peers. As a result, many gifted learners in our mainstream classrooms and underachieving because they are not being sufficiently challenged intellectually by their teachers and course work. "Gifted kids want those challenges and they need those challenges ... but

they end up the guys and gals who are throwing pencils across the room and falling asleep because

Dr. Linda Kreger Silverman, who founded the Denver Institute for the Study of Advanced

they aren't pushed," said author Ridley Pearson, who spoke at the NAGC conference.

Development, says that many of our brightest and most creative children have strong “right brain”

skills, which are more intuitive and visual, as opposed to children with “left brain” skills who are generally more methodical, and good at learning in the stepby-step fashion generally favored by traditional classroom teaching techniques, and who subsequently get the best grades. According to Silverman, it is the children with superior “right brain” skills who are in greater demand by today’s employers who want workers who can “think outside the box,” understand complexities and “see the big picture.” As a result, she says, our educational systems need to change the way it views children with atypical “right brain” learning skills and find new ways to challenge them to use their often underutilized intellectual abilities.

Researchers Find Way to Suppress Down Syndrome Mutation

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esearchers at the University of Washington, using stem cells, have found a way to remove the extra (third) copy of chromosome 21, which is the definitive characteristic of individuals with Down Syndrome. The extra 10

December 2012

copy of the chromosome, called trisomy, is a genetic anomaly which is responsible for almost a quarter of all spontaneous miscarriages, and the symptoms associated with Down Syndrome, including the characteristic eye,

facial and hand features, as well as impaired intellect and a range of medical problems. The researchers are now able to correct trisomy for chromosome 21 in human cells grown in the laboratory. While sci-

entists do not believe that this technique will be able to reverse Down Syndrome completely, they do believe that, over time, it could lead to gene therapies that could treat some of its specific aspects.


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Q&

A ISSUES & ANSWERS

Preparing for the Unexpected

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hough we all hope and pray that our already complicated lives should not be overturned by disasters or other emergency situations, recent events like Hurricane Sandy should serve as a wake up call for all of us. While both natural and manmade disasters can cause untold misery to many across the world, the Special Needs population is more severely affected than most, and any severe disruption to their lives can easily become life-threatening. Here are some lessons to be learned from Sandy that will help us protect our loved ones in the future. CAN EMS FIND YOUR HOUSE? Place stickers with the phone number of your local Hatzolah on all phones in your house, and program it into your cell phones. When calling Police or Hatzolah, talk slowly and clearly, and explain your problem. Make sure to give your address. Give a call back number. DO NOT HANG UP until the dispatcher tells you to. Police, Hatzolah, or other emergency providers cannot help you if they are unable to identify your house while driving past it in the street. Whether you own or rent your home, make sure that your street number is easily visible, day or night, from the street. If there are a number of entrances or apartments, try to have someone wait outside for the emergency responders to show them the way. KEEP MEDICAL RECORDS It is important to keep your own set of medical records, including these pieces of important information:  Patient’s full name  Date of birth  All doctors names, specialties, and phone numbers Any allergies  All diagnoses 12

December 2012

 Past surgeries  All medications and supplements—including natural—with their dosages.  A few words describing the patient’s medical condition.  A note about any bad reactions to medications or anesthesia  Medical insurance information  Legal, signed permission for your emergency contact to make medical decisions in the event that you cannot be reached.  Phone number of nursing agency if applicable Having this important information available may make a difference when every minute counts! It will also help prevent serious medical errors and dangerous drug interactions. It should be kept in an easily accessible place where you can find it quickly to take along in any type of emergency. One option is to keep a copy of these records on a small thumb drive on the same key chain with your house keys, or to upload it to an online backup service. A copy should also be given to your emergency contact, and kept updated. When dealing with a child, only the parent or legal guardian has the legal authority to make medical decisions, unless they have given a designated emergency contact a signed permission slip enabling them to make these decisions until you can be reached. Keeping medical records current and available can help when consulting with new doctors, and in an emergency it can help save a loved one’s life. During the recent disaster, many people who were forced to evacuate their homes took the time to prepare everything they would need for a few days—including medical records, medications and medical supplies--and left early. Others were forced out by the rising waters, and fled their homes literally with little

more than the shirts on their backs. PERSONAL AND MEDICAL IDENTIFICATION In an emergency situation, families can easily become separated from their loved ones. If you have a family member with medical or mental issues, it is doubly important to make sure that they can be easily identified. Simple steps like placing printed name labels with a name and phone number in all clothing can help more easily identify missing people, especially those with communication issues. Teach young children to tell their name, address and phone number to a responsible adult if they get lost or separated. Consider giving someone who may tend to wander, such as a person with autism or Alzheimer’s, a GPS tracking chip that can be worn as a piece of clothing or jewelry to locate these people when they go missing. Any people with serious medical issues should carry the pertinent information on a special card in a wallet or purse—or on an ID bracelet or necklace in order to provide the information to first responders or emergency room personnel. POWER OUTAGES If you live in an area prone to power outages and have a family member who is medically dependant on electrically powered equipment, you might consider purchasing a generator for use during power outages. The cost of a portable generator starts at several hundred dollars, and is proportional to its electrical capacity. However, it can be difficult to hook up to permanently wired equipment, and maintenance is complicated. Portable generators should never be operated indoors, because of the danger of carbon monoxide poisoning.

By Golda Turner

A home standby generator system is a more expensive investment, but if your health depends on keeping essential electrical equipment running through a power outage, it is well worth the extra money. Some home standby units run on gasoline, while others can be connected to the home’s natural gas line. The generator is permanently mounted outside the house and needs a car battery to start up. The unit must be hooked up by a licensed electrician to the lines in the home’s circuit breaker box that power the crucial electrical equipment that needs to keep running, as well as lines for some wall outlets and essential lighting. The size and cost of the unit will depend upon how much power it must generate to run all those devices. The system automatically charges the car battery and test starts itself to make sure it is always ready to automatically take over if your home loses power. In the wake of Hurricane Sandy, there has been a nationwide run on generators of all types and sizes. The best models will not be widely available again for a few months. MAKE A CONTINGENCY PLAN Most disasters and emergencies don’t give you much advance warning, so it is important to make sure that everyone in your household is aware in advance of specific emergency procedures and contingency plans in case of a fire, medical emergency or natural disaster. Make sure the Go-Kits for all the people in your household are handy and up-to-date (see below). Keep your essential batterypowered equipment and cell phone fully charged. Make sure you have fresh spare batteries on hand for your flashlight and battery-powered radio. Consider buying handcrank powered devices if you are afraid of an extended power out-


ISSUES & ANSWERS Q &A age. Keep an emergency supply of bottled water and nutritious, ready-to-eat foods in your house. Program the numbers of Hatzolah and Chaveirim into all of your phones. Keep a list with the individual phone numbers of your nurses or aides if applicable. If there is sufficient advance warning of the emergency, evacuate any medically involved or fragile person to a place of safety. If that person lives alone and chooses to stay in their home, arrange to check on their well being regularly until the emergency has passed. Talk to your family about fire safety. Install smoke and carbon monoxide detectors around the home, and change their batteries regularly. Keep a working fire extinguisher in the kitchen. Teach children about STOP, DROP, AND ROLL as a means of putting out a fire on clothing. Conduct home fire drills, so that everyone will know what to do without panicking. Provide everyone in the household with their own small personal flashlight, so they can find their way

in the dark. Establish an outside family meeting place if the home must be evacuated so that everyone knows where to go. Also make contingency plans for evacuating anyone in your household who has special medical needs. HAVE A “GO-KIT” Prepare waterproof emergency Go-Kits, which contain all of the essentials needed to sustain each person in your household for a week, including seven days worth of all prescription medications, and additional supplies like hearing aid batteries or a diabetic blood sugar testing kit, that you may not be able to easily find elsewhere. Also, consider adding a small batterypowered flashlight and radio, and a first aid kit. Keep the “Go-Kit” in a convenient place where you can grab it and go in case of emergency. This Go-Kit should be checked and all medications replaced every six months. INSURANCE COVERAGE Homeowners insurance will usually cover damage to your house and its contents due to a fire or accident, but it does not cover flood

WHERE CAN I LEARN MORE? There are a number of publications that you can request which discuss emergency preparedness for the disabled. From FEMA, 800.480.2520, www.fema.gov:  FEMA 475 Preparing For Disaster  FEMA 476 Preparing For Disaster For People With Disabilities and Other Special Needs  FEMA 154 Emergency Preparedness Checklist From National Organization on Disability, 646.505.1191, www.nod.org/emergency:  Disaster Readiness Tips For People With Mobility Disabilities  Disaster Readiness Tips For Owners of Pets or Service Animals From US Department of Homeland Security Ready Campaign, 800.BE.READY, www.ready.gov:  Preparing Makes Sense. Get Ready Now  Older Americans  Disabilities and Special Needs There are also online courses on emergency planning for

damage! Be aware that if you have added a wheelchair lift or handicapped ramp to your home, or suffered the loss or damage to valuable personal items such as jewelry, or medical equipment, that loss may not be covered unless explicitly listed in a rider to the policy, entailing an additional premium cost. The same is true for insurance coverage for any special modifications to your vehicle. Speak to your insurance agent about adding coverage of these items to your policy. If you want additional coverage, consider buying “umbrella insurance” which is designed to provide extra help in cases of catastrophic losses. It is necessary to purchase a separate policy for flood insurance, but even that will not cover loss or damage to the contents of your basement. Make sure your insurance coverage is adequate. Some home insurance policies automatically increase their level of coverage to compensate for inflation. If yours does not, review it regularly to make sure it is sufficient to cover full replacement

people with disabilities offered by the University of Kansas Research and Training Center on Independent Living, 785.864.4095, www.train.org. DISASTER AID CONTACT INFORMATION Though Hurricane Sandy is behind most of us, it is worthwhile keeping this reference information should the need ever arise again. FEMA 800.621.3362 (Tel), 800.462.7585 (TTY), 800.621.3362 (VRS) www.disasterassistance.gov This is the government agency responsible for assisting people in federally declared disaster areas. Services can include benefits such as grants for temporary housing, home repair, low cost loans, and other services. FEMA DISABILITY SPECIALIST Jim Flemming is the Regional Disability integration specialist for FEMA. If a disabled person in the NY/NJ area is in dire need due to a federally declared disaster, he can be contacted at James.flemming@dhs.gov INSURANCE ASSISTANCE United Policy Holders is an organization that assists people having issues with their insurance

in case your home and its contents is totally destroyed, as happened to thousands of homes in the region due to Hurricane Sandy Take digital pictures or videos of the contents of each room in your house, and especially the most expensive items that you have insured, and keep a copy of these pictures in a different location. These pictures will help you when you file a claim for compensation from your insurance company. And most importantly, there is the Heavenly insurance coverage. Remember to have your Mezuzos and Tefillin checked twice in seven years by a competent sofer. Check them more frequently if they are exposed to extreme environmental conditions and temporarily remove them whenever you paint the room. Golda Turner is the director of Beineinu, an organization providing information and support to families and professionals dealing with special needs. Their website, www.Beineinu. org, contains a wealth of information related to all types of special needs. Golda can be reached at 347.743.4900 or Golda@Beineinu.org.

companies. www.uphelp.org/programs/ roadmaptorecovery. . CHABAD - Chabad Shlichim in all areas have been known for organizing and providing needed assistance. For the nearest CHABAD shaliach, check www.chabad.org RESOURCE INFORMATION, MEDICAL EQUIPMENT, SUPPLIES, & MORE Our website, www.Beineinu.org has lists of medical related gmachs, equipment loan closets, equipment exchange programs, Bikur Cholims, Medical organizations, and many other resources and services, as well as articles containing much needed information. AUTISM CARES - This organization’s Autism Response Team provides support for families with an autistic member who are affected by natural disasters. Call 888.autism2 (888.288.4762) Beineinu is at the forefront of providing information and support to families and service providers all over the world dealing with special needs. In times of need, we also compile and send out email lists of where to get help. For assistance you can email Golda@ Beineinu.org or call us at 347.743.4900. December 2012

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Q&

A ISSUES & ANSWERS By Deborah Berman, LCSW

Jews and the First Wave of the American Disability Inclusion Movement: The League of the Physically Handicapped, 1935-1939

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he American Inclusion Movement’s First Wave, which was focused solely on Inclusion in the workforce, has been almost entirely forgotten. It occurred in the 1930’s, decades before the 1960’s zeitgeist brought about broader and more famous changes in pro-disability policy, architectural barriers, and independent living. The First Wave was led by a mostly Jewish cohort of young, militant, disabled activists from Brooklyn and the Lower East Side who called themselves the League of the Physically Handicapped (LPH). The LPH was the very first mobility impaired disability-rights group in recorded history. Its leader, Sylvia Bassoff, is the forgotten mother of what would become the wider Disability Inclusion Movement in the United States. Sylvia Bassoff was one of the victims of the 1916 polio outbreak. She was stricken at sixteen months old and was partially paralyzed from the neck down. Her parents, Jewish émigrés from Eastern Europe, provided a disability-accepting Yiddish/English-speaking household where she and her three siblings were saturated in a rich Jewish cultural and political atmosphere. That setting most certainly served at the foundation for her future as one of the most successful, if obscure, Jewish political agitators in American history. Bassoff grew up with the sense that anyone— whether a disadvantaged Jewish immigrant or a disabled person— has a right to live and work unimpeded by prejudice or policy. When Bassoff turned eighteen, armed with self-confidence, ambition, and youthful energy, she struck out on her own and began to look for work. However, the reality of life as a disabled person in the 1930’s shattered her expec14

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tations that the world would be as accepting and as her upbringing had been. Not only was she job-searching in the middle of the worst economic depression in American history, but she was obviously disabled, relying heavily on a set of crutches. Even after attending the elite Drake Busi-

to a standardized civil service test. However, these fair hiring practices seemed to stop with the disabled. Bassoff and thirty of her sheltered workshop colleagues, none of them with any experience in organizing or advocacy, nervously met in secret to discuss a way out of segregated charity work and into

ness School and finishing at the top of her secretarial class, she watched as less efficient but ablebodied classmates were hired instead of her. Finally, at the age of nineteen, she had to take a position as an envelope stuffer in a mass-mailing fundraising department at a charity that hired only persons with disabilities. Bassoff and her officemates viewed the work as degrading and segregationist. Franklin Roosevelt had recently been elected President and his successes in spite of his mobility impairment from polio made him a hero among the disabled population. In response to the grim realities of the Depression, Roosevelt revamped the moribund Emergency Relief Bureau (ERB)—today’s Human Resources Administration (HRA) – and fully implemented the WPA program. However, even though the President himself was mobility impaired, no disabled people were being hired by these Federal programs. Young Sylvia Bassoff and colleagues viewed the WPA as the only way out of the charity sector of the workforce. After all, the WPA hired other marginalized populations, such as Jews, thanks

Inclusion in the workforce. In May, 1935, the group finally acquired concrete evidence of how the disabled population was being excluded from government jobs. The WPA and ERB employment applications had a formalized discrimination system in which the page was stamped “PH” for “Physically Handicapped” upon the conclusion of a job interview. This code meant an immediate rejection of the candidate, regardless of qualifications or aptitude. Led by Bassoff, the group of young Jewish disability activists formalized their social action group. They dubbed themselves the League of the Physically Handicapped (LPH) and set out on a campaign to deal directly with the WPA policy-makers. The LPH began their campaign to acquire WPA jobs by visiting the New York City Satellite office of the Emergency Relief Bureau (ERB), where they staged what was probably the first civilrights sit-in in history. They entrenched themselves in the ERB office and picketed for close to a week, marching on crutches and in wheelchairs at a time when the disabled were virtually invisible. In a chaotic New York City street

scene, protesters chanted critical slogans aimed at the ERB Commissioner, who declared that the government owes nothing to the disabled but institutions and home relief. He then made the self-defeating decision to subject some of the non-violent disabled activists to arrests and rough treatment in front of crowds of able-bodied sympathizers and reporters, with predictably negative press fallout. As a result of this week-long march, radical changes in the New York City ERB hiring policies were immediately implemented. Thirty-three core members of the LPH won jobs via the ERB. Sylvia Bassoff was given a choice job as a typist, ironically at the very ERB office where she and her disabled colleagues had staged the initial sit-in. Although pleased with their new mainstream jobs, the group did not forget the systematic federal work discrimination they had experienced. In 1936, only months after their New York City victory, the LPH set out to take their issue directly to President Roosevelt himself. Led by Sylvia Bassoff, then just twenty-one years of age, around a dozen core LPH members, most of them Jewish and all of them young and with obvious mobility disabilities, got into the back of an open flatbed truck and made the journey from New York City to the nation’s capital. The group arrived in Washington, D.C. and, unannounced, entered the federal building that housed the WPA. They demanded to meet with the President to discuss the systematic exclusion of the disabled from WPA jobs. Their disheveled looks from hours of exposure to wind and weather, combined with their clunky crutches and other mo-


ISSUES & ANSWERS Q &A bility paraphernalia, attracted more than a few stares in an era where the disabled were an utterly invisible part of American society. The group made it up to the WPA office and demanded to be seen, but were completely ignored. There were few chairs in the waiting room, so the group sat on the floor and refused to leave. Too exhausted and too mobility impaired to stand up and go down to the truck, the group unwittingly staged the first sit-in in a federal building. This episode, consequently, became the model for civil rights sit-ins nationwide. The press got of wind of the LPH’s all-night sit-in and media attention was intense. The disabled activists, however, were neither self-satisfied nor indignant. The group of young twentysomething’s was terrified of losing their hard-won ERB jobs, being

year old daughter of Jewish immigrants in the 1930’s. Over the course of the next year, the LPH was successful in pressuring Roosevelt’s advisors to the WPA to repeal the discriminatory policy and eliminate the “PH” stamp on every Federal job application. While the LPH is responsible for opening up the federal work force to future generations of disabled Americans, the LPH activities in New York and Washington, D.C. are almost entirely unknown. It was a short-lived movement because it quickly accomplished its one goal: disability Inclusion in civil service employment. During its approximately four years of activism, from about 1935-1939, its achievements were noteworthy indeed. Imbibing the 1930’s spirit of social agitation, a major part of which was the Jewish struggle against nativist

arrested, or, even worse, tried for treason. This was an era of Communist paranoia and violent Nativism in the U.S., directed in particular against Jews. As a result, the motives of this largely Jewish group of disabled dissenters were constantly being questioned. For example, a New York Times article on the LPH protest at the New York City ERB concluded with the LPH members repeatedly denying accusations that they were Communists and anti-American. Twenty-four hours into the sit-in, a top advisor to Roosevelt agreed to meet with the core members of the LPH. Sylvia also received a letter from President Roosevelt encouraging her in her mission, praising her leadership skills, and expressing his commitment to resolve the problem. This was quite an accomplishment for a disabled twenty-one

Yachad mission is inclusion.

sentiments, quotas, and segregation, the LPH refused to remain invisible. The organization broke the disability employment stereotype as being limited to the philanthropic world’s charity workshop settings and expanded it into the mainstream government sector by starting a trend in the hiring of the disabled in other branches of the federal government. Rather than accepting the disabled-as-charity recipient role that lay within the very core of the American collective psyche, the actions and accomplishments of the LPH laid the foundation for a fundamental change in the perceptions and practices of the government of the most powerful nation in the world toward those with disabilities. Deborah Berman is a Senior Social Worker at Yachad, National Jewish Council for Disabilities.

The National Jewish Council for Disabilities is the only Jewish organization whose Yachad

is dedicated to addressing the needs of all individuals and including them in the full spectrum of Jewish life.

More than just Shabbatonim, Yachad offers more than 35 national and local programs reaching 5,000+ Yachad members nationwide. To find out more, visit us at www.yachad.org.

Yachad is an agency of the Orthodox Union

Because Everyone Belongs 212.613.8229 |

www.njcd.org December 2012

15


Q&

A ISSUES & ANSWERS By Dr. Peter Della Bella and Carolyn Driscoll, LMSW

Patient Centered Medical Home

A

national survey in 2006 found that more than 13 million children in the United States are estimated to have special health care needs, such as chronic developmental, physical, behavioral or emotional conditions. The survey also found that 40 percent of families reported that their child’s health condition has caused financial problems; 25 percent of families needed to reduce the number of hours worked, and 29 percent needed a parent to leave work entirely to care for their child. The survey showed that families were spending approximately 30 percent of their time each week coordinating care for their child. In addition, children with special needs are more likely to have unmet health care needs, according to a 2004 study published in the Archives of Pediatrics and Adolescent Medicine. For parents of children with special needs, health care is typically a discontinuous series of providers, places and appointment times. Records are scattered among family doctors and various specialists who rarely, if ever, communicate with one another. They each take a piece of the puzzle and work on it independently, never seeing how

their piece ultimately fits in with the rest. The lack of coordination and active communication among the treatment providers can become a major obstacle to optimal pediatric health. One answer to this problem is the Patient-Centered Medical Home, also referred to as medical home, which was first introduced in the late 1960s by the American Academy of Pediatrics and the American Academy of Family Physicians. It referred to having a single source of all medical information for pediatric patients with special health care needs. The concept has grown into a fully developed method for providing comprehensive primary care through a trusting partnership among doctors, patients, and families. In 1992, the American Academy of Pediatrics defined key aspects of the medical home -- care should be family-centered, accessible, and delivered in a compassionate and culturally sensitive manner. It seeks to replace fragmented and disease-reactive care with continuous care that is proactive, comprehensive, and wellcoordinated across all stages of life. Medical homes are especially important for children who have multiple and complex health care

WHAT TO LOOK FOR IN A MEDICAL HOME  Your child is assigned a personal physician who directs a team of providers involved in his/her care.  Your child is able to see his/her doctor when they need to and clinical advice is available 24 hours.  Your child’s medical home team facilitates and electronically tracks all referrals and testing, and follows up with you when results are received  You are fully informed and included in all decision-making, your feedback is actively sought, and your family’s cultural values are acknowledged, respected, and incorporated into your child’s plan of care.  You are provided with a copy of an updated care plan after every visit. Children with special needs whose primary, specialty and subspecialty care is coordinated under a pediatric medical home model, experience fewer missed school days, emergency room visits and unmet medical issues. 16

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concerns. Children with special needs frequently receive care from many providers and often require additional therapeutic and related services. In a pediatric medical home, families develop a longterm trusting partnership with a personal physician who leads a team of qualified health care professionals to manage all aspects of care and coordinates with other providers when needed. A plan of care is developed by the medical home team in partnership with the family, and this plan is shared with all providers involved in the child’s care. When referrals are needed, the medical home team provides specific information to the referring provider and reviews findings and recommendations with the family. Parents are not forced to navigate the health care system on their own. They simply make one phone call to the contact person for their medical home team who then works with them to coordinate and track all care provided. Within the medical home model of care, parents play an active role in helping to manage their child’s health condition. They know their child best, and physicians working in a medical home utilize this valuable resource to better understand the child’s condition, see how it impacts the family’s daily living, and identify what resources are available to help manage it. The families’ priorities and cultural values are acknowledged and respected. The medical home model includes facilitating access to and coordinating with non-medical and social supports such as, schools and community-based developmental and mental health assessment and treatment agencies, to utilize the resources they provide. Pediatric medical home teams often include care coordinators, social workers, mental health professionals, and developmental specialists. Their expertise helps families address and

coordinate services for all aspects of their child’s health care needs. Findings from the National Survey of Children with Special Health Care Needs showed that children without a medical home are (1) twice as likely to experience delays in accessing care, (2) twice as likely to have unmet health care needs, and (3) three times as likely to have unmet needs for family support services as children who receive care in a medical home. Research published by Massachusetts General Hospital for Children, and a 2011 study conducted by doctors from Boston University found that the pediatric medical homes are associated with better access to care, increased satisfaction with care, significantly fewer hospitalizations, and increased parental understanding of child health. Parents of children who have special health care needs often feel overwhelmed in trying to understand the totality of their child’s medical conditions. The medical home model provides a framework for developing a strong partnership between parents and their child’s personal physician, which leads to enhanced satisfaction and improved care. The medical home’s team approach extends far beyond the bounds of a typical doctor’s visit. It helps parents become active partners in the management of their child’s treatment through management tools which can lead to better outcomes. For more information on the Patient-Centered Medical Home visit the National Committee for Quality Assurance website at ncqa.org. Dr. Peter Della Bella is Medical Director of Premier HealthCare, a Patient-Centered Medical Home for children and adults with developmental disabilities and their families. For more information about Premier HealthCare visit yai.org/PCH or call 1-866-2-YAI-LINK. Carolyn Driscoll is a Research Assistant with YAI.


ISSUES & ANSWERS Q &A By Avigael (Stephanie) Saucier Wodinsky, Ph.D., M.Ed., M.B.A., GAC-ABA, GAC-AI

We Could Do Better

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hen we have children, we expect to be able to raise them in our communities and educate them in our schools. For many, the story goes as planned. Others find this scenario to be a difficult or even impossible path to follow. There seems to be a pattern, of sorts, in our schools and communities. Our children are made to fit within three general categories. In which category they fit appears to determine the ease with which they will find a niche that works and the level of “chanokh lana’ar al pi darko” that will apply to them. One category is the “typically developing” and minimally involved children. These are the children who have little to no difficulty with learning or behavioral issues. These children attend day school and go to groups at shul. They have friends and participate in activities. Occasionally, they need a little academic support and find the help they need in resource rooms or homework clubs, or at home with a parent. Their behavioral issues are typical for their age group. Most of our children fall into this group. Another category is the children with more severe learning or behavioral issues. Wonderful programs such as Yachad, Sinai, Kulanu, PTACH, and HASC have been developed to support these children academically and in the community. One can find a number of therapeutic day schools in cities around the country. While families experiencing this level of special needs face extremely difficult challenges, they definitely have some options available to help them educate their children. Many educators and community leaders are sensitive and committed to helping these families find a path that fits.

The category of children which often encounters the greatest difficulty in terms of education and community inclusion falls somewhere in between the other two, and this category is growing at alarming rates. These are the children with mild-to-moderate social and behavioral needs. These

level of academic supports found in self-contained environments. Socially, they need contact with typical peer models in order to learn appropriate behavior. Most day schools or community events do not have sufficient resources, policies, or training available to serve such children. There are some day schools

children often, but certainly not always, have diagnoses such as ADHD, PDD-NOS, high-functioning autism, sensory processing disorder, and others. These children are typically bright and academically capable, but have difficulty making friends. They are often socially delayed. They struggle with organization and maintaining attention. They have difficulty following directions and staying on task. While they can be disruptive to classroom routine, and require a level of support that is not readily available in most classroom environments, they do not need the

that are trying to educate this “middle” category of children and some shuls and community programs are trying to find ways to support them. While their efforts are worthy of praise, in my opinion, on the whole, we could do better. Using “shadows” or “facilitators” is frequently the preferred method for accommodating these children. While that is a useful strategy, it should be used as a transitional tool to help support a child while he or she gains necessary skills; a safetynet until he or she is able to function independently.

Educational models including environmental management, instructional accommodations, student self-management, and staff development would go far to help these children. Environmental management includes concepts such as physical seating arrangements, organizational strategies, and transition-planning, among others. Instructional accommodations include curriculum, materials, processes, and outcomes. Student self-management includes strategies initially taught by the teacher, but that eventually become studentregulated and allows the student to independently manage his or her own learning. Staff development requires training for teachers, development of policies, collaboration, problem solving, and communication. Obviously, financial resources are an issue. Nevertheless, I feel that often these children are denied a chance to participate with their peers out of fear and misunderstanding. Our goal as educators, parents, and neighbors should be to help all of our children to become successful, contributing members of our communities. “Chanokh lana'ar al pi darko” should not be a matter of categories, but a continuum of strategies, programs and policies used in educational and community settings for the success and enrichment of all of our children. Dr. Wodinsky and her family recently moved to Teaneck, NJ from Atlanta, GA where she was the founder and director of The Rayim Connection, a non-profit organization that provided year-round programming for children in an inclusive setting. She is a special educator, inclusion specialist, and consults with families and schools. She earned her master’s degree in special education and holds graduate academic certificates in applied behavior analysis and autism intervention. December 2012

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FAMILY By Tzivy Reiter, LCSW

United We Stand: The Impact of Disabilities on Marriage

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here has been much made in the media about the stress on marriage and the high rates of divorce affecting couples who have a child with a developmental disability. Yet at the same time, counter studies have been published that refute many of these claims – reporting that this data has been exaggerated and that these families do not have a significantly higher divorce rate. Which of these assertions is true? In our experience working with families, we can certainly understand both perspectives. There is undoubtedly an inordinate amount of stress placed on a marriage when a child has a disability, and we have seen marriages unravel before our eyes due to complications and stress that simply can’t be managed. When this happens, the consequences of divorce can be enormous and exponential: the financial pressures, stress of single-parent caregiving, impact on the child with a disability who has an even harder time managing change; as well as effects on the typically developing children who are already coping with having a sibling with special needs. Yet we have also seen couples who parent a child with a disability with marriages that are incredibly strong: couples who “have each other’s backs,” who understand the unique pressures they each face and provide support to one another as they meet them. We have seen couples with an extraordinary level of emotional closeness that is fostered by the all-encompassing challenge that is caring for a child with special needs. What are some of the challenges that these marriages face? What are the family dynamics that can contribute to the stress in a marriage when there is a child with special needs? And 18

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most importantly: what are the strategies that many couples have successfully utilized to transform some of those challenges into strengths?  Financial Stress: Families who have a child with a disability often experience extraordinary financial stress due to the increased costs of therapy, treatment, special diets, respite and other care. It may also create a situation where

ally the mother) carries a disproportionate amount of the caregiving responsibilities. These roles may be assumed by design or they may just evolve over time. This can occur even when financial responsibilities are shared. In these instances, the primary caregiver will often feel that her/ his spouse just doesn’t “get it”the extent of the care they need to provide, the minutiae of their

one parent has to work overtime in the provider role, becoming virtually an absentee parent while the remaining parent assumes the caregiving role. The financially providing parent may feel extremely pressured and not understand why his/her spouse resents his long absences, causing both parents to feel misunderstood and unappreciated. Unequal caregiving responsibilities: Often one parent, (usu-

daily responsibilities, the stress from navigating the bureaucratic service delivery system and their personal need for some time away from caregiving. This divide can create emotional distance unless it is recognized and suitable attention is focused on the needs of both parents.  Time and Energy: There are only so many reserves of time and energy to be had, and the child with disabilities will likely

consume all of them. There is little left over for even the typically developing children in the family, let alone the couple. Even if the couple understands their need and right to have time together and does not perceive it as indulgent, it is usually not realistic as caregiving issues and the needs of the child with disabilities often get in the way. In order for this couples time to happen, family and/or community members must recognize and actively work to address this issue, giving couples precious time alone outside of their caregiving responsibilities to connect and recharge their emotional batteries.  Differences in coping styles: Having a child with a disability often requires parents to acknowledge the loss of the child they wished to have, and to accept and embrace the child they were given. This process is not a finite event with a beginning and an end, but rather continues throughout one’s lifetime. It is often revisited at different stages in the child’s development and in the family’s life cycle. Often parents have different coping styles and do not experience this process in the same way. One partner may need more time to process his/her situation more, more outlets for verbal communication and support, and to be more open and direct about his/ her feelings. Another partner may be more private about his feelings, may not come to an acceptance at the same rate as his/ her spouse, or even at all. Some spouses have a more positive outlook while others have a hard time moving forward from their pain. A recent NY Times article, “The Psychic Toll Paid In a Special Needs House” by Ron Lieber, captured it well: “One person in a couple with a child whose disability was unexpected may


FAMILY have difficulty accepting it,” said Christoper Currin, a parent and financial planner who worked with divorced couples. “A deeper wellspring of love may open up in one of them, while the other goes to that well and finds it empty.” In addition, spiritual differences can be highlighted, as some parents can strengthen their religious faith in the face of such a challenge, while others will find themselves questioning their beliefs and/or angry about their situation. Finally, stereotypical male/female differences can also come into play. Many fathers we know have acknowledged difficulty in expressing their feelings, preferring instead to problem-solve and “fix things.” They are left feeling helpless when they realize their current problems cannot be “fixed.” Many mothers have expressed their wish that their husbands would simply be there for them and listen to their struggles without feeling blamed or pressured to solve them. Successfully communicating couples need not necessarily have the exact same style of coping. Yet they should be aware of their differences in approach, accept one another’s coping style, and periodically communicate about these issues. All feelings should be validated as legitimate, even if they differ from one’s own. The parent who has a harder time acknowledging his feelings should not be made to feel that his style is less healthy, and should be given the time and space to process feelings at his own pace. The parent who may need more open communication, processing and emotional support, should actively pursue other outlets in order to meet that need - such as counseling, peer mentoring and support groups. Programs that address some of these differences head-on can be very beneficial for families. Mothers and Fathers groups can illuminate some of these differ-

ences and provide support in navigating them. The less communicative parent can be taught to validate feelings and agree to set aside a small amount of time to just listen, if not talk him/herself. Parents who are successful in working through these coping differences report “checking in” with one another periodically about how they are doing. “Are we OK? If we are not OK, what can we do differently?” This gives them a sense of working through things as a team, even if they are

of the other and come to mutually agreed upon decisions [in consultation with their Rabbi, as deemed appropriate].  Excessive Parental Involvement: A new phenomenon that in the current generation of families is the excessive involvement of grandparents. Adult parents of children with disabilities are typically in need of as much assistance as possible, and many grandparents provide it in the form of financial assistance, babysitting and help navigating the

“There is undoubtedly an inordinate amount of stress placed on a marriage when a child has a disability, and we have seen marriages unravel before our eyes due to complications and stress that simply can’t be managed.” not always on the same page on every issue.  Decisions regarding family size: This is certainly not limited to families who have children with disabilities, as all couples need to be on the same page regarding these issues. Families who have children with disabilities have additional issues to consider in growing their families: caregiving responsibilities of the parents; burnout level of the primary caregiver; anxiety of one or both parents regarding the health status of future children; the risk of any genetic issues, if they exist, to future children; concern for unduly burdening the typically developing children in the family; and more. If parents are not united in their wishes regarding family size, it can create enormous resentment and feelings of alienation in one or both of them. Enhanced communication can help each understand the concerns and feelings

service system. The downside to such assistance is that at times the grandparents may overstep boundaries and inadvertently intrude upon the parents’ authority, space or cohesion as a couple. Successful couples accept help from their parents, while at the same time presenting a united front and maintaining parental authority and appropriate boundaries in the relationship. OTHER PROTECTIVE FACTORS THAT HELP STRENGTHEN COUPLES: Tap into the humor. One couple jokingly says that they had better stay together because “no one else in the world would take us with this package!” Another couple, who find themselves depleted after a full day of caregiving their child with high behavioral needs, have a “secret signal” to let each other know if they need help, because “we are so wiped, we can’t even look at each other, let alone communicate, af-

ter a day like that!” Show appreciation. Expressing gratitude, even for the things that one’s spouse should be doing, goes a long way to reinforcing the connection between both partners. Experience joy. Finding ways to experience joy as a family is essential, even if it seems very challenging to do so. Locating accessible trip destinations, programs that take into account the needs of children with disabilities, and sensory friendly recreation opportunities – help couples and children create positive associations and fun family memories which can get them through the difficult times. Seek support. Services, support and as much respite as possible are not luxuries. They are necessary to keep families functioning and marriages healthy and thriving. In conclusion, couples who parent children with disabilities deserve compassion and understanding of the unique challenges that they face on a daily basis. Family, community members and professionals who interact with them, should strive to provide extra support in meeting those challenges, thereby strengthening their marriages and entire families in the process. Tzivy Ross Reiter, LCSW-R, is a Director at Ohel Bais Ezra and an advisor to Building Blocks Magazine. She has written extensively about issues related to developmental disabilities and mental health. She is also the author of “Briefcases & Baby Bottles: The Working Mother’s Guide to Nurturing a Jewish Home; Feldheim, 2012.” With over four decades of experience in caring for those across the spectrum of developmental disabilities, OHEL Bais Ezra has elevated and enriched the lives of thousands of individuals and families. They offer parents much sought guidance and clear direction with many cutting edge services and programs, they are able to tailor programs that meet the specific needs of each individual and optimize their potential. For more information, Call 1.800.603.OHEL web: ohelfamily.org Facebook: facebook.com/ohelfamily. December 2012

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FAMILY By Steve K. Walz, Jewish Press Israel Correspondent

Israel Offers Superior Services to “Special Needs” Olim

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ew and veteran immigrant (olim) families, who have a special needs child or adult at home in Israel have access to a variety of government and private sector outreach services, which a growing number of Anglo immigrants claim are superior to many services available in the USA. New benefits are still being added. For example, last month, the Israeli government announced that wheel-chair bound disabled olim would be entitled to a substantially increased stipend to help pay the rent on their apartments. In addition, new immigrants, who applied for such benefits earlier this year, and who were waited for final approval by the Israeli cabinet, will now receive retroactive rental stipends

20

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dating back to May. Rents for decent apartments in many Israeli cities and towns often exceed 3000 shekels a month (about $750), and until now, wheel-chair bound olim were only entitled to between 800-1500 shekels a month toward their rent. Now, they are eligible for up to 3000 shekels a month in government rent subsidies, which will cover a significant portion of their basic living expenses. New immigrants who suffer from other types of disabilities will also received an increase in their maximum government rent subsidies from 600 to 1200 shekels a month. Single parent families with a disabled person at home are also entitled to rental assistance.

There are many more “quality of life” enhancing programs available through the Israel’s vari-

eral are very self-sufficient and find support on their own. There’s also a mutual support system

Kids are treated at Rambam Hospital in Haifa.

ous HMO’s (community clinics), Bituach Leumi (National Health Insurance), hospitals and nongovernmental/non-profit organizations (NGO’s). In addition, local municipalities work with both the Ministry of Education and private NGO’s to offer programs serving special needs youngsters and young adults. The growing number of physical and mentally challenged youngsters, especially those with an ASD (Autism Spectrum Disorder), has prompted parents to raise funds for private “after school” clubs and programs. In Modiin, a city with a mushrooming English-speaking immigrant population, there are 7 kindergartens devoted to special needs children that are funded by the Ministry of Education and the local municipality. In addition, a local group of Englishspeaking parents have formed an after school hours “club” for autistic youngsters. An American-born medical professional who lives in Central Israel and works in one of the country’s most well-known HMO’s revealed, “Israelis in gen-

that is very effective, while nonprofits play a big role. In Israel, standard ‘socialized care’ makes sure each child has a pediatrician and, until age 5, preventive care (called Tipat Chalav). It's hard to get lost in such a system. Also, within the socialized care system, a program called ‘Hitpatchut Hayeled’ (Child Development) gives kids developmental pediatric care. It is a fantastic resource for various types of youngsters with special needs. When such a child comes into my office, I refer the parents to ‘Hitpatchut Hayeled’ for evaluation and the appropriate therapies, whether they are available through the HMO’s (Kupat Cholim) or elsewhere.” English-speaking immigrants who have moved to Northern Israel benefit from the multitude of services provided by the region’s largest medical facilityRambam Hospital in Haifa. The Children’s Hospital at Rambam (www.rambam.org.il) is Northern Israel’s only hospital exclusively dedicated to pediatric medicine and is anchored in the community. Youngsters and their


FAMILY families turn to it on their own or are referred by family doctors, in-house (hospital) physicians, schools, and social welfare agencies. The hospital takes a personal approach to children, and includes parents as partners in the healing process. Amongst some of the services provided to children with Special Needs by Rambam include an ADHD and Adolescent Clinic, as well as an Eating Disorders Clinic. The metro Jerusalem region is blessed with a plethora of cutting-edge non-profit organizations that work closely with the English-speaking immigrant community. One such organization is the Tishma School & Center for Children with Autism. Tishma was established in Jerusalem in January, 2001 to provide an intensive behavioral intervention program for children diag-

nosed with autism. Since opening with one room and just two students, Tishma has expanded rapidly. It now serves 60 students in a rented property in the south of the city. Tishma provides each child with a customized educational program based on the specific skills that require development and strengthening. The school accepts any child with a formal diagnosis of autism or PDD (Pervasive Development Disorder). Ruchie Aloof, who made aliyah from New Jersey to the town of Yad Binyamin near Rehovot, and who is the mother of a PDD youngster, didn’t know how much assistance she would receive from the “system” in Israel. “You know, this is not the easiest thing for a parent to deal with, especially in Israel, where you have to be a bit more pushy

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718.434.4442

or, as the saying goes, ‘the more you squeak the more oil you will receive’. What I discovered is that my PDD son is more eligible for various types of assistance than in the USA,” she told the Jewish Press. “For instance, many special needs children are eligible for alternative therapies such as horseback riding and other animal therapies that are subsidized by your insurance. In the USA, they’ve only started to think about this type of therapy. Some youngsters who might not have great verbal skills could be put on a horse and they are actual able to control the animal. It’s amazing to watch. If your child is recognized by Bituach Leumi (National Health Insurance) as having special needs, you will receive a stipend every month towards alternative therapy. You choose the enrichment therapy that fits your

child’s needs. Of course, the government also assigns you a social worker who will advise and help you navigate the system. Families with a child or young adult with special needs are even entitled to discounts on electricity etc. And in designated school districts, busing is provided as well. It’s not a perfect system and there will always be hurdles to deal with but the bottom line is that my child is thriving in school.” As a service to our readers, see page 99 for an abridged list of various outreach services available to the “Special Needs” community in Israel. Steve K. Walz, is the Jewish Press' Israel-based correspondent. He is the former editor of the Jewish Press, who made aliyah in 2001.

See page 99 for more information on services in Israel.

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FAMILY Coping with Limited Services Out of New York

H

aving a child with special needs can be especially challenging for parents, particularly as they attempt to navigate their way through the system in order to take advantage of the services that are available for their child. But while parents who live in the greater New York area have many options when it comes to attempting to provide their child with services that are appropriate within a private school setting, those who live outside the metropolitan area find themselves with very limited options, if any. Avigael Wodinsky was living on Long Island when her son was diagnosed with autism at the age of eighteen months. “My son was two when we moved to Atlanta, but we had already gotten a taste of early intervention in New York,” said Wodinsky. “We weren't able to get early intervention in Atlanta because by the time kids turn two they are being transitioned out of the system. We had to wait until he turned three and became the responsibility of the public school system.” While Wodinsky had gotten a degree in applied behavior analysis in order to be able to provide services for her son, she quickly discovered that finding therapists was no easy task and those that were in the area had long waiting lists. Wodinsky took matters into her own hands and trained local college students to do the work she wanted to be done with her son, even building a sensory gym in her basement. From there, it was just a short leap to the birth of The Rayim Connection, which offered access to Jewish activities and programs to children of all abilities. “We had a self contained Sunday school for children, an inclusion programs for summer camps, music therapy, gymnastics, krav maga and all sort of 22

December 2012

By Sandy Eller

programming,” said Wodinsky. “Our kids were not welcomed at Shabbos groups in shuls and this finally gave them a chance to interact with other Jewish children while being involved in Jewish activities.” Unable to find a day school in Atlanta that would accept her son, despite the fact that he finished kindergarten and was able

have much. There are waiver programs in existence to provide services, but they are much smaller and very difficult to get onto.” Porush wonders what she will do once her son turns twenty two and is no longer eligible for the high school program he is currently enrolled in. “In New York there is residential housing for children who

still feel that sense of belonging.” The sense of belonging and continuity is very important to both the children with special needs and their parents who typically find themselves on the outside looking in. “It is very isolating to have a special needs kid and for these children and their families we are their community,” explained Weisberg.

to read both English and Hebrew, Wodinsky relocated to Teaneck where son is currently enrolled in the Yavne Academy in Paramus. The Rayim Connection is, in Wodinsky’s words, defunct, for now. “No one wants to put money into something like this,” said Wodinsky. “I speak to many of the parents from Atlanta and all but one of the children is in public school. There is no place in Atlanta day schools for these kids.” Chicago resident Sara Porush, the mother of a fifteen year old with familial dysautonomia, finds the lack of services in Chicago particularly challenging. “Illinois ranks fiftieth in the country for providing services for the disabled,” reported Porush. “In New York, there are services all over, but in Illinois we don't

outgrow the schools, but they are just starting to work on that here,” said Porush. “We know of one non-Jewish family who moved to Wisconsin because they couldn't get the services they needed in Illinois and we joke about moving to New York just so we can get more services.” One saving grace for Illinois parents has been Keshet, which, for the past thirty years, has been providing services for children with special needs in Chicago that includes Jewish programming. “We weave the fabric of Judaism into all of our programs which include day school, summer camp, Sunday school and more,” said Abbie Weisberg, executive director at Keshet. “You can be ultra Orthodox, modern Orthodox or not Jewish at all and

Keshet serves approximately 450 children annually, with some coming from as far away as Los Angeles, Denver, Wisconsin and Minneapolis. “There just isn't much being offered outside of New York City,” said Weisberg. “I met with the Board of Jewish Education in New York and they told me ‘Nobody does it like Keshet’. We serve hundreds of children every year here in Chicago, but through our model, which is being used in numerous other places, we impact the lives of thousands.” Sandy Eller is a freelance writer who has written for various websites, newspapers, magazines and private clients in addition to having written song lyrics and scripts for several full scale productions. She can be contacted at sandyeller1@gmail.com.


FAMILY By Chaim Wakslak, PhD

D

Direct Support Counselors: Working with Individual’s and Their Special Needs

uring my years as Clinical Director I never cease to be amazed by a group of men and women, both young and old, who serve on the front line by working “hands on” with the Special Needs population. You will find these unsung heroes in every agency, for they are critical and vital to the services being rendered. You will find them providing personal care and administering medications in residential programs; teaching and training in day community habilitation and respite programs; while always facilitating growth, development and maximum independence. These are the Direct Support Counselors. Before a Direct Support Counselor can begin working, they must undergo an exhaustive screening process to insure their suitability for the job. Once accepted, they must then participate in an intensive orientation process and attend a host of training programs that range from Medication Administration, to Fire and Safety, to Client Rights and Abuse (referred to as 624 & 633 regulations, as they are identified in the NY State code). When all is said and done, I do not believe that the wages and benefits received by these employees are commensurate with the amount of effort, responsibility and stress involved with this type of work. It goes without saying that not everyone is suited for this type of a position. So what are the characteristics that an excellent Direct Support Counselor possesses?  EMPATHY It is clear that empathy, for the most part, is an inherent characteristic, and not something which can be learned. There are varying degrees of empathy, and

some people are able to empathize more than others. To work with a person with Special Needs means being able to understand their deficits, appreciate their

strengths and conduct all interactions with compassion, dignity and a positive attitude. If you can totally put yourself in the place of the one you are working with, you will do nothing but perform in an excellent fashion.  DEPENDABILITY People with developmental disabilities differ in their dependency needs. Some are unable to obtain their own meals, bathe themselves, get dressed, or go to the bathroom independently. Others require only minimal supervision, intermittent guidance, safety reminders and behavioral monitoring. Regardless of the particular circumstances, they have to be able to depend on the person assigned to them. It is well known that people with Special Needs do not react well to change. One way that they compensate for their limitations is by establishing a regular routine. Any disruption to their familiar schedule, environment or activities can often yield untoward reactions. Furthermore, they become extremely attached to the person who is working with them. That relationship provides them with

an additional sense of security – one of a familiar face and predictable mode of interaction. The substantive issue is always to strike a proper balance so that one does not foster over-dependence while on the other hand providing enough supervision, assistance or intervention to assure their well-being. It is for these reasons that it is crucial for a Direct Support Counselor to be dependable.  PATIENCE Individuals with intellectual challenges, sometimes coupled with physical disabilities, emotional difficulties and poor communication skills, cannot move and process information quickly. We live in a hurried society, and we have become used to fast paced living. It can be difficult to slow down to the pace of the person we are working with. A good rule is to allow a person to do as much as they can for themselves, and to avoid doing things for a person that they can do for themselves. Doing too much for them leads to them losing some of their physical abilities and increased dependence. It can also damage the dignity of a person, which is an important part of their mental health and quality of life. Additionally, a counselor without patience can succumb to frustration which is reflected in their tone of voice, and sometimes even anger.  STRENGTH There will be days and times when you feel like you are at your limit. You may be having a bad day yourself, or the person you are working with may be having a bad day, or you are just burned out. Times like these call for strength. Sometime a Direct Support Counselor will find themself in a battle with their supervisor or administration in advocating

and fighting for what they perceive would best meet the needs of the person they are working with. It is very easy to become frustrated by the red tape of regulatory agencies, or administrative bureaucracies. It takes a lot of patience and strength to advocate for your care recipient. A position of a Direct Support Counselor is not for the weak!  FLEXIBILITY Caregivers have to be some of the most flexible people I know. Things can change in an instant when you are working an individual with Special Needs. A Direct Support Counselor must be open to change because, whether you like change or not, it will happen. This type of position is best for people who can adapt quickly, and accept change easily. Let’s not forget to value and salute our Direct Support Counselors! Rabbi Wakslak received a Ph.D. in clinical psychology from Hofstra University in 1974. He is a New York State licensed clinical psychologist and served as clinical director and administrator of the Brunswick Physical Medicine and Rehabilitation Hospital in Amityville, where he specialized in clinical neuropsychology for over 20 years. He also served as a consultant to the Hebrew Academy of Special Children, Bais Ezra/Ohel, the New York State Department of Education, and the New York State Department of Disability Determinations. At the present time, Dr. Wakslak is the clinical director of HASC Center in Brooklyn. Rabbi Wakslak also has a long and distinguished rabbinic career. He received semicha in 1970 from Rav Gedaliah Schorr, zt’l, at Mesivta Torah Vodaath. He served as the rabbi of the Young Israel of Belle Harbor for 13 years. During his tenure, a new shul and mikveh were built, and he was instrumental in the establishment of Yeshiva Mercaz HaTorah of Belle Harbor. In 1986, he assumed the position as mara d’asra of the Young Israel of Long Beach, where he has served for the past 26 years. December 2012

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FAMILY By Melanie Kwestel

L

Getting Past the Pain: Coping with the Death of a Chronically Ill Child

eo Tolstoy wrote, “Every unhappy family is unhappy in its own way.” He might well have added, “Every bereaved family is bereaved in its own way.” The death of any child is devastating, but for parents of children with special needs, who require more hands-on care and time than healthy children, the passing of that child can seem an insurmountable pain. Parents are often as conversant with their child’s medical condition as the many physicians with whom they interact, and the sheer number of hours of care builds an intimacy that can seem closer than the bonds they have with their other children.

For some, this loss seems insurmountable. “My life will never be the same,” mourned Sharona. “I don’t believe there is light at the end of this tunnel. I am just trying to learn how to live in the tunnel where I am.” Yet others, after the passage of time, and who have the responsibility of other children to raise, have found ways to cope with the devastating loss. “We know how to commemorate the yahrzeit, but there are no guides to celebrating the birthday of a child who has died,” noted Batsheva. Every year on Yoni’s birthday, her family buys balloons. They write messages to the child, things they would want

him to know, tie them to the balloons, and then let them go. “We watch them climb into the sky, and I imagine that somehow they will get to him,” she said.

Many families keep a favorite toy or the blanket that comforted their deceased child in a spot where it can be seen, a reminder of a beloved child whose presence

“The death of any child is devastating, but for parents of children with special needs, who require more hands-on care and time than healthy children, the passing of that child can seem an insurmountable pain.”

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FAMILY is felt daily. Photographs can help ease the loneliness, and several families have electronic picture frames that cycle through dozens, if not hundreds, of photos. Spending time with bereaved families makes it clear that it is these myriad little challenges that populate their days, particularly in the first years. They wonder how they will answer the unintentionally callous who suggest that their other children will

somehow make up for the loss, or that they can have another child. How will they deal with the pain that accompanies what Dr. Norman Blumenthal, director of Chai Lifeline’s bereavement department calls, “The Question”: “How many children do you have?” There are no easy answers, nor is there one answer that suffices for everyone. As Deborah Horenstein noted, “My child was now in the spiritual realm, but I was here. I was alive. I had to find the work I was meant to do.” While most of New York and New Jersey was preparing for Hurricane Sandy, Deborah and her husband Avrom spent the weekend with 50 bereaved parents at Chai Lifeline’s Healing Hearts Bereavement Retreat. The Horensteins served as parentpartners, a couple whose experiences over the past five years might help more recently bereaved parents find the path that would work for them. Ariella Horenstein, a’h, was only eight years old when she passed away five years ago. She

suffered from a complex immune disorder, epilepsy, and Crohn’s Disease. Deborah was so involved with Ariella’s medical care that she briefed new medical personnel on her condition with the precision and accuracy of a physician. When they were told that their best hope for Ariella was a bone marrow transplant, Deborah and Avrom brought Ariella to Duke University Medical Center in Durham, North Carolina. They lived there for a year and half while Ariella fought bravely, but ultimately unsuccessfully, for her life. After Ariella’s passing, the Horensteins moved back to their home in Monsey, New York. Shoshana and Talya, their daughters, resumed their school routines. While they were extremely sad, Deborah and Avrom were not lost. In Ariella’s life and death, they found tremendous meaning and the ability to move forward. “Ariella really had suffered. I don’t think you can separate her death from her illness,” Deborah replied when asked how she coped with her loss. For years she had studied the works of rebbeim like Rabbi Yitzchok Kirzner, z’tl, who wrote of suffering and faith during his own long battle with illness. Her own emunah allowed Deborah to accept Ariella’s death. “It’s not in the natural course of things (to lose a child). That’s what makes it so clear that it’s coming from Hashem,” she stated. As Deborah said, Ariella’s task on Earth was finished. Their daughter had touched so many lives. Now it was time for her and Avrom to continue with their lives. Soon after they returned, Deborah began to take a course that would prepare her for medical school and a planned career as a pediatric oncologist. This August she entered the University of Medicine and Dentistry of New Jersey. Kwestel Continues on Page 27 ➘

Stigma. It’s a shame.

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December 2012

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FAMILY By Shoni Eidlisz, LMSW

How to Advocate Effectively for Your Child

T

here is certainly a sense of urgency if you are the parent of a child with special needs struggling in school. Nevertheless, to serve as an effective advocate for your child, it is imperative that you learn the proper advocacy techniques, and apply them in a calm, and patient manner. In addition, parents must gain a working understanding of the federal laws which determine your child’s rights to get the services he or she needs. HOW TO PREPARE FOR YOUR CHILD’S IEP MEETING: The IEP (Individualized Education Plan) meeting is very important. You and the other IEP team members at the meeting will discuss the services that are appropriate to provide for your child. It provides an opportunity for you, the parent, to ask questions and to share insights about your child. BEFORE THE MEETING ✔ Check the date of your child’s last IEP. It must be rewritten every year. ✔ Request copies of any evaluations and past IEP’s. ✔ If you disagree with the school’s evaluation, you may request in writing an independent educational evaluation at no cost to you. The results of this evaluation must be considered by the IEP team. ✔ Prepare a list of questions for the meeting. ✔ Make a list of your child’s strengths and needs and your major concerns about his/her education. ✔ Think about your child’s academic progress. What has worked? And what hasn’t been effective? AT THE MEETING ✔ Be on time. ✔ If needed, bring someone who can provide support at the meeting and/or bring someone who has special knowledge or special expertise regarding your child. ✔ Ask each person to identify themselves and write down their names and titles. ✔ Share your visions for your child, both short term and long term. ✔ Discuss your child’s strengths and needs. ✔ Remember that the diagnostic testing tools do not present the total picture of who your child is and what his/her needs are. ✔ Ask questions if you don’t understand something. ✔ Take detailed notes. ✔ Don’t accept any decision on your child’s IEP unless it is explained and you fully understand and are in agreement. ✔ Request copies of your child’s new IEP. 26

December 2012

✔ Do NOT sign anything before reading it completely, and if you need more time to digest it, don’t let yourself be pressured into signing it. PRACTICAL ADVOCACY TIPS: Build a Reliable Team Find independent evaluators who can help you understand your child’s needs. Consider consulting an educational advocate, who can help you to understand the laws, procedures, and strategies used at meetings with government officials. Learn the Rules Every state has a different set of rules and regulations defining a child’s rights to services and the procedures which are used to obtain those services. Learn what they say and mean, and bring a copy of them to all meetings with government officials to set the IEP, which will determine which services your child will receive. Prioritize Your Issues Create a list of what services you believe will be most helpful to the success of your child. When you meet with school personnel or the Board of Education, remain focused on your objectives. However, also be prepared, going into the meeting, to turn the argument into a negotiation by suggesting a reasonable compromise that you have thought through in advance. Document Everything and Keep All Paperwork Document every communication you have with government officials and agencies. Keep a written log of all telephone and face-to-face conversations. Take notes at all meetings. If possible, have another person attend the meetings who can take the notes for you and possibly later serve as a witness. However, don’t make any notations on any official documents or letters that you may want to use later as exhibits at a due process hearing. If you do want to notate them, do it on copies, not the originals. Sign Nothing Until You Read It Thoroughly and Understand It You could be signing something you do not agree with. Put It in Writing If you speak with someone who has agreed to something verbally, send a letter confirming what was said. Send important letters certified mail with a return receipt requested. Consider How Each Step You Take Would Look to an Impartial Decision Maker When you challenge a government denial of your request for services for your child, in many cases the final decision will be made by a hearing officer. You want to show that hearing officer that you have shared information with the school, treated school per-

sonnel respectfully, and made an honest effort to implement the reasonable measures that the school system has offered. You also must show that you are using the due process system, rather than fighting over procedural violations that do not affect the quality of your child’s education. Learn About The Special Education Laws In order to effectively advocate for your child, it is imperative to understand the laws which apply to special education and services. The Individual with Disabilities Act, Section 504 and No Child Left Behind are the three main federal laws which deal with students who may have special education needs. INDIVIDUAL WITH DISABILITIES EDUCATION ACT (IDEA) governs how states and public agencies provide early intervention, special education and related services to children with disabilities. It set procedural safeguards that protect the rights of parents and children during the identification, evaluation and placement process. Parents may challenge decisions regarding their child’s education through a due process proceeding, which could include mediation or an impartial hearing. Mediation Mediation involves the parent and a representative of the school district working collaboratively with an independent mediator. Any issues settled in mediation must be stated in a written agreement and immediately applied to the child’s IEP. Any issues not settled at the mediation session can be discussed further with the Committee on Preschool Special Education (CPSE) or the Committee on Special Education (CSE) or brought to an impartial hearing. Impartial Hearing The parent (or the school district) can request an impartial hearing before a hearing officer who renders a written decision. Section 504 of the 1973 Rehabilitation Act is an anti-discrimination law which is most often used to obtain accommodations for qualified students. No Child Left Behind provides standards for all students regardless of their disability. Shoni Eidlisz is the Director of Early Intervention for Omni Childhood Center, which provides evaluations and individual comprehensive therapy services for children from Birth – 3 years old, and preschool and school age children (3-21 years old). OMNI Childhood Center is located at 1651 Coney Island Avenue and at 18 Heyward Street, in Williamsburg. For further information, or to make a referral, please call 718.998.1415.


FAMILY By Lisa R. Silvey

Teaching Adolescents to Become More Independent

W

hen a child is born, he knows one thing - how to take. He cries - we feed him, change him, cuddle him, anything to make to him happy. As this child gets older, we start to teach him to feed himself, to pick up the spoon, to ask nicely for a drink, to tell us his bathroom needs. Later, he learns to bathe and dress himself, tell us what he wants to eat for breakfast, and get on the bus without a fuss. And then he becomes older and decides that he wants items that are not in the family budget. He realizes that in order to purchase these items, he will need money and thus he gets a job. Be it, babysitting, shoveling snow, raking leaves, or going to work in a pizza shop. This adolescent is learning the rules of independence that are the roots of becoming an adult. And what do we do when this young child is unable to take a shower independently because he cannot handle the sensory stimulation of the water on his back, or does not have good interpersonal relationships with peers due to his impulsivity, be it physical or verbal? What about the child who is 7 years old who prefers to eat with his hands instead of using a fork?

How do we as parents manage and teach such important skills to our children? Rule number  As parents we must remain calm. Even an infant can pick up on a parent’s tension. This can break the tranquility in the entire home, and chaos can erupt. Rule number  Maintain perspective. Remember that this child may not be able to button his shirt independently at ten, even though his younger sister has been doing so for three years. Rule number  Have patience. It is also a good idea to teach a new skill when the child is not under the pressure to do it RIGHT NOW. For example, take ten minutes when the other children are doing homework to pull out a shirt with buttons on it, or to teach better oral hygiene. Do it when you are finished with the morning rush, and the child will feel less pressured as well. Don’t expect for everything to be perfect all at once. Rule number  Expect small successes. Be happy when he ate part of the meal with a fork. Smile when he helped his father rake the leaves for ten minutes, or cut carrots for five. These are all steps in the right direction. What about when your child

starts getting older? As parents, we are always looking carefully at our child’s strengths and weaknesses, and guiding them toward a livelihood that will work for them. This can also be done with our children with special needs. If you see that your child has a talent with helping you in the kitchen, perhaps find a local caterer who would be willing to allow him to help out in their kitchen. Another child who enjoys yard work, could be placed with one of the many landscapers who could always use more help in the autumn raking up leaves, or cutting back bushes. Does your child like animals? Contact your local ASPCA. They are always looking for volunteers to come on a regular basis to comfort the pets, feed them, and also clean their cages. At my IEP meetings, I always stress to the parents the most important goal for their teenager with special needs is learning how to start making a living. What a great feeling it is for a child to receive a paycheck, or even just a ten dollar bill for his hour or two of work. It is possible that the person who is mentoring your child cannot or will not want to pay for his time, but your

child should be paid. Give the mentor the money, and they will pay the child. He does not need to know where the money came from. It is important to teach him that his time is valued, and it will motivate him to want to work more. Finally, open a bank account for your child. Show him the monthly statements, and if he shows increased independence, give him his own debit card to let him start managing his own money. Banks will set up an account with monthly spending limits. In conclusion, teaching independence to any teenager can be challenging, but especially so when this child has special needs. As parents, patience, motivation, and much b’siate d’shmiya is always needed to help our child succeed and survive in the most independent manner he is capable of.

Kwestel Continued from Page 25 ➘

something your child would be happy about,” Avrom said quietly. Avrom also took a leading role in raising funds for the Ariella Horenstein Bikur Cholim Society at Duke University Medical Center. He worked with Rabbi Zalman Bluming, a Chabad shaliach for the area, and the medical center to create a thriving enterprise where Jewish families can find the emotional and social support they need to get through the long months of a child’s hospitalization. Duke University donated a two-story building across

the street from the hospital that is now equipped with a threebedroom hospitality suite, fully stocked kosher kitchen, living room, library, and computer center. Volunteers and a social worker help parents regroup and find solace and strength. “We realized there was a huge need for something like this, and we think it is something Ariella would have wanted for other families. It’s nice to know that people who go to Duke for medical care will have it easier because of her,” he continued.

While there are books and guides to help parents through the pain of the loss, Dr. Blumenthal emphasizes that there are no hard and fast rules. “Everyone deals with the death of a child differently. You never get over it. You just learn to live with the loss.”  With the exception of Deborah and Av-

The Horensteins chose to memorialize Ariella through tzedaka projects. They dedicated Chai Lifeline’s Ariella Horenstein Music in Our Lives program, an initiative that brings performers to family events and Camp Simcha. The Horensteins had been Chai Lifeline clients, and they felt that the organization would do a good job transforming Ariella’s love for music into programs that bring joy to sick children. “You want to do something that has a connection with your child,

Lisa Silvey a practicing speech pathologist and special education teacher in the central New Jersey area. She has close to twenty years experience working with a wide variety of patients with special needs. Specialties include teaching vocational and self help skills to adolescents using a speech and language model, as well as Traumatic Brain Injury. She can be contacted via email at: lisa.silvey@yahoo.com.

rom Horenstein, all names in this article have been changed at the request of parents.

Melanie Kwestel is the director of communications of Chai Lifeline, the international not-for-profit organization that brings joy and hope to families of seriously ill children. December 2012

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FAMILY FORUM Welcome back to the Family Forum!

O

ne of the lessons to be learned from the story of the origins of the Jewish People, as related in Sefer Bereishis, the first book of the Chumash, is that raising a Jewish family has never been easy. It has always been among our most challenging and rewarding tasks. We learn from the struggles of our forefathers in dealing with their spouses, siblings and children that life is full of surprises and unexpected developments, and that the key to success is patience, understanding, and faith

in Hashem. We learn that Hashem gave our forefather Avraham 10 daunting tests of his faith, not to punish him, but rather to bring out his innate capacity to overcome obstacles and to demonstrate the indomitable power of his faith in the face of the most difficult challenges. Out of those challenges eventually came the Jewish People which has faced and survived fresh challenges in each generation, and, through its faith, has persevered to this day. Each family facing the challenge

of raising a child with special needs is unique. In overcoming that challenge, those families have valuable and unique lessons which all of us can benefit from, whether we are in a similar position or not. For those within the Special Needs community, this forum is offered as a vehicle for sharing and chizuk where we can pool our experiences to help each other going forward, because we know that each day will bring new tests and challenges in every Special Needs family.

Living with Asperger Syndrome

G

rowing up with Asperger’s Syndrome poses many challenges. As a child, I had difficulties making friends and navigating social situations. In my teenage years, I felt depressed and had so many negative social experiences; I could not understand why I would want friends. In school, I excelled academically. I had a voracious thirst for knowledge and general information. When I graduated high school, my familiar and “safe” routine ended. Slowly, but surely, I realized how bleak my future really was. I did not want to go to college because just thinking about navigating a new campus, new curriculum and new people overwhelmed me. I had no goal in sight. Why endure college when I had no hope of employment at the end?

28

December 2012

From a young age, I loved playing video games. So, the months that followed high school graduation, I played video games for several hours a day. I was discouraged with the realization that all I could contribute to the world was playing video games. I wanted more for myself but I needed help. That help came from the nonPareil Institute. NonPareil Institute is a nonprofit video game train-towork program for adults on the autism spectrum. Two years ago, I visited nonPareil Institute. From minute one, I felt comfortable and realized I had found my passion and place in the world. I felt comfortable because they understood my invisible challenges. From day one I experienced success there. I learned the

design process of video game development. As I advanced through the training, I realized I enjoy and get the most satisfaction out of the more technical side of game development. That’s when I decided to take the Coding 101 course at nonPareil. This is where I learned how to communicate commands to the computer and to program software. This past summer I decided I wanted to design and program an iPhone game. I taught myself Objective C, Apple’s computer language. Through this newly learned programming language, I was able to develop my first application on the Apple App Store: npiSpaceApe. The game’s hero is a cosmonaut ape named Dmitri. The objective of the game is to help guide Dmitri through space dodging obsta-

By participating in the forum, parents and other family members of those with Special Needs empower others to meet these challenges. In particular, the forum serves as a crucial source of solace, hope and inspiration for those first confronting these situations, just by showing them that they are not alone, and how other families have found ways to confront and overcome these challenges which, at first, seem so overwhelming.

The Editors

By Aaron Winston

cles such as asteroids and picking up bananas floating in space. (npiSpaceApe is available in the Apple App Store and Google Play Market for 99 cents…check it out!) I was always capable of learning the skills needed to develop software but the way universities and workplaces are designed would not work for me. nonPareil has changed my life. It has given me confidence in many areas of my life. For instance, I have learned to drive a car and got my license. I now socialize with people at work, and have made friends who I enjoy spending time with outside of work. Yes I have challenges. I still have Asperger’s. But, it is not about the disability but rather the abilities one has that make the difference.


FAMILY FORUM

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Empowering Parents to Be Advocates One Parent’s Experience

y newborn son appeared not seem to be reacting to sounds as well as his twin sister. He just did not seem to be reacting if the phone rang, the door opened, or if his siblings spoke. This raised a “red flag” in our minds. The pediatrician thought we were overreacting and did not feel that the baby needed a hearing test. As parents, we asked, cajoled, and begged, until he gave us the referral. At the testing, the baby did not respond to the sounds until they were presented at 80-90 decibels (the volume of a jet flying overhead). The audiologist told us to take him home and “not worry.” In her opinion, he would “catch up” and hear fine by the time he was one or two years old. We immediately called another audiologist, had him retested, and he was fitted with hearing aids by the time he was 6 weeks old. Flash forward three years. Our son is now finishing early intervention and we are asking our district to send him to an auditory-oral preschool for services. We are told that he is not eligible for services as he is not “delayed enough.” We are told to return with him when he is at least 1-2 years delayed compared to his “hearing peers.” As parents, we were given the copy of the law from the State of New Jersey describing eligibility for school services and read that services are not determined by the amount of delay, rather by the physical disability. Again, we ask, cajole, and beg for services for our son stating that

the purpose of early intervention is to lessen the delay and we do not want to cause a delay at this point which would follow him through school. After being refused again, we go to due process and sue the district for services for our son. We are granted services and he is placed in an auditory-oral preschool until age 5. Can you now guess what happens at age 5? Again he is evaluated by the district, found to not have “enough of a delay”, and refused services. This time we are told that he speaks “fine for a deaf child” and he does not need speech therapy! To add to the mix, we have decided to place him in a Jewish nonpublic school of our choice.

The district informs us that in a non-public school, our son is not eligible for any services. We, the parents, remind the district of our past law suit. They agree after much discussion to give him one session of speech therapy for 20 minutes once a week, with 3 other children (all of whom can hear). Again, we decide to advocate for our son. I take him down and register him for the district’s special education kindergarten. The person in charge of our child study team sees me and asks me why I have decided to send him to public school. I explain that since he is now a public school student he must be provided, under the law, with speech 5 times a week, teacher of the

LEARN FROM OUR EXPERIENCE! HERE ARE GUIDELINES TO USE WHEN ADVOCATING FOR YOUR CHILD:  Remember that you are your child’s parent. You have legal and moral rights as his/her parent.  You have the right to advocate for your child and no one will advocate for him/her as effectively.  Remember the professionals are not always correct. As parents, you have the right to question.  Remember the professionals are not always correct. As parents, you have the right to disagree.  Take an educational advocate with you to meetings. They are an extra pair of ears to digest what is being discussed. They can give recommendations to the committee that you may not be considering.  Don’t get emotional! The team will consider your concerns more effectively if you are level headed.  You have the right as the child’s parent to request additional evaluations. Do this if needed.  Make sure everything that has been approved is in writing on the forms before signing. The committee often says that they will “add it later after you have signed the form.” Once the form is signed, they do not have to (and usually don’t) add it later.  Do not sign anything unless you are 100% in agreement with what has been written. You can request a follow-up meeting once the changes have been made.  Advocacy does not end with the signing of the IEP. You will need to be in contact with your child’s entire educational team (principal, teacher, specialists) throughout the year.

By Batya Jacobs

deaf 5 times a week, physical therapy 3 times a week, occupational therapy 3 times a week, and counseling 2 times a week. He looks at me aghast and states that that is a tremendous amount of services and money. I ask him to do the math- individual speech in the non-public school 3 times a week and supplemental instruction 3 times a week or all of the above. Within an hour we had written acknowledgement that he would receive the services in the nonpublic Yeshiva day school. Unfortunately, our fight for services for our child did not end there. This was a yearly battle, every time we met for a child study team yearly evaluation and review, we were told that services would be limited or cut completely. It got to a point where our son’s elementary school principal would start the meeting by stating that the IEP would not be signed. But our son was fortunate that he had parents who would not agree to what “the professionals” said. We were willing to advocate for our child to ensure that he would receive the most appropriate education possible. We were willing to go to court to ensure that our son could be educated in the school of our family’s choice. We were willing to speak to teachers, principals, child study team members, and specialist to ensure that they were all working together and that our son would receive the services he needed and was entitled to.

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FAMILY FORUM By Yehuda Minchenberg

Do You Believe in Miracles?

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hen our son Tuvia was 11 years old, he sang Anim Zemiros at his brother’s Bar Mitzvah. To many, this may seem like quite a typical accomplishment. However, for a boy who could not really say his name at age of 3 and spent the next 7-8 years in special ed classrooms (first in the public school system and then in Sinai Schools in NJ), this was a tremendous feat. Although preparations had been made and the words had been practiced both at home and at school, it was not a sure thing that Tuvia would actually get up in front of an entire shul and be able to project so that everyone could hear him. In matter of fact, a back up had been put into place just in case Tuvia lost his nerve and decided at the last minute not to do it. There was precedent for such a possibility as he was once supposed to give a 1 minute dvar torah on parent’s day in his school and when it came time for him to walk up to the lectern, he was not able to bring himself to come forward. Although teachers tried to cajole and his parents and grandmother had come specifically for this speech, it did not happen. Therefore, it was hard to blame those who had their doubts that Tuvia would actually say Anim Zemiros, putting aside whether it would be said clearly and the letters enunciated properly. Suffice it to say that when he actu-

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ally did get up and “perform”, everyone was very impressed and told him how proud they were of him. It was at this point that the laining for his Bar Mitzvah seemed like a possibility. No proclamation was made that this was going to actually happen. Tuvia just began to talk about his Parsha and he was going to lain it just like his older brother did so at his Bar Mitzvah. Could one tell a willing and hopeful child with limited capabilities in so many different areas that laining is quite different than Anim Zemiros. After all, there are many shuls that don’t even say Anim Zemiros! So if the words weren’t said exactly right, it wouldn’t really matter. Laining, however, is a whole other ball of wax. People are counting on the Ba’al Kriah to read clearly and correctly or else their obligation of hearing the Parsha could be put into question. It was decided that the effort would be made and the outcome would be determined by time and patience. A few months after the watershed moment of Anim Zemiros, the first pasuk (which had been read by Tuvia many times before but not with the correct trup or all the correct pronunciation) was started. It was read together by myself and Tuvia one time. The next night, we read it again. After about 3 nights, it sounded

like Tuvia was ready to try it on his own. He did so successfully. Great…1 down and 51 pesukim to go. Of course, the more pesukim he learned, the more which would have to be remembered and not confused with subsequent pesukim. This was practiced from a Chumash and the idea of buying a Tikun never even was suggested- we would see what would happen. This process was repeated for each subsequent pasuk. But instead of practicing just the next pasuk, we would start from the beginning and then make our way to the new pasuk. Once aliyos had been learned, we would alternate days of reviewing one aliyah a night and then the unfinished aliyah until the new pasuk. As could be imagined, this style of learning/teaching took a very long time. Every so often, someone would ask Tuvia what he was going to do for his Bar Mitzvah. He would proudly say “I am going to lain my parsha just like my brother!” The adult would then look at me and I would say, “that is the plan- we shall see”. Once the parsha was done, my wife and I felt that we were not going to push our luck and that we would spend the remaining 10 months reviewing the parsha. However, it was Tuvia who said “Ok, we finished the parsha, let’s do the haftorah”. Who were we to say no to a willing and motivated child?! So we

continued with the knowledge that this one might be a little tricky since the haftorah is very long and, in our shul, is preferably read from klaf. However, the Torah side of the Chumash did not seem to faze Tuvia as he had basically memorized his parsha so the lack of nekudos and trup did not make any difference. A few months later, the haftorah was done. Now, came the hard part- making sure it would be clear enough and enunciated properly. With the help of the Ba’al Kriah of the shul, Tuvia was guided as to what would need to be corrected and he slowly but surely worked at it…a little bit every day. The day of the Bar Mitzvah came and the question loomed “How would it turn out… would it be like the speech in school or Anim Zemiros of 2 years ago?” Tuvia was composed and never displayed anything which resembled nervousness. Standing right next to him as he stunned the crowd, I would describe his feeling that day of being one of tremendous pride and accomplishment- the feeling of a person who never doubted his capabilities for even one moment. How would you have felt being the parent of this child? I will tell you-like someone who wishes that everyone could feel what I was feeling on that day- Yiddishe Nachas to the infinite exponent!


FAMILY FORUM By Yehuda Minchenberg

Shabbos Afternoon

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n some families, Shabbos afternoons mean a trip to the local park. However, for our family that is quite challenging as our 11–year-old, autistic son Shmuel and our soon to be 8–year-old daughter Devorah spend most of their time their finding leaves on the ground and seeing what would happen if they could manage to throw them into the nearby stream. Of course, that is if we are secure enough in the fact that neither one of them will try to sit/climb on top of the low stone wall that separates the park from the 6-8 foot drop into the water. Meanwhile, Devora’s twin, Zev (also

on the spectrum), has no interest in such pursuits and therefore will climb on top of anything

which is supposed to be slid upon or climbed into but definitely not on top of. Of course,

this makes everyone in the park nervous and there are plenty who are willing to let us know that this is really dangerous. Because this is not necessarily what we would like to hear, we try to have one of us watch Zev at all times, one of us watch Shmuel and Devora at all times, and one of us to watch Mordechai, our typically developing (bli ayin hara) 3-year-old at all times who likes to either go on the swings or the see saw. While this is all happening, our 13-year-old son Tuvia, who has ADHD and has difficulty in social situations, is usually roaming from one activity to another trying to find

something to do or playing ball with boys who are a few years younger than he is. As there are only 2 of us, the park experience becomes a bit stressful unless almost no one else is there. Then again, the only reason why nobody else would be in a popular Shabbos park would be because it is getting dark, it is too cold, too rainy, or too hot, in which case we would probably not want to be in the park either. So, this brings us back to what we were doing in the house before we decided that the children need an outing and we should go to the park. As scriptShabbos Afternoon Continues on Page 35 ➘

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FAMILY FORUM By Shani's Mother

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Seizures – A Mother’s Story and Perspective

was having a normal, everyday conversation with my healthy teenage daughter, when suddenly she seemed to “space out.” I tried calling her name a few times…and nothing. She appeared to be in her own world. After calling her name a few more times and touching her on her shoulder, she appeared to snap back to reality and said “huh?” I didn’t pay much attention to this behavior as it had happened so many times in the recent past, and I simply attributed it to her being a teenager, who got lost in thoughts or daydreams. After all, she appeared healthy, so what was a little daydreaming in the middle of the day? However, I soon realized that there was a lot more to it. After some time, my daughter began to tell me that she felt “funny” at times throughout the day, but couldn’t describe what “funny” meant. She told me that when she felt this strange feeling, she would often drop things that she was holding and that her fingertips tingled. Baffled by her symptoms, I took her to the pediatrician who told me not to worry. She recommended that my daughter lose weight, drink more water throughout the day, and get a better night’s sleep. After the “all clear” from my pediatrician and permission not to worry, I assumed all was okay. Then, one night, I heard banging and clattering in the kitchen. Fearing that there was a burglar in the house, I ran out, baseball bat in hand, only to find my daughter stumbling around the kitchen, banging

into cabinets and chairs. When I called her name, she appeared not to hear me and kept stumbling like a “drunk” person. She had a smashed cookie in one hand and a drink of water in the other, which was spilling all over the floor.

there was some abnormality on the EKG (which I later learned was typical after a seizure). After much testing and trips to heart specialists, she was cleared of any heart problem. The cardiologist felt that it was a neurological problem and

I quickly called an ambulance and took her to the emergency room. However, by the time we got to the hospital, she had seemingly recovered and did not remember anything that had happened. The emergency room personnel who saw a “healthy child” looked at me funny and released her as a “healthy teen,” but told me to follow up with a cardiologist, as

should be followed up. After an EEG (electro-encephalogram, which tracks brain activity) showed seizures, she was diagnosed with adolescent onset epilepsy. With this diagnosis, our world became a game of twists and turns. Although the new diagnosis was scary, I assumed that it would be easily treated and things would turn out okay. Boy

was I wrong. The problem with epilepsy is that with each person, the symptoms vary greatly, as do the treatments and outcomes, which makes epilepsy a daunting and frustrating game of trial and error. Another issue is dealing with the side effects of the seizure medications, which can, and often do, have adverse effects on mood. My daughter experienced a lot of this. Because she was unable to control her moods, or even recognize her mood swings, it led to her feeling depressed and down about herself. As a mother who always wants to make her child feel good about herself, it hurt that I could not do so. The most difficult part of this disorder is managing it with medications. Though there are many medications used to control seizures, it was very difficult to find the exact combinations and doses that worked for my daughter. Even once found, the doses have to be constantly monitored and changed depending on the frequency of the seizures. I look forward to helping my daughter live a full, productive, and happy life. I hope that she realizes she has loving and supportive parents and a family who loves her for who she is. My wish for her is that she realizes her tremendous strength and potential. I pray every day that she finds a husband who will love and accept her for who she is. Most importantly, I hope that she realizes that she defines her diagnosis - her diagnosis does NOT define her!

Editor's Note: For more information on seizure disorders see page 52.

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FAMILY FORUM

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ears ago, when we first began exploring the reasons for my son’s developmental delay, we were happy to receive a label. We pushed for an autism diagnosis because it helped strengthen our case for services. We took him to many specialists, each one confirming the diagnosis. We were fortunate to receive the “maximum” and were provided with wonderful therapists. Our experience with early intervention was frightening and sometimes frustrating, but we knew that our son’s best interests were being looked after. After we left the early intervention system, our son was labeled by the school district with an autism classification under IDEA. We were happy he was placed in a fully inclusive public school and, to his benefit, in a fully inclusive class. For 3

The Label

years, he made tremendous progress academically and in terms of functional independence as one of a few children with IEPs in a class of typically-developing children. Eventually, though, we began to see how this label is perceived by others. Our local day schools and shuls had no support or programming for children like ours. My son begged to attend day school and actively participate in shul, like his siblings. Efforts to help develop inclusive programming were embraced only by families like my own. My husband called it the “not in my backyard syndrome”. The attitude expressed by most drove us to a larger Jewish community where we believed we would find more acceptance and programming. Currently, my son is considered

high-functioning by diagnosticians. He is closer to the ADHD label than the autism label. People sit at our Shabbos table and see no difference between our son and theirs. However, even though his test scores were above grade-level and former teachers all felt he could be supported (and excel) in a general education classroom, most of the day school administrators we consulted couldn’t see past the label. Without even observing him in his natural environment, they decided he could not be educated in their system. Finally, we thought we found a day school that would accept him without condition. He excels academically in both Hebrew and English subjects. However, their anxiety over his label resulted in formation of strategies that is caus-

By Yocheved Cohen ing a significant decline in his functional independence. The “full support to make sure he’s successful” model is not the right model in all situations. Indiscriminate use of “Shadows” is not necessarily the best strategy for high functioning children with the autism label. The diagnosis that initially provided the justification for services my son needed to help him grow (to the degree that some call it “miraculous”) now holds him back. The label is what many see instead of the smart, funny, playful boy we (and so many others who know him) love so much. We owe it to ourselves to look past the labels given to our children. There are many miracles waiting to happen if we have the faith to give them the opportunities they deserve.

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FAMILY FORUM By Mother in the Shoe

Does RSA stand for Related Service Adventures?

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isclaimer: The story you are about to read is true, however names have been changed…or have they? Last spring I had an annual IEP meeting for my child. It was an uneventful experience. The team continued to recommend placement in the same state approved, non public school she has attended previously, a full time para, a transportation para on the bus and related services. Shortly thereafter, I received a Final Notice of Recommendation which I checked the box, “I agree”, sent it back to the CSE and thought that too was uneventful. When September came, my child’s transportation para began to accompany her on the bus, just as she had done for years. Everything was going smoothly, or so I thought when about a month into the school year, much to my surprise, the social worker at my daughter’s school calls to inform me that an agency, we’ll refer to them as “Procrastinated” contacted her on a Friday afternoon, about an hour prior to dismissal to tell her they now have the contract on bus paras for the school. However, after the weekend no paras showed up to work. Some children stayed home, others were transported by their parents and caregivers. After several weeks passed and no paras were sent by Procrastinated, the district agreed to address the problem. They sent the contract to “Deferred” who contacted the parents in mid November, they were not calling to

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supply the paras, mind you, but to inform the parents that they now have the contract. When it became obvious that Deferred had failed to produce a single para, most of the parents were already fed up with this transportation crisis and requested impartial hearings against the district to release the RSA- related service authorization which they gave to their children’s former paras. From what I hear, those parents who did not request a hearing, are still waiting for Deferred to send paras for their children. Unfortunately, difficulties with contract agencies have become the norm these days. Think about it, the agency won the contract from the DOE by submitting the lowest bid. Many of these agencies underbid and then in order to profit, they pay the therapists and paras lower wages which is the primary reason why they have such difficulties filling the slots they have won to service the students. When the agency realizes they do not have the ability to fill the slot, they should release it. They should…but they don’t. Even when they must release the contract, the DOE just flips the case to the next contract agency down the line. For example, a friend of mine has a son who used to receive occupational, physical and speech and therapies. I use the term ”used to” because this year, although he is mandated on his IEP for these related services, he is not receiving them. The physical therapy contract was sent to “Exclusive”, Occupational therapy to “Prolific” and Speech and Language to “Super-califragilitic-expialidoicous “(If your child can pronounce it, then they don’t need speech therapy anymore!) Two of the agencies did not produce therapists but held the

contracts nonetheless. The speech agency did send a speech therapist but she was right out of school and not trained in working with students who stutter. This student stutters; the therapist however, worked on increasing his receptive language which is an area of relative strength for the student. After a few weeks, the therapist was transferred to a different school. The agency has not found a replacement. The parent has spent an inordinate amount of time calling the contact person at district who is assigned to handle related services. The first time the parent called was about two weeks into the school year after no therapists showed up to work with her son. The district representative looked into the situation and told the parent that her son’s services had been contracted to the above agencies and no RSA would be forthcoming because the student is “being serviced”. The parent tried to explain that her son has not been receiving his mandated therapies but to no avail. Evidently, the DOE considers merely contracting out of a related service or support as tantamount to providing the service even if no one is actually working with the student. The district representative told the parent that she would contact the agencies and she should give it another week. The next week after her son was still not receiving his related services, the parent called back and again asked about issuance of RSAs for her son. The district representative told her she would look into it and the parent should call back in a few days. The parent called the district at least six more times over the following week but received

no response. When she finally got through, she was told that the RSAs would not be released because the case was contracted out to three new agencies: “Associated”, “Superb” and “Extreme”. This time, the parent called all of the agencies to ask when her son’s services would begin. As it turns out Associated is based in Texas and right now has no New York based therapists at the moment. Superb and Extreme are attempting to find therapists. The parent’s only recourse now is to request a hearing. She would also like compensatory services/ make up sessions for all the missed related services. She fears that even with a hearing officer ordering that RSAs be issued, at this point in the school year, it will be exceedingly difficult to find therapist with availability. The loss to this student cannot be measured. Many students who are not receiving their mandated related service and supports will not make meaningful progress and in some cases may even suffer regression and loss of skills. There are also students who are presently in general education classrooms and their ability to remain in the least restrictive setting is threatened by the fact that they are not receiving the services and supports crucial to their education. Students with disabilities are being harmed because the DOE is seeking to save money contacting out services to the lowest bidder. The DOE should realize this plan is unrealistic and places students in jeopardy. Besides requesting impartial hearings, parents should contact their local state and city representatives to explain what is happening and the impact it is having on students with disabilities.


FAMILY FORUM Shabbos Afternoon Continued from Page 31 ➘

ing favorite Arthur or Mickey Mouse shows is a favorite pastime in our home, several of our children can be heard talking about them while working on puzzles. Puzzles were great up to a point since it became very difficult watching children (ranging from 8-13 years old) doing the same 100 piece puzzles over and over again, leave them in the middle because they lost focused or got bored, and then spilled a new puzzle over the floor in the hope that this one would catch their interest more. However, as would be imagined, this would get really messy. To exacerbate the situation, Shmuel would decide that the 2 sweaters which he put on himself (one of which may be his the other may very well be his

mothers which he found while rifling through his drawers and then his mother’s leaving any unwanted clothing on the floor in 2 different bedrooms) are not really keeping him warm enough (even in hot weather) and so it is time to bring down a blanket or 2 from upstairs. The result is chaos as pieces from several different puzzles are then dragged in a few different directions by the blankets which are being schlepped across the living room. The alternative possibility is that one of the scripts which Devora or Tuvia are reciting are particularly fascinating to him in which case he will start his kangaroo hop in front of the mirror which is nearby or on top of the puzzle pieces which, inevitably, will send them scattering in several

different directions and again will cause a mess. Then came magnatiles. Boruch Hashem for magnatiles. They have created a fascination for almost all of our children. The problem is that although they come in a few different shapes, the most popular and numerous of them are squares. Shmuel will most often use them to build a tower that is approximately 5 ½ feet high and then revel in the noise that is made when he topples it over and then starts again. This is enjoyed by all except by Zev who likes to use them to create patterns on the floor with the same tiles and then remove one piece from the pattern, put it at the end of the design and then move every other piece one spot over until he has moved them

all. Then the process starts over again with the next piece. At first the thought was, just get another set. It was a good idea but now there are just more pieces causing competition, fighting (between several children who have extreme difficulty articulating what it is they want to say), and a tremendous amount of noise every time the tower is caused to topple. It is usually at this point in the afternoon (winter Shabbosos are much more welcome than the summer ones as they are much shorter and we also get help from local teenage girls who are able to lend a hand. During the summer, neither of these positives are present) when we decide that it is time to go to the park. Please see paragraph # 1. And don’t even get me started on the kitchen!

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EDUCATION By Rabbi Dr. Mordechai Salfer, PhD

Can the Charter School Concept Serve Jewish Educational Needs?

WHAT IS A CHARTER SCHOOL? A charter school is an independently operated public school, however it is not privately owned. There is a governing board which makes the decisions of the school, as opposed to an individual who may own a private school. Often, the charter school board acts independently of the local district board of education where the charter school physically resides. Other times, the local board of education is the sponsor of the charter school. The charter school receives both federal and state funding for its operating expenses and has a non-profit status. It is subject to the same local state laws which a public school is required to uphold. The charter school concept empowers individuals to create a school that they feel better serves their children or offers them opportunities which the regular local public school does not. For example, a charter school can offer an additional focus on foreign languages and cultures, the arts, science, drama, music, etc. WHO RUNS THE CHARTER SCHOOL? The governing board of the charter school generally chooses who will be the school superintendent, principal, teachers, administrators, etc., as opposed to a regular public school which is governed by the local district board of education. This gives the charter school board autonomy in choosing the best candidate for every one of those positions. Often, a management company is hired by the governing board to help develop and submit the initial plans, and take an idea of a group discussed in a living room and develop it into a fully operating and running school. It manages many of the December 2012 36

school’s fiscal, educational, and general operations to ensure that the school conforms to state and federal requirements. The charter school is required to provide all of the needs of each child, such as OT, PT, Speech, etc. and the management company must provide the services within a balanced school budget.

based on the special needs of a child. The child’s IEP designates the category which determines the amount of additional funding. Charter schools receive this same increased funding for special needs children. HISTORY OF CHARTER SCHOOLS In 1991, the first charter school law was written in Minnesota to

school can discriminate and accept only Jewish children, so there are no specifically Jewish charter schools. There have been a few innovative ideas for serving Jewish children with charter schools, however they have largely targeted children from secular Jewish families by offering a focus on the Hebrew language.

WHERE DOES CHARTER SCHOOL FUNDING COME FROM? The funding of a charter school is the per pupil rate that each district school receives from the state. Regular district schools, however, receive a significant additional per pupil funding from the local district’s property taxes, which charter schools do not receive, and which is often equal to or more than the base state funding. As a result, public schools have a tremendous financial advantage over any charter school. In most states, the state funding allocated per pupil is increased

offer school choice. Today, there are approximately 3,000 charter schools nationwide, as compared with over 86,000 public schools. The movement was intended to offer choice, create a healthy competition, and try new ideas in education. The main underlying principles were autonomy from the ‘system’ and increased accountability for student achievement. ARE THERE CHARTER SCHOOLS SPECIFICALLY FOR JEWISH CHILDREN? Legally, because of the constitutional concept of separation of Church and State, no

OTHER CONCERNS ABOUT CHARTER SCHOOLS Any school supported by public funding is precluded from any teaching of religion in the school. However, the building may be leased by a religious entity or institution from the charter school for use outside of school hours, as long as the schedules permit. Another concern is that a charter school is covered by state standards which may require it to teach material which some parents may find to be objectionable. However, this is a concern for any school that receives public funding.


EDUCATION

A ‘SPECIAL EDUCATION’ CHARTER SCHOOL? A charter school can have almost any particular focus including, in theory, a special education charter school. It would be operated by a governing board which would choose their principal, teachers, special education staff, therapists, etc., deemed qualified and appropriate for the students. The schedule would contain a full day of the various required subjects, therapies, social skills training, sports, etc., as required by each student’s IEPs, but yet allow for the flexibility to have either a late start or an earlier day. This would make it possible to have the

students attend a separate educational program, similar to what used to be known as afternoon Hebrew School, which students

There are many who have opposed charter schools for Jewish children, but they may be more understanding if they were focused

“The charter school concept empowers individuals to create a school that they feel better serves their children or offers them opportunities which the regular local public school does not.” would attend after completing their daily public school classes.

more specifically on a targeted subpopulation, such as special educa-

tion. The needs of special education children are often more than regular Jewish day schools are prepared to handle. Special education charter schools would offer a viable and practical alternative, especially if supplemented with well-planned Hebrew School programs. Rabbi Dr. Mordechai Salfer, PhD, is the rosh Yeshivas Doresh of Miami, a special needs mesivta and yeshiva, which offers vocational education and training post-high school. He is the executive director of Tree of Knowledge Learning Center and operated a charter school for hospitalized children in Miami. He holds doctorates in clinical psychology and education. Interested parties can contact rabbisalfer@gmail.com.

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EDUCATION The Montessori Method

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e are born to learn, in whatever capacity we are able. We study the world with our senses, and try to understand it. Our special children have more of a challenge, but they are just as interested in knowing what is going on around them. We know that because we observe their keen interest in everything we do and say. We need to nurture this interest, to encourage it. The best way to help all children learn is to let them explore in any way they can. It needs to be said that although a Montessori classroom may look unstructured, the opposite is true. There is a strong curriculum in place, with the teacher monitoring each student’s progress closely. This is the fascinating story of how the Montessori method was developed, how it fits into our Jewish world, and how it can help our children with Special Needs. THE FOUNDER’S BACKGROUND Maria Montessori was a scientist, observer and thinker. She was also somewhat rebellious, and challenged many notions of her time. She was the first woman of her time to complete a medical degree, and she went on to specialize in research and education. She believed that all children are born with potential, and it is our job to help them find it. She believed in adapting the child’s environment to enable them to reach their full potential and that for children with Special Needs, it is even more important to be aware of and encourage this potential. Dr. Montessori was particularly interested in helping children with Special Needs, and she became a voice for them while she studied psychiatry. She studied poor but “normal” children from the slums of Rome. She took the curriculum of the 38

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time and worked on changing it from teacher-based to studentdriven, with the teacher serving as a guide. She found that when taught in this way, the students achieved more than adults

this is that there is no emphasis on being at a certain educational level due to one’s age. Also, the older students sometimes teach the younger, which enhances the learning for both.

thought they were capable of, and at earlier ages. The key to Montessori learning is allowing children to go at their own pace. The work is done through hands-on learning—tangible materials they can manipulate in order to learn about their world. Another key is allowing younger children to mix with older children. The advantage to

THE JEWISH CONNECTION More Jewish schools are starting to use the Montessori method in their instruction, although not all of them are considered strictly Montessori. The Luria Academy, a Brooklyn elementary school, is becoming a Montessori school, and its staff is currently being trained in the methods. The school is noted for accepting stu-

By Mori Sokal

dents of all backgrounds, including non-Jews. However, all the students learn Jewish topics such as Hebrew along with the history and geography of Israel, and they daven each day. The Torah Montessori School was started in Chicago 6 years ago by Rivkah and Moshe Schack, who dramatically changed direction in their lives when they felt the need for a different type of education for their child. They sold their accounting firm, completed two years of training, and opened up their own yeshiva based on Montessori ideals. Rivkah says that although there are some areas where Montessori is not a perfect fit, “there is a way to use it to make the most of ‘chinuch l’noar al pi darco (teaching a child according to his needs).” She says this Torah ideal and Montessori fit together perfectly, because that is exactly what the Montessori method does—it allows each child to learn the way he or she needs to. More locally, Yocheved Sidof, a Brooklyn mother, had the same idea and went to Chicago to ask Rivkah how to start up a Torah Montessori school in Crown Heights, which would combine a deep connection with Torah while encouraging children to learn in their own way. This initiative got off the ground in 2010. Yocheved is now directing the Lamplighters Yeshiva. It began with a class of 12 boys ages 3-5, and now also has a 1st and 2nd grade class; next year, they plan to add a girls’ 1st and 2nd grade. The preschool now has girls, ages 3-5, also. Yocheved is very excited about what this will do for the yeshiva worldShe described Lamplighters as “a Jewish school which employs Montessori methodology to reach every child.” Even though the


EDUCATION Yeshiva is a Chabad school, its mission is to revolutionize Jewish education for the benefit of the whole Jewish community. Yocheved and the Schacks are working together to bring their message to the world; that you can help each child reach their potential through learning in their own way. Rivkah travels between New York and Chicago in order to run both schools. They also ran a five week training seminar for the Lamplighters’ teachers called CAPD—Chinuch Al Pi Darko (Capdtraining.org) this past summer. Rivkah explained that the training should imbue the teacher with a sense that every child needs their own education plan, even for those children who don’t have an IEP. They also do parent education, because not everyone is willing to try something new. Yocheved’s current goal is to turn Lamplighters into a model for other Jewish schools. As Rivkah said, they keep modifying for success; after all, American Montessori International is really about being flexible. The methodology has been specifically modified to accommodate the fact that the students are learning in multiple languages; in Lamplighters’, Hebrew is the first language taught. The next goals include expanding Lamplighters through 8th grade, establishing it as a demonstration school and finding new teaching technologies that can help improve education overall.

THE SPECIAL NEEDS CONNECTION Several aspects of this type of learning mesh well with children with Special Needs. For example, if a child’s main difficulty is sitting still and concentrating at a teacher-given task, in a Montessori classroom the child is free to move about and to concentrate on his or her particular interests. Also, the child is not required to pass a formal test, or to cover a specified amount of material within a time limit. As Mrs. Schack points out, including children with Special Needs encourages the other children to respect those with challenges in their lives—promoting the concept of ahavas yisroel. For example, the Torah Montessori School has a few students with severe food allergies, so to accommodate them, the school does not allow any outside food, and sanitizes all the children every day. For children who need Occupational Therapy or Speech Therapy, the freer learning environment and individual learning pace allows them to get what they need and not miss any work. In addition, the children stay with the same teacher and don’t switch classrooms during the school day. This provides a more stable environment which is important for children who have emotional needs. The downside here is that children with focus issues may find it more difficult to learn

and complete their individual work with so much going on around them. Also, the students are expected to work independently. One who needs more attention from an adult teacher instead of just a peer may not receive it. Also, the teacher may be fully trained in the Montessori method, but not have the background they need to work with students with Special Needs. A regular Montessori classroom may also need to be modified to address accessibility issues. Parents must choose what will work for their child. Some schools are specifically geared towards particular needs, such as the Lane Montessori School for Autism in Toronto. Its teachers are trained in ABA therapy and know how to work with autistic children. They also scaffold, providing a support system

while bringing the students toward more independent work, little by little. Lori Bourne, in her blog, “Montessori is for Everyone,” also mentions the option of homeschooling, so the student who needs one-on-one attention combined with an atmosphere of learning can achieve this by working with a dedicated parent who has the appropriate materials needed for the child. While it may take some work to find the right place, it is possible to find a Montessori learning environment that will work to help your child. Mori Sokal has a Masters' degree in Early Childhood and Special Education. She taught in America for five years, and has tenure in the New York City Public Schools. She currently lives and teaches in Israel, where she works with both regular and Special Needs students.

SOURCES:  http://www.michaelolaf.net/maria.html  http://www.michaelolaf.net/montessori12-18.html  http://prospectheights.patch.com/articles/prospect-heightsschool-set-to-expand  http://www.amshq.org/Family%20Resources/Montessori%20 Education%20and%20Your%20Child.aspx  http://www.blog.montessoriforeveryone.com/montessori-andthe-special-needs-child.html  http://www.montessoriforeveryone.com/Lane-MontessoriSchool-for-Autism_ep_67-1.html  http://www.montessorispecialneeds.com/index December 2012

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EARLY INTERVENTION A Source of Hope for Children with Special Needs

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COVER STORY

f you have a child or grandchild under the age of 3 whom you suspect may have a developmental delay, don’t wait. If your suspicion is correct, the services your child may be eligible to receive under a government program known as Early Intervention (EI) could make a crucial difference in improving the quality of the rest of their life. But those services do not come au-

tomatically. You must have your child evaluated and then fight for their rights to these crucial services. The articles in this section will show you how. We will also explain to you why this is a very special time in a child’s development, and how the phenomenon of neuroplasticity gives very young children tremendous recuperative powers, allowing them to compensate for severe

neurological damage if the proper therapy is started soon enough. We also explain the history of the Early Intervention as it evolved over time, and the political pressures that it faces today as it suffers budget cuts and competes to survive at a meaningful level against other programs for the limited available government funding. Yaakov Kornreich By Stephen Glicksman, PhD

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Establishing Eligibility for Early Intervention Services

hen seeking services for your child through an Early Intervention Program, there are a few things to keep in mind: First, Early Intervention is an entitlement program. That means that if your child meets the eligibility requirements for the program, he or she is entitled to the services (unlike, for example, the Medicaid Waiver program, which is not an entitlement program: There are a certain number of Waiver slots funded by the State, and when they are gone, they are gone). The second thing to keep in mind is that while Early Intervention is provided at no cost to families, it is expensive to run. Recent figures from the New York City Budget Office show the city paying $115.9 million to provide Early Intervention services in 2010 with New York State chipping in an additional $111.4 million. If you include the state and local share of Medicaid, which also pays for some of EI, the total city and state cost for EI services in New York City in 2010 comes to $321.6 million. And, that does not include what the federal government pays into the system, bringing the grand total to $482.3 million to provide services to 60,767 children, just in New York City, and over the course of just December 2012 40

one year. This means that, at a time when city and state funds are low, and notwithstanding the fact that Early Intervention is an entitlement program, services today are not as generous as they once were. Which brings us to our third point to keep in mind: Early Intervention is not a program for children who “need therapy”; rather, it is a program for children with developmental delays and disabilities. That means that not everybody who could benefit from services is necessarily eligible for them. If, for example, your child has a lisp, or simply isn’t speaking at the same level as his more advanced cousin, he may not actually have a speech delay. Similarly, if your child breaks his leg falling off of a swing, he should probably get some physical therapy and your insurance company will probably pay for it. Early Intervention, however, will not provide these services because the need for physical therapy in this case is a medical need and not a developmental delay. So, if you say at your eligibility meeting that your child is not delayed, that there is nothing wrong with him, and that he “just needs speech therapy” (as I have heard parents say), the

City representative will most likely tell you to hire a therapist on your own (as I have heard the City representatives respond).

With all this in mind, how does one get to an eligibility meeting and how are services actually approved? If your child is between the ages of zero and three years old and you feel that her development is lagging behind other children you know, the first step is to call the New York City Government Information and Services line at 311 and request an

evaluation for EI services. Note that it is currently against EI regulations for agencies to solicit families on their own or even to put their own phone numbers in their advertisements. Instead, 311 is the single point of entry for EI services in New York City (although, when you call them, you can ask to be referred to a specific agency, and they may do so). Once you give over your information and concerns, the City will then refer you to a specific EI provider and you will receive a phone call (probably a few calls) from that agency to schedule evaluations. Evaluations for EI services can be conducted in your home or in an EI Center. Everyone going through the Early Intervention process gets seen by at least two evaluators: The specialist and the generalist (it is, by law, a “multidisciplinary evaluation”). The specialist is the evaluator who tests for delays in your specific area of concern. For example, if you call EI because your child isn’t walking yet, the specialist will most likely be a physical therapist. If you find that your child is having difficulty eating solid foods, the specialist will most likely be a speech/ Glicksman Continues on Page 45 ➘


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Proposed Changes to Early Intervention

he NY State Early Intervention Program, a state-funded program which provides therapeutic services to infants and toddlers who are suspected or known to have a developmental delay or a diagnosed condition with a high probability of resulting in a developmental delay, is set to change on January 1 of 2013 with new regulations that threaten the efficacy and efficiency of the program. The new regulations, implemented by the NYS Department of Health, attempt to address potential conflicts of interest. They therefore forbid early intervention agencies and individual therapists who evaluate children (evaluations are needed to determine if children meet the eligibility criteria to receive services) from also administering treatment under early intervention to any children they evaluate. Any individual who is approved as a service coordinator and an evaluator has until January 1 to choose which service they will continue to provide. In addition, any relatives or business affiliates of service coordinators cannot provide services to the eligible children in the program they serve. While addressing potential conflicts of interest may be helpful, the real danger of these changes lay in the other impact of the changes to the system. Currently, families can choose an efficient “one-stop shop,” where their child will be evaluated, and treated, if they are eligible. When things go smoothly there is less stress for families. But in the new system, families may not get the evaluations or services they need because of “potential conflicts of interest.” They may be forced to go to several different providers for evaluations and treatment. This will result in a more fragmented, less effective service

delivery system. The burden will likely fall on families, already under stress from finding out their child has a disability or delay in the first place, to coordinate multiple therapists from different agencies; many evaluators, and a service coordinator from another agency still. (For some families this may become a full time job.) The “one-stop shop” system is considered optimal for many reasons: it offers better opportunities to meet the support needs of families. In addition, ongoing communication between members of the service team is much more likely to occur. Administrative delays are minimized by more efficient communication within one agency, which results in fewer service interruptions to children and families. Following the implementation of these changes in New York State on January 1, service coordinators will need to ensure that families understand that their choice of an evaluator will determine who can provide services to their child if eligible. Since the language in regulations defines conflict of interest to include business relationships, it poses a particular challenge in determining the contractual relationship agencies may have with specialty providers such as bilingual professionals, since this would preclude service provision. Under the new regulations, the professional evaluator who provides the evaluation for the child, as well as the agency which employs or contracts with that therapist, will be unable to provide any therapeutic services to this child and family. Some families may be thrilled with the professionalism, skill and cultural sensitivity of their child’s evaluator, only to find out that this person and the agency which employs them are now prohibited from providing

services to their child. To make things worse, the evaluating agency may be unable to provide effective referrals, leaving the family in the dark as to choosing a quality treatment provider(s) for their child. Some waivers to these new regulations may be issued by the Commissioner for areas considered to have shortages of 'certain' disciplines in 'certain' regions of the state; however, it is unclear at this point on what basis this will be determined. In addition, although the regulations are scheduled to go into effect on January 1st, the forms or procedures to request these waivers are not yet available. HOW EFFECTIVE IS EARLY INTERVENTION? Data submitted by all states on child outcomes funded by the U.S. Department of Education demonstrates extraordinary successes of the Early Intervention Program and Preschool Special Education Programs (www.theeco-center.org). Without interventions, children with delays or severe disabilities may gain skills slowly and some may even lose skills. However children who receive interventions will gain skills and may even catch up with typical children their age. The results of Early Intervention and Preschool Special Education Program data showed that over 68% exited the EI program with substantial gains, and 53% were actually able to catch up to their non-disabled peers. In all 98% made gains while in the program. These results exceeded all previous expectations about the effectiveness of the programs. Here is how it works: children who are substantially behind their peers are referred to as having a developmental delay. The solid line on the graph (line e)

By Linda Farkas

illustrates typical development. All the other lines represent some kind of delay in the early years. If Angela is 12 months old with the skills of a 6-month-old, without intervention she will likely continue to grow at the same rate. This means at 18 months of age she will have the skills of a 9 month old. The State provides intervention services because Angela is acquiring skills at half the rate she should be. Left untreated, she will continue to fall further behind her peers (line b). The purpose of intervening early in life is to change the child’s rate of skill acquisition. Line (c) shows children whose growth was greater than expected - this means that after receiving intervention the children made more progress than their growth rate before intervention. The children with growth pattern (d) are able to catch up to what is expected for their age.

All states report the percentage of children in each of the five growth trajectories to the U.S. Department of Education. The percentages of children showing greater than expected growth and exiting within age expectations is then computed from these percentages. In 2010–11, children with delays or disabilities who received services under the Individuals with Disabilities Education Act (IDEA) demonstrated greater than expected developmental progress. Many children exited the program functioning within age expectations. Farkas Continues on Page 45 ➘

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EARLY INTERVENTION The History of Early Intervention

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ow often have we heard stories of people who were diagnosed with serious illnesses and told by their doctors, “You’re lucky we caught this in time; had you waited another week, who knows?” Just as detecting a physical malady early can often be the difference between life and death, finding and treating a mental or emotional delay early can also greatly impact one’s development. This is exactly the goal of early intervention. Early intervention (EI) provides children up to age three with services that will promote healthy development in a number of areas, including physical, cognitive, communication, social-emotional, and adaptive.

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The federal government mandates that children who qualify for these services should receive them at no cost to the parent. Studies have shown that EI can be effective in many cases. A 2009 study published in the journal Pediatrics found that children with autism who were given EI from a year and a half old averaged an 18-point increase in IQ. Those who received traditional interventions improved their IQs by an average of only four points. A parent who sees any sort of delay in their child can request an evaluation to see if the child is behind in a particular area and qualifies to receive services either in school or in one’s home. In New York State, for example,

By Barry Katz

the Department of Health provides these for which one’s child may be eligible: family education and counseling, home visits, parent support groups, special in-

these individuals. A look back at the history of education in the United States shows that most parents felt that these services were ineffective. Thus, these par-

struction, speech pathology and audiology, occupational therapy, physical therapy, psychological services, service coordination, nursing services, nutrition services, social work services, vision services, and assistive technology devices and services. To understand how EI came to be, one must begin with the nature-nurture debate. For decades, educators and psychologists debated what had more influence in a child’s upbringing – the child’s inborn nature, or environmental factors. As more information emerged, most professionals agreed that both nature and nurture play vital parts in a child’s development. Once the experts realized that educating children – especially those with developmental delays – early in life would help their development, the government employed programs to assist

ents formed advocacy groups and ultimately influenced politicians to intercede on their behalf. In 1965, the United States Department of Health and Human Services launched Project Head Start, an eight-week program for children in more than 2,500 communities throughout the country. This experiment targeted children from disadvantaged backgrounds whom the government felt were receiving an inferior education. Although the results were unimpressive, Head Start served as a prototype for future programs. Many consider 1973 the turning point for EI, with the passage by Congress of the Americans with Disabilities Act, which governs how the states and public agencies provide EI. At the same time, a task force was assembled to study the needs of children with disabilities. They found that


EARLY INTERVENTION more than half were receiving inadequate care, about a million were excluded altogether from the public schools, and many were being enrolled in private schools, often at a great expense to the parents. As a result, Congress enacted the Education for All Handicapped Children Act in 1975 that offered a “free and appropriate education” (FAPE) to all children with special needs. This did not, however, include children under age three. This was amended in 1986 to include not only children with disabilities, but also those at risk for developmental delays. Further amendments led to the passage of the Individuals with Disabilities Education Act (IDEA) in 1990. Part C, Sec. 31 of the act reads: “Congress finds that there is an urgent and substantial need to enhance the development

of infants and toddlers with disabilities, to minimize their potential for developmental delay, and to recognize the significant brain development that occurs during a child's first 3 years of life… to enhance the capacity of families to meet the special needs of their infants and toddlers with disabilities … to develop and implement a statewide, comprehensive, coordinated, multidisciplinary, interagency system that provides early intervention services for infants and toddlers with disabilities and their families.” While the 1990s saw an explosion of EI programs, critics were concerned about its cost. Others wondered about its effectiveness. Some studies showed that EI had poor results, but the authors of The First Three Years and Beyond attributed those findings to ineffective studies: “Recent

studies demonstrate that when early intervention studies are of high quality, sufficient duration, and subjected to rigorous evaluation, they do indeed have a positive impact, not only during the childhood years but into adulthood, too.” Further amendments of the IDEA included the introduction of Individual Education Programs (IEPs) in 1997. This made the determination of a course of action for the child into a collaborative effort between the parents and educators. This also gave parents displeased with their child’s progress the right to a hearing by an arbitrator, who would decide if there should be changes made to the IEP. Although the IDEA is still in effect today, the harsh current economic climate has meant severe budget cuts in EI programs.

This past January, New York State Governor Andrew Cuomo proposed removing $99 million from EI services over the next five years. A Special Education Itinerant Teacher (SEIT) said that her colleagues are feeling the effect. “Some of my co-workers who used to have cases for 20 hours a week now have five or ten.” And those are the lucky ones. “A lot of them don’t have any cases yet [this year].” But if one believes that a child provided with EI may improve and ultimately function a great deal more effectively than had he or she not received these services, one can conclude that EI is a most worthwhile investment. Barry Katz is a college administrator and adjunct professor who lives in Brooklyn, NY with his wife and three children. He can be contacted at iambarrykatz@gmail.com.

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EARLY INTERVENTION By Dana Ledereich, MA, OT/L

Why Does Early Intervention Work?

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he government’s Early Intervention program was established to service children in the 0-3 years of age population who present with developmental delays. The treatment philosophy behind Early Intervention is based upon the theory of neuroplasticity which posits that therapeutic treatment at this age can be most effective at making neurological changes and therefore developmental changes. Neuroplasticity is based upon the brain’s ability to adapt and change in response to physical or environmental changes. For many years, the medical community believed that people were born with the brain already fixed, and that no new neural passages or synapses ever formed. Therefore, the accepted theory was that the brain was static and any traumatic brain injury was irreversible. In more recent years, neuroscientists found evidence that a baby’s brain was not yet fully developed and was susceptible to outside influences. This became the basis for early intervention. Most recently, neuroscientists have discovered proof that neuroplasticity is not exclusively in the domain of babies but is available to adults as well. While adults are capable of neural plasticity, it is more evident in babies. When infants first begin to coo and babble they produce a variety of sounds and not only those exclusive to their native tongue. As they learn to talk, those sounds not used in their native language fall by the wayside and they lose the ability to make them. While adults may be able to learn a new language, they speak it with accents from their dominant language because they have lost the ability they had as babies to form all sounds and can no longer retrieve them. Another area where neuro44

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plasticity is limited to babies is in emotional development. The limbic system of the brain regulates emotion and develops fairly early in a baby’s life. A baby raised in a hostile environment or one devoid of loving adults typically develops with a deep mistrust of other people. This outlook can be very hard to change. But an infant raised in a warm and loving home where his needs are responded to and met develops a

manent. The same theory applies when a child is hyper responsive (over responsive) to sensory stimuli. Given the appropriate intervention, the child’s tolerance for that particular stimulus can be significantly increased. It is neuroplasticity that allows for the change in tolerance and this leads to the desired change in behavior. Motor learning theory is the driving force behind much of physical rehabilitation treatment.

“An infant raised in a warm and loving home where his needs are responded to and met develops a sense of security that serves him well when faced with stressful situations later on in life.” sense of security that serves him well when faced with stressful situations later on in life. For occupational therapists, neuroplasticity forms the theoretical basis of much of the rehabilitation treatment both for sensory and for motor delays. Sensory integration treatment primarily involves constructing an environment, using therapeutic equipment, to enable a child to receive the sensory input that he needs. It is child-directed and works on the theory of neurological thresholds. For example, if a child is hypo responsive (under responsive) to a particular sensory stimulus, he will tend to seek out more stimulation. By providing a safe way for him to receive this stimulation, the brain can meet and fulfill its need. This causes a change in behavior and helps the child to better tolerate and interact with his environment. Given enough stimulation, the changes will hopefully be per-

A child will naturally do whatever is easiest and most comfortable for him in order to achieve a particular goal, even if it involves an inefficient movement pattern. In order to help a child to unlearn incorrect movement patterns, more efficient movement patterns must be substituted. Therapy involves creating a situation where the only way the child can be successful at a particular task is through the correct movement sequence. This can be achieved through methods such as blocking the incorrect muscles from being used, thereby forcing the correct ones to be used. Eventually, the brain develops a new pattern of movement using the more efficient muscles. A child placed in a situation where he needs to write before he is developmentally ready to do so, often develops an incorrect pencil grasp as well as poor letter formation, both of which contribute to illegible handwriting. He wanted

to meet the expectation of writing letters so he held the pencil with his entire fist, because that was the easiest and most comfortable way for him to hold the pencil. As he gets a bit older, this type of pencil grasp slows him down because it is an inefficient way for him to write. Pencil grips are most effective when used continuously. If every time he writes for a substantial amount of time, he will eventually learn the more efficient way to hold his pencil. It is neuroplasticity that allows him to change this movement pattern. On a larger scale, a child with cerebral palsy often has difficulty controlling his limbs and therefore presents with atypical movement patterns. He uses whichever muscles are easiest for him in order to achieve his motor goal. So while he may be able to walk, his gait will be erratic at best. Neuroplasticity is what allows therapy to teach him better control over his muscles. Early Intervention is effective because it addresses the child when he is most open to change. A baby is born with a brain that is receptive to learning new ways of doing things. But this window will close. The latest research shows neuroplasticity even into old age but only in certain areas of the brain, but addressing developmental delays at their inception gives a child the best chance at remediation and rehabilitation. Dana Ledereich, MA, OT/L is a pediatric occupational therapist with a private practice in Brooklyn, NY. She evaluates and treats children age birth-13 years with sensory processing issues, poor handwriting, developmental concerns and neurological issues. She has lectured to both parents and professionals on various topics in sensory processing and handwriting development. She is available for lectures as well as to mentor new therapists. She can be reached at 718.252.2939.


EARLY INTERVENTION Farkas Continued from Page 41 ➘

Early Intervention (Part C) and Preschool Programs (Part B) report data annually on three outcomes:  Social relationships, which include getting along with other children and relating well with adults  Use of knowledge and skills, thinking, reasoning, problem solving, early literacy and math skills  Taking action to meet needs, including feeding, dressing, selfcare, and following rules related to health and safety In 2010–11, child outcomes for Part C (ages birth through 2 years) showed:  68 - 73% of children showed greater than expected growth across all three outcomes. They were gaining skills at a faster rate Glicksman Continued from Page 40 ➘

feeding therapist. The generalist is the evaluator who looks at your child’s growth as a whole, focusing on five areas: Cognitive skills, speech skills, adaptive skills, social-emotional skills, and motor skills. It really doesn’t matter if you “only want” a speech therapist to come in or if you are “only concerned” about motor skills; everyone who gets evaluated through Early Intervention has to be seen by a generalist and a specialist. It also doesn’t really matter if one therapist comes in and says that your child is not eligible; your child still needs to be seen by both evaluators. In addition, either evaluator might recommend other evaluations (which you can either schedule or refuse) based on concerns that arise during the initial evaluations. Also, during this time you will be in frequent contact with your service coordinator, your “go to” person from the agency arranging your child’s evaluations to whom you can ask all of your questions and from whom you can receive guidance

when they left the program than when they began.  55% of children exited within age expectations for knowledge and skills, while 61% were within age expectations for taking action to meet needs. Part B Preschool outcomes (ages 3 through 5) showed:  81% of children showed greater than expected growth for each outcome area.  53% of children exited within age expectations for knowledge and skills to 66% for taking action to meet needs. James J. Heckman, a professor of economics at the University of Chicago, a Nobel Memorial Prize winner in economics and an expert in the economics of human development, has proven that there are great economic gains to be had by investing in early child-

hood development. According to Heckman, early childhood education is a cost-effective strategy— even during a budget crisis. Deficit reduction will only come from wiser investment of public and private dollars. His data shows that one of the most effective strategies for economic growth is investing in the developmental growth of at-risk young children. Short-term costs are more than offset by the immediate and long-term benefits through reduction in the need for special education and remediation, better health outcomes, reduced need for social services, lower criminal justice costs and increased self-sufficiency and productivity among families. He estimated the return, or savings to society, to be approximately $7.00 for every 1 dollar spent on early childhood intervention.

The success of the EI program is well documented. However by increasing barriers to treatment and services with these new regulations, New York State may be guaranteeing poorer outcomes for children, to the detriment of taxpayers, and increased problems for their families and society as a whole. State officials need to know that the public is watching the outcome of these changes, and expects them to make the necessary adjustments to make sure that the EI program remains as effective for the children who are entitled to it as has been proven it can be.

in navigating the EI process. Once the evaluations are complete, eligibility is met in one of three ways. A child is eligible for services if A) there is a significant delay in one of the five areas assessed (defined as a 33% delay, a 12-month delay, or a score falling two standard deviations below the mean on a standardized test), or B) if there is a mild delay in two of the five areas assessed (defined as a 25% delay or a score falling 1.5 standard deviations below the mean on a standardized test), or C) if the child is diagnosed with, “a physical or mental condition that often leads to problems in development” such as Down Syndrome, Autism, or Cerebral Palsy. Once all of the evaluations are written and the agency believes your child is eligible for services, a meeting will be set up (referred to as an “Individualized Family Service Plan meeting”, or IFSP) with you, your service coordinator, and a representative from the City (referred to as an Early Intervention Officer Designee, or EIOD- Early Intervention is really into acronyms). It is at this meet-

ing that the EIOD will actually determine if your child meets the eligibility criteria and decide what services your child will receive, if any. From the time of your child’s referral until the completion of the IFSP meeting, the law dictates that the process can take no more than forty-five days. And, once services are approved, they can begin immediately. The main thing to remember when going through the Early Intervention process is the question being asked by Early Intervention: Why should the taxpayers pay to provide therapeutic services for your child? And the answer to that question is, “Because of all the things he cannot do.” So, that is what the evaluations need to describe. As a parent, you know that in addition to having a speech or motor delay, or a diagnosis of Autism or Down Syndrome, your child is also a wonderful, adorable, beautiful child with many skills and abilities and talents… but that’s not what is going to make her eligible for Early Intervention. So, don’t overly person-

alize all of your child’s challenges that are described by the evaluators in their reports. They are simply answering the question being asked: What delays or disabilities make your child eligible for services? And, again, if you do not believe your child is actually “delayed” but want therapeutic services anyway, you should probably contact your insurance company and leave the limited amount of Early Intervention resources available to those who truly need it and for whom the program is meant to serve. To learn about the eligibility and evaluation process in more detail, you can download the brochure, “The Early Intervention Program” from the New York State Department of Health (http://www.health. ny.gov/publications/0532.pdf), call 311, or contact a local provider to ask questions.

Linda Farkas is the adult sibling of an Individual with Developmental Disabilities. She has worked tirelessly to assist families to advocate for community based services.

Stephen Glicksman, Ph.D. is the Developmental Psychologist at Women’s League Community Residences and Jumpstart Early Intervention. He can be reached by calling Women’s League at 718-853-0900, or at sglicksman@womensleague.org. December 2012

45


DIAGNOSIS A Life with Autism

B

etween 1997 and 2008, the number of children diagnosed with autism spectrum disorders (ASD) increased almost fourfold, according to the National Health Interview survey. The 2007 National Survey of Children’s Health indicated that 1.1 percent of all children born in this country are on the autism spectrum. The number of children diagnosed with ASD who will grow to adulthood over the next 10 to 15 years numbers in the millions. This raises an obvious question. Once they age out of the services mandated by the Individuals with Disabilities Education Act, can these individuals be absorbed into mainstream society and the labor market, and if so, how? There are some individuals, such as Temple Grandin, who were diagnosed with autism as children and then found ways to make valuable contributions in their specific fields (in Grandin’s case, animal management for the livestock industry). Dr. Stephen Shore is another example. He is a 51-year-old adult with autism who is an assistant professor of Special Education at Adelphi University. They serve as inspirational role models and sources of hope for the parents of today’s children with autism. But they are also the rare exceptions rather than the rule. They were products of an unusual combination of strong parental support, expert training and education, as well as extraordinary personal perseverance. Their experiences cannot be duplicated on a scale to match the needs of the tidal wave of children with autism who will be coming of age in a few years, and certainly not with the techniques, infrastructure and resources available today. According to Dr. Shore, the key 46

December 2012

to successfully mainstreaming individuals with autism is to accept them for who they are. Rather than trying to eliminate or ignore their autistic characteristics, we should help them to make the necessary adaptations to enable them to function successfully, in much the same way that a nearsighted individual does

autism aging out of grade school will double, and then double again. We will need to find constructive ways to help them utilize the skills and abilities that they do have, instead of focusing on their autistic behavioral patterns or lack of social skills which can be easily accommodated in the workplace, but only if there is

when he puts on a pair of glasses. Employers in particular need to understand that these individuals can function productively in their workplace, “by shifting the emphasis from focusing on their deficits to using their strengths.” Today, about 90% of adults on the autism spectrum in this country are unemployed or underemployed, and they are just the tip of the iceberg. In coming years, the numbers of people with

truly a desire by management to do so. Obviously, we are not talking about those individuals who are so profoundly affected by autism that they cannot communicate or function with others effectively. But it is both possible and necessary for us as a society to provide opportunities for the gainful employment and social acceptance of higher functioning individuals on the autism spectrum. This will

By Yaakov Kornreich

significantly enhance their happiness and self-esteem, and benefit society as a whole, by turning them into productive citizens instead of lifelong burdens. Many of these individuals can do much more than bag groceries, re-stock shelves or do other menial jobs, which is often the only type of work available to them today. Employers need to understand that many of these individuals have valuable skills, some directly related to their autism, making them particularly well-suited for certain types of productive work. For example, an article published by the New York Times in January, 2010, described the unique contribution made for more than 50 years by George Kramer, then 71, to a small hardware store in Flatbush which still bore the Kramer name. George had severe behavioral problem as a child, but his parents rejected the advice of doctors at the time who called him “mentally retarded” and recommended that he be placed in an institution such as the notorious Willowbrook State School in Staten Island. Instead, George’s parents kept him at home and put him to work doing chores in his father’s hardware store. Over the years, George proved to be not only capable, but indispensable to the store’s operation. He was always scrupulously honest and reliable in performing his daily duties, which expanded to include handling incoming phone calls to the store, preparing it for the start of business each morning and closing it securely every night. George also became a walking directory of the store’s inventory, memorizing the catalog number and location of every one of the pieces of hardware on its shelves. Need a part? Just ask George, and


DIAGNOSIS he would tell you exactly where it was. As long as George was there, the store didn’t need a computerized inventory tracking system. Thirty years ago, when George’s father agreed to sell the hardware store, he attached a special condition to the sale. George would have to be kept on as an employee. But the new owner didn’t need any convincing. During the brief time he had spent in the store, he had already seen just how indispensable George was to its smooth operation. The new owner assured George’s father that as long as he owned the store, George would have a job there, and was true to his word. George still has problems with social interactions. He seldom makes eye contact and rarely expresses emotion, but sometimes unexpectedly blurts out what is on his mind. Some of his symptoms we now associate with autism. In recent years, George has been living in a group home for adults with developmental disabilities located near the Young Israel of Avenue J. He davens there every Shabbos morning, and stands up after the drasha to say out loud and with obvious feeling, “Good Shabbos, rabbi!” George is also scrupulous about reciting kaddish in memory of his parents on their Yahrzeits each year. George is a vivid example of how even individuals with more serious autistic symptoms can still lead useful, satisfying lives, and how certain characteristics of autism can make them more suitable for particular types of jobs. Some autistic individuals are heavily visually-oriented, which makes them suitable for training in the graphic arts. Others are fascinated by video games or computers, making them good candidates for high end jobs in computer and information technology. According to Dr. Shore, the preparation of a child with au-

tism for success in later life needs to begin at home. Their parents must recognize and accept the special nature of their child and adjust their attitudes and expectations accordingly, rather than becoming what Shore calls “aphids” – autistic parents heavily in denial.

This makes them good candidates for jobs in which they need to quickly recall and repeat the same information, such as manning a customer service desk or an information booth, or jobs in which they need to master complex rules and routines, such as data entry or tax return preparation.

“The key to successfully mainstreaming individuals with autism is to accept them for who they are.” Shore believes that, “it is important for parents to explain the situation to their child in the appropriate manner and at the right time, usually when the child realizes he is having problems and starts asking questions.” He recommends a 4-step approach to that process. First talk about the child’s strengths, and then about the child’s challenges (without using the words “weakness” or “disability”). Next the parent should encourage their child to make “non-judgmental comparisons with family members and friends, demonstrating how everyone has their own different strengths and challenges.” The final stage is to reveal the diagnosis to the child, “after having created the proper framework in which the child can understand it, without damaging his self-esteem and confidence.” Dr. Shore suggests that as highfunctioning children with autism grow up, they be directed into potential fields of employment where some of the characteristics of autism can work to their advantage. For example, autistic individuals prefer predictable interactions. They are particularly good at repeating instructions and actions exactly. Like George Kramer, they often commit to memory all of the detailed information they need.

Dr. Shore notes that it is often easy for employers to eliminate triggers for autistic behavioral problems from their workplace environment with minor adjustments. For example, individuals who are hypersensitive to sounds could be moved to a quieter part of the office, or simply be given noise-dampening headphones. Others who are sensitive to the overhead florescent lighting in an office might be given a baseball cap with a visor to make them more comfortable. When Dr. Shore was diagnosed with autism as a child, his parents, too, resisted the recommendation that he be institutionalized. Instead, they provided him with what we would call today an intensive, home-based early intervention program, which emphasized music, movement, sensory integration, narration and integration, albeit on a trial and error basis. For example, when the time came to prepare him for his Bar Mitzvah, Stephen learned the layning by memorizing it as a song. The training he received from his parents was similar to the cognitive-developmental systems approach for children on the autism spectrum which is known today as the “Miller Method.” Today Dr. Shore leads a relatively “typical” life, splitting his time between Adelphi Univer-

sity in Long Island and his home in Newton, Massachusetts. He is married, teaches Special Education, lectures widely and is an author of several popular books on autism. But what about today’s young adults who are still learning how to live their lives with autism? Aaron Winston lives in Dallas, Texas, where he attended the local day school and yeshiva high school, and was diagnosed with Asperger’s Syndrome at the age of 16. Now 21, Aaron is the head student programmer at the nonPareil Institute, a non-profit, non-sectarian technical training program for high functioning young adults with autism located in the Dallas suburb of Plano, Texas. It was founded two years ago by people with successful prior experience in computers who recognized that the field might offer career opportunities for their children with autism. Aaron is one of the leaders of the more than 90 nonPareil students working together to develop cellphone apps and video games for the commercial market. After Aaron graduated from the Texas Torah Institute, he did not know what he wanted to do next. He says that he wasn’t “very social in high school, and didn’t really understand why people want friends.” His parents encouraged him to enroll in the local community college, but his first visit to the campus created so much anxiety in Aaron that he never came back. Meanwhile, Aaron’s mother had heard about the nonPareil Institute from an online listserve, and decided that he had nothing to lose by giving it a try. Aaron immediately felt very comfortable there. He had always enjoyed playing video games, and when he discovered that he could use the computer programming skills he was learning at nonPareil to create his own games, he Kornreich Continues on Page 50 ➘ December 2012

47


DIAGNOSIS Autism News and Updates

T

he following is a summary of significant recent findings from autism research, as published in respected scientific journals. These results are still subject to independent confirmation by other researchers before being accepted in the scientific community as confirmed. Autism is an inadequately understood family of related conditions. People with autism generally lack normal social interaction skills and engage in a variety of irregular and often characteristic behaviors, such as repetitive movements. While there is no precise medical treatment for autism, a range of accomplishment has been shown with early behavioral intervention. Diagnosing autism can be dif-

ficult, as there is no specific medical test available for doctors to perform. Mostly the only way for a doctor to suspect that a child is autistic is through parental feeling and observation. Early signs of autism vary by age, and it is important to attempt early detection in a child who may have autism. Experts say that you cannot precisely diagnose a child with autism until he or she is at least 3 years of age. However today we can recognize early signs of autism in infants and toddlers that should be monitored as the child grows. Realizing the importance of early diagnosis, researchers at Women & Infants’ Brown Center for the Study of Children at Risk, in collaboration with researchers

By Dr. Joshua Weinstein

at University of Pittsburgh, have been studying the cry acoustics of six-month-old infants. Their

cries of low-risk infants through recordings and then compared to each other. Infants were consid-

research has recently been published in Autism Research. “Because we can measure various aspects of babies’ cries from the earliest days of life, it may be possible to use this technique to identify risk for neurological problems such as autism long before we can detect behavioral differences,” said Stephen J. Sheinkopf, PhD, the lead researcher, a psychologist at the Brown Center for the Study of Children at Risk, and an assistant professor (research) in the Department of Psychiatry and Human Behavior at the Warren Alpert Medical School of Brown University. The cries of infants at risk for autism were compared to the

ered to be at risk if they had an older sibling with a confirmed ASD diagnosis. Based on observations of the videotapes, cries were categorized as either pain related or non-pain related. The study found that atrisk infants produced pain related cries with higher and more variable fundamental frequency (commonly referred to as “pitch”) as compared to low-risk infants. A small number of the at-risk infants were later diagnosed with an ASD at 36 months of age. Dr. Sheinkopf concluded that “These findings demonstrate the potential of this approach for babies as young as six months of age.” Another recent study by re-

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December 2012


DIAGNOSIS searchers from the University of Aarhus, Denmark, reported in the journal Pediatrics (published on November, 12th, 2012) that pregnant women who catch the flu or have a longer lasting fever, more than a week, have a higher risk of giving birth to a baby with an ASD (autism spectrum disorder). The authors gathered and analyzed data on a populationbased group of 6,736 children some of them were born in Denmark from 1997 to 2003. Scientists from the Seattle Children's Research Institute discovered new gene mutations which were associated with the development of autism, epilepsy, hydrocephalus and cancer. They were mutations in the following genes - AKT3, PIK3R2 and PIK3CA. Their study was published in Nature Genetics (July 2012 issue). Babies with autism don’t show outward signs of the neurological disorder in the first six months of life, but after that develop differently than other children, a study published in the journal Child Development showed. Researchers at the Kennedy Krieger Institute's Center for Autism and Related Disorders looked at 235 primarily white children with and without an older sibling with autism, testing them at regular intervals from ages 6 to 36 months. A study found that older fathers have a higher risk of having children with some kind of ASD than younger fathers. Researchers explained in the journal Nature that an older father has a higher chance of passing on new mutations to his offspring than older mothers. A child whose parents or siblings have been diagnosed with bipolar disorder or schizophrenia has a higher risk of being diagnosed with an autism spectrum disorder, scientists from The University of North Carolina reported in Archives of General Psychiatry (July 2012 issue). Researchers from Caltech (California Institute of Technol-

ogy) reported in PNAS (Proceedings of the National Academy of Sciences) (July 2012 issue) that specific changes in an overactive immune system can contribute to autism-like behaviors in mice. They added that in

lies. They found that people who have a schizophrenic sibling are 12 times more likely to have autism than those with no schizophrenia in the family. The existence of bipolar disorder in a sibling also showed an increased risk of au-

“Early signs of autism vary by age, and it is important to attempt early detection in a child who may have autism.” some cases, this activation may be related to how a fetus develops while in the womb. Heather E. Volk, Ph.D., M.P.H., of the University of Southern California, and colleagues examined the relationship between traffic-related air pollution, air quality and autism. The study included data obtained from 279 children with autism and a control group of 245 children with typical development who were enrolled in the Childhood Autism Risks from Genetics and the Environment study in California. They found that exposure to traffic-related air pollution, particulate matter and nitrogen dioxide during pregnancy and during the first year of a child’s life appears to be associated with an increased risk of autism. Published in the Archives of General Psychiatry, a study found that although schizophrenia and autism may look like completely different illnesses, closer inspection reveals many common traits. These include social and cognitive dysfunction and a decreased ability to lead normal lives and function in the real world, according to Dr. Mark Weiser of Tel Aviv University's Sackler Faculty of Medicine and the Sheba Medical Center. Studying comprehensive databases in Israel and Sweden, researchers found that the two illnesses had a genetic link, making it an even bigger threat within fami-

tism, but on a smaller scale. A great advance, this study sheds new light on the genetics of these disorders. The results will help scientists better understand the genetics of mental illness, said Dr. Weiser, and may prove to be a fruitful direction for future research. The number of children ages 6 to 21 in the United States re-

ceiving Special Education services under the autism disability category increased 91% between 2005 to 2010, while the number of children receiving Special Education services overall declined by 5%. The demand for Special Education services continues to rise in disability categories associated with pervasive developmental disorders. Joshua Weinstein has been an educator and administrator for over four decades. He holds a Ph.D., two Masters Degrees in Educational Administration and Supervision and an MBA in Executive Administration. He has been the CEO in healthcare, social services, and business corporations. He’s the president and founder of Shema Kolainu-Hear Our Voices, Tishma for children with autism in Jerusalem and ICare4Autism- International Center for Autism Research & Education- a global leader in autism research & education. He can be reached via email at jweinstein@skhov.org.

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49


DIAGNOSIS

Kornreich Continues from Page 47 ➘

threw himself enthusiastically into the work. Cooperating with other students with autism at nonPareil has helped Aaron to develop some of the social skills that he had lacked his whole life. He takes great satisfaction in his work and loves the open, supportive atmosphere of the institute, where each student is accepted as they are, and encouraged to develop their capabilities as far as they can take them. Aaron says that he is “10 times more content and happy at nonPareil than ever before, and would be happy to continue working there for the rest of my life.” Aaron has developed other ambitions. He has learned how

to drive a car, and talks about getting married someday and starting a home and family of his own. He has also continued to learn Torah in private sessions with a local rabbi, and attended OUsponsored Yachad events. Most important, Aaron says that the satisfaction and self-confidence he has gotten at nonPareil has given him “more faith that he has a place a mission in the world now.” He has also come to view his Asperger’s as at least partially a blessing, because it has given him the ability to focus more completely on those things which are important to him. But what about much younger children whose families are still struggling with their autism. I asked my daughter, Nechama

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December 2012

Spero, whose 8-year-old son, Shalom, is on the spectrum, what

Shalom’s future. He shows high intelligence, including excellent

expectations she has for him when he grows up. Nechama responded that Shalom still has a long way to go to overcome his social problems. He is communicative, but has difficulty engaging with other typically developing children. He does better with adults than with his peers. She also expressed some frustration with the privacy rules governing Special Education students, which inhibit Shalom’s opportunities to interact with his classmates outside of school. She never got a class list, and was only able to obtain the phone number of one of his classmates by getting it off of a pair of the child’s socks which Shalom took home from school by mistake one day. Only then did she learn that the other child lived around the corner. Shalom understands that he goes to a different type of school than his two sisters, and that he is expected to follow a different set of rules than they do when they are at home. But his mother believes that Shalom is not yet ready to accept and understand the explanation for those differences. Nechama has high hopes for

problem-solving skills, and proficiency in math, reading, music and computers. Even though he may never function well in a traditional classroom environment, she believes he will have many options as he grows older. Today, adults with autism like Temple Grandin and Stephen Shore, who have found the fulfillment that comes with independence and a successful career or family of their own, are still much too rare. In 10 or 15 years, there will be millions more maturing young adults with autism facing a crossroads in their lives, like Aaron Winston did. The challenge for society is to provide more programs like the nonPareil Institute which enable them to develop their intelligence and innate skills and take them as far as they can go. Yaakov Kornreich is the Senior Editor of Building Blocks and the Health and Living Supplement of the Jewish Press. He has been writing for Jewish publications and organizations for more than 40 years. Most recently, he is the co-author of "Young Israel at 100" recently published by the National Council of Young Israel.


DIAGNOSIS Understanding PANDAS

A

bout fourteen years ago Dr. Susan Swedo, the head of child psychiatry at the prestigious NIMH (National Institute of Mental Health) described a series of children who had developed Obsessive Compulsive Disorder from an immune reaction to a Group A beta Hemolytic Strep infection. This germ is the one that causes Strep throat in children all over the world. It has been previously shown that immune reactions to Strep can cause serious diseases like Rheumatic Fever or a kidney disease call Acute Glomerulonephritis. Dr. Swedo described children who had another syndrome - Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep - PANDAS. Her patients had developed acute mental illness - Obsessive Compulsive Disorder - which was not responding to ordinary psychiatric medications. When she realized the connection to Strep she immediately treated them with antibiotics and some improved dramatically. The ones who did not improve were given IVIG, an immune treatment, and they recovered completely. Since that time it has been noted that PANDAS can cause other acute anxiety disorders such as phobias, fears, worries and panic attacks. In some children, the symptoms can be irritability, tantrums, emotional labiality (instability), explosivity, anger and even depression. Tics and vocal tics are common in PANDAS, with or without the psychiatric changes. Stuttering can start during a PANDAS episode. There are often associated symptoms such as frequent urination, bedwetting, deterioration in handwriting skills, and unexpected loss of cognitive skills, like math or reading comprehension. Many of the PANDAS children seem to

have suddenly developed poor attention spans and restlessness similar to ADD or ADHD. In many children the first episode starts after a Strep throat or a bout of pneumonia. Some children have not been ill at all but their blood tests show a high an-

PANDAS is a rare disease, causing severe Obsessive Compulsive Disorder. Now we know that the symptoms can be varied and that there are mild to moderate cases - not only severe ones (like the ones in Dr. Swedo's original group). It now seems that PAN-

tibody level against Strep. The diagnosis is not always made based upon lab tests. Whenever there is an abrupt onset of deterioration in the child's behavioral health, PANDAS should be considered. Parents often ask “where has our child gone?” “This is not the one we know!” Since PANDAS is an abnormal immune reaction to the germ, not the infection itself, the treatment of this condition is controversial. Research studies are now trying to determine the ideal way to deal with the symptoms of PANDAS. The mental, physical and emotional symptoms usually subside by themselves within about three months of the first attack. If PANDAS recurs, the symptoms often last longer and can be more severe. Originally it was thought that

DAS is actually pretty common. My experience working in the Orthodox Jewish community has made me realize that Jewish kids are probably more susceptible to PANDAS than other ethnic groups. This might be because of the constant exposure to Strep, which is always going around in the schools, or it may be a genetic predisposition. There is no proven treatment yet for PANDAS. The treatment with IVIG is the strongest and most effective in severe cases. The problem is that IVIG is very expensive. It costs thousands of dollars, and some insurance companies do not want to pay for it, because its effectiveness has not been clinically proven. A study now being conducted at Yale University will scientifically test how effective it

By Susan K. Schulman, MD

is, and if the test is positive, it will probably make it more available to those with health insurance. For most of the milder cases of PANDAS, the best option is to treat it with a long term regimen of antibiotics. In my experience, the antibiotic, azythromyacin (Zythromax), which is also an immune modulator, seems to work the best. I also give the affected children probiotics, Omega 3 from fish oil, and Vitamin D3 in regular (not mega) dosages, for medical reasons. Some have found that amoxil/ clavulonate (Augmentin) works on PANDAS children. At a time when we are trying to minimize the overuse of antibiotics, it may seem strange to suggest using antibiotics long term (6-12 weeks or more), but it really is necessary in these children. When the research studies currently in progress are published, doctors will know better how to diagnose and help these children. Even though it has been 14 years since Dr. Swedo published her findings, PANDAS is still not recognized by many doctors who treat children. This is very unfortunate since PANDAS is treatable. Once the abnormal immune reaction is eradicated, the emotional and neurological disorders will melt away. One thing is for sure. Everyone suffers when a child is suffering from a mental or emotional disorder. The parents, the whole family, the teachers, the classmates, and the friends all feel the negative effects. When the child recovers his own personality after being treated for PANDAS, everyone breathes a sigh of relief. Dr. Susan Schulman has been a community pediatrician in Brooklyn since 1976. She is the author of the book Understanding Your Child's Health, which will soon be released in an expanded and revised edition. December 2012

51


DIAGNOSIS Seizure Disorders: Causes and Treatment

S

eizures, a condition where a person’s brain activity becomes disturbed for a certain amount of time and causes changes to behavior and attention, are actually not uncommon. According to Dr. Shlomo Shinnar, director of the Comprehensive Epilepsy Management Center of Montefiore Medical Center and professor of neurology at Albert Einstein, 10-12% of people will have a seizure sometime in their lifetime. He said that a person’s risk for developing seizures is higher in infancy and childhood, then goes down as a young adult, and then rises again at age 60 or 70, when strokes and dementia place seniors at a higher risk. Interestingly, while most people associate seizures with convulsive, uncontrollable body behavior, Dr. Shinnar said that only 10% of all seizures are convulsive. The vast majority involve what he calls “space cadet behavior,” where a person quietly stares off into space or acts unresponsive or clumsy for a short period of time. This is the reason why epilepsy can go undiagnosed for so long,

since parents or caregivers don’t associate this behavior with seizures. It’s often not until a person has a convulsive seizure that they come in for diagnosis and treat-

hours apart. Unprovoked means not linked to an acute, immediate cause, such as a high fever – common for children –a major head trauma from a fall or accident,

months you start to have seizures, the cause is probably that stroke..” While many people worry about potential brain damage caused by seizures, to the best of our

ment – sometimes after the person has had 20-30 seizures over a period of several years, he said. When are seizures considered to be epilepsy and when are they just seizures? Epilepsy is diagnosed after a person has two or more unprovoked seizures more than 24

or a stroke. While head injuries and strokes can cause epilepsy, a person must have at least two seizures that do not immediately follow such events in order to be diagnosed. “If you have a stroke and a seizure [immediately afterward], it’s not epilepsy,” Dr. Shinnar said. “If, however, in six

knowledge at this time, it seems that brief seizures – 10 minutes or less – don’t cause brain injury, Dr. Shinnar said. Prolonged seizures of more than 30 minutes or a dozen or more repeated brief seizures may cause brain damage, but it’s unclear at this point and needs more research.

WHAT IS A SEIZURE DOG A seizure dog (A.K.A Seizure Response Dog) is a service dog that has been specially trained to help its owner during an epileptic seizure. They are trained to summon help when needed, sit with their owner throughout the seizure, retrieve a phone, and protect them until they regain consciousness. Seizure dogs are even taught to use their own body to break the persons fall, lie on top of them to protect them from hitting hard surfaces and keep 52

December 2012

By Rachel Wizenfeld

them from being robbed while unconscious. A service dog can alert a parent if their child is having a seizure so the parent can come to the aid of their child. Some seizure dogs are even trained to predict an oncoming seizure by sensing a specific scent often emitted by epileptic patients to warn their owners to seek a safe place before the seizure begins. This creates a sense of safety and security for a person with epilepsy.

T

How are Service Dogs Trained?

here are special trainers who work hard to train these special dogs. Puppies are selected according to their personality, temperament and health, not by breed. Once chosen, these puppies go through intensive training. To get certification and be paired with a recipient, these dogs must meet high standards and behavior requirements. The consumer must meet with the trainers to discuss their desired goals for their service dog to ensure their dog is trained to meet their specific needs. Once

the dog is trained the recipient and dog go to a training center to learn to work together, which usually lasts from two weeks to a month. Once the dog is in the owners care, a trainer typically visits the recipients home every few months to make sure things are working out well. According to the Americans with Disabilities Act seizure dogs are allowed in all public places with their owner including restaurants, stores, hotels, theatres, etc. even where dogs usually are banned.


DIAGNOSIS The main risk during a seizure is that of a person injuring him or herself, either while driving, where a person get into a crash, or swimming, where a person could drown, or even just walking down the stairs. The most common causes of seizures are age dependent, Dr. Shinnar said. In children, fever is the most common cause – known as febrile seizures. In adults, it’s usually an acute injury head injury or a tumor, and in seniors, a stroke, due to a blood clot or cerebral hemorrhage, is the most common cause. There are also developmental and genetic causes and conditions like autism and cerebral palsy that often lead to epilepsy – “anything that results in an abnormal brain injury or brain development,” Dr. Shinnar said. However, across all ages, “the

most common cause is, ‘we don’t know,’” he said. For more than half of children and adults, the cause of epilepsy and seizures is unknown; in the elderly, less so. But unlike other conditions where discovering the root cause is critical, treatment is the same for epilepsy whether or not the cause is known. Seizure medications are only effective at preventing seizures. They do not cure epilepsy. Knowing the cause does not help. In fact, people with unknown causes of epilepsy actually have the best prognosis and less severe epilepsy. “It’s one of those funny things,” Dr. Shinnar said. “Parents always want to know a cause, but it’s better if we don’t find one – those are the better cases.” And because seizure medications don’t help long-term prognosis, medication becomes

a very individualized process. is no clear answer, and it’s a very Side effects of seizure medi- individualized choice, he said. cation, which can range from More than half of children with behavioral, to causing weight epilepsy will outgrow it, so degain, hair loss, bone density pending on a child’s profile, Dr. loss, or causing potential birth Shinnar thinks carefully before defects in pregnant woman – treating them or not. “If he has a may dissuade some patients syndrome, where we know there’s from taking medication. In ad- a 95% chance he’ll outgrow [epidition, while approximately 2/3 lepsy], and he has one brief seiof patients will respond well to zure every six months to a year medication, about 1/3 will not, and gets it before he goes to sleep, and their seizures will not be I might wait before medicating. If he has daytime seizures in school, fully suppressed. “You have to do the risk benefit though, I’ll treat it.” [analysis] – if you’re a 30-year- Dr. Shinnar said that although old truck driver, dependent on he thinks twice about using medyour job, it may skew you toward ication, there are many who pretaking medication,” Dr. Shinnar fer to medicate right away. “There said. “For a 35-year-old woman are good people in both camps,” in NYC who takes the subway he said. and never drives, and she wants to have children, you would be Rachel Wizenfeld is a frequent contributor to the Jewish Press and the heavily skewed towards not treat- founder of PopWriter.net. She lives ing.” The bottom line is that there with her family in Los Angeles. Editor's Note: For a personal story of a mother's journey see page 32.

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TREATMENT Does Movement Really Matter?

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ack in the day, before the advent of home gaming systems, it was more common for kids and adults to take to the streets or the local parks where they played, socialized, and explored the world around them. Typical activities which created opportunities for various types of body movement included a game, a bike ride, or perhaps a stroll on a walking path. In addition, years ago, infants were placed on the floor more often than the infants of today. Infants and children were also held more often by a caregiver, and had more frequent physical contact with the environment. But does this matter? Is it just a reflection on the past or has this change in our children’s activity possibly impacted their development and future academic achievement? If we were to stop for a moment and look around us, we would see that all living things are in constant motion. Even remaining perfectly still – an act that is actually one of the most difficult movements - requires a balance of muscle contraction, good posture and balance skills from our vestibular and vision centers, to find a point zero or a centering point for our bodies to come back to. Further assessment shows that difficulties in this area arise many times in the classroom and at our dining room tables when children are “on the go”, frequently readjusting their position, or perhaps compensating by sitting on their knees or slouching. These compensations may be just due to fatigue, but they may signal a deeper issue with balance and motor control. In utero, one of the first forms of movement are primitive reflexes. After we are born, they assist us as infants with head control, exploration of our environment, 54

December 2012

hand eye skills, visual motor integration, balance and posture skills, and hand development. During the first year of life, these reflexes are integrated and mature into higher centers of the brain. During this transition, we develop more voluntary control over our bodies. We can see examples of these primitive reflexes in an infant under six months of age.

Whenever their head turns to one side, an arm and leg will typically extend outward whilst the other arm and leg will have a tendency to flex closer to the body. This is a form of involuntary control. Here is another example: As the head is lifted up, the arms and legs extend outward, and as the head is tucked in the arms and legs will also be tucked in. Over the course of the first year of life, these responses should no longer be part of an automatic response. If, for some reason, these primitive reflexes remain in place without integrating and maturing into the child’s overall develop-

ment appropriately, they can interfere later on with abilities that a child needs to read, such as tracking smoothly across a page. Children who retain their primitive reflexes have a tendency to trip or bump into objects. They can have difficulty sitting or standing still, or learning to distinguish between right from left, and suffer from poor handwriting skills, poor copying skills, disorganization, toe walking, “W” sitting, and attention deficits. Recently I treated a 7 year old girl and a 14 year old boy who presented with similar concerns, including decreased attention, difficulty with focusing, trouble following multistep directions, poor eye tracking, poor reading comprehension and reduced spatial awareness. Both were clumsy, had poor confidence, academic underachievement, were “on the go” and had difficulty sitting and standing still. On assessment, they were asked to stand with their feet together, their hands at their side and looking straight ahead, and they nearly toppled over just after a few seconds of doing so. They had difficulty moving their eyes smoothly from left to right without moving their head, and had difficulty with reading and reading comprehension. Both had received services addressing their issues with balance, posture, and sensory integration. But their parents reported that as one issue was resolved, there was another one right behind it to be addressed, like a

By Paul Stadler, MS OTR/L

never ending line of problems that the parents felt should have been addressed in their child’s prior years of services. Research has demonstrated that an average of 33% of children in mainstream classrooms will have many of these issues, while in special education classrooms they affect more than 90% of the students. Many of these children have received related services such as occupational therapy, physical therapy, speech therapy, SEIT’s, and modified instruction. Our development of these skills as babies is facilitated by early forms of free movement- from being on the floor on our tummy and back, being rolled or from rolling over, lifting our heads up off the floor and grabbing a toy within our reach, bringing our hands together, pushing our chests off the floor with our hands, and crawling through obstacles such as a tunnel or an obstacle course. We learn through movement. Our visual motor skills, fine motor skills, gross motor skills, sensory motor skills are matured and developed from movement. But it also requires the maturation of our reflexes and development of our balance and posture to provide a strong foundation and maximize our abilities in the years to come. Paul Stadler is an occupational therapist with over 14 years of experience working with children from birth to 21 years of age with varied diagnoses. He is adjunct professor for Daemen College for infant and childhood development, a speaker at the 2012 American Occupational Therapy Association national conference on Neuro Motor Immaturity, a licentiate of INPP (inpp,org.uk), an instructor of the INPP school-based program for Assessing Neuromotor Readiness for Learning: The INPP Developmental Screening Test and School Intervention Program. He can be reached at 347.247.6835, paul@paulstadler.net or by visiting www.paulstadler.net.


TREATMENT The Art of Play

The Benefits of Athletics for Children of All Abilities.

t was more than 25 years ago when 10-year-old Chaim* went outside to play with his brother. Across the street from Chaim lived the Friedman family. The Friedmans’ daughter Chana was born with Down syndrome. Chana was a friendly and lovable girl who was the same age as Chaim. One day Chana crossed the street and sat down on the lawn to watch Chaim and his brother play, something that delighted Chana. After a while, Chaim began a conversation with Chana, who responded in kind. The beginnings of a friendship took hold. Although old enough to understand that Chana was “different,” Chaim was not fazed in the least by Chana’s differences. In fact, Chaim would try to involve Chana in the games and athletics that he played with his brother. Chana loved the interaction and participated as much as she was able. Chana was overjoyed to be friends with Chaim. Up to that point her friends, were all from her class, which was for children with Special Needs—at the time there was no concept of “mainstream” classes that included both typically developing children and children with developmental disabilities. As Chaim and Chana grew older, their paths in life separated. Both, however, learned important lessons that they have carried with them to this day. Chaim is now married with a family and remains involved in the special needs community. Chaim has raised his children to be sensitive to the needs of others and has opened his home and heart to those with special needs. Chana lives in a group home setting and has a job in the community. She interacts with customers from all backgrounds and cultures. She is able to do this, in part, due to her relationship years ago with Chaim. Being involved in athletics is

beneficial to all who participate. Health benefits are the most obvious perks—increasing participants’ heart rate, staying in shape, and losing or maintaining a healthy weight, are helpful to all. Another major benefit to athletics is increased self-esteem. Encouraging children who are not inclined to participate in sports can yield tremendous growth in their self-awareness. Why? Because participation in athletics can often make a child more popular. When children who are not naturally drawn to sports, or those who are not confident in their abilities, are encouraged to participate, it allows all the children to experience their peers in a different light. This works when done in a non-patronizing way, so that all the children are participating as equals. There are many benefits from integrating typically developing children and those with special needs in sports. The child with special needs will experience an increase in self-esteem as well as an overall feeling of belonging. Oftentimes such a child may feel as if he/she does not belong—either because of assumed or actual perceptions by other children. Spending quality time with a typically developing child gives a child with special needs that sense of belonging, of being part of the group and enjoying that group’s successes and setbacks. On the flip side, the benefits for the typically developing child are also immense. Foremost is the child learning lessons in sensitivity that no class can teach. It is this experience that can shape children for the rest of their lives. This interaction will help reduce the stigma that is, unfortunately, still prevalent within our community. The typically developing child learns that he/she is not so

different from the child with special needs. In fact they often learn that they share more commonalities than differences. Integrating the typically developing children and the children with special needs in athletics can teach all of us “adults” the true meaning of Achdus. We know that it is easy to feel close to those who are similar to ourselves, be it the way we dress or the shul we may go to… The true meaning of Achdus, however, is the sense of togetherness we can feel among all Jews from all walks of life. It does not matter what type of Yarmulka one wears or the shul where one davens, or even if one goes to shul at all. The true meaning of Achdus is a together-

ness we can feel as children of the same Father in Heaven. Bringing the typically developing children and those with special needs together in this way can bring the entire community together. * Names throughout the article have been changed. ** We have just experienced Hurricane Sandy where many people lost all their possessions, were, and in some cases, remain displaced, and some who, R’L, lost their lives. Through this crisis I personally, as I am sure most of you as well, experienced and witnessed the true Achdus that our great nation is capable of. The help that came from communities within the greater New York area, as well as communities far away is astounding. Let us merit the continuation of this Achdus.

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TREATMENT Are Primitive Reflexes Affecting Me?

T

his past summer I taught an infant and child development course for a group completing their master’s program in education. After I asked one of the students to read the syllabus out loud, I soon realized that while he was reading without errors, his head was moving from side to side as he read. When I stopped him and asked him if he was moving his head, he replied ‘If you’re asking me I guess I am.’ I then asked him to continue reading without moving his head and only move his eyes. By the second line he started to laugh, realizing that he was moving his head despite being asked not to do so; he simply could not complete the task of reading without moving his head. The third time he tried, he sat up straight; holding the paper rigidly and proceeded to read without moving his head. I then asked him to explain what he had just read and, incredibly, he was unable to do so. His reading comprehension seemed to have been lost when he was told that he could not move his head. This accomplished student, who was completing his Masters degree, was unable to maintain his reading comprehension when reading by moving his eyes instead of his head. When I asked him about his childhood history, he revealed that he had difficulty sitting still in class, fatigues easily when reading, that reading can bring on headaches, and that he always performed better as a listener rather than a reader. We did a basic eye screening and found that his eyes were unable to complete a left to right or right to left movement without jerking his eyes when he crossed the midline of his face. He then admitted that he had difficulty as a child learning right from left and catching a ball. He also revealed that he was disorga56

December 2012

nized as a child, which made his schooling years difficult and was a source of criticism from teachers and parents due to his resulting academic under-

theory of cognitive development suggests that the basic building blocks of cognition arise from the primitive reflexes an infant is born with. What are some of

achievement. He was incredibly cooperative in allowing himself to be used as an example for the class, by giving them an insight into his earlier years. There were indications that motor stages of his development were either skipped or did not mature compared to typical infants. He further revealed that he was difficult to soothe as an infant in the first 3 months of his life, and was a late talker. This case proved to be of great interest to the rest of the class for the remainder of the semester. We soon started to talk about cognition. Where does it start, what are the stages? Jean Piaget’s

these primitive reflexes and how and in what capacity can they interfere with a child’s performance in the school years? WHAT ARE PRIMITIVE REFLEXES? A reflex is an automatic movement that always occurs the same way following the same stimulus. Think about a newborn infant when an object is placed into their hand - they will automatically close their hand around the object – this is known as the palmer reflex. Primitive reflexes are the automatic responses that develop in utero. They are present in the full term infant, and should be

By Paul Stadler, MS OTR/L

integrated into more developed reflexes by the time a child is 6 months of age. By this time, for example, a child should have voluntary control and no longer automatically close their hand when an object is placed in it. WHAT ASSISTS IN THE INTEGRATION OF PRIMITIVE REFLEXES? Movement. Integration or inhibition of the reflexes takes place as a result of an action or motor response. We need movement to help the reflexes integrate and allow our nervous system to mature. Further, our motor skills are linked to balance and posture, which also depend on a mature reflex system. Reflex maturity provides a measure of the maturity of the central nervous system. When the nervous system is in a state of immaturity, sensory processing, balance, posture, attention, behavior, and motor skills can be negatively affected and can cause the child difficulties at home and especially in the classroom. These can include organization difficulties, reading problems, writing problems, copying problems, behavior problems, attention problems, and academic underachievement. Opportunities for movement should be made available as early as possible to a newborn. The best playground for the developing infant is the floor, in all positions, on their back, on their tummy and on their sides. These provide the infant a chance to develop their motor, visual, sensory, and cognitive skills. IS IT POSSIBLE THAT REFLEXES MAY BE INTERFERING WITH MY CHILD’S SCHOOL PERFORMANCE? Here is a look at some primitive reflexes that may interfere with your child’s performance if they are still present and not


TREATMENT integrated. Before making a link between primitive reflexes and school performance, a detailed

evaluation should be completed by someone who is licensed and/ or certified in reflex inhibition programs. Also, it is necessary to establish the presence of a cluster of reflexes, rather than a single one, before making a link between primitive reflexes and academic difficulties. THE ASYMMETRICAL TONIC NECK REFLEX (ATNR) The role of this reflex is to help develop movement in utero. Whenever the head is turned to right, the right arm and leg will extend outward and the left arm and leg will flex. It also assists in the birth process, ensures a free airway when the child is on their tummy, and helps with the development of hand-eye coordination. If this reflex does not integrate, balance is affected. It also causes difficulties with crossing the midline and horizontal tracking, a necessary skill for reading and writing, as in the case of the student mentioned above. SYMMETRICAL TONIC NECK REFLEX (STNR) This reflex assists the infant in defying gravity and is thought to assist in visual accommodation. We see this movement when the infant begins to lift their tummy

off the floor in preparation to creep. The head is bent toward the floor, and the arms automati-

cally bend as the legs extend and lift the bottom off the ground. As the head is extended, the arms will extend and the legs will bend as if the infant is sitting on their knees while supported on their extended hands. If this primitive reflex does not integrate, problems arise with posture in sitting and standing, upper and lower body integration, swimming, hand-eye coordination, visual accommodation (skills necessary for catching a ball and copying from a black board) and vertical tracking and “W” sitting. Finally, There Is The TONIC LABYRINTHINE REFLEX (TLR) The role of the TLR is to assist in building the extremes of flexor and extensor tone and to act as the primitive response to gravity before more mature posture reactions develop. If this reflex is retained, then a child may have difficulty with balance, motion sickness, eye movements (convergence), visual perceptual skills (figure ground), and difficulty with spatial skills. During a typical well-visit to the pediatricians’ office, your infant will often be checked for the presence of these reflexes but probably will not be checked for

the integration of the reflexes. Movement is an essential ingredient to learning, sensory pro-

cessing, and motor development. The primitive forms of movement, in the form of the primitive

reflexes that initially serve a vital role to our development, require integration facilitated by movement to allow higher centers of motor maturity to develop. They provide the child with a concrete foundation for academic achievement in the years to come. Paul Stadler is an occupational therapist with over 14 years of experience working with children from birth to 21 years of age with varied diagnoses. He is adjunct professor for Daemen College for infant and childhood development, a speaker at the 2012 American Occupational Therapy Association national conference on Neuro Motor Immaturity, a licentiate of Institute for Neuro-Physiological Psychology (INPP), an instructor in the INPP school-based program for Assessing Neuromotor Readiness for Learning: The INPP Developmental Screening Test and School Intervention Program. He can be reached at 347.247.6835, paul@paulstadler.net or by visiting www.paulstadler.net

December 2012

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TREATMENT By Dr. Chrystalla Orthodoxou

Dentistry for Children with Special Needs

A

recent study from the Tufts University School of Dental Medicine found that people with intellectual and other developmental disabilities are more prone to dental disease than the general population and that further research is required to identify effective interventions. The study, based on the electronic dental records of 4,732 patients who receive dental care from Tufts Dental Facilities Serving Persons with Special Needs, found that even when provided with access to care, some individuals are unable to tolerate complex dental procedures, which compounds the problem. By sensitizing children with special needs to dental and other medical procedures, some practitioners are able to implement best practices at an early age, eliminating the costly need to perform routine dental cleanings in hospitals while under anesthesia. Children with special needs have higher rates of poor oral hygiene, gingivitis, and periodontal disease than the general public. According to the Data Resource Center for Child and Adolescent Health, parents identify preventive dental care as the most prevalent of these children’s unmet health care needs. Most dentists are unwilling to treat youngsters with special needs because they lack the necessary training. Low Medicaid reimbursement rates create another barrier to care. This is a typical case: A year ago, no one could have imagined that Joel would be able to sit in a dentist chair. The 10-year-old, who has an autism spectrum disorder, has benefited from a sensory integration and desensitization program from a team of professionals at Premier HealthCare (PHC), a 58

December 2012

member agency of YAI. Joel really isn’t that different than most children. Just the thought of a dental visit increases his anxiety. Even walking by a dental room upset him.

The desensitization program is tailored to the individual patient. A comprehensive assessment identifies psycho-social history, abilities, skills set, fears and potential sensory issues. Ob-

pational therapy as fun and he felt safe with OT in the familiar treatment room. After months of sensory integration, Joel moved from the OT room to just outside the dental

In the past, he had to be anesthetized or wear a restraining device to limit his movement in the dentist’s chair. “Working with children with special needs early on is really going to help in the long run,” said Dr. Beth Diviney, Ph.D., BCBA, is a Behavior Consultant who is part of a multi-disciplinary desensitization team at PHC which has had success working with special needs children at an early age. “We’ve seen that after they observe a sibling or peer sitting in a dental chair, and then learning what the routine is and what the expectations are . . . they are gradually willing to do what needs to be done to tolerate a procedure without the use of restraint or medication. We make it fun.”

servation is another critical component, especially if the child is non-verbal. The team develops a strategy and formulates a plan before implementation begins. “Sensory integration calms the patient down,” said Abigail Tayamen-Macatangay, OTR/L, Supervisor of Occupational Therapy at PHC. “Knowing that Joel responds to sensory stimulation has helped us make the experience of going to the dentist, less frightening.” An OT Assistant worked with Joel for over a year. She would bring Joel to an OT Treatment Room prior to his dental appointment. She found that putting on a weighted vest and rocking on a therapy ball comforted Joel. He also would squeeze some putty or a handball. Joel perceived the occu-

room. He rocked on a therapy ball and he had a favorite puzzle to ease his anxiety. Later, the therapy ball was moved inside the dental room. While Joel was initially frightened by the chair, he finally sat on the edge of the chair after a string of sensory lights were placed around his shoulders and in his lap. Eventually, Joel sat in the dental chair with the dentist and her assistant in the room. He tolerated the instruments and even seemed to enjoy the vibrating sensation in his mouth. Of course, it was comforting for him to know that his OT Assistant was just a few steps away. Dr. Sun Won was then able to give Joel a mild dental cleaning, thanks to the team approach. “I never thought I’d see him Orthodoxou Continues on Page 60 ➘


TREATMENT By Faith Fogelman

Glimpses into Guide Dogs

P

ets need people. We provide food, facilitate care, and address their daily needs. Pets provide companionship and dogs are among the most lovable. It is no wonder that the Hebrew word for dog is kelev - from the heart. Dogs keep secrets and are our best friends, but they are friends who depend on us, albeit not always exclusively. Sometimes we depend on them for protection and even for mobility. People with visual disabilities can be guide dog users which reverses dependency roles as the dog serves as the eyes of the master. While they are still pets who depend

disabilities. Total blindness, (congenital or adventitious) is self-explanatory. Legal blindness is visual acuity not greater than 20/200 in the better eye with the best correction, which ranges from shadow vision to functioning without the usual array of visual diagnosis indicators, such as a guide-dog, mobility cane, extra thick glasses, or physical damage to the eyes. A second definition is a peripheral visual field of no greater then 20degrees - tunnel vision, despite good distance vision. Visual impairment is visual acuity no greater than 20/60 in the bet-

for about six months, learn how to focus, receive mobility commands, and gain confidence guiding people. The application process reflects applying to college or a job in the sense of submitting completed forms or documents with basic information, forwarding recommendations to support candidate suitability for the opportunity, and writing an essay about self. Specifically, candidates submit a completed application form, an eye report, medical and other forms, write a statement of need, and forward letters of reference which support the need and express confidence that the applicant can care for the animal. Dogs continue to belong to the school and reports

of mistreatment may necessitate removal. Usual breeds for guide dogs include labrador retrievers, black labradors, german shepherds, and sometimes boxers. There are four guide-dog schools in the suburban New York City area and in most cases applicants go for a two week period to the school site. The schools match dogs to masters based on temperament, walking pace, height, and compatibility, among other variables. Once all variables are satisfied, masters learn how to work their dogs, teach commands, and provide rewards for intelligent disobedience, a situation when dogs determine that it is unsafe to proceed against Fogelman Continues on Page 61 ➘

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TREATMENT FES and Dropfoot

D

By Herschel Sauber

rop foot is a condition of weakness or motor control that interferes with a person’s ability to lift their foot while walking. It causes stumbling and tripping, and affects the safety and efficiency of their gait. Drop foot can occur as a side effect of many conditions, among them cerebral palsy, stroke, multiple sclerosis, incomplete spinal cord injury, and traumatic brain injury. Where there is lower leg paralysis or weakness, there is the potential for drop foot. Physical therapy is the usual course of action for correcting drop foot. Ankle foot orthoses (AFO’s), are traditionally prescribed in addition to therapy. AFO’s are custom molded plastic shells that stabilize the leg and foot, and hold it in a corrected position. This has proven to be very effective.

For growing children, however, AFO’s can present some difficulties. AFO’s are often bulky, and can only fit into specific footwear. They need to be replaced fairly often to accommodate a child’s changing height and weight. Compliance can be an issue as well, as discomfort, both physical and psychological, can come into play. The idea of neuroplasticity has been around for many years. Research has shown that nerves are always changing and regrowing, and that muscles can be retrained. FES (Functional Electrical Stimulators) technologyorhas been used successfully in physical therapy for decades. This technology applies low level electrical currents to nerves, promoting muscle use. In recent years, advances have been made that now allow us to

package FES in compact devices for everyday use. In the case of foot drop due to the aforementioned conditions, FES directly applied to the peroneal nerve prompts a muscle contraction that lifts the foot while walking. The benefits of this technology over the traditional AFO are many. These devices are small and unobtrusive, achieve optimal gait with minimal exertion, and can actually retrain and strengthen muscles during use. Bioness and Walkaide are two such FES systems currently on the market. Certified physical therapists and/or orthotists trained in both gait analysis and the programming of these devices determine the appropriate timing for stimulation with every step. In a study conducted by the

American Academy of Cerebral Palsy and Developmental Medicine, Walkaide was shown to successfully improve mobility with increased ankle control and dorsiflexion (ability to raise the foot). Over four months of use, participants continued to benefit, suggesting improved response to the Walkaides FES over time.

Orthodoxou Continued from Page 58 ➘

or caregivers can help prepare a child for the visits by showing pictures of the dentist, tooth brushes and other dental

Today, Joel no longer needs the therapy ball before his dental appointments. He still enjoys the sensory lights, a

be happier with the results. “He’s much calmer now,” she said. “He’s OK with going to see the dentist.” During one dental visit, the team invited Josefina into the room, where her son was sitting calmly in the chair, ready for his appointment. As Dr. Won examined Joel, she kept saying, “I can’t believe it.”

in the chair; it was such an ordeal,” she added. “He didn’t want to be there.” Collaboration among the nursing team, dentist, dental assistant, behavior analyst, occupational and possibly a physical therapist was critical to the program’s success, and even some of the professionals had their doubts. “None of us were trained to collaborate in this way,” Dr. Diviney said. “Each discipline is accustomed to doing its part; if you’re a dentist, you may have a dental assistant in the room, but not a room full of other professionals.” It takes a tremendous amount of time and patience, but the results are nothing short of amazing when the professionals collaborate on such a close level. Parents or the person accompanying the child to the dentist’s office also play a major role in desensitation. Parents 60

December 2012

“By sensitizing children with special needs to dental and other medical procedures, some practitioners are able to implement best practices at an early age, eliminating the costly need to perform routine dental cleanings in hospitals while under anesthesia.” instruments, and gently massaging the face near where a dentist may eventually be working. They even stay in the dental suite with the child during a cleaning or dental procedure.

vibrating toothbrush in his hand, and a container filled with raw rice, beans and beads, known as a rice bath to get him through procedures. Josefina, Joel’s mother, couldn’t

Herschel Sauber is a licensed and certified prosthetist orthotist with over 20 years experience in his field. His brooklyn office services patients in all 5 boroughs and long island, as well as parts of new jersey and the hudson valley.Shmuel heifetz is a board eligible prosthetist and recent graduate of the newington oandp program. His up to the minute knowledge of technique and technology coupled with innovative thinking round out the company's multi-faceted approach. Orthocraft inc. Specializes in complicated cases, and sees patients of every age. The practice can be reached at 718.951.1700.

Dr. Chrystalla Orthodoxou, Chief of Dentistry for Premier HealthCare, has over 15 years experience treating individuals with developmental disabilities. She has developed and implemented the use of desensitization and behavior techniques to help children and adults patients with special needs. She has lectured extensively on using these techniques to deliver quality dental care to patients with severe anxiety, phobias, and sensory processing disorders. She currently serves on the New York State Office for People With Developmental Disabilities Task Force for Specialty Care Dentistry and is a clinical faculty member of the dental department at North Shore Long Island Jewish Hospital.


TREATMENT Fogelman Continued from Page 59 ➘

the command of masters. If the master and the matched guide dog are working well together, a guide dog trainer accompanies them back to the master’s home to teach the dog frequent routes of the master and assess how the master is working the dog in the neighborhood. When on-site orientations are deemed unnecessary, a dog is brought to the applicant’s home and training commences immediately. In both cases, dogs learn how to shift allegiance from trainers to masters. There are advantages and disadvantages to both approaches. Dogs trained in suburbia may be frightened by big city noise and regress. On the other hand, there may be a lack of compatibility when dogs are assigned to masters without a compatibility process. In both cases, unforeseen circumstances may surface.

KEYNOTE SPEAKERS

Masters may prove reluctant to care for the dog; guide-dogs may not get along with other dogs, or may be too distracted in crowded environments to guide well, and so on. Masters should tell family, friends, and others not to pet guide dogs, provide treats, or try to grab the leash, thereby educating about the differences between pets and guide dogs. Although most establishments accept guide dogs, there are location restrictions for service animals including pools, biology and chemistry laboratories, rides in amusement parks, and so forth, for the safety of other people. Additionally, dogs and masters may need to separate for those with conditions triggered by prolonged dog exposure. Asthmatics can have attacks near dogs and that possibility trumps dogs and masters being together. As noted above, dogs can be

TENTH ANNUAL

removed for abuse and other variables including decreased ability to work well. Removal is traumatic for masters and even separation for prolonged periods of time can be difficult. Many guide dog owners, especially those who reside alone, develop a couple identity with the animal. When guide dogs are removed or die, the grief is beyond pet loss. Masters in good standing with the guide dog school can apply for a second dog and fall back on their mobility and orientation cane skills in the interim, as they do when dogs are hospitalized; supporting that only good cane travelers or those with residual vision are viable candidates. Although people with visual disabilities who use guide-dogs comprise the largest population of service animal users, miniature horses are emerging as substitutes for guide-dogs, although

not in urban areas. People with other disabilities may use trained monkeys to substitute for limitations with grasping or reaching. Even still, no service animal engenders love like guide dogs which underscores the loss for both when guide dogs and masters must permanently separate. The master has depended on the guide dog and the loss is both for the animal and for its guiding abilities. The majority of guide dog users who lose dogs due to death are inclined to apply for another one. Guide dogs are a choice; they are not necessarily the preference of all people with visual disabilities. For over a decade, Faith Fogelman has directed programs for disadvantaged students, including students with disabilities, at CUNY colleges. She is a licensed social worker and an adjunct professor in human services at NYC College of Technology.

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December 2012

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ASK THE EXPERT Expert Answers to Real-Life Questions

Here are the answers to serious questions raised by parents and caregivers of special needs individuals in a variety of real-life situations. These answers are valuable to all of us, not only for the practical guidance they offer for the specific circumstances described, but also for revealing the approach of professionals in the field based upon their knowledge, training and experience. Please note answers are for information purposes only, and are not a substitute for an actual evaluation. If you have any questions for a future issue you can contact us at ileneklass@aol.com. Compiled by Chaya Ilene Klass By Yitty Rimmer, MA OTR/L

Ask the Occupational Therapist:

are highly flaccid, for example this condition is found amongst infants who are born very premature, or have suffered a trauma during birth. Muscle tone increases with age and in a foot to head direction, both

skills needed to function at home, in school, in his daily life, and to move forward and become a productive member of society. In the meantime, try these ideas at home to help him develop proper fine motor skills in conjunction

 Give your child an opportunity to help carry heavy items, such as 1-2 ½ gallon bottles of milk, or orange juice containers, a 5lb. bag of potatoes, a pile of books etc. This will help him strengthen muscles in his arms,

for passive tone at rest, and for active tone. Some young infants, especially premature infants who exhibit unusual muscle patterns, will eventually outgrow these presentations as they mature and physically grow stronger. Others require intensive therapy to strengthen their muscles in order to develop oral motor, fine motor, and gross motor skills. To summarize and answer your question, your child will always have a genetic disposition to low muscle tone. However, with proper therapy, not just Occupational, but also Physical and Speech if indicated, your child will be able to strengthen his muscles in order to develop the

with therapy as indicated:  Children with hypotonia, or low muscle tone, tend to have difficulty moving against gravity, and often they sit slouched in a chair. Try to encourage your child to maintain a good posture when sitting with 90 degrees at the hip, 90 degrees at the knees, and 90 degrees at the ankles. Use step stools, books, rolls of paper towels, or rolled up towels to help your child into this position, and be able to maintain it. This will allow your child to strengthen muscles in his shoulder, back and stomach during everyday activities. (Such as eating at a table, playing a computer game, doing homework at a desk, etc.)

shoulders, back and even abdominal (stomach).  Often children with low muscle tone have difficulty with a neutral wrist posture that is needed for handwriting skills. Have your child color a picture that was placed vertically on the wall. This will “force” him to strengthen his wrist through wrist extension while coloring against the wall. For a more personalized, extensive exercise regiment, consult an Occupational Therapist.

Q:

My son was diagnosed with low muscle tone. Will he outgrow this condition? And what should I do at home to help him?

A:

Hypotonia is the medical term used for low/weak muscle tension, or a loss of muscular tension. There is a range of normal muscle tension that every person is genetically disposed to. Those on the higher range of normal muscle tension have an easier time playing sports, appear better coordinated, and develop their fine and gross motor skills earlier. Those on the lower range of normal muscle tension appear to have difficulty moving themselves against gravity, have a harder time playing sports, and develop their fine and gross motor skills much later. The reason I specified the normal muscle tension range, is that children who have extremely high muscle tension are those who are diagnosed with neuromuscular disorders such as Spastic Cerebral Palsy. While those with an extremely low muscle tension, December 2012 62

Yitty Rimmer has a Masters in Occupational Therapy from New York University. She currently has her own private pediatric practice in Brooklyn, NY.


ASK THE EXPERT

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By Rachel Soroka-Teller, MA, CCC/SLP, TSHH

Ask the Speech Therapist:

Q:

My two and a half year old son can only say one word at a time and doesn’t put any words together. I had him evaluated and was told that he is not eligible for services. What can I do at home to help improve his speech and language?

ter. Together, you can mix, pour, cut, open, and even eat (!) your way through making dinner. Make sure to take safety precautions. A plastic knife can enable even the youngest children to cut foods safely. Similarly, laundry becomes fun again. Name and describe each item, to who it belongs to (Mommy’s shirt, Daddy’s pants), and whether it is wet or dry.

Walk through your neighborhood. Children love to talk about the flowers and the leaves. “Can you smell a flower, crunch a leaf?” BOOKS ARE YOUR THERAPY ASSISTANT I will repeat that: books are amazing! They expose children to new words and concepts. Simple books with small sentences become familiar to a child if read

THE WORLD IS ONE BIG THERAPY ROOM Even outside your home, you can incorporate language everywhere. Rather than sitting on the bench while your child plays in the park, stand by his side. Narrate what your child is doing: “go up, up, up” the ladder, and “dowwwwwwn” the slide. Sing a cute nursery rhyme, while going back and forth on the swing. When shopping at a grocery store, give your child a shopping list of one or two items to remember. With an older child you can talk about the difference between a fruit and a vegetable. Younger children love to look at the colors of the fruits and the differences between each one. Each aisle presents an opportunity to categorize foods. For example, “It says this is the pasta aisle, do you think we can find milk here?”

often enough. A story, such as “Good Night, Moon,” becomes a favorite because it is simple to understand. Later on, your child can “read” the book to himself. Books with no words, but which have engaging pictures, invite a child to create his own story. “Good Night, Gorilla,” is an amazing example. Children’s imaginations go wild when following the sneaky gorilla. When reading a story to your child, tailor your words based on your child’s level of understanding. Look at each picture first. Discuss what you see in each picture. Try making predictions, as to what will happen next, based on the pictures and storyline. Ask your child simple questions: “What happened?” “Where did the mommy go?” When you finish reading the book, have your child “read” it

A:

A speech-language provider is the best person to assist your child in increasing his language skills. However, a mother/ caretaker can use some techniques in order to facilitate communication. Here are some tips to fast-track your education. TALK, TALK, AND WHEN YOU GET TIRED, TALK SOME MORE Children learn by absorbing what is in their environment. A child who is always spoken to begins to pick up the words that are constantly repeated to him. The more exposure the child has to a word, the more likely he will attempt to use it. Make activities in your daily routine becomes your lesson plan. When getting your child dressed in the morning, label each clothing item. Once your child begins to label clothing items, expand your language to include two words, such as color + clothing. You can then use words to describe the sequence (“First put on your shirt, then your pants.”) Children love to cook. Cooking time is a great opportunity to use action words. Your child can stand next to you at the coun-

to you. There are no wrong answers, which empowers a child to use his imagination. PLAYTIME IS LEARNING TIME Have you ever watched your child play? You will feel like you are watching a “mini me.” Everything you do is mimicked in his play (even yelling!). A child who loves construction will build huge towers. A little girl will cook at her toy stove and care for her dolls. Play along side your child and provide the words for his actions. “Oh, let’s wash your baby and then feed her dinner.” Occasional use of television and videos can be educational, as well. Sit next to your child and talk about what is happening on the screen. What animals did Uncle Moishe see at the zoo? What steps does Dora need to take to get to school? THE FINAL WORD Up your level of expectation once a skill, such as using one word, is mastered. Expand on his sentences. He says, “Ball,” you respond, “It’s a big ball.” Comment on what he says. “Oh, you see a dog. That’s right. It says, ‘woof!’” Highlight the word that he may not use consistently, “The boy is crying.” By incorporating language into every part of your day, your child learns naturally. He is not aware that he is learning as he goes about his daily routine. Make it fun, exciting, and natural, and watch the language develop. Finally, if you do not see a significant improvement in your child’s language skills within six months, request a reevaluation. Rachel Soroka-Teller, MA, CCC/SLP, TSHH is a speech-language pathologist. She is a center-based provider at StrivRight, where she services children from newborn to age 5. She specializes in treating children with hearing impairments and auditory-processing difficulties. Rachel can be reached at rteller@ strivright.org December 2012

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ASK THE EXPERT By Marc R. Katz

Ask the Eligibility Specialist:

Q:

I am a single father of a forty four year old adult with a developmental disability. As I am nearly 70 years old, I have been thinking about my adult child’s future. My other two children are preoccupied with their own families and live “out of town”. Since I lost my wife eight years ago, I have been contending with mixed feelings about residential placement for my son, but I am now seriously considering his future. I want to be the one to move my son into a home of his choice and be included in the process as well as maintain an ongoing relationship with him because I am still his father. Furthermore, the fear of the unknown, as who will take care of my son when I am no longer here, is more than a worrisome thought. Although my son receives various OPWDD funded services at home, please offer me some guidance to better meet the everyday needs of my son as well as alleviate my own feelings of anxiety.

A:

You are not alone, as I have personally been involved with many situations where an adult child lives with an aged parent or sibling, who despite being dedicated and loving, did not make plans for their future. There are many reasons for this. Often the parents will feel that it is in their child's best interest to live with them for as long as he or she possibly can, and they will "hope for

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the best" about the future. They may be unfamiliar with the residential opportunities that are available for their child or how to access them. They may find it difficult to face their own mortality by making plans for the future. In many situations, the parent has become so accustomed to the companionship of their child, that it is understandably too painful to relinquish it.

in selecting his next home. In making the decision to move forward with planning for your son’s future, it is important to keep these points in mind:  In addition to your son, your other children are a big part of the decision and should be consulted. In some instances, siblings will feel comfortable committing to assume responsibility for the care of their family member after

While undoubtedly well-intentioned, this reasoning comes with natural consequences. It usually results in an emergency situation where siblings or others are forced to assume caregiving responsibilities that they may not be interested in or prepared for. On the other hand, if a residential placement is found, the individual is forced to adjust to a brand new living environment, with new caregivers, without the benefit of a transition period to yield positive desired outcomes. In addition, the emergency nature of the placement often denies both the individual and his family the choice and input that they would ordinarily have been entitled to

their parents can no longer provide it. Plans should be should be revisited periodically to ensure that they continue to be realistic. -Individuals who move into a new home will be much more comfortable if they can exercise choice regarding the selection of this home. This includes familiarity with their roommates, and input into the type of home, location, staffing, and furnishings, all of which is routinely done with a proactively planned placement.  Frequent and regular visitation, including overnight and on weekends, is encouraged between individuals who live in a residence and their families.  Agencies cannot "hold a

place" in a residence in an openended manner for an individual until such time that they need it. The Office for People with Developmental Disabilities (OPWDD), who oversees service providers in New York, will not allow agencies to have vacancies in certified residential settings that are capable of serving another individual who would greatly benefit from it. Therefore, any family pursuing residential placement needs to be prepared to move forward with it.  Although your son is a recipient of OPWDD services, he needs to be enrolled in Medicaid Waiver (if not already), as traditional residential services are also funded by Medicaid. Thus, there are some additional steps that need to be taken with regard to housing services. In the back pages of this issue, you will find a resource directory that consists of various agencies that provide assistance with residential placement (even during these fiscally challenging times). Specifically, an agency’s intake specialist will be able to assist you in successfully navigating the maze of the enrollment and eligibility process for housing services. In short, many parents report mixed feelings when making plans for their children's future: love, pride, sadness at impending change and anxiety about the future. Universally, parents report feeling a great deal of protectiveness over their child with a disability. Yet there is no better way to protect them than to plan for their future. Marc R. Katz, a NYS Certified School Psychologist, is an Assistant Director at Ohel Bais Ezra. For more information about evaluations, intake, or referral of services, please call 1.800.603.OHEL, visit www.ohelfamily.org, or e-mail info@ohelfamily.org. OHEL delivers a breadth of community services through OHEL Bais Ezra, OHEL Lifetime Care, OHEL Foster Care, OHEL Mental Health Services, OHEL Institute for Training, and Camp Kaylie.


ASK THE EXPERT

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By Dr. Stephen Glicksman

Ask the Psychologist:

Q: A:

Is it ever okay to bribe my kids?

The quick answer is, “no, it is never a good idea to bribe your kids”; but, to truly understand the question, we first need to define some terms. Namely, we need to understand the difference between a “bribe” and a “reward”. Put simply, a “reward” is a reinforcer given in response to a child engaging in a positive behavior. By being rewarded, children learn that certain behaviors are viewed positively by adults and that engaging in these behaviors will lead to positive outcomes. In other words, you give a reward to a child who is engaging in a behavior you want to see continue. A “bribe”, on the other hand, is

Ask the Physical Therapist :

Q:

I noticed that my three-year old son likes to sit with his knees bent widely and his legs tucked under. My pediatrician told me to discourage him from sitting in this ‘W’ position. Is it really problematic? And how can I help my son to avoid sitting this way?

a reinforcer given in response to a child engaging in, and then stopping, a negative behavior. You give a bribe to a child who is engaging in a behavior you want to see stop. From an adult’s perspective, a bribe is given to show the child that if he stops engaging in the negative behavior, he will be given a positive outcome. From the child’s perspective, however, giving a bribe only reinforces the negative behavior, as the child has just learned that, “If I want a reward, I first need to behave inappropriately and then stop behaving inappropriately when I’m ready to be rewarded.” For example, let’s say that you are in a grocery store, and your child is having a hard time. He starts touching everything on the shelves, asking for things he knows you never buy, whining, crying, and generally getting more and more out of control. At first, you might choose to ignore the behaviors (thus providing no reinforcement for the inappropriate behaviors at all). After a while, though, as he is getting louder and louder, and you are getting more and more frustrated and embarrassed by the behavior, you finally say, “Listen, if you just stop whining and yelling, we can go for ice cream when we’re

A:

Your pediatrician is right – when your child is sitting in the ‘W’ position, it prevents him from moving his upper body properly and from learning to twist and turn to reach toys and objects on either side of him. It is important for your son to learn to rotate his ‘trunk’ and shift his weight from one side to the other in order to strengthen his core muscles and balance. By sitting in the ‘W’ position, your child could eventually develop hamstring tightness, tibial torsion or hip dislocation. Often children choose to sit this way because of poor muscle tone. The best way to discourage

done here.” That is a bribe, because the situation entails you giving him something (providing a reinforcer) in exchange for him ceasing a negative behavior (yelling, whining, annoying, embarrassing…). In the short term, that may work to get through the shopping experience with the least amount of embarrassment; in the long term, however, what bribing has taught your child is that, if he wants ice cream, he needs to first whine, yell, and embarrass you in the store and then stop. Furthermore, he has learned that he has the power to get you to do something (like buying ice cream even though you have a million chores to take care of) that you were not necessarily planning on doing; in other words, you have taught him how to control your behavior. Contrast this with providing a reward in a similar situation: You are taking your child shopping. In the past, especially when he was in the kind of mood he seems to be in today, taking him to the store has led to whining and yelling. Knowing that, before you enter the store, you turn to your child and say, “I know shopping can be hard for you sometimes, so listen: If you behave nicely while we are in the store, we can go

for ice cream when we’re done.” That is a reward, because the situation entails you giving him something (providing a reinforcer) in exchange for him engaging in a positive behavior. You set up the rules. You remained in control. He has learned that, in order to be rewarded, he needs to behave appropriately. Remember: Our power as parents lies not in our ability to control our children’s behavior (at the end of the day, if a child wants to whine and scream and embarrass you, he has the power to do so); rather, our power like in our ability to control the environment. By really paying attention and knowing our children’s moods, signals, likes, and dislikes, we can usually predict pretty accurately when there is a higher likelihood of negative behavior and then plan accordingly. By preempting negative behaviors by offering rewards for positive behaviors, we should be able to avoid falling into the bribery trap altogether. Stephen Glicksman, Ph.D. is the Developmental Psychologist at Women’s League Community Residences and Jumpstart Early Intervention. He can be reached by calling Women’s League at 718.853.0900, or at sglicksman@womensleague.org.

By Dr. Zvi Gutman, DPT

your son from ‘W’-sitting is to prevent it from becoming a habit. Show him how to sit with his legs in other positions, such as straight in from of him or crisscrossed. Be consistent about reminding him to change his position. You can also provide him with more support while he is sitting by having him sit against a couch. To improve his tone, try activities that strengthen trunk muscles and stability such as sitting on a yoga ball or playing catch while standing. Completing a puzzle will also encourage him to twist his upper body to reach puzzle pieces and sit properly.

Q:

I often put my daughter in her exersaucer while I’m doing chores around the house. The other day a friend told me that being in the exersaucer could hurt my daughter’s development. Is that true?

A:

An exersaucer is a stationary play gym that allows a child to sit upright, bounce and spin. It’s also a source of much debate among physical therapists. In my opinion, it does interfere with a child’s development for many reasons. It holds your child’s hips in an unnatural extended posiGutman Continues on Page 66 ➘ December 2012

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ASK THE EXPERT By Herschel Sauber, Certified Orthotist (CO)

Ask the Orthotist :

Q: A:

My daughter is starting to stand and she is very unstable on her feet and it looks like her arch is collapsing? This is only a problem if the foot is severely displaced or pronated. It is completely normal for a pre- walker to have flat feet.

The arch starts to develop slowly as the child starts to walk. When this does not occur and the arch is collapsed and toes are pointed outward then some bracing intervention may be appropriate. We are now seeing many early walkers around 1 year old who have low muscle tone. This doesn’t mean they are weak. It simply means their muscles at rest are very floppy. This can cause a condition known as hyper pronation of the foot and ankle.

Gutman Continued from Page 65 ➘

tion. This is not conducive to the development of good body alignment. Also, an exersaucer does not allow your child to see his or her feet which inhibits their learning to move and walk. Exersaucers force children to push 66

December 2012

Excessive or hyper pronation puts undue stress on the knees and hips by changing the alignment of the lower extremities, taxing the muscles of the legs greatly. This often results in complaints of fatigue and “tired legs”. Due to the technological advancement in materials and plastics that orthotists now have at their disposal, short ankle height SMO braces can be used to help support this weakness and correct the early walkers balance. This allows for strengthening and proper modeling of the bones as they grow. One such SMO commonly used is the SureStep SMO. While there are many different types of orthoses that attempt to correct low tone pronation, the SureStep system uses the unique, patented principle of compressing the foot into alignment. Through the use of an extremely lightweight, thin and flexible plastic, SureStep allows for more natural movement of the foot and ankle while still maintaining proper alignment in standing, walking and running. Usually the child has to wear these devices from six months to a year, sometimes longer, if their low muscle tone continues. These very thin devices easily fit into the child’s existing shoes. In conjunction with an early intervention physical therapy program, these can help the child grow out of this problem.

Q:

I am a new mother and my pediatrician explained to

off on their toes and makes them walk on their toes – which causes many more problems later in life. Exersaucers may also cause damage to your child’s ligaments in the hips, knees and ankles if he or she is dangling in the seat and not fully supporting their weight

me the importance of having my son sleep on his back and also for him to have tummy time during the day and I was wondering why it is so important?

A:

There are some very common orthopedic disorders that appear in children that can be easily corrected and treated through orthopedic bracing. One of these is plagiocephaly. Babies need tummy time because they are spending more and more time on their backs. In the early 90s, the American Academy of Pediatrics’ Back to Sleep program successfully decreased the incidence of Sudden Infant Death Syndrome (SIDS) in the United States by 40 percent by encouraging parents to place their babies on their backs to sleep. Around the same time, a number of infant carriers that doubled as car seats became widely used. This combination of back sleeping at night and daytime pressure on the infant’s head can create a flattening of the skull. When a baby develops flat areas on the back of the head and possibly the forehead, it’s called plagiocephaly. Often, this flattening is made worse by a condition called Torticollis or wry neck. Torticollis is a single muscle or group of muscles that are tight or weak on one side of the neck, causing a baby to tilt or turn to one side. The muscle fibers can shorten because of continued resting in one position. It is very important that an infant be placed on his back to

through their legs. Instead of placing your daughter in an exersaucer, it is much better to give her some ‘floor time’ and allow her to pull herself up and build her own muscle strength.

sleep. However, it is also important to a baby’s development that he get supervised tummy time and constant repositioning throughout the day. When the condition is caught early, it can be treated very well with physical therapy. In severe cases a custom cranial remolding orthosis can be used to gently correct the problem. It is worn 23 hours a day and gently guides the baby’s head into a more normal shape. This intervention does not hurt as it only promotes corrective growth, and has to be started early. Herschel Sauber is a licensed and certified prosthetist orthotist with over 20 years experience in his field. His brooklyn office services patients in all 5 boroughs and long island, as well as parts of new jersey and the hudson valley.Shmuel heifetz is a board eligible prosthetist and recent graduate of the newington oandp program. His up to the minute knowledge of technique and technology coupled with innovative thinking round out the company's multi-faceted approach. Orthocraft inc. Specializes in complicated cases, and sees patients of every age. The practice can be reached at 718.951.1700.

Dr. Zvi Gutman, DPT is a licensed NY physical therapist specializing in adult and pediatric physical therapy and works with Gutman Physical Therapy, P.C. He can be reached at 646.481.7854 or zvigdpt@gmail. com for appointments or questions. www.gutmanpt.com.


ASK THE EXPERT

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By Juby Shapiro

Ask the Advocates:

Q:

My daughter has a medical condition and she was given a 1:1 full time health para throughout the school day to help her and make sure her health, safety, feeding and hygiene needs are taken care of at school. Given the nature and severity of her needs, she is unable to attend school without her para. My daughter is attending a general education private school program and receives all mandated IEP services at school. Last year, contracted agencies came to provide occupational and speech and language therapies and my daughter received an RSA for a health para. I found a health para who was willing to work with my daughter and I trained her on how to work with my daughter. Last year everything worked out well. In the spring, the district held an IEP meeting and continued to recommend the same services. When school began in September, I rehired the same para. After several weeks of waiting for the RSA to come in the mail, I contacted the person at the district who deals with RSAs and told her that I have not received an RSA for my daughter’s health para and that she has been working since the beginning of the school year and needs to be paid. The woman put me on hold for a few minutes. When she returned to the phone, she told me that no RSA would be issued because my daughter’s case had been sent to a contracted agency. I asked for the name and number of the agency and I called them. They looked up my daughter’s name on their

computer and confirmed that they had been assigned to her case several weeks prior however, they had not yet located a para for her. They asked me who has been my daughter’s para up until now and would she be interested in working for them. I also asked them if she agrees to work for them, will she be compensated for the time she worked from the beginning of the school year up until now. They replied, “we are only able to compensate her from the date she begins working for us.” I spoke to my daughter’s para and she agreed to contact the agency. She soon called me back and said that she is unwilling to work for them because she would then have to take a substantial pay cut be making 8 dollars an hour less that she had before for performing the same job. She was also concerned about being compensated for the hours she has worked since September. I called the women at the district and told her the situation. She said since the case was contracted out, there is nothing she can do. I am worried my para will quit soon if she not paid, which I understand. After all, it is unreasonable to ask someone to work for free and I cannot afford to pay her. I’ve been told that if I ask for a hearing, the process could take months and my daughter cannot afford to sit out of school for months because she has no health para. Help!

A:

The IDEIA is the law that students who have been found to have educational dis-

abilities are guaranteed a Free and Appropriate Public EducationFAPE- in the least restrictive environment with the supports and services necessary for the student to learn and make meaningful progress in school. Your child cannot obtain an appropriate education if she is not able to attend school because the full time health para on her IEP has not been provided. This is a breach of service on the DOE’s part. When

the DOE has recommended services on a student’s IEP, it is not enough to mandate services but not make reasonable efforts to insure they are implemented. In your daughter’s case, whether through contract agency or RSA, the DOE had a responsibility of providing a para from the first day school began in September. Your daughter cannot attend school without a para. The district’s position that simply contracting the service out to an agency fulfills their obligation is incorrect. If it is on your child’s agreed upon IEP, then they are responsible for making sure it is provided. Additionally, your daughter’s para has no obligation to work for the agency and accept a large pay cut. You were correctly informed that the impartial hearing process can

take months. However, in cases such as your daughter’s, and other cases involving other related services, a specific type of hearing called a “pendency” hearing can be requested. Pendency hearings are expedited and can typically be held within days or a week or two after the request has been received. Once a request for a pendency hearing has been made, the hearing officer can immediately order the release of the RSA in the interim dating back to the date the hearing request was filed. This will help with paying your daughter’s para going forward. As far as back pay and the whole issue of whether you are entitled to this relief till the end of the school year, these points need to be addressed in the hearing request:  Request for an expedited pendency hearing to order an RSA for the health para as per the last agreed upon IEP.  The health para should be able to continue on the RSA for the duration of the school year.  The health para should be compensated wither through a backdated RSA or through direct pay for the time she worked from the day school began in September till the day pendency began as per the hearing officer’s order. After the pendency hearing, when the resolution period has ended (30 days after the hearing request was filed.), there will be at least one additional hearing date to address issues 2 and 3 above. While parents can represent themselves, it is strongly advised to bring an advocate or attorney who is well versed in the law and your child’s rights. Juby Shapiro is a special education advocate and the parent of two children with special needs. She is the founder and director of TAFKID, a not-for-profi t organization dedicated to helping families whose children have a variety of disabilities and special needs. TAFKID can be reached at 718.252.2236 or tafkid@aol.com. December 2012

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PRODUCT REVIEWS

The world of special needs children has grown tremendously over the past few years. New diagnoses, new therapies and a while range of new products and books to make life a little bit easier. It’s hard to know which product or book & what is best for your child and their specific needs. That’s where we come in with our unique review section. Therapists and educators in the field have reviewed all of the items in these reviews. We hope you enjoy! Chaya Ilene Klass  Yitty Rimmer  Breindy Rosenblatt

Buddy

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ore than just a stuffed animal for the child who needs his security teddy bear! This stuffed animal provides your child with a variety of sensory stimulations. Tactile through textures and a secret rough patch to help stimulate a child’s sense of touch. Visual through contrasting black, white and red colors throughout the toy that even benefits the child with impaired or low vision. This toy provides auditory stimulation through parts that squeak, crinkle, and rattling of bells, allowing the child to play and explore sound. Oral stimulation is provided through a teething ring. The teething ring can also be pulled, as the “animal’s tail”, and will then cause the

entire toy to vibrate, providing the child with a calming vibration. This toy is not just engaging for the young infant and early toddler, but can also provide stimulation to a child with developmental disabilities, who has sensory needs, through non-invasive exploration of different senses complete with a calming vibration that almost acts like a massage.

Available at www.playabilitytoys.com

$28.95

Therapeutic Benefits:  Increases fine motor coordination skills through grasp and release.  Encourages the young child to focus and engage in playing with the toy attachments, increasing cognitive awareness.

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 Encourages visual perceptual skills through bright, contrasting colors and mirrors that help the child focus on specific toy attachments.  Increases sensory awareness through touch (tactile), visual, sound (auditory), oral, and calming vibration input.

Cushy Beans Sit Cushion

his product is like a mini beanbag for a child with three interchangeable, machine washable tactile covers. One cover is satin, the other is a velvet corduroy material, and the third cover is a fluffy cotton material. This cushion is very appealing for the child who is hypo-responsive. The one, who constantly slides off his chair, squirms, wriggles, kicks, fidgets, and just cannot seem to stay seated. This cushion can be used either for the child to sit on, or placed on the child’s lap. The choice of textures accommodates the child who has either tactile defensiveness and may prefer one texture to another, or the child who simply seeks tactile input and will enjoy hav-

ing a choice to accommodate his day-to-day tactile needs. Each of the three covers open and close with Velcro, giving the children the ability to set up the cushion for themselves independently. The white inner cushion is also waterproof and the surface is washable, making it ideal for use within a classroom setting where it can be used to help as many children as needed. The cushion is small, and lightweight, making it a portable option for home use as well.

Available at www.achievement-products.com

$29.95

Therapeutic Benefits:  Helps a child process tactile input through a choice of different fabric cushion covers.  Helps a child calm down through deep pressure by using the cushion as a lap buddy.  Helps a child focus by being able to sit on a moveable surface, thereby reducing the child’s need to fidget.  Helps a child develop fine motor skills by being able to open the Velcro of the cushion cover, place the cushion inside (like a pillowcase), and then seal it by pushing the Velcro fasteners together. 68

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PRODUCT REVIEWS 3” Benbow Learning Scissor for Left Handed Children

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eave it to a company – Pocket Full of Therapy- that specializes in therapy products, to come up with this idea for young children. This scissor helps left handed children learn to hold a scissor and cut properly. It has safe rounded edges and rubber coated metal holes to make sure that small hands do not get hurt, or inflict damage on others while undergoing the “learning to cut” process. The concept is great but there is just one limitation. This scissor is only accommodating for the very small, young child. Once a child is past 5 years old, they are unable to fit their fingers into this scissor. This product

was actually tested on young children. One of the testers, a child who is 5 ½ could not use these scissors comfortably because the holes were too small for him. If you have a young child who is left handed and finds it frustrating to use regular safety scissors, then it pays to purchase this scissor in order to help the child develop proper use of scissors and cutting skills. These scissors are available in right handed as well.

Available at www.pfot.com

$4.95

Therapeutic Benefits:  Develops fine motor coordination skills through learning to hold and use a scissor.  Develops strength in the hand muscles through being able to use a scissor to cut out items.  Encourages visual motor skills through various activities that can be done with cutting out shapes/pictures with scissors.

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Q-Bitz

bitz from Mindware is an exciting visual agility game that is beautifully crafted. The game comes with 120 pattern cards and 16 cubes. Each player has their own color coded set of cubes, with a wooden tray to hold the pieces in place. The players need to recreate the patterns as fast as possible. There are 3 different challenges here that play to different strengths. The first is based on speed alone. The second challenge introduces the element of luck (roll the cubes). The third requires memory skills. The first player

in each round to match the pattern keeps the card and the most cards wins the game. It can be played with 2 to 4 players and the suggested age is 8 and up, though kids as young as 6 can understand this. It can also be a tool for those with short-term memory loss issues.

Available at Double Play 4115 14th Avenue, Brooklyn, New York

$23.00

Therapeutic Benefits:  Develops visual perceptual skills through copying pattern cards  Encourages speed and timing, in the race to be the first to correctly solve their board  Pattern recognition and recreation skills are strengthened  Increase fine motor skills  Increases hand eye coordination

Let’s Go Together!

If You Can Dream It, We Can Get You There we

get you ther

(877) 346-7987 • bussanimobility.com

Extensive product lines • Custom mobility van conversions New and Pre-owned Wheelchair accessible vehicles December 2012

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PRODUCT REVIEWS Super Duper StoryMaker

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uper Duper StoryMaker is another fantastic App that uses pictures to create and retell stories. You can record your own voice to accompany pictures in the book as well as insert text. You can insert personal photos as well. When you’re finished creating, you can print or email your story to share with family and friends. When creating picture scenes, you can select pictures from a variety of categories (e.g. Foods, transportation, people, places) so you can target semantic aspects of language, including categorization and sorting. This app can be used in many different ways, depending on your language goal. For example, this app can be used to target retell-

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ing stories, following directions, expanding utterances, spatial terms, quantitative terms, vocabulary, story comprehension, print awareness, sequencing, predicting, and so much more. The pictures are child-friendly and cover a variety of themes (e.g. home, beach, store). It can be used with children with auditory processing delays, receptive language delays, expressive language delays, word retrieval difficulties, and reading comprehension difficulties.

Available at www.superduperinc.com

Elastic Waist Pants

he Adaptive Clothing Showroom is a long overdue, and much needed resource for children and adults with adaptive needs. This company sells clothing, that has been manufactured or adapted to provide a person with disabilities the ability to dress independently. For the child or young adult with difficulty manipulating a zipper, and button on a pair of pants, elastic pants provide the optimal solution. Elastic pants can be easily donned, or removed, making the child or young adult indeTherapeutic Benefits:  Increases fine motor coordination skills through grasp and release.  Encourages independent dressing skills throughout the day

pendent in dressing throughout the day. This is particularly exhilarating for the school day, where a lack of independent dressing skills can turn a trip to the bathroom into a cumbersome experience. Not anymore though, for when a child has elastic pants he can independently take care of his personal needs.

Available at www.adaptiveclothingshowroom.com

$22.99

 Promotes self-esteem through the ability to take care of oneself without relying on others.

To have your book or product reviewed contact us at 347.466.6960 or ileneklass@aol.com You can also mail items to:

Jewish Press

Building Blocks - Review Dept. 4915 16th Avenue • Brooklyn, New York 11204 70

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PRODUCT REVIEWS Early Developing Sounds Articulation Flip Books

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ow many kids hate repeating sounds for articulation practice? Why struggle getting kids to do their articulation practice when we have these exciting therapy books to use! Early Developing Sounds Articulation Flip Books are exciting and colorful and keep children engaged and laughing throughout the whole session. There are five different books in all. Each book contains three "flip-able" panels that allow students to change one or all three sections of amusing and fun sentence stories i.e. the rabbit/ ate a strawberry / on the caboose. Each panel is divided and color-coded by sound and word position (initial, medial, final) for quick and easy identification. The books are divided in to “entire world of _____” series and each book focuses on a different group of sounds, i.e. p, b; m, n; s, r, l; wh, l; t, d; sh, ch; k, g; s, z; f, th, v. Sounds can be practiced in single words, phrases, sentences, struc-

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tured and spontaneous conversation. In addition to articulation, these books can also be used for receptive and expressive language tasks including vocabulary development, verb tenses, pronouns, prepositional phrases, syntax, sentence formulation, prediction and word retrieval. In addition, ‘wh’ questions- what where and who questions can be targeted as well as story comprehension. These books will be an exciting addition to any therapy session or at home practice of speech and language goals. The children feel like they are making their own sentences as they flip the pages thereby making it easier for them to practice the sounds they need to. No boring articulation therapy sessions here!!!!!

Available at www.therapro.com

$79.99

“Ask and Answer” WH Questions App

his exciting App is a “today” version of Super Duper’s famous ‘wh’ card decks. It can be used on iPhone, iPad, or iPod touch. You can choose which ‘wh’ card decks to use- who, what, when, where, why (28 questions each)-you can choose one deck or multiple decks to contrast different question forms. In addition you can select which specific questions you want to use from each deck. It has clear, colorful pictures and it consists of four games:  Multiple Choice- choice of 3 answers OR choice of 3 questions  Decoder game- select your answer choice (also choice of 3) and slide the decoder over your choice to see if it’s right Therapeutic Benefits:  Auditory processing- question form discrimination, visual cues, set size can be manipulated to increase levels as the child progresses  Language comprehension- learning different question forms, understanding concepts and descriptions

 Matching game- you pick a question from one side and answer from the other side and decide if they match  Drag and match game- drag card to the matching answercan choose set size This app can also be shared via email, facebook, twitter, or message. It’s great for kids who need extra reinforcement, and/or visual choices while working on increasing their language skills.

Available at www.superduperinc.com  Expressive language- expansion of sentences (you can have the question read aloud or you can read it- visual or auditory presentation), work on asking questions, use appropriate syntactical forms can describe the pictures, learn concepts- all language tasks (vocabulary)

Playstix

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laystix from Popular Playthings is a reimagining of Lincoln Logs. It comes with 150 pieces in seven different sizes and each size is color coded (warning – choking hazard – keep away from very small children). It also includes a 25 page booklet that provides various ideas so you can create many interesting things. The pieces fit together and are sturdier than other log building sets. In fact, there is a snap and lock feature depending on the design. Therapeutically, this helps in a number of areas like Therapeutic Benefits:  Social Engagement and Interaction  Creative Thinking and Imaginative Play  Helps with Sensory Motor Development

hand eye coordination, bilateral hand use, and fine motor skills. This is great for social interaction and problem solving as well. The set is sure to keep your little ones busy for quite a long time.

Available at Double Play 4115 14th Avenue, Brooklyn, New York

$20.00

 Communication and Social Interaction  Develops Cognition and Problem Solving  Problem Solving and concentration  Helps with hand eye coordination and bilateral hand use December 2012

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PRODUCT REVIEWS Weighted Lap Blanket Candy Construction Building Set

his is a weighted lap blanket that is perfect for your fidgety child or student! This lap pad is large enough to cover a child like a blanket, providing an even yet gentle distribution of pressure throughout the covered area. This pressure, while gentle, is enough to give the child a sense of where their body is positioned relative to their surrounding. This

helps the child focus better on a tabletop activity or just calm down and unwind. This weighted lap pad is easy to clean by wiping down with any sanitizer. It folds easily for compact storage too.

Available at www.sensorycraver.com

$120.00

Therapeutic Benefits:  Increases proprioceptive and tactile sensory input through deep yet gentle pressure.  Increases calming and focused behavior through deep yet gentle pressure.  Can increase strength if used with an activity that encourages movement.

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his is Tinker Toys reincarnated. This toy is very appealing to the young preschool child since it looks like large pieces of candy. Don’t worry though; none of these pieces can go into a child’s mouth! They are too large. The young testers of this toy had fun building and easily connecting the sticks, circles, squares, even a “bar of chocolate” to create their own candy wonderland. This toy easily lends itself to a child’s imagination. Who wouldn’t want to “drive” a car, build houses, or “ride”

a Ferris wheel out of candy? This toy is highly recommended to help young children develop their fine motor coordination and strength, as well as their imagination. This toy is also ideal for a child with motor coordination disabilities who would benefit from being able to utilize large pieces to construct objects.

Available at Double Play 4115 14th Avenue, Brooklyn, New York

$30.00

Therapeutic Benefits:  Develops fine motor coordination skills.  Develops strength in the hand muscles through manipulation of connecting pieces.  Develops imaginative play  Helps develop cognitive skills through color recognition


PRODUCT REVIEWS

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Phonological Awareness

ebber Hear Builder ™ Phonological Awareness is an interactive software program that helps children improve their phonological awareness and increase their auditory processing skills. Phonological awareness is the ability to understand the relationship between written and spoken language, and to be able to reflect upon and manipulate these abilities. It also includes the knowledge of, or sensitivity to, the sound structure of spoken words. This evidence based program includes 9 different games that help children (ages 4-11) increase their awareness of sounds, syllables, and words. The program features exciting graphics that keep the children entertained as they learn to segment, blend, and manipulate sounds as they earn instruments and band members to form the band The Phonemix.The 9 areas targeted include:  Sentence segmentation- click on the one with 2 words  Syllable blending- click on the word made by blending these syllables  Syllable segmentation- Click on the bass for eachsyllable in the word; hit thecowbell when you are finished.  Rhyming- click on the word that rhymes with this word  Phoneme Blending- click on the word made by blending these sounds  Phoneme Segmentation and Identification- click on the sound you hear at the beginning of this word  Phoneme Deletion- click on the word you get when you remove

the ____ sound  Phoneme Addition- click on the word you get when you add the a ____sound  Phoneme Manipulation- click on the word you get when you change a sound Each game has many levels that can be individualized for each child that is playing. Data is saved after each game and used for tracking of progress and generating progress reports. The CD’s come in home edition (1-4 students) as well as the professional edition which can be used for an unlimited number of students and has more specific individualized instruction. In addition, the professional edition has the ability to add background noise to each game (none, low, or high). It is also SMART Board compatible so you can use it with your whole class. Research has shown that children who begin reading instruction with sufficiently developed phonological awareness understand the instruction better, master the alphabetic principle faster and learn to read quite easily. Using the Hear Builder Phonological Awareness will give your children or students the skills they need to become proficient readers and good listeners.

www.hearbuilder.com

$69.95

The Therapy Resource for Families & Professionals!

Parent-centered Activities • Speech & Language • Sensory Integration • Early Learning •

225 Arlington Street Framingham, MA 01702 Tel: (800) 257-5376 Fax: (800) 268-6624 www.therapro.com December 2012

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BOOK REVIEWS By Bracha Holczer Bracha Holczer is part of a family that relishes books, especially after lights out. She is a reading specialist in an elementary school. She can be reached at bholczer@aol.com.

Adalyn’s Clare

By Kari Dunn Buron Illustrator: Lou Wisniewski Publisher: AAPC (Autism Asperger Publishing Co.) Publishing, Shawnee Mission, KS, aapcpublishing.net  2012

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hen too much anxiety consistently overwhelms a child, so much is at stake. The out of control behavior that accompanies out of control emotions is a debilitating. The ability to naturally create and sustain relationships with teachers and especially other children is negatively affected. Social functioning, an integral part of school life, becomes elusive even for very bright fearful children. The first issues that must be addressed in such a case is building trusting relationships and learning how to calm down when everyday events cause excess anxiety. Author Kari Dunn Burton has worked through these issues herself, and has seen in her work how highly anxious children benefitted from learning calming techniques and making friends. Written with the idealistic goal of helping children understand what school life is like for very anxious classmates, Adalyn’s Clare by Kari Dunn Buron is a partially illustrated story in twenty two

David’s World A Picture Book about Living with Autism

By Dagmar Mueller Illustrator: Verena Ballhaus Publisher: Sky Pony Press, New York, NY skyhorsepublishing.com  2012

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he young storyteller, a brother of the David in the title, tells what it is like to have an autistic brother. He explains what David does that makes it seem as though he is living in his own world. Our very honest narrator knows his brother’s likes and dislikes, and really wants to communicate with him. Their mother explains the problem as David speaking a ‘different language’ and that’s why there are misunderstandings. The narrator poignantly expresses his wish that he could understand his brother’s language and his brother could understand everyone else’s. He sincerely wishes to understand what it is like to be David, or at least how to help him. The narrator compares how much better things are now that David and the family learn with a therapist, and relates ways that David is amazing, so the reader can see how a sibling could love a brother who presents such great challenges. The retelling of how only David was able to help calm a very agitated puppy in a creative way is fascinating, and gives a welcome glimpse into the blessings that come along with the special talents an individual with autism can have. 74

December 2012

short chapters. Adalyn, an academically capable but socially awkward fourth grader is helped tremendously through her therapy dog, Clare. Adalyn learns how to work through her big anxieties and floods of emotion and hold herself back from out-of-control explosions over daily frustrations. Clare learns to be a calming presence for Adalyn, and other animals in the science room at school offer Clare wise advice about other needs Adalyn has. Adalyn’s extreme special interest, or, as some may call it, obsession, in science is used to help her socially as well. More an insight into the inner world of children like Adalyn than a how-to manual for preventing temper tantrums in fearful children, this easy-to-follow story, without being preachy, helps other children see fearful children as children just like them. This story will resonate with adults in anxious children’s lives, and the adult reader will relate to the understanding adults in the story as well as those willing to learn new ways. As more children with special needs rightfully take their places in our classrooms, we need to partner with everyone that can contribute to their success, and that includes the other children in the room. As we all know, children may gravitate away from and even tease those that don’t blend in, but those same children also have the power to accept and even embrace those with differences. Reading this story to or with a class can go a long way toward sensitizing a class to making sure that we take care of everyone as best as we can. Ballhaus’s illustrations are artsy and unusual, even zany. David’s body is drawn with bricks - as if he’s literally built differently, or protecting himself from the world he cannot understand. Noises are depicted as physical things coming out of mouths, helping the reader visualize what the autistic character may be perceiving. David’s World is an interesting picture book that siblings or classmates of autistic children can relate to, and can open the door to helpful discussions that deepen understanding and empathy, and the illustrations are certainly the types of pictures that are worth 1000 words!


BOOK REVIEWS Grandparent’s Guide to Autism Spectrum Disorders - Making the Most of the Time at Nana’s House By Nancy Mucklow Publisher: AAPC (Autism Asperger Publishing Co.) Publishing, Shawnee Mission, KS, aapcpublishing.net  2012

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randparents are an integral part of their grandchildren’s lives. Whether grandchildren spend long hours each day or short visits every now and then in their grandparents’ care, the unique cross-generational love is a blessing. But what happens when a grandchild seems unwilling or unable to bask in the glow of the grandparents’ affection? Or if the grandparents feel a grandchild’s extreme behavior is too much for them to handle? This is often the case when symptoms of ASD (Autism Spectrum Disorders, including PDD-NOS and Asperger Syndrome) get in the way. When grandparents understand the specific challenges their grandchild with ASD faces in everyday life, the grandparents become part of the solution. Most parents of a child with ASD would love their own parents to be capable and reliable members of their support network! To that goal, author Nancy Mucklow, noted author of books clarifying life for people with symptoms on the autism spectrum and their families and caregivers, presents a practical, easily understandable resource. A very effective tool she uses at the beginning of each chapter is presenting the reader with a vignette depicting a real problem that occurs when grandchil-

Autism as Context Blindness

By Peter Vermeulen, PhD Publisher: AAPC (Autism Asperger Publishing Co.) Publishing, Shawnee Mission, KS  aapcpublishing.net  2012

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s more children receive diagnosis of autism spectrum disorders, the medical, educational and therapeutic communities strive to come up with sources for the symptoms and match appropriate therapies. Autism seems to affect so much of an affected person’s functioning, ranging widely from individual to individual, and researchers keep trying to discern a common thread clarifying the nature of this spectrum of disorders. With symptoms affecting the sensory processing functions, communication, learning, and other life systems, autism is difficult to sum up as a single type of problem. Many researchers and practitioners focus on the behaviors that are problematic, but others feel the focus should be on the thought processes which are the root of the behavior. Previously, Dr. Vermeulen wrote about autistic thinking as being too detail focused, and not able to connect details into meaningful wholes, but has since found this not to be absolute. In this book, Autism as Context Blindness, Dr. Vermeulen presents a nuanced explanation of how autistic thinking is characterized by a deficiency in a key area - differentiating understanding of words, objects, instructions, etc. according to a situation’s context. This, he believes, leads to the atypical behaviors, and may explain why some current approaches to cognition and social skills training in individuals with autism encounter difficulty. The beginning portion of the book patiently and thoroughly ex-

dren with ASD spend time at with grandparents at home or out and about. The chapter then thoroughly explains in a clear way, with helpful charts, the factors that contribute to the problems and how to avoid the seemingly inevitable meltdowns. Grandparents are guided to set up the time spent together and even the whole relationship for success. At the end of each chapter, the reader is in for a treat - a new vignette about the same people, but this time, the strategies and tips Mucklow described in the chapter are implemented, and the outcome is heartwarming! All the biggies in ASD are addressed in Grandparent’s Guide: sensory issues, assessing new situations for difficulties the grandchild may have, executive function, rules for behavior, and encouraging good communication, and all in concise book of about 120 pages! Mucklow has thoughtfully included a list of resources and books that interested grandparents can read to further educate themselves about ASD and also children’s books that grandparents can share with grandchildren to enhance understanding and provide common language to what is going on. Grandparents are encouraged to get the rest of the family in line with creating a supportive, safe environment for all members of the family. Others in the family who wish to be a valuable resource for the parents and child can also do well with the strategies and suggestions explained in this book. Every member of a family is precious, and Mucklow guides grandparents in choosing the right techniques to work toward a comfortable, supporting and loving relationship with their grandchildren. plains the way context is a crucial element in typical successful perception, communication, social behavior, and reasoning. Dr. Vermeulen masterfully explains this multifaceted and complicated concept of understanding the same information in different ways corresponding to changing situations with many illustrative examples and backs it all with scientific research. It is fascinating to learn about the ways autistic thinking differs from the typical in a uniform sort of way. Typical thinking can often clear up unclear situations by using the context (i.e., does the comment, “Oh! Great!” mean a sincere expression of how great a situation is, or a sarcastic remark exclaimed when something goes wrong?), while autistic thinking may rule this comment as only being one way all the time, as if ‘blind’ to the changing context. All aspects of life where context plays a role are carefully examined and illustrated so the reader comes away with a broad appreciation for the huge amount of flexibility required for functional thinking and reasoning. Autistic thinking about those same situations is discussed, which can help focus a care provider’s efforts. The latter part of the book is devoted to describing many aspects of autism through the lens of context blindness. Bringing context to the attention of autistic individuals has been done and the results are shared. Dr. Vermeulen offers general suggestions about clarifying context through modifying environments and specific training which can directly benefit autistic individuals and drastically improve problematic behavior. Autism as Context Blindness offers a valuable glimpse into autistic thinking which every teacher, therapist, doctor, and parent of autistic individuals can benefit from. December 2012

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BOOK REVIEWS 1,001 Tips for the Parents of Autistic Boys By Ken Siri Publisher: Skyhorse Publishing, New York, New York skyhorsepublishing.com  2010

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arents of children with any diagnosis are most likely a well-read bunch. Armed with information from the plethora of books available about theories, treatments, strategies, philosophies, schools of thought, etc. about every diagnosis, not to mention all the periodicals, online resources, and discussions with other parents, teachers and professionals, this bunch of parents can end up writing their own books just with the notes from all these resources! Ken Siri, parent of a boy with autism, coauther of Cutting-Edge Therapies for Autism, has culled through the latest books and information and compiled this wide-ranging book listing 1,001 Tips for the Parents of Autistic Boys. He sets out to tell everything parents of an autistic boy “...need to know about diagnosis, doctors, schools, taxes, vacations, babysitters, treatments, food, and more,” in hopes of spurring parents to “take ownership” of all aspects of life with autism. His goal is to arm parents with the information they need to go out and fight for their child, and his book

41 Active Learning Strategies for the Inclusive Classroom (Grades 6-12)

By Diane Casale-Giannole and Linda Schwartz Green Publisher: Corwin, A SAGE Company, Thousand Oaks, California corwin.com  2012

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ith many years of experience teaching students from kindergarten through graduate school, the authors have a lot to offer teachers who want to teach effectively. With the reality that students at the middle school and high school levels are pre- and actual adolescents, characterized by a unique combination of learning tendencies, the authors persuasively argue for the need to engage students actively. The last thing a teacher wants to see is a sea of disinterested faces with dull eyes. Especially with adolescents who experience learning deficits (academic, cognitive, social, organization, or motivation), actively involving students in intentional learning ensures a heightened interest. This in turn ups the motivation factor which immediately enhances learning and long-term retention of the learned information. With so much information available about brain-based learning, it would be a shame to continue out-dated practices in adolescent classrooms, especially when more students with classifications are working their way through the grades. Teachers need more tools than ever to engage and hold students’ interest and efforts. Lessons need to allow for diverse learning styles and various methods of responses to make sure we catch all students. A master chart and dedicated chapter help guide strategy choice appropriate for various goals, and a thorough chapter about grouping helps plan “who goes where with whom to do what.” Finally, the main course is served - the active learning strategies encountered in this book are each presented in an accessible way, with stories of how it is implemented in the classroom and ideas about matching it to curriculum areas. One intriguing strategy offered is #3 - Barometer, where after studying a situation that has many sides (ex, nature and nurture during a DNA unit), students present their 76

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accomplishes all that and more. Reading this book is sort of a shortcut to encyclopedic knowledge required when one is an informed parent of an autistic boy. Contents are organized by topics occurring chronologically and the tips are numbered. They include all the various ways researchers, parents, authors and professionals refer to children with autism. And what a resource this book is! Any need, any question, any planning for the future - one of the 93 chapters is designed to address each specific concern. Chapters are devoted to symptoms, dealing with a diagnosis, evaluations, IEPs, therapies, and supporting the family unit, preparing for emergency room visits, clothing issues, gift ideas, special needs trusts and, last and longest of all, taxes. Each chapter is a starting point to help get a grip in one area, and parents are then well equipped to direct further research and questions in a targeted way. Some tips are here to educate, some to inspire. Some are super practical, some are idealistic overviews. Some apply to many children, some to just a few. Many tips include websites for further research, all have sources cited clearly. Ken Siri did a tremendous service to parents of autistic boys, and readers of 1,001 Tips for the Parents of Autistic Boys will reach for this ambitious book again and again. opinion and try to find others in the class who share their convictions, or try to convince those on the other side to switch over. Another useful and engaging strategy is #14 - Jigsaw. This is a great way to have a whole class prepare and review large amounts of information. Each student is assigned a part of a whole set of information to prepare. All students who prepared the same part conference to reinforce learning, then are assigned to teach it to their study group, each of whom prepared and reviewed a different part of a set of information. Using active and social methods (preparation, group reviews, peer teaching) has been proven to help adolescents learn, allows even weaker students to own their learning, and is well worth the switch from older techniques such as dry lecturing. Another strategy has the typical lecture handout revamped and designed to force students to pay attention (it involves true/false statements the students answer throughout the lesson with designated space for students notes near each statement. Using this book will feel like consulting a master teacher as a mentor, or a coach devoted to improving your teaching craft and making your classroom a place where real learning goes on. With so much benefit resulting from a good education in today’s times, ensuring all students feel invested in learning is a worthy accomplishment. The strategies in 41 Active Learning Strategies are the tools you need for that kind of classroom where that happens every day. (Don’t worry, teachers of younger grades, the authors have a book for you as well - 40 Active Strategies - Grades K-5).


BOOK REVIEWS Differentiating Instruction for Students with Learning Disabilities New and Best Practices for General and Special Educators By William N. Bender Publisher: Corwin, A SAGE Company, Thousand Oaks, California, corwin.com  2012

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raditional teaching models are just not enough to ensure that all students in a class can succeed, and old practices of ignoring or worse - shaming those that don’t succeed, or simply demanding that parents hire tutors to make up the slack, guarantees failure and sometimes acting out. Even the very bright students’ needs are not always met in traditional lesson formats, and often their vast potential is left untapped. Even when the brightest students are achieving high marks, it is nearly effortless, no real learning habits are developed, and behavior problems crop up when bright children are bored. Students have always known what they need, and often complain bitterly that their teachers are going too slow or too fast, or are not explaining things well, or are making them write the answer when they can’t possibly do justice to their knowledge when writing. “If only I could just show the teacher what I know instead of writing it!” Teachers must be open to changing practices if the students require it, and also be knowledgeable about how to asses learning in ways that students can successfully demonstrate actual learning and needs. Dr. William N. Bender, the author of Differentiating Instruction for Students with Learning Disabilities uses current research to update instructional tactics with a focus on RTI - Response To Intervention, a widely used initiative discussed extensively in this book to individually screen all students to assess achievement of skill benchmarks, identify students who can benefit from supplemental instruction (= intervention) and more intense progress monitoring. These are usually the students with learning disabilities or other deficits that may hinder learning. The supplemental instruction changes according to the response, becoming more intense or less as progress monitoring dictates. Research-based instructional programs are used exclusively, leaving guesswork out of deciding what will work.

To have your book or product reviewed contact us at 347.466.6960 or ileneklass@aol.com You can also mail items to:

Jewish Press

Building Blocks - Review Dept. 4915 16th Avenue Brooklyn, New York 11204

Dr. Bender does teachers of every subject a tremendous service by depicting in great detail what goes on in a classroom taught traditionally (whole class lesson format, no differentiation of instruction or assessment) and why many students are failed by this approach. Differentiated instruction models of various degrees and intensities are carefully explained, giving novice through experienced teachers’ choices about how much to change. A game-changing factor to differentiating instruction is incorporating current technology into the classroom, instruction design, information sourcing and assessment models. While some schools in this audience may not wish to allow 21st century technology to invade the classrooms, others are using it extensively and can harness its appeal to today’s students with the many exciting practices described in Chapter 3. Other broad ranging learning strategies that do not require technology are presented as well. Perhaps the most important chapter in the book is the last (Cognitive Strategy Instruction for Differentiated Classes). Here, a motivated teacher will find strategies for teaching students how to set themselves up to learn, self-monitor and self-regulate, along with helpful charts and teaching tips. Cognitive strategy instruction is the most important teaching for children with learning disabilities. It is the glue that makes everything else stick. Many learning disabled students are burdened with deficits in executive functioning and organizational difficulties. These alone can doom the most capable student, let alone one who also has ADD, language or processing disorders, or other difficulties. Cognitive strategies help students understand and complete tasks, and can make a difference in a child’s life far beyond memorizing a few facts. Every good teacher hopes their guidance has life-long affects, and teachers feel gratified and validated when students come back years later and still remember what they were taught. Parents of students who need help in this area will find their jobs as homework enforcers and retrievers easier when they help the students learn these strategies to become as responsible for their own learning as possible. The Corwin publishing company’s motto of “Helping educators do their work better,” is evident throughout the informative chapters of this ambitious book which offers teachers, staff developers and parents practical skills to accomplish their crucial missions. ABOUT OUR REVIEWERS Chaya (Ilene) Klass, MS, OTR/L, is an occupational therapist who works for the NYC Department of Education and treats children in the community. She can be reached at ileneklass@aol.com. Bracha Holczer is a reading specialist. She has taught reading with the New York City Department of Education and currently acts as a consultant while raising her children. She can be reached at BHolczer@ aol.com. Breindy Rosenblatt MS CCC-SLP TSHH is the Speech Supervisor at the Auditory Oral School of New York/StriVright to Succeed. Yitty Rimmer has a Masters in Occupational Therapy from New York University. She currently has her own private pediatric practice in Brooklyn, NY. Rachel Soroka-Teller is a speech-language pathologist at Strivright/Auditory-Oral School of New York. She services children from birth to age 5 with a variety of speech-language delays and developmental disorders. She uses technology to engage children in fun and interactive therapy sessions. She can be reached at rteller@auditoryoral.org. December 2012

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RESOURCES DIRECTORY DIRECTORY LISTINGS

Compiled by Suri Greenberg The listing below is intended to serve as a starting point for family members, professionals and care givers seeking programs, institutions and service providers designed for special needs individuals and their families within the Jewish community. Building Blocks does not specifically endorse any of those listed. Readers are urged to contact them individually for more information. You must make your own determination as to whether the services and programs they offer are appropriate for your specific case. Also note, that languages are in addition to English.

EARLY INTERVENTION APPROVED PROGRAMS

Early Intervention Services

For children birth - 3 years w/special needs.

Services Provided

Evaluations Feeding Therapy l Special Education l Nutrition Counseling l Service Coordination l Family Support/Counseling l Speech/Language Therapy l Physical & Occupational Therapy l ABA Program – Center & Home Services Routines Based Interventions & Collaborative Coaching l l

TO REFER YOUR CHILD TO THE EARLY INTERVENTION PROGRAM CALL 311. This Early Intervention Program (EIP) is a public program for children under the age of three who are either suspected of having or at risk for developmental delays or disabilities. EIP is funded by NYS and NYC. All EIP services are provided at no cost to parents. Health insurance may be used for approved services. A child’s eligibility for the program can be determined only by state-approved evaluators under contract, and all services must be authorized by the NYC Early Intervention Program.

For more information about CHALLENGE: T. 718.851.3300 W. Challenge-ei.com

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Advanced Professional Resources Address: 224 Franklin Ave., Hewlett, NY 11557 Phone: (516) 791-6200 Fax: (516) 791-6026 Location: Home Services Provided: Occupational, Physical, Speech Therapy, Special Instruction, Social Work, Nutrition, Vision, Ongoing Service Coordination, Evaluations

Phone: (718) 972-0880 Location: Home & Center Services Provided: ABA, sensory integration, Medek, multidisciplinary evaluations, speech therapy, special instruction, occupational therapy, physical therapy, family counseling, social work services, family training, nutrition services, psychological services, vision services, assistive technology, audiology, service coordination, individual and group developmental services

AHRC NY Address: 83 Maiden Lane, New York, New York 10038 Phone: (212) 780-2500 Website: www.ahrcnyc.org Location: Home and Center Services Provided: ABA, Family Training, PT, OT, SLP, Psych, Evaluations

Donna Klein and Associates, Inc. Address: 690 North Broadway, Suite GL2 White Plains, New York 10603 Phone: (914) 686-3116 Website: Donnakleintherapy.com Location: Home Services Provided: Sensory integration

The Auditory Oral School of New York/ StriVright to Succeed Address: 3623 Avenue L Brooklyn, New York 11210 Phone: (718) 531-1800 Website: www.auditoryoral.org Location: Home and Center Services Provided: Sensory integration, speech language therapy, auditory-verbal therapy, audiological testing and central auditory processing evaluations, OT, PT, special instruction home-based/center-based hearing education services. Center for Hearing and Communication (formerly League for the Hard of Hearing) Address: 50 Broadway, 6th floor, New York, New York 10004 Phone: (917) 305-7700 Website: www.chchearing.org Location: Center Services Provided: Auditory oral speech and language therapy (individual and group) Challenge Early Intervention Center Address: 649 39th Street Brooklyn, New York 11232 Location 2: 70-14 141st Street, Flushing, New York 11367 Location 3: 1911 Richmond Avenue, Staten Island, New York 10314

EIS LAASOIS/WIECDC Address: 22 Middleton Street Brooklyn, New York 11206 Phone: (718) 303-9400 Website: www.EISLAASOIS.org Location: Home and Center Services Provided: Floor time, Sensory Integration and NDT Hamaspik of Rockland County Address: 58 Route 59, Suite 1, Monsey, New York 10952 Phone: (845) 356-8400 Hand in Hand Development, Inc Address: 465 Grand Street, 2nd Floor, New York, New York 10002 Phone: (212) 420-1999 ext. 149 Location: Home and Center Hebrew Academy for Special Children – HASC Preschool Address: 1311 55th Street Phone: (718) 851-6100 Website: www.hasc.net Location: Home and Center Services Provided: Sensory integration, Medek, assistive technology, therapeutic yoga, music therapy, computers, family counseling, play therapy, feeding therapy, parent support groups; nursing


RESOURCES DIRECTORY EARLY INTERVENTION APPROVED PROGRAMS CONTINUED… HASC Spring Valley Address: 46 Grandview Avenue, Spring Valley, New York 10977 Phone: (845) 356-0191 Website: www.hasc.net Location: Home and Center Services Provided: ABA, OT, PT, SP, Sensory Integration, Family Counseling, Music Therapy

Omni Childhood Center Address: 1651 Coney Island Avenue Brooklyn, New York 11210 Phone: (718) 998-1415 Website: www.omnirehab.com Location: Home Services Provided: ABA, Floor time, Sensory integration, Medek

HASC Woodmere Address: 321 Woodmere Boulevard Woodmere, New York 11598 Phone: (516) 295-1340 Location: Home, Clinic Website: www.hasc.net Services Provided: ABA, Floor time, Sensory Integration, Play therapy, Parent support groups

Shema Kolainu – Hear Our Voices Address: 4302 New Utrecht Avenue Brooklyn, New York 11219 Phone: (718) 686-9600 Website: www.shemakolainu.org Location: Home Services Provided: ABA, Special Instruction, Speech, OT, PT, Counseling, Social Work, Audio, vision, Evals, Service Coordination

Jumpstart Early Intervention Program Address: 3914 15th Avenue Brooklyn, New York 11218 Phone: (718) 853-9700 Location: Home Services Provided: OT, PT, Speech, Special Instruction, Nutrition, Sensory integration, Medek, family counseling, play therapy Little Wonders, Inc. Address: 88-66 Myrtle Avenue Glendale, NY 11385 Phone: (718) 850-0400 Website: www.littlewonders-ei.org Services Provided: OT, PT, ST, Family Counseling, Play Therapy, Music Therapy, Parent Support Groups, Service Coordination, Multidisciplinary Evaluations. Languages: Spanish, Polish, Russian, Italian, French, Creole, Greek, Tagalog, Hindi, Punjabi, Hebrew, Urdu and Yoruba. Los Niños Services Address: 535 8th Avenue, 2nd floor, New York, New York 10018 Phone: (212) 787-9700 Location: Home Website: www.losninos.com Services Provided: ABA, Speech therapy, PT, OT, Special Ed teachers, Social work, Psychology, Parent training, Development and Parent/ child groups, Parent support groups McCarton Center Address: 350 East 82nd Street New York, New York 10028 Phone: (212) 996-9019 Website: www.mccartoncenter.com Location: Center Services Provided: ABA, sensory integration, S & L therapy, educational testing

Step By Step Infant Development Center Address: 1049 38th Street Phone: (718) 633-6666 Website: www.stepbystepny.com Location: Home and Center Services Provided: ABA, sensory integration, Medek, OT. PT. ST, special instruction, parent training, nutrition, vision, auditory training, family counseling, music and art therapy, parent support groups, swimming, respite. YAI Network Address: 460 West 34th Street New York, New York 10001 Phone: (866) 2-YAI-LINK Website: www.yai.org Location: Home and Center Services Provided: ABA, Floor Time, Sensory Integration Yedei Chesed Address: 48 Scotland Hill Road Chestnut Ridge, New York 10977 Phone: (845) 425-0887 Website: yedeichesed.org Location: Home Services Provided: Counseling, play therapy, music therapy, parent support groups Yeled V’Yalda Early Childhood Center Address: 1312 38th Street Brooklyn, New York 11218 Phone: (718) 686-3700 Website: www.yeled.org Location: Home and Center Services Provided: ABA, Sensory integration, Medek, play therapy, parent support groups

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RESOURCES DIRECTORY CPSE SCHOOLS OR CENTERS (3-5) The Ability Center Address: 3521 Avenue S Brooklyn, NY Phone: (718) 336-3832 Website: Theabilitycenter.net Location: Center Population: Mild to moderate to severe developmental delays, Autism/PDD, Speech & Language impaired, ADD/ADHD, Visually Impaired, Hearing Impaired, Learning Disabled, Multiply Handicapped Services: Speech therapy, OT, PT, Sensory Integration, MEDEK AHRC NYC Address: 83 Maiden Lane New York, New York 10038 Phone: (212) 780-2500 Website: www.ahrcnyc.org Location: Center Services Provided: ABA, Family Training, PT, OT, SLP, Psych, Evaluations Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Emotionally Disturbed, Multiply Handicapped Services: Speech therapy, Play therapy/counseling, ABA, Sensory Integration, TEACCH, PECS Languages: Spanish Add’l. Info: State approved Aim High Children’s Services Address: 202 Foster Avenue Brooklyn, New York 11230 Phone: (718) 853-1750 Website: www.aimhighchild.org Location: Home, Center, Will send providers to private schools Population: Mild-severe developmental delays, Autism/ PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally Disturbed, Multiply Handicapped Services: SEIT, OT, PT, Speech, Play therapy/counseling, ABA, Floor time, sensory integration Languages: Yiddish, Hebrew, Russian, Spanish Add’l. Info: State approved 80

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The Auditory Oral School of New York Address: 3623 Avenue L Brooklyn, New York 11210 Phone: (718) 531-1800 Website: www.auditoryoral.org Location: Home, Center, will send providers to private schools Population: Mild-severe developmental delays, Autism/ PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing impaired Services: SEIT, OT, PT, Speech, Play therapy/counseling, HES, ABA, Sensory integration, Speech-language therapy, Auditory-oral therapy, Audiological testing & central auditory processing (CAPD) evaluations, Multidisciplinary evaluations for children birth to five years, Family counseling, Play therapy, Music therapy Languages: Yiddish, Hebrew, Russian, Spanish, Ukrainian, Hungarian, Cantonese, Mandarin, French, ASL Add’l. Info: State approved Center for Hearing and Communication (formerly League for the Hard of Hearing) Address: 50 Broadway, 6th floor New York, New York 10004 Phone: (917) 305-7700 Website: www.chchearing.org Location: Center Population: Hearing impaired Services provided: Speech, Auditory oral speech & language therapy Comprehensive Kids Developmental School Address: 99 Essex Street New York, New York 10002 Phone: (212) 566-8855 Website: www.comprehensivecenter.com Location: Home, Center, Will send providers to private schools Population: Mild-severe developmental delays, Autism/PPD, Speech & Language impaired,

Learning Disabled, ADD/ADHD, Emotionally disturbed Services: SEIT Languages: Spanish, Chinese, Korean, Yiddish, Greek, Russian EIS LAASOIS/WIECDC Address: 22 Middleton Street Brooklyn, New York 11206 Phone: (718) 303-9400 Website: www.EISLAASOIS.org Location: Center Population: Mild-severe developmental delays, Speech & Language impaired, Learning Disabled, ADD/ADHD, Emotionally disturbed, Visually impaired, Multiply Handicapped Services Provided: OT, PT, Speech, Floor time and Sensory Integration Languages: Yiddish Add’l. Info: State Approved Gesher Early Childhood Center Address: PO Box 649 Cedarhurst, New York 11516 Phone: (516) 730-7377 Website: www.gesher-ecc.org Location: Center Population: Mild developmental delays, Speech & Language impaired, Learning Disabled Services Provided: Sensory Integration Addl. Info: Privately funded Hand in Hand Development, Inc Address: 465 Grand Street, 2nd Floor New York, New York 10002 Phone: (212) 420-1999 ext. 149 Hebrew Academy for Special Children – HASC Address: 1311 55th Street Brooklyn, New York Phone: (718) 851-6100 Website: www.hasc.net Location: Home, Center, Will send providers to private schools Population: Mild-severe developmental delays, Autism/ PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Multiply handicapped Services: SEIT, OT, PT, Speech,

Play therapy/counseling, Sensory Integration, Medek, Yoga, Augmentative communication, Assistive technology, music therapy, nursing Languages: Yiddish, Hebrew, Russian, Spanish Addl. Info: State approved, Breakfast provided, Kosher meals, Transportation provided through the Dept. of Ed A Helping Hand Address: 703 East 4th St., Suite 3 Phone: (718) 435-7464 Location: Home, Will send providers to private schools Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD Services: ABA, SEIT, State Approved Languages: Yiddish, English Imagine Academy Address: 1458 East 14th Street Brooklyn, New York 11230 Phone: (718) 376-8882 Website: www.imagineacademy.com Ages Served: 3-21 Hours: 8:30AM-3:30PM Classes: Mixed Population Served: Moderate to severe developmental delays, Autism/PDD Services: OT, PT, Speech, Play Therapy/Counseling, ABA, Floor time, Pre-vocational, Art, Music, Yoga, Therapeutic Swim Languages: Hebrew Addl. Info: Privately Funded, Transportation provided through the Department of Education, Lunch provided JCC Therapeutic Nursery Address: 411 East Clinton Avenue Tenafly, NJ 07670 Phone: (201) 408-1448 Location: Center Services Provided: OT, Speech, Play Therapy/Counseling, Sensory Integration, Parent Counseling, Parent Support Group Population Served: Mild developmental delays, Autism/PDD,


RESOURCES DIRECTORY CPSE SCHOOLS OR CENTERS (3-5) Speech and Language Impaired, Learning Disabled, ADD/ADHD, Emotionally Disturbed Addl. Info: Privately Funded Kiryas Joel Pre-School (Part of Kiryas Joel UFSD) Address: 1 Diner Road Monroe, New York 10950 Phone: (845) 782-7510 Location: Center, Will send providers to private schools Population: Mild to moderate to severe developmental delays, Autism/PDD, Speech & Language impaired, Learning disabled, ADD/ ADHD, Emotionally disturbed, Hearing Impaired, Visually Impaired, Multiply handicapped Services: SEIT, OT, PT, Speech, Play Therapy/ counseling, ABA, Sensory Integration, MEDEK Language: Hebrew, Yiddish Addl. Info: State Approved. Full/Half Day Classes Los NiĂąos Services Address: 535 8th Ave, 2nd Floor, New York, New York 10018 Phone: (212) 787-9700 Website: www.losninos.com Location: Home Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ADHD, Emotionally disturbed, Hearing impaired, Visually impaired, Multiply handicapped Services Provided: SEIT, ABA Languages: Spanish, Russian, Ukrainian, Italian, Portuguese, French, and others National Jewish Council for Disabilities/ Yachad (NJCD) Address: 11 Broadway, 13th fl. New York, New York 10004 Phone: (212) 613-8229 Website: www.njcd.org Location: Center, Will send providers to Private Schools Population: Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Hearing impaired Services Provided: Audiological Omni Childhood Center Address: 1651 Coney Island Avenue Brooklyn, New York 11210 Phone: (718) 998-1415

Website: www.omnirehab.com Location: Home, Center, Will send providers to private schools Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing impaired, Multiply handicapped Services: SEIT, OT, PT, Speech, Play therapy/ counseling, Sensory Integration, Medek Languages: Yiddish, Spanish, Russian, Hebrew, Polish Addl. Info: State approved Otsar Family Services Address: 2334 West 13th Street Brooklyn, New York 11223 Phone: (718) 946-7301 Website: www.otsar.org Location: Center Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally disturbed Services: OT, PT, Speech, Play therapy/counseling, ABA, Floor Time, Sensory Integration, Music therapy, Dance therapy, Parent workshops & Support groups Sesame Sprout, Inc. Address: 96-08 57th Avenue Corona, New York 11368 Phone: (718) 271-2294 Website: www.sesamesproutschool.com Population: Mild developmental delays Services: OT, PT, Speech Languages: Spanish Addl. Info: State approved Small Wonder Preschool Address: 90-45 Myrtle Avenue Glendale, New York 11385 Phone: (718) 849-3002 Website: www.smallwonders.org Population: Moderate to severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, Hearing impaired. Services Provided: OT, PT, Speech, Play therapy/counseling, ABA, Parent Support Groups, Miller Method (for children on the Autism Spectrum). Languages: Spanish, Polish, Creole, Guajarati, Tagalog, Bengali, Arabic, Hindi, Punjabi, Urdu and American Sign Language, Bilingual staff.

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RESOURCES DIRECTORY CPSE SCHOOLS OR CENTERS (3-5) CONTINUED… UCP of New York City Address: 80 Maiden Lane, 8th Floor New York, New York 10038 Phone: (877) 827-2666 Website: www.ucpnyc.org Location: Center Population: Mild-severe developmental delays, Speech & Language impaired, Learning Disabled, Multiply handicapped Services: Floor Time, Sensory Integration Languages: Spanish Additional Info: State Approved, Privately Funded

Addl. Info: State Approved, Privately Funded YAI Network Address: 460 West 34th Street New York, New York 10001 Phone: (212) 273-6182 Website: www.yai.org Location: Home and Center Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ADHD, Multiply handicapped Services Provided: SEIT, OT,

PT, Speech, Play therapy/counseling, ABA, Floor Time, Sensory integration Languages: Spanish, Chinese, Mandarin, Cantonese Addl. Info: State Approved & State Funded Yeled V’Yalda Early Childhood Center Address: 1312 38th Street Brooklyn, New York 11218 Phone: (718) 686-3700 Website: www.yeled.org Location: Home Based, Will send

providers to private schools Population Served: Mild-severe developmental delays, Autism/ PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing impaired, Visually impaired Services: SEIT, OT, PT, Speech, Play therapy/counseling, ABA, Sensory Integration, MEDEK Languages: Hebrew, Yiddish, Russian, Spanish

CSE SCHOOLS OR CENTERS (5-21) C.A.H.A.L. Address: 540-A Willow Avenue Cedarhurst, New York 11516 Phone: (516) 295-3666 Website: www.cahal.org Population: Speech & Language impaired, Learning Disabled, ADD/ ADHD Ages: 5-18 Gender: Boys & Girls Classes: Separate & mixed Hours: 8:00 – 5:00 Services: OT, PT, SPEECH Addl. Info: Therapies provided on site, Lunch provided, Kosher Meals, Transportation through Dept. of Ed. Ezra Hatzvy Academy Address: 2555 Nostrand Avenue Brooklyn, New York Phone: (718) 975-1041 Website: Ezrahatzvy.com Ages: 5-21 Gender: Boys/Girls Classes: Mixed Hours: 9:00-4:00PM Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning disabled, ADD/ ADHD, Hearing impaired, Emotionally disturbed, Vision impaired, Multiply handicapped Services Provided: ABA, Floor time, Aquatics, OT, PT, SP. Languages: Yiddish Addl. Info: Privately funded, Handicapped accessible, Therapies provided on site, Transpor82

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tation through Dept. of Ed. Gesher Early Childhood Center Address: PO Box 649 Cedarhurst, New York 11516 Phone: (516) 730-7377 Website: www.gesher-ecc.org Population: Mild developmental delays, Speech & Language impaired, Learning Disabled Ages: 3-6 years old (nursery, kindergarten, PRE-1A) Gender: Male & Female Classes: Mixed Hours: Mon-Thurs: 8:30-3:30, Fri: 8:30-12:15 Services: Classrooms run by Early Childhood Special Education Teachers providing a dual curriculum, Related Services are provided on site thru CPSE agencies or the BOE Addl. Info: Privately funded Gesher Yehuda Yeshiva Address: 49 Avenue T Brooklyn, New York 11223 Phone: (718) 714-7400 Population: Speech & Language impaired, Learning disabled, ADD/ADHD Ages: 5-13 Gender: Male & Female Classes: Mixed Hours: 8:45-4:15 Services: ST, OT, Counseling Addl. Info: Privately funded, Transportation provided through Dept. of Ed.

Girls’ Program – An Alternative Educational Program for Girls Ages 5-9 Address: 2221 Avenue R Brooklyn, New York 11229 Phone: (718) 336-5296 Fax: (718) 336-5298 Ages: 5-9 Gender: Girls Hours: 9-3:45 Population: Mild developmental delays, Speech & Language impaired, Learning Disabled Services: OT, PT, Speech, Counseling Addl. Info: Therapies provided on site, Lunch Provided, Meals kosher, Transportation through Dept. of Ed. Ha’or Beacon School Address: 2884 Nostrand Avenue Brooklyn, New York Phone: (718) 951-3650 Population: Autism/PDD, Learning Disabled, Speech & Language Impaired, ADD/ ADHD, Emotionally disturbed Ages: 5-13 Gender: Male Hours: 9:00-4:00 Services: Speech, OT, PT, Counseling Addl. Info: Therapies provided on site, Privately funded, Lunch provided, Kosher meals, Transportation provided through Dept. of Ed

HASC School Age Program Address: 6220 14th Avenue Brooklyn, New York 11230 Phone: (718) 331-1624 Ages: 5-21 Gender: Male & Female Classes: Separate & Mixed Hours: 8:30-2:45 Population Served: Moderate to severe developmental delays, Autism/PDD, Multiply handicapped Services: ABA, Carbone, OT, PT, Speech, Counseling, Vision, Hearing, Medically Frail, Nurse Languages: Yiddish, Hebrew, Russian Addl. Info: State Approved, After School Program, Kosher Breakfast and Lunch, Transportation provided through the Board of Education HASC@Remsen Address: 555 Remsen Avenue Brooklyn, New York 11236 Phone: (718) 495-3510 Website: www.hasc.net Population: Mild to Moderate to severe developmental delays, Autism/PDD, Emotionally disturbed, Multiply handicapped Ages: 5-12 Gender: Boys & Girls Classes: Mixed Hours: 8:45-2:15 Services: SP, OT, PT, Counseling Addl. Info: State Approved


RESOURCES DIRECTORY CSE SCHOOLS OR CENTERS (5-21) CONTINUED… HASC Spring Valley Address: 46 Grandview Avenue Spring Valley, New York 10977 Phone: (845) 356-0191 Website: www.hasc.net Location: Home and Center Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning disabled, ADD/ ADHD, Hearing impaired, Vision impaired, Multiply handicapped Services Provided: ABA, Sensory integration, SEIT, OT, PT, SP, Play therapy/Counseling Languages: Yiddish Add’l Info: State approved HASC Woodmere Address: 321 Woodmere Blvd., Woodmere, New York 11598 Phone: (516) 295-1340 Website: www.hasc.net Population: Mild to severe developmental delays, Autism/PDD, Speech & Language impaired, Learning disabled, ADD/ ADHD, Emotionally disturbed, Multiply handicapped Services Provided: SEIT, OT, PT, Speech, Play Therapy/Counseling, Parent Training Addl. Info: State approved HASC Center, Inc Address: 5601 First Avenue Brooklyn, New York 11220 Phone: (718) 535-1953 Website: www.hasccenter.org Location: Center Population: Mild to severe developmental delays, Autism/PDD, Speech & Language impaired A Helping Hand Address: 703 East 4th Street Phone: (718) 435-7464 Ages: 5-21 Population: Moderate to severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD Services: ABA, SEIT, Pendency Languages: Yiddish, English Imagine Academy Address: 1458 East 14th Street Brooklyn, New York 11230 Phone: (718) 376-8882 Website: www.imagineacademy.com Ages Served: 3-21 Hours: 8:30AM-3:30PM

Classes: Mixed Population Served: Moderate to severe developmental delays, Autism/PDD Services: OT, PT, Speech, Play Therapy/Counseling, ABA, Floor time, Pre-vocational, Art, Music, Yoga, Therapeutic Swim Languages: Hebrew Addl. Info: Privately Funded, Transportation provided through the Department of Education, Lunch provided IVDU Elementary School for Girls Address: 1277 East 14th Street Brooklyn, New York Phone: (718) 758-2999 Website: www.NJCD.org Ages: Kindergarten-grade 5 Gender: Girls Population: Learning Disabilities, Mild developmental disabilities, Speech & Language Delays, ADD/ADHD Services: OT, PT, SEIT, Speech, counseling Addl. Info: Therapies provided on site, Transportation provided from all 5 boroughs IVDU Upper School Boys Division Address: 1305 Coney Island Avenue Brooklyn, NY Phone: (718) 372-7203 Website: www.NJCD.org Ages: 13-21 Gender: Boys Population: Learning Disabilities, Mild-moderate developmental disabilities, Speech & Language Impaired, ADD/ADHD, ED, broad range of needs (students grouped by ability level) Services: Speech, Therapy, OT, Counseling, Travel Training, Vocational Training Addl. Info: Transportation provided from all 5 boroughs IVDU Upper School Girls Division Address: 1277 East 14th street Brooklyn, New York 11230 Phone: (718) 677-4279 Website: www.NJCD.org Ages: 13-21 Gender: Girls Population: Learning Disabilities, Mild-moderate developmental disabilities, Speech & Language Impaired, ADD/ ADHD, ED, broad range of needs (students grouped by ability level) Services: Speech, Therapy, OT, Counseling, Travel Training, Vocational Training Add’l. Info: Transportation provided from all 5 boroughs

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RESOURCES DIRECTORY CSE SCHOOLS OR CENTERS (5-21) CONTINUED… Kinor Dovid - Harmony Address: 3820 14th Avenue Brooklyn, New York Phone: (718) 435-8080 Website: www.harmonyservices. org Population: Mild to Moderate developmental delays Ages: 18+ Gender: Male Classes: Separate Groups: Small groups, separate for men & women Hours: M-Th: 9-3, 3-7:30; Fri. & Sun: 9-1:30 Services: OT, PT, Speech, Counseling, Pre-vocational Languages: Yiddish, Hebrew Optional Beis Medresh Program. Kinor Malka - Harmony Address: 1467 39th Street Brooklyn, New York 11218 Phone: (718) 435-8080 Website: www.harmonyservices. org Population: Mild to Moderate developmental delays Groups: Small groups, separate for men & women Ages: 18+ Gender: Female Classes: Separate Hours: M-Th: 9-3, 3-7:30; Fri. & Sun: 9-1:30 Services: OT, PT, Speech, Counseling, Pre-vocational Languages: Yiddish, Hebrew Optional Seminary Program. The Manhattan Children’s Center Address: 124 West 95th Street, New York City 10025 Phone: (212) 749-4604 Website: www.manhattanchildrenscenter.org Population: Autism/PDD Ages: 3-18 Gender: Males/Females Groups: Mixed School Hours: 8:30-2:45PM Services: ABA, OT, Speech Add’l. Info: Privately funded, Therapies provided on site, Transportation provided through Dept. of Ed 84

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Ohr HaLimud – The Multi-Sensory Learning Center Address: 1681 42nd Street Brooklyn, New York 11204 Phone: (718) 972-0170 Website: www.ohrhalimud.org Ages: 7-14 Gender: Girls Hours: 8:30-4:00 Population Served: Dyslexia Omni Childhood Center Address: 1651 Coney Island Ave. Brooklyn, New York 11210 Phone: (718) 998-1415 Website: www.omnirehab.com Ages: 0-21 Gender: Boys & Girls Classes: Separate Population: Mild-severe developmental delays, Autism/ PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing impaired, Multiply handicapped Services: ABA, Pre-vocational Languages: Yiddish, Spanish, Russian, Hebrew, Polish Add’l. Info: State approved, Therapies provided on-site, Handicap accessible, Transportation provided through Dept. of Ed P’TACH Address: 1428 36th Street #211 Brooklyn, New York 11218 Phone: (718) 854-8600 Website: www.ptach.org Population: Learning Disabled Ages: 6-18 Gender: Boys & Girls Schools: Separate schools Hours: 8:45-5:00 Services: Speech, Counseling Languages: Yiddish Addl. Info: Therapies provided on-site, Transportation provided through Dept. of Ed. PS/IS 226-BiY Address: 6006 23rd Ave Brooklyn, New York 11204 Phone: (646)339-9041 Population: Mild-severe developmental delays, Speech & Language impaired, Learning Disabled, ADD/ADHD, Multiply Handicapped

Ages Served: 11-15 Gender: Boys and Girls School Hours: 8:00-3:00PM Languages: Yiddish, Hebrew Addl. Info: Transportation Provided through Department of Education, Kosher Breakfast Provided, Handicapped Accessible Services: OT, PT, Speech, Guidance and Pre-vocational SEAD - Special Education Academy of Deal Address: 1 Meridian Road Eatontown, New Jersey 07724 Phone: (732) 460-1700 Website: www.seadschool.org Population: Mild developmental delays, Autism/PDD, Speech & Language Impaired, Learning Disabled, ADD/ ADHD Ages: 3-14 Gender: Boys & Girls Classes: Mixed Hours: 8:30-4:00 Services: OT, PT, Speech, Social Skills Shema Kolainu – Hear Our Voices Address: 4302 New Utrecht Ave., Brooklyn, New York 11219 Phone: (718) 686-9600 Website: www.shemakolainu.org Population: Moderate-severe developmental delays, Autism/ PDD, Speech & Language impaired, ADD/ ADHD, Emotionally Disturbed, Hearing impaired, Visually impaired, Multiply handicapped Ages: 5-11 Gender: Boys & Girls Classes: Mixed Hours: 8:30am-2pm Services: ABA, OT, PT, Speech Add’l Info: State Approved, Handicap Accessible, Therapies provided on-site, Transportation through Dept. of Ed. Sinai Schools Address: 1485 Teaneck Road, Suite 300, Teaneck, NJ 07666 Phone: (201) 833-1134 Website: www.sinaischools.org Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired,

Learning Disabled, ADD/ADHD, Emotionally disturbed, Hearing impaired, Visually impaired Ages: 6-21 Gender: Boys & Girls Languages: Hebrew Classes: Separate & Mixed Hours: 8:00am-4pm Services: OT, Speech, Psychological, behavioral, Floor time Addl. Info: Therapies provided on site, Privately Funded, Handicap Accessible, Breakfast and Lunch provided, Kosher Meals, Private Transportation & Transportation provided through Dept. of Ed depending on place of residence. STEP (Special Torah Education) Address: 3005 Ave L Brooklyn, New York 11210 Phone: (718) 252-8822 Population: Moderate to severe developmental delays, Autism/PDD, ADD/ ADHD, Multiply handicapped, Emotionally disturbed, Speech & Language impaired Ages: 5-21 Gender: Boys and Girls Classes: Separate Hours: 9-4 Services: OT, PT, Speech, Counseling, Aquatic Languages: Hebrew, Yiddish Addl. Info: Handicap Accessible, Lunch provided, Kosher meals, Transportation through Dept. of Ed. UCP of New York City Address: 80 Maiden Lane, 8th Floor, New York, NY 10038 Phone: (877) 827-2666 Website: www.ucpnyc.org Population: Moderate to severe developmental delays, Multiply handicapped Gender: Boys & Girls Classes: Mixed Hours: 8-2 Services: OT, PT, Speech, Play therapy/counseling Languages: Spanish Addl. Info: State Approved, Privately Funded, Therapies provided on site, Handicap Accessible, Breakfast & Lunch Provided, Transportation through Dept. of Ed.


RESOURCES DIRECTORY CSE SCHOOLS OR CENTERS (5-21) CONTINUED… The Yaldeinu School Address: 1600 63rd Street Brooklyn, New York 11204 Phone: (718) 851-0123 Population: Autism/PDD Ages: 5-11 Gender: Boys & Girls Classes: Separate Hours: 9–3 Services: ABA, OT, Speech Languages: Yiddish Addl. Info: Therapies provided on site, Lunch provided, Kosher meals, Transportation through Dept. of Ed.

Phone: (718) 302-5222 Population: Mild to severe developmental delays, Autism/PDD, Speech & Language impaired, ADD/ADHD, Learning Disabled. Ages: 12-18 Gender: Boys Hours: 8-6PM Services: OT, PT, Speech, Counseling Languages: Yiddish Addl. Info: Privately funded, Therapies provided on site, Breakfast & Lunch provided, Kosher meals, Transportation provided. Handicap Accessible.

Yeshiva Bonim Lamokom Address: 425 East 9th Street Brooklyn, New York 11218 Phone: (718) 693-9032 Population: Mild developmental delays Ages: 5-21 Gender: Boys Hours: 9–5 Services: OT, PT, Speech Languages: Yiddish Addl. Info: Privately funded, Therapies provided on site, Pre-vocational, Breakfast & Lunch provided, Kosher meals, Transportation provided through Dept. of Ed.

YESS! Yeshiva Education for Special Students Address: 147-37 70th Road Flushing, New York 11367 Phone: (718) 268-5976 Website: www.yessyeshiva.org Population: Mild developmental delays, Speech & Language impaired, Learning Disabled Ages: 5-14 Gender: Boys & Girls Classes: Mixed Hours: 8AM-3:45 & Fri. 8AM-1:30 Services: OT, PT, speech, counseling Addl. Info: Therapies provided on site, Privately Funded, Handicap Accessible, Breakfast & Lunch Provided, Kosher Meals, Transportation through Dept. of Ed.

Yeshiva Binyan Olem Address: 68 Franklin Avenue Brooklyn, New York

THERAPY & EVALUATION SERVICES The Ability Center Address: 3521 Avenue S Brooklyn, New York Phone: (718) 336-3832 Website: Theabilitycenter.net Location: Center Population: Mild to moderate to severe developmental delays, Autism/PDD, Speech & Language impaired, ADD/ADHD, Visually Impaired, Hearing Impaired, Learning Disabled, Multiply Handicapped Services: Speech therapy, OT, PT, Sensory Integration, MEDEK Addl. Info: Accepts RSA’s, Handicapped Accessible Advanced Professional Resources Early Intervention Services Address: 224 Franklin Ave., Hewlett, NY 11557 Phone: (516) 791-6200 Fax: (516) 791-6026

Location: Home Services Provided: Occupational, Physical, Speech Therapy, Special Instruction, Social Work, Nutrition, Vision, Ongoing Service Coordination, Evaluations Ahava Medical & Rehabilitation Urgent Care Center Flatbush Location: Address: 2555 Nostrand Avenue Phone: (718) 951-8800 Williamsburg Location: Address: 16-18 Sumner Place Phone: (718) 336-9500 Website: www.ahavamedical.com Location: Center Services: Speech Therapy, PT, OT Addl. Info: Transportation available, Accepts Medicaid, Managed Care Medicaid, Medicare and Most Insurances, Same Day Appointments

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RESOURCES DIRECTORY THERAPY & EVALUATION SERVICES CONTINUED… Arrowsmith Program Address: 245 St. Clair Ave, West, Toronto Phone: (416) 963-4962 Website: www.arrowsmithschool.org Population: Speech & Language impaired, Learning disabled, ADD/ADHD Services: It is available to public and private schools. It Identifies, Intervenes and Strengthens the weak cognitive capacities that affect learning through a program of specific cognitive exercises. For over 30 years the Arrowsmith program has proven effective for students having difficulty with reading, writing and mathematics, comprehension, logical reasoning, problem solving, visual and auditort memory, nonverbal learning, attention, processing speed and dyslexia. The Auditory Oral School of New York Address: 3623 Avenue L Brooklyn, New York 11210 Phone: (718) 531-1800 Website: www.auditoryoral.org Location: Home, Center, Will send providers to private schools Ages: Birth to school age (EI – CSE) Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ADHD, Emotionally disturbed, Hearing impaired Services: SEIT, OT, PT, Speech/ Language, Special Ed, Counseling, Sensory Integration, Hearing Education Services (HES) Languages: English, Yiddish, Hebrew, Russian, Mandarin, Cantonese, ASL Addl. Info: Accept RSA’s & P3’s, For audiological evaluations pending acceptance of insurance, Handicap accessible, Private evaluations Blanche Kahn Diagnostic Center Address: 1121 East 14th Street Brooklyn, New York Phone: (718) 434-4600 E-mail: info@bkhealthcenter.com 86

December 2012

Website: http://www.hasccenter. org/center.php Services: Uniquely Designed to meet the Medical Needs of People with Disabilities, Internal Medicine, Podiatric Medicine, Physiatry, Neurology, Psychiatry, OT, PT, Speech Therapy, Women’s Health, Geriatric Medicine, Dermatology, Psychosocial Evaluations Languages: Yiddish, Hebrew, Russian Addl. Info: Accepts Medicaid and Medicare, Handicap accessible, Extended Hours Comprehensive Children’s Therapy Services Address: 99 Essex Street New York, New York 10002 Phone: (212) 566-8855 Website: www.comprehensivecenter.com Location: Home, Center, Will send providers to private schools Ages: 3-16 Services: OT, PT, Speech, Counseling Languages: Spanish, Yiddish Addl. Info: Accepts RSA’s Comprehensive Evaluation Services Address: 460 Grand Street New York, New York 10002 Phone: (212) 566-8853 Website: www.comprehensiveevaluations.com Location: Home, Center, School Ages: 3-5 Disciplines: Speech, OT, Physical, Developmental, Psychological, Social History Languages: Spanish EIS LAASOIS/WIECDC Address: 22 Middleton Street Brooklyn, New York 11206 Phone: (718) 303-9400 Website: www.EISLAASOIS.org Location: Home and Center Ages: 0-18 Population: Mild-severe developmental delays, Speech & Language impaired, Learning Disabled,

Emotionally disturbed, Visually impaired, Multiply Handicapped Services Provided: OT, PT, Speech, Floor time and Sensory Integration Languages: Yiddish Addl. Info: Accept RSA’s Euro-Peds National Center for Intensive Pediatric PT Address: 461 W. Huron Street #406 Pontiac, MI 48341 Phone: (248) 857-6776 Website: www.europeds.org Ages: 1-21 Location: Center Population: Mild-severe developmental delays, Multiply Handicapped Services Provided: PT, European-based Intensive PT for the treatment of non-progressive neuromuscular disorder. Addl. Info: Accepts most major health insurances Gutman Physical Therapy, P.C. Address: 860 Cranford Avenue Valley Stream, New York 11581 Phone: (646) 481-7854 Website: www.gutmanpt.com Languages: English, Hebrew and Yiddish Location: Home/Center Ages: 2-99 years Population: Mild-severe developmental delays, Autism/ PPD, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing impaired, Visually impaired, Multiply Handicapped Services Provided: PT, Sensory Integration, Will conduct private evaluations Addl. Info: Accepts RSAs and most Insurances, Handicapped accessible Hands on OT Rehabilitative Services, P.C. (Amy Guttman, OTR/L, Evelyn Guttman, OTR/L) Address: 1679-58th Street Brooklyn, NY 11204 Phone: (718) 621-3385 Website: www.handsonotrehab.com Ages: Birth-21 Location: Center

Population: Mild-severe developmental delays, Autism/PDD, ADD/ ADHD, Emotionally disturbed. Services Provided: OT, Sensory Integration, Neuro-developmental training and Neuro-technology programs, Home Programs, Family Education, Staff training, School Educational Training and consultations. Harmony Address: 1070 East 17th Street Brooklyn, New York 11230 & 1467 39th Street Brooklyn, New York 11218 Phone: (718) 986-7648 Location: Home, Center, Will send providers to private programs Ages: 18+ for therapy, 3+ for psychological and psychosocial evaluations Population: Mild-severe developmental delays, Autism/PDD, Multiply handicapped Services: OT, PT, Speech/Language, private evaluations, Counseling, ABA, Sensory Integration, Augmentative Communication Languages: Yiddish, Hebrew, Spanish, Russian Addl. Info: Accepts RSA’s and Insurance, Handicap Accessible, Full service Article 16 Clinic Providing on-site and homecare services. Hebrew Academy for Special Children Address: 1311 55th Street Phone: (718) 851-6100 Website: www.hasc.net Location: Home, Will send providers to private schools Ages: Birth – 5 Population: Mild-severe developmental delays, Autism/ PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Multiply handicapped Services: OT, PT, Speech & Language, Special Ed, Psychological, Audiological, MEDEK, ABA, Sensory Integration, Floor Time. Languages: Hebrew, Yiddish, Russian Addl. Info: Handicap Accessible


RESOURCES DIRECTORY THERAPY & EVALUATION SERVICES CONTINUED… HASC@Remsen Address: 555 Remsen Avenue Brooklyn, New York 11236 Phone: (718) 495-3510 Website: www.hasc.net Location: Center Ages: 3-5 Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, ADD/ ADHD, Emotionally disturbed, Multiply handicapped Services: OT, PT, Speech/Language, Special Ed, ABA, Sensory Integration Addl. Info: Handicap Accessible HASC Center, Inc Address: 1221 East 14th Street, Brooklyn, NY 11230 Administration Offices: 5601 First Avenue Brooklyn, New York 11220 Phone: (718) 434-4027 Website: www.hasccenter.org Location: Center Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ADHD, Emotionally disturbed, Multiply handicapped Services: OT, PT, Speech/Language, Special Education, Primary Medical Care, Neurology, Podiatry, Endocrinology, Psychiatry, Psychology Languages: Yiddish, Hebrew Addl. Info: Medicaid/Medicare, Handicap Accessible The Haven for Stuttering, PLLC Address: 17 Pennington Way Spring Valley, New York 10977 Phone: (845) 517-0965 Website: www.stutteringhaven.org Location: Center Ages: 3-adult Population: Mild to severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, Emotionally disturbed, Hearing impaired Services Offered: Speech Language, Evals, Counseling, Refresher Sessions Languages: Hebrew, Spanish HorseAbility / Center for Equine Facilitated Programs Address: SUNY College at Old Westbury / PO Box 410-1 / Old Westbury, New York 11568 Phone: (516) 333-6151 Website: www.horseability.org Location: Center Ages: 3+ Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing

Impaired, Visually Impaired, Multiply handicapped. Services Offered: Speech Language, Private Evaluations, OT/PT, Hippotherapy, Therapeutic Riding, Equine-Facilitated Psychotherapy. Languages: AMS Addl. Info: Therapists are independent contractors and payment is submitted directly for Hippotherapy (PT, OT, ST) and EFP (Equine Facilitated Psychotherapy). Services may be reimbursed depending on which insurance the therapist’s practice accepts, Handicap Accessible. Jumpstart Early Intervention Program Address: 3914 15th Avenue Brooklyn, New York 11218 Phone: (718) 853-9700 Location: Home, Will send providers to private schools Ages: 0-3 years Services: OT, PT, Speech/Language, Special Ed, Sensory Integration, MEDEK Population: Mild-severe developmental delay, Speech & Language impaired, ADD/ADHD, Hearing impaired, Visually impaired, Multiply handicapped Los Niños Services Address: 535 8th Ave., 2nd Floor New York, New York 10018 Phone: (212) 787-9700 Website: www.losninos.com Location: Home, Center, Will send providers to private schools Ages: 0-5 Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing impaired, Visually impaired, Multiply handicapped Services Provided: ABA, Private Evaluations Languages: Spanish, Russian, Ukrainian, Italian, Portuguese, French, and others

Otsar would like to thank its dedicated staff for all their hard work and devotion to our children and adults.

5 Hanover Square Suite 1201 New York, New York 10004

McCarton Center Address: 350 E. 82nd Street New York, New York 10028 Phone: (212) 996-9019 Website: www.mccartoncenter.com Location: Home, Center, Will send providers to private schools Ages: 2-13 Population: Mild-severe developmental delay, Autism/ PDD, Speech & Language impaired, ADD/ ADHD Services: ABA, OT, Speech/Language, private evaluations

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RESOURCES DIRECTORY THERAPY & EVALUATION SERVICES CONTINUED… National Jewish Council for Disabilities/Yachad (NJCD) Address: 11 Broadway, 13th Fl. New York, New York 10004 Phone: (212) 613-8229 Website: www.njcd.org Location: Center, Will send providers to Private Schools Ages: 5-21 Population: Speech & Language impaired, Learning Disabled, Hearing impaired Services Provided: Audiological, Will Conduct Private Evaluations Addl. Info: Accepts Insurance, Private Evaluations provided. Omni Childhood Center Address: 1651 Coney Island Avenue Brooklyn, New York 11210 Phone: (718) 998-1415 Website: www.omnirehab.com Location: Home, Center, Will send providers to private schools Ages: 0-21 Population: Mild-severe developmental delays, Autism/ PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing impaired, Multiply handicapped Services: OT, PT, Speech/Language, Special Ed, Private evaluations, ABA, MEDEK Languages: Yiddish, Spanish, Russian, Hebrew, Polish Addl. Info: Accepts RSA’s, P3s, and all Major Insurance, Handicap Accessible Pesach Tikvah-Hope Development Address: 18 Middleton Street Brooklyn, New York 11206 Phone: (718) 875-6900 Website: www.pesachtikvah.org Location: Center Based, Will send Providers to Private Schools Ages: 5+ Population: Autism/PDD, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Multiply handicapped Services: Psychiatric and pharmacological Languages: Hebrew, Yiddish, Spanish December 2012 88

Addl. Info: Handicap Accessible, Accepts insurance Shema Kolainu – Hear Our Voices Address: 4302 New Utrecht Ave. Brooklyn, New York 11219 Phone: (718) 686-9600 Website: www.shemakolainu.org Location: Home and Center Based, Will send Providers to Private Schools Ages: 0-5 Population: Mild-severe developmental delays, Autism/ PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing impaired, Visually impaired, Multiply handicapped Services: ABA, OT, PT, Speech/ Language, Special Ed Languages: Hebrew, Yiddish, Spanish Addl. Info: Handicap Accessible Social Learning Institute Address: 2127 59th Street Brooklyn, New York 11204 Phone: (718) 331-3601 Website: www.behavior4kids.com Languages: English and Yiddish Location: Home/Center Ages: 2-24 years Population: Mild-severe developmental delays, Autism/ PPD, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing impaired, Visually impaired, Multiply Handicapped Services Provided: ABA, Red and Green Social Skills System, Eclectic Behavioral Approach, Will conduct private evaluations Addl. Info: Accepts RSAs and most Insurances, Handicapped accessible Sweet Dream Therapy Farm, Delta Society Facility Address: Sweet Dream Therapy Farm, 826 Green Valley Road, Jackson, New Jersey 08527 on the border of Lakewood NJ Phone: (732) 806 - 7370 Website: sweetdreamtherapyfarm.webs.com Location: Home and Center Population Served: Mild-severe

developmental delays, Autism/ PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing impaired, Visually impaired, multiply handicapped. Ages: 1-Adult Services Provided: Animal Assisted Activities and Therapies. We use a wide diversity of gentle, trained animals, Sensory Integration, Emotional stabilization, Speech assistance and progression, physical developmental assistance, developmental learning assistance. Work with OTs, PTs, Speech, Drs, Schools. Languages: Hebrew, Yiddish and English Addl. Info: Handicap Accessible, does not accept insurance. Therapy in Motion Address: 856 - 46th Street Brooklyn, New York 11220 Phone: (718) 435-7000 Location: Center Services: MEDEK, PT Tikvah at OHEL Address: 2925A Kings Highway Brooklyn, New York 11210 Phone: (718) 382-0045 Website: www.ohelfamily.org Location: Center Ages: 3+ Population: Mild-severe developmental delays, Autism/PDD, learning Disabled, ADD/ADHD, emotional challenges Services: Family, Couple, & Individual counseling, Child & Adult counseling, Psychotherapy, Psychiatric Evaluation, Medication Treatment Addl. Info: Accepts Medicaid, Medicare & Many other ins. On a sliding scale, Handicap Accessible UCP of New York City Address: 80 Maiden Lane, 8th Floor, New York, NY 10038 Phone: (877) 827-2666 Website: www.ucpnyc.org Location: Center Ages: 3-21 Population: Mild-severe developmental delays, Speech & Language impaired, Learning Dis-

abled, Multiply handicapped Services: Floor Time, Sensory Integration, OT, PT, Speech/Language, Special Ed Watch Me Grow Location 1 Address: 162 West 72nd St., Suite 5, NY, NY 10023 Location 2 Address: 361 East 19th St., Suite 2, NY, NY 10003 Phone: (212) 721-5220 Website: www.WatchMeGrowNYC.com Location: Center, Will send providers to private schools Ages: 0-21 Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ADHD, Emotionally disturbed, Hearing Impaired, Visually Impaired Services Provided: OT, PT and Speech Therapy, Sensory Integration Addl. Info: Accept RSA’s, Private evaluations YAI Network Address: 460 West 34th Street New York, New York 10001 Phone: (212) 273-6182 Website: www.yai.org Location: Home & Center Ages: All Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ADHD, Multiply handicapped Services: OT, PT, Speech/Language, Special Ed, ABA, Floor Time, Sensory integration, All therapies for children and adults of all ages Languages: varies Additional Info: Private evaluations, Autism evaluations, Handicap Accessible Yeled V’Yalda Early Childhood Center Address: 1312 38th Street Brooklyn, New York 11218 Phone: (718) 686-3700 Website: www.yeled.org


RESOURCES DIRECTORY THERAPY & EVALUATION SERVICES CONTINUED… Location: Home, Center, Will send providers to private schools Ages: 0-21 years Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing impaired,

Visually impaired Services: ABA, Sensory Integration, Medek, OT, PT, Speech/Language, Special Ed, play therapy/counseling Languages: Yiddish, Hebrew, Spanish Add’l Info: Accepts RSA’s and P3s

CAMPS & END OF SUMMER PROGRAMS AHRC NYC Address: 83 Maiden Lane New York, New York 10038 Phone: (212) 780-2500 Website: www.ahrcnyc.org Location: Camp Anne - Ancramdale, NY and Harriman Lodge - East Jewett, NY Duration: 3 weeks Type: Sleep-Away camp Ages: Children 5-20 & adults 21+ Gender: Male & Female, mixed Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Emotionally Disturbed, Multiply handicapped Special services: Daily Living Skills Add’l Info: Handicap accessible, NY State approved, accept children not toilet trained Bonim Lamokom Address: 425 East 9th Street Brooklyn, New York 11218 Phone: (718) 693-9032 Website: BonimLamokom.com Location: Liberty, NY Duration: 8 weeks Population: Mild developmental delays Ages: 12-25 Gender: Boys Hours: 9–5 Add’l Info: Privately funded, Therapies provided on site, Kosher Food Provided Camp HASC Address: 5902 14th Avenue Brooklyn, New York 11219 Phone: (718) 686-5930 Website: www.hasc.net/camp Location: 361 Parksville Road Parksville, NY 12768 Duration: 7 weeks Type: Sleep-Away camp Ages: 3-Adulthood Gender: Male & Female Groups: Mixed Population: Mild to moderate to severe developmental delays, Autism/PDD, Speech & Language impaired, Learning disabled, ADD/ ADHD, Hearing Impaired

Addl. Info: Therapy provided, Kosher food provided, We also offer a day camp option for campers who wish to stay with their family in their summer home, Accept children not toilet trained, Camp after Camp program for oneweek after camp (All female staff for females 5-12). Therapy not provided on-site. Camp Kaylie @ OHEL Address: 4510 16th Avenue Brooklyn, New York 11204 Phone: (800) 603-OHEL Website: CampKaylie.org Location: Wurtsboro, New York Type: Fully integrated camp Ages: 10-16 Gender: Male and Female Groups: Separate Population: Typical kids with no disabilities and kids with developmental disabilities Programs offered: A groundbreaking camp offering an exhilarating camp experience of unmatched sports and activities, leadership programming, state of the art facilities, magnificent grounds and a camp for kids of all abilities where campers thrive in a diverse environment nurturing personal leadership, self-confidence and an inclusive spirit Camp Mishkon-Sternberg Address: 1358 56th Street Brooklyn, New York 11219 Phone: (718) 851-7100 Website: www.jbfcs.org Location: Narrowsburg Duration: 6 weeks Type: Sleep-Away camp Ages: 3+ Gender: Boys under 9, girls 3+ Groups: Separate Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, Hearing Impaired, Visually Impaired, Multiply Handicapped Add’l Info: Kosher food, handicap accessible, state approved, special ed and therapy provided, accept children not toilet trained

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RESOURCES DIRECTORY CAMPS & END OF SUMMER PROGRAMS CONTINUED‌ Chai Lifeline / Camp Simcha Special Address: 151 West 30th Street Third Floor, NY, New York 10001 Phone: 877-CHAILIFE Website: www.ChaiLifeline.org Location: Glen Spey, NY Type: Sleep-away Ages: 7-17 Duration: 2 weeks Gender: Male and Female Groups: Separate Population: Multiply Handicapped Addl. Info: Handicap Accessible, Kosher food provided, Physical therapy provided on-site, Accept children who are not toilet trained Note Camp Simcha Special accepts children with medical illnesses and disabilities resulting from illness whose cognitive functioning is at age level. All applications must be approved by the camp’s medical director. Ezra Hatzvy Academy Address: 2555 Nostrand Avenue Brooklyn, New York Phone: (718) 975-1041 Website: Ezrahatzvy.com Type: Day Camp Duration: 6 weeks Ages: 5-21 Gender: Boys/Girls Groups: Separate/Mixed Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning disabled, ADD/ ADHD, Hearing impaired, Emotionally disturbed, Vision impaired, Multiply handicapped Addl. Info: Handicapped accessible, Special Education and related services provided on sire, accept children not yet toilet trained. Hand in Hand Family Services Address: 390 Kings Highway Brooklyn, New York 11223 Phone: (718) 336-6073 Website: www.hihfs.org Location: Flatbush Type: Day camp Ages: 5+ Gender: Boys & Girls Population: Mild to moderate to severe developmental delays, Au90

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tism/PDD Addl. Info: Handicap Accessible, Kosher food provided, NY State Approved, Special Education and related services not provided on-site. Harmony Address: Kinor Dovid: 3820 14th Avenue Brooklyn, New York Kinor Malka: 1467 39th Street Brooklyn, New York 11218 Phone: (718) 435-8080 Website: www.harmonyservices.org Location: at Camp Manavu and at Camp Chedva Duration: 8 Weeks Type: Sleep-away camp Ages: 18+ Gender: Male and Female Groups: Separate Population: Mild-severe developmental delays, Autism/PDD, Speech and Language Impaired, Learning disabled, ADD/ADHD, Hearing impaired, Visually impaired Addl. Info: Kosher food provided HASC Woodmere Address: 321 Woodmere Boulevard Woodmere, New York 11598 Phone: (516) 295-1340 Website: www.hasc.net Location: Woodmere, New York Duration: 6 Weeks Type: Extended School Year Ages: 3-10 Gender: Male & Female Groups: Mixed Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning disabled, ADD/ ADHD, Emotionally disturbed, Multiply handicapped Addl. Info: Special education and related services (therapy) provided on site, Kosher food provided, NY State Approved, Accept children not toilet trained Camp HorseAbililty Address: SUNY College at Old Westbury / Old Westbury, NY 11568 Phone: (516) 333-6151 Website: www.horseability.org

Duration: 1 week Type: Day camp Gender: Male/Female Groups: Mixed *Separate programs may be offered if there is sufficient demand. Population Served: Mild-severe developmental delays, Autism/ PDD, Speech & Language impaired, Learning disabled, ADD/ ADHD, Emotionally disturbed, Multiply handicapped Addl. Info: Handicap Accessible, accepts children who are not toilet trained. JCC of the Greater Five Towns Address: 207 Grove Avenue Cedarhurst, New York 11516 Phone: (516) 569-6733 Website: www.fivetownsjcc.org Location: JCC / North Woodmere Park Duration: 6 Weeks Type: Day Camp Hours: 12:00-4:30 Ages: 5-16 Groups: Mixed JCC Therapeutic Nursery Address: 411 East Clinton Avenue Tenafly, NJ 07670 Phone: (201) 408-1448 Ages: 3-6 Gender: Male/Female Group: Mixed Duration: 6 weeks Type: Day Camp Population Served: Mild developmental delays, Autism/PDD, Speech and Language Impaired, Learning Disabled, ADD/ADHD, Emotionally Disturbed Addl. Info: Handicap Accessible, accepts children who are not toilet trained, kosher food not provided, not NY state approved, Special Education and Related services provided on site. Kaplan JCC on the Palisades Neil Klatskin Day Camp/Camp Tikvah Address: 411 East Clinton Avenue Tenafly, NJ 07670 Phone: (201) 408-1448/

201-567-8963 Website: www.JCCOTP.org/ NKDC Kaplan JCC on the Palisades Camp Haverim Address: 411 East Clinton Avenue Tenafly, NJ 07670 Phone: (201) 408-1448 Ages: 3-21 Gender: Males & Females Groups: Mixed Population Served: Mild to Severe developmental delays, Autism/PDD and Learning disabled. Addl. Info: Kosher Food, Handicap Accessible, NJ DDD Qualified Provider Kaplan JCC on the Palisades On Our Own Address: 411 East Clinton Avenue Tenafly, NJ 07670 Phone: (201) 408-1448 Ages: 16-30 Duration: 6 weeks Gender: Males & Females Groups: Mixed Population Served: Mild to Severe developmental delays, Autism/PDD and Learning disabled. Addl. Info: Kosher Food, Handicap Accessible, NJ DDD Qualified Provider, Special Education and related services not provided on site. Kids of Courage Address: 13158 Broadway, Suite 207 Hewlett, New York 11557 Phone: (888) 9-KIDSOC Website: www.kidsoc.org Location: Traveling Ages: 5-Young Adult Population Served: Multiply Handicapped, Serious Illness & Disability Addl. Info: Kosher Food, Handicap Accessible Kulanu Torah Academy Address: 620 Central Ave. Cedarhurst, New York 11516 Phone: (516) 569-3083 Duration: 8 Weeks Type: Day camp Ages: 3-21 Gender: Boys & Girls


RESOURCES DIRECTORY CAMPS & END OF SUMMER PROGRAMS CONTINUED… Groups: Mixed Population: Mild to moderate to severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD Addl. Info: Handicap Accessible, Kosher food provided, NY State Approved, Accept children not toilet trained

Website: www.otsar.org Location: Otsar Center in Bklyn Duration: 2 weeks Type: Day camp Ages: 5-15 Gender: Male & Female Groups: Mixed Population: Mild-severe developmental delays, Autism/PDD

National Jewish Council for Disabilities/ Yachad (NJCD) Address: 11 Broadway, 13th Floor New York, New York 10004 Phone: (212) 613-8229 Website: www.njcd.org Location: PA, NY, Israel Duration: 6 weeks Type: Sleep away camp Ages: 9+ Gender: Male, Female Groups: Separate and Mixed Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Hearing impaired Addl. Info: Handicap Accessible, Kosher food provided, Accept children not toilet trained. Special education and therapy can be arranged in certain locations

Pesach TikvahHope Development Address: 18 Middleton Street Brooklyn, New York 11206 Phone: (718) 875-6900 Website: www.pesachtikvah.org Duration: 2 weeks Type: Day Camp Ages: 5-21 Gender: Male and Female Groups: Mixed Population: Mild developmental delays, Autism/PDD, Learning Disabled, ADD/ ADHD, Multiply handicapped Addl. Info: Handicap Accessible, Kosher food provided, NY State Approved

OHEL Children’s Home & Family Services, Bais Ezra Address: 4510 16th Avenue Brooklyn, New York 11204 Phone: (800) 603-OHEL Website: www.ohelfamily.org Location: Bklyn, Queens, Long Island Duration: 2 weeks Type: Sleep away & Day Camp Ages: 5-21 Gender: Male, Female Groups: Separate & Mixed Population: Mild developmental delays, Autism/PDD, Speech & Language impaired, Multiply handicapped Services: Family, Couple, & Individual counseling, Child & Adult counseling, Psychotherapy, Psychiatric Evaluation, Medication Treatment Addl. Info: Kosher food provided, Handicap Accessible, NY State Approved, Accept children not toilet trained Otsar Family Services Address: 2334 West 13th Street Brooklyn, New York 11223 Phone: (718) 946-7301

Camp Ruach Hachaim Address: 266 Penn Street Brooklyn, New York 11211 Phone: (718) 963-0090 Website: www.campruachhachaim.org Location: Bloomingburg, NY Duration: 8 weeks Type: Sleep-Away camp Ages: 7-30 Gender: Male Population: Mild to moderate to severe developmental delays, Autism/PDD, Down Syndrome, Speech & Language impaired, Learning disabled, ADD/ADHD, Hearing Impaired Addl. Info: Kosher food provided, take children from all over the world Sesame Sprout, Inc. Address: 96-08 57th Avenue Corona, New York 11368 Phone: (718) 271-2294 Website: www.sesamesproutschool.com Duration: Six weeks Type: Day camp Ages: 2-12 Gender: Male & Female Classes: Mixed Population: Mild developmental delays Addl. Info: Therapies provided on-site, Handicap accessible, NY State approved, Accept children not toilet trained

TAFKID

assists families whose children have been diagnosed with a variety of disabilities and special needs.

Services provided by TAFKID include:

D Family Support Services & Information D Educational Advocacy D Individual Case Consultation D Referrals to Doctors, Therapists, Schools and Government Programs

D Parent Matching D Family Recreation Programs D Parent Training and Meetings D Guest Lecturers D Community Sensitivity and Training D Informational Publications D Pediatric Equipment Lending Program D Tape/Video Lending

is a not-for-profit organization services are free of charge to all families. For more information call TAFKID at (718) 252-2236 or e-mail: tafkid@aol.com

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RESOURCES DIRECTORY CAMPS & END OF SUMMER PROGRAMS CONTINUED… The Special Children’s Center Address: 1400 Prospect Street Lakewood, New Jersey Phone: (732) 367-0099 Duration: Four weeks Type: Day camp Ages: 0-22 Gender: Male & Female Classes: Mixed Population: Mild to Moderate to severe developmental delays, Autism/PDD, Speech & Language impaired, Learning disabled, ADD/ ADHD, Emotionally Disturbed, Hearing impaired, Visually impaired, Multiply handicapped Addl. Info: Handicap accessible, Kosher food provided, Accept children not toilet trained STEP (Special Torah Education Program) Address: 3005 Avenue L Brooklyn, New York 11210 Phone: (718) 252-8822 Duration: 7 weeks Type: Day Ages: 5-21 Gender: Boys and Girls Classes: Separate Population: Mild to moderate to se-

vere developmental delays, Autism/ PDD, ADD/ ADHD, Multiply handicapped, Emotionally disturbed, Speech & Language impaired Addl. Info: Handicap Accessible, Kosher meals, Accept children not toilet trained UCP of New York City Address: 80 Maiden Lane, 8th Floor, NY, New York 10038 Phone: (877) 827-2666 Website: www.ucpnyc.org Location: 175 Lawrence Avenue Brooklyn, New York 11230 Duration: 3 weeks Type: Day camp Ages: 13-21 Gender: Male and Female Groups: Mixed Population: Mild-severe developmental delays, Autism/PDD, Multiply handicapped Addl. Info: Handicap Accessible, OMRDD-funded, Accept children not toilet trained YAI Network Address: 460 West 34th Street New York, New York 10001

Phone: (212) 273-6182 Website: www.yai.org Type: Day camp & Sleep-away camp Location: Sleep away camp in Claryville, NY in the Catskills; day camp in Rockland County Duration: Sleep away camp 2-4 weeks, day camp 4-6 weeks Ages: Sleep-away camp: 8-18; day camp: 8-14 Gender: Male & Female Groups: Separate sleeping quarters, mixed activities Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ADHD, Multiply handicapped Addl. Info: Handicap accessible, Kosher food provided at sleep away camp Yedei Chesed Address: 48 Scotland Hill Road, Chestnut Ridge, NY 10977 Phone: (845) 425-0887 Website: yedeichesed.org Location: Monsey, New York Duration: 2 separate weeks

Type: Day camp Ages: 3 & above Gender: Male & Female Population: Mild-severe developmental delays, Autism/ PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing impaired, Visually impaired, Multiply handicapped Addl. Info: Handicap Accessible, Kosher food provided, NY State Approved, Accept children not toilet trained Yeshiva Binyan Olem Address: 68 Franklin Avenue Brooklyn, New York Phone: (718) 302-5222 Population: Mild to severe developmental delays, Autism/PDD, Speech & Language impaired, ADD/ADHD, Learning Disabled. Camp Location: Monticello Ages: 12-18 Gender: Boys Type: Sleepaway camp Duration: 8 weeks Addl. Info: Therapies provided on site, Kosher meals.

DAY HABILITATION PROGRAMS Ahivim Address: 6 Mountain Rd #204 Monroe, New York 10950 Phone: (845) 774-7000 Email: info@ahivim.org Website: www.ahivim.org Gender: Male and Female Groups: Separate Hours: 9-3 Population: Mild to moderate to severe developmental delays Addl. Info: Day Hab Without Walls AHRC NYC Address: 83 Maiden Lane New York, New York 10038 Phone: (212) 780-2500 Website: www.ahrcnyc.org Location: Center Ages: 18+ Gender: Male & Female Groups: Mixed Hours: 9-5 Population: Mild-severe developmental delays Addl. Info: Handicap accessible, December 2012 92

Transportation provided, Vocational Services provided, DayHab Without Walls Hand in Hand Family Services Address: 390 Kings Highway Brooklyn, New York 11223 Phone: (718)336-6073 Website: www.hihfs.org Location: Center Ages: 18+ Gender: Male & Female Groups: Separate Program Hours: 9-5PM Population: Mild to moderate to severe developmental delays Add’l Info: Handicap Accessible, Kosher food provided, Transportation Provided, Day Hab without walls, Vocational Services offered. HASC Center, Inc Address: 1221 East 14th Street Brooklyn, NY 11230 Phone: (718) 434-4027 Website: www.hasccenter.org

Gender: Men’s Yeshiva and Young Women’s Programs Groups: Separate & Mixed Hours: 9:00 – 3:00, Extended hours until 7PM. Locations: Boro Park, Flatbush, Williamsburg. Language: Yiddish, Hebrew Population: Mild-severe developmental delays Addl. Info: Vocational services offered, Handicap Accessible, Kosher food provided, Transportation provided, Center Based, Work Readiness and Supportive Employment Offered. Human Care Services Address: 1042 38th Street Brooklyn, New York 11229 Phone: (718) 854-2747 Website: www.humancareservices.org Ages: 18+ Gender: Male & Female Groups: Separate

Hours: 9:00 – 5:00 Population: Mild-severe developmental delays Addl. Info: Yeshiva and Seminary day program, Yeshivas Lev Tahor and Machon Lev Seminary. Pre-Vocational services offered, Handicap Accessible, Kosher food provided, Transportation provided from Brooklyn, Queens, Long Island, Staten Island, Manhattan, and the Bronx, Center Based Kaplan JCC on the Palisades Adult Day Program Address: 411 East Clinton Avenue Tenafly, NJ 07670 Phone: (201) 408-1448 Ages: 21+ Gender: Males & Females Hours: 9:15-2:15PM Groups: Mixed Group Size: 14 Population Served: Moderate to Severe developmental delays Addl. Info: Kosher Food, Handicap Accessible


RESOURCES DIRECTORY DAY HABILITATION PROGRAMS CONTINUED… Kinor Dovid - Harmony Address: 3820 14th Avenue Brooklyn, New York Phone: (718) 435-8080 Website: www.harmonyservices.org Population: Mild to Moderate developmental delays Ages: 18+ Gender: Male Groups: Small groups, separate for men & women Hours: Mon-Thrs: 9-3, 3-7:30; Sun. & Fri: 9-1:30 Languages: Yiddish, Hebrew Addl. Info: On-site therapies, Center based, DayHab without walls, Vocational Services, Handicap Accessible, Kosher food provided, Transportation provided Optional Beis Medresh Program. Kinor Malka - Harmony Address: 1467 39th Street Brooklyn, New York 11218 Phone: (718) 435-8080 Website: www.harmonyservices.org Population: Mild to Moderate developmental delays Ages: 18+ Gender: Female Groups: Small groups, separate for men & women Hours: Mon-Thrs: 9-3, 3-7:30; Sun. & Fri: 9-1:30 Languages: Yiddish, Hebrew Optional Seminary Program. National Jewish Council for Disabilities/Yachad (NJCD) Address: 11 Broadway, 13th Fl., New York, New York 10004 Phone: (212) 613-8229 Website: www.njcd.org Ages: 21+ Gender: Male & Female Groups: Mixed Group Size: 30 Hours: 8:30-3:30

Population: Mild to moderate developmental delays Addl. Info: Handicap Accessible, Vocational Services,Transportation provided, Kosher Food Provided, DayHab Without Walls, Supplemental Day Hab also available. OHEL Children’s Home & Family Services, Bais Ezra Address: 4510 16th Avenue Brooklyn, New York 11204 Phone: (800) 603-OHEL Website: www.ohelfamily.org Ages: 21+ Gender: Male & Female Groups: Separate & Mixed Size: 3-5 Hours: 8am-4pm Population: Mild-severe developmental delays. Special programming for adults & seniors Addl. Info: Center Based, Handicap Accessible, Transportation Provided, Vocational services offered, Kosher food provided, Employment training and placement services. Otsar Family Services Address: 2334 West 13th Street Brooklyn, New York 11223 Phone: (718) 946-7301 Website: www.otsar.org Ages: 21+ Gender: Male & Female Groups: Mixed Hours: 8:45-2:30 Population: Mild-severe developmental delays Addl. Info: Handicap Accessible, Kosher food provided, Transportation provided, Vocational services not provided Sinai Schools (Netivot) Address: 1485 Teaneck Road, Suite 300,

Teaneck, NJ 07666 Phone: (201) 833-1134 Website: www.sinaischools.org Population: Mild-moderate developmental delays Ages: 18-40 Gender: Boys & Girls Classes: Mixed Hours: 10-4PM Addl. Info: Day Hab without walls, vocational services offered. The Special Children’s Center Address: 1400 Prospect Street Lakewood, New Jersey Phone: (732) 367-0099 Ages: 18+ Gender: Male & Female Groups: Separate Group Size: 5+ Hours: 9:00-3:00 Population: Mild to Moderate to severe developmental delays, Autism/PDD, Speech & Language impaired, Learning disabled, ADD/ ADHD, Emotionally Disturbed, Hearing impaired, Visually impaired, Multiply handicapped Addl. Info: Center based, Vocational Services, Handicap accessible, Kosher food provided, Transportation provided UCP of New York City Address: 80 Maiden Lane, 8th Flr. NY, New York 10038 Phone: (877) 827-2666 Website: www.ucpnyc.org Ages: 21+ Gender: Male & Female YAI Network Address: 460 West 34th Street New York, New York 10001 Phone: (212) 273-6182 Website: www.yai.org Ages: 21+ Gender: Male & Female Groups: Mixed Hours: 9-3

Population: Mild-severe developmental delays Addl. Info: Center-based, DayHab Without Walls, Handicap Accessible, Transportation Provided, Vocational services offered Women’s League Community Residences – CBR, Creative Business Resources Address: 1556 38th Street Brooklyn, New York 11218 Phone: (718) 853-0900 Website: www.womensleague.org Population: Individuals with Learning and/or Developmental Disabilities Addl. Info: Vocational services, Job placement, Job coaching, & training Yedei Chesed Address: 48 Scotland Hill Road Chestnut Ridge, NY 10977 Phone: (845) 425-0887 Website: yedeichesed.org Ages: Post high school Gender: Male & Female Groups: Separate Group Size: 16 Hours: 9 – 3 Population: Moderate to severe developmental delays Addl. Info: Vocational services offered, Center Based, Handicap Accessible, Kosher food provided, Transportation provided Yeshiva Bonim Lamokom Address: 425 East 9th Street Brooklyn, New York 11219 Phone: (718) 693-9032 Website: www.bonimlamokom.com Ages: 19-26 Gender: Male Population: Mild to moderate developmental delays Addl. Info: Vocational Services offered

RESIDENTIAL OPPORTUNITIES Hand in Hand Family Services Address: 390 Kings Highway Brooklyn, New York 11223 Phone: (718)336-6073 Website: www.hihfs.org Population: Mild to moderate to severe developmental delays, Autism/PDD, Emotionally Disturbed

Addl. Info: IRA’s and Supportive Apartments Harmony Address: 1070 East 17th Street Brooklyn, New York 11230 & 1467 39th Street Brooklyn, New York 11218 Phone: (718) 986-7648

Ages: 21+ Gender: Male & Female Population: Mild developmental delays Addl. Info: Supportive Apartments HASC Center, Inc Address: 5601 First Avenue Brooklyn, New York 11220

Phone: (718) 535-1953 Website: www.hasccenter.org Gender: Male & Female Population: Mild-severe developmental delays, Autism/PDD, emotionally disturbed, Hearing impaired, Multiply handicapped Addl. Info: IRA’s, Supportive Apartments December 2012 93


RESOURCES DIRECTORY RESIDENTIAL OPPORTUNITIES CONTINUED… Human Care Services Address: 1042 38th Street Brooklyn, New York 11229 Phone: (718) 854-2747 Website: www.humancareservices.org Ages: All Gender: Male & Female Hours: 9:00 – 5:00 Population: Mild-severe developmental delays, Autism/PDD, Hearing Impaired, Visually Impaired, Multiply Handicapped Addl. Info: IRA’s, Supportive Apartments Jewish Board of Family and Children’s Services/Mishkon Address: 1358 56th Street Brooklyn, New York 11219 Phone: (718) 851-7100 Website: www.jbfcs.org Ages: All Gender: Male, Female Population: Mild-severe developmental delays, Autism/PDD Specialization: Emotionally disturbed, Hearing Impaired, Visually Impaired, Multiply Handicapped Addl. Info: IRA’s, ICF OHEL Children’s Home & Family Services, Bais Ezra Address: 4510 16th Avenue Brooklyn, New York 11204 Phone: (800) 603-OHEL

Website: www.ohelfamily.org Ages: 13+ Gender: Male & Female Groups: Separate & Mixed Size: 3-5 Hours: 8am-4pm Population: Mild-severe developmental delays, Autism/PDD Specialization: Emotionally disturbed, Hearing impaired, Visually impaired, Multiply handicapped Addl. Info: IRA’s, Supportive Apts. Pesach TikvahHope Development Address: 18 Middleton Street Brooklyn, New York 11206 Phone: (718) 875-6900 Website: www.pesachtikvah.org Ages: 21+ Gender: Male & Female Population: Mild to Moderate to Severe developmental delays, Autism/PDD, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Multiply handicapped Addl. Info: Supportive Apartments Sinai Schools Address: 1485 Teaneck Road, Suite 300, Teaneck, NJ 07666 Phone: (201) 833-1134 Website: www.sinaischools.org Ages: 18+ Gender: Male Population: Mild developmental delays

The Special Children’s Center Address: 1400 Prospect Street Lakewood, New Jersey Phone: (732) 367-0099 Ages: Any Age Population: Mild to Moderate to severe developmental delays, Autism/PDD, Speech & Language impaired, Learning disabled, ADD/ ADHD, Emotionally Disturbed, Hearing impaired, Visually impaired, Multiply handicapped UCP of New York City Address: 80 Maiden Lane, 8th Flr, New York, New York 10038 Phone: (877) 827-2666 Website: www.ucpnyc.org Ages: infants-adults Gender: Male & Female Population: Mild-severe developmental delays, Autism/PDD Specialization: Hearing impaired, Visually impaired, Multiply handicapped Add’l Info: IRA’s, Supportive Apts. Women’s League Community Residences, Inc. Address: 1556 38th Street Brooklyn, New York 11218 Phone: (718) 853-0900 Ages: All ages Gender: Male & Female

Population: Mild-severe developmental delays, Autism/PDD Specialization: Emotionally disturbed, Hearing impaired, Visually impaired, Multiply handicapped Addl. Info: ICF’s and Supervised IRA’s, Supportive Apartments YAI Network Address: 460 West 34th Street New York, New York 10001 Phone: (212) 273-6182 Website: www.yai.org Ages: 21+ Gender: Male & Female Population: Mild-severe developmental delays, Autism/PDD, Multiply Handicapped Addl. Info: IRA’s, Supportive Apartments Yedei Chesed Address: 48 Scotland Hill Road, Chestnut Ridge, NY 10977 Phone: (845) 425-0887 Website: yedeichesed.org Ages: post high school Gender: Male & Female Population: Moderate to severe developmental delays Specialization: Emotionally disturbed, Hearing impaired, Visually impaired, Multiply handicapped Addl. Info: IRA’s, Supportive Apartments

MEDICAID WAIVER, RESPITE & OTHER PROGRAMS The Ability Center Address: 3521 Avenue S Brooklyn, New York Phone: (718) 336-3832 Website: Theabilitycenter.net Services: Children and Parent Groups to address the needs of families. Ahivim Address: 6 Mountain Rd #204 Monroe, New York 10950 Phone: 845-774-7000 Email: info@ahivim.org Website: www.ahivim.org Services Provided: Medicaid Waiver, Parent Support Groups, Sibling Support Groups, Respite, Overnight Respite. Chai Lifeline, Inc. Address: 151 West 30th St., Third Floor, New York, NY 10001 December 2012 94

Phone: (877) CHAI LIFE Website: www.chailifeline.org Services Provided: Offers emotional and social support groups for children with life threatening or chronic medical illnesses and their families.

Friendship Circle of the Upper East Side Address: 419 East 77th Street New York, New York 10021 Phone: (212) 717-4613 Website: www.fcues.com

The Friendship Circle of the Five Towns Address: 74 Maple Avenue Cedarhurst, New York 11516 Phone: (516) 295-2478 ext. 13 Website: http://www.fc5towns.com

Friendship Circle of Crown Heights, New York Address: 792 Eastern Parkway Brooklyn, New York 11213 Phone: (718) 907-8835 Website: www.fcbrooklyn.com

Friendship Circle of Lower Manhattan, New York Address: 121 W19th Street New York, New York 10011 Phone: (646) 688-5300 Website: www.friendshipnyc.com

The Friendship Circle of Suffolk County, New York Address: 318 Veterans Highway Commack, New York 11725 Phone: (631) 543-1855 Website: www.thefriendshipcircle.com

Friendship Circle of the Upper West Side, NY Address: 166 West 97th Street New York, New York 10025 Phone: (646) 789-5770 Website: www.ChabadWestSide.org/FCWS

Friendship Circle of Queens, New York Address: 211-05 Union Turnpike Queens, New York 11364 Phone: (718) 464-0778

The Friendship Circle of Dix Hills, New York Address: 501 Vanderbilt Parkway Dix Hills, New York 11746 Phone: (631) 351-8672


RESOURCES DIRECTORY MEDICAID WAIVER, RESPITE & OTHER PROGRAMS CONTINUED… Friendship Circle of Great Neck, NY Address: 400 East Shore Road Great Neck, New York 11024 Phone: (516) 487-4554

Friendship Circle of Union County, New Jersey Address: 193 South Avenue Fanwood, New Jersey 07023 Phone: (908) 898-0242

Programs Offered: Friends @ Home, Sunday Circle, Parents Webinar, Holiday Programs, Clubs, Sports Nights, Mom’s Night Out, etc…….

The Merrin-Bienenfeld Friendship Circle, Lake Grove, NY Address: 821 Hawkins Avenue Lake Grove, New York 11755 Phone: (631) 585-0521 ext.103 Website: www.fcstonybrook.com

The Ari Kraut Friendship Circle of Central Jersey Address: 26 Wickatunk Road Manalapan, New Jersey 07726 Phone: (732) 536-2319 Website: www.friendsnj.com

Friendship Circle of Roslyn, New York Address: 75 Powerhouse Road Roslyn, New York 11577 Phone: (516) 484-3500

The Friendship Circle of Bergen County, New Jersey Address: 310 South Drive Paramus, New Jersey 07652 Phone: (201) 262-7172 Website: www.BCFriendship.com

HaMercaz at Jewish Family Service of Los Angeles Address: 12821 Victory Blvd. North Hollywood, CA 91606 Phone: (866) 287-8030 Website: www.hamercaz.org Programs and Services Offered: Family Support Services for parents and siblings, Respite when available, Sunday Program for birth to 19, mixed program for Males/Females, Handicap Accessible, Kosher food provided, will accept children not toilet trained, Monthly Recreation program from Birth to 18, Program is open to families, Fee dependent on event. Population served: Mild to Moderate to severe developmental delays, Autism/PDD, Speech & Language impaired, Learning disabled, ADD/ ADHD, Emotionally Disturbed, Hearing impaired, Visually impaired, Multiply handicapped.

Friendship Circle West Hempstead, New York Address: 223 Windsor Lane West Hempstead, NY 11552 Phone: (516) 564-1012 Friendship Circle of the River Towns, New York Address: 303 Broadway Dobbs Ferry, New York 10522 Phone: (914) 693-6100 Website: www.chabadrt.org The Friendship Circle of Westchester County, New York Address: 20 Greenridge Avenue White Plains, New York 10605 Phone: (914) 437-5762 Friendship Circle of Bedford, New York Address: 16 Old Village Lane Katonah, New York 10536 Phone: (914) 666-6065 Friendship Circle of Rockland County/Monsey, NY Address: 123 Route 59 Suffern, New York 10901 Phone: (845) 368-1889 The Friendship Circle of Metrowest, New Jersey Address: 66 W. Mt. Pleasant Ave. #205 Livingston, New Jersey 07039 Phone: (973) 251-0200 Website: www.fcnj.com

Friendship Circle of Greater Mercer County, NJ Address: 103B Kingston Terrace Drive Princeton, New Jersey 08540 Phone: (609) 683-7240 Website: www.mercerfriends.com The Goodness Group of Wayne, NJ (Passaic County) Address: 194 Ratzer Road Wayne, New Jersey 07470 Phone: (973) 694-6274 The Friendship Circle of Fairfield County, Connecticut Address: 770 High Ridge Rd, Stamford, Connecticut 06905 Phone: (203) 329-0015 #414 Website: www.friendshipCT.com Friendship Circle of Hartford, Connecticut Address: 2352 Albany Avenue West Hartford, Connecticut 06117 Phone: (860) 232-1116 Website: www.friendshipcircleCT.com For all other Friendship Circles: Friendship Circle International Address: 816 Eastern Parkway Brooklyn, New York 11213 Website: www.friendshipcircle.com To Find A Friendship Circle Near You: http://www.friendshipcircle.com/ friendship_circle_locations.asp

Hand in Hand Family Services Address: 390 Kings Highway Brooklyn, New York 11223 Phone: (718) 336-6073 Website: www.hihfs.org Programs Offered: Medicaid Service Coordination, Community Habilitation, Respite, Sunday Program for ages 5-15, separate program for Males/Females, Afterschool Program 5 days a week for ages 5-15, separate program for Males/Females Population: Mild to moderate to severe developmental delays, Autism/PDD Addl. Info: Handicap Accessible, Kosher food provided, Transportation Provided, No Fee Harmony - Kinor Dovid/ Kinor Malka Address: Kinor Dovid: 3820 14th Ave. Brooklyn, New York Kinor Malka: 1467 39th Street Brooklyn, New York 11218

Phone: (718) 435-8080 Website: www.harmonyservices.org Programs Offered: Medicaid Waiver, Sunday Program, After School Program, Respite, Family Support Services HASC Center, Inc Address: 1221 East 14th Street Brooklyn, New York 11230 Phone: (718) 434-4027 Website: www.hasccenter.org Gender: Male & Female Programs and Services Offered: Medicaid Waiver, Respite, Overnight respite, Holiday Respite, After School Program, Sunday Autism Program, Family support services for parents and siblings HASC School Age Program Address: 6220 14th Avenue Brooklyn, New York 11230 Phone: (718) 331-1624 Website: www.hasc.net/camp Programs Offered: No-fee after school program 4 days a week for male & female ages 5-21, mixed groups, handicap accessible, transportation provided, Kosher food provided, take children not toilet trained HorseAbility / Center for Equine Facilitated Programs Address: SUNY College at Old Westbury / PO Box 410-1 / Old Westbury, NY 11568 Phone: (516) 333-6151 Website: www.horseability.org Programs Offered: Medicaid Waiver, Family Support Services for siblings, Respite, Sunday Program, 5-day a week After school Program and 7-day a week Recreation Program serving all ages. Gender: Male/Female Groups: Mixed *Separate programs may be offered if there is sufficient demand. Addl. Info: Handicap accessible, Accepts children not yet toilet trained.

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RESOURCES DIRECTORY MEDICAID WAIVER, RESPITE & OTHER PROGRAMS CONTINUED… Human Care Services Address: 1042 38th Street Brooklyn, New York 11229 Phone: (718) 854-2747 Website: www.humancareservices.org Programs and Services Offered: Community Habilitation, Medicaid Service Coordination, Family Reimbursement Program, Behavior Management Program, Respite, Separate Sunday Program for Males/Females Ages 3-20 for Mild to moderate to severe developmental delays, Autism/PDD, Hearing Impaired, Multiply Handicapped, handicap accessible, transportation provided, Kosher food provided, No fee. Imagine Academy Address: 1458 East 14th Street Brooklyn, New York 11230 Phone: (718) 376-8882 Website: www.imagineacademy.com Programs Offered: Family Support Services for Parents & Siblings, Respite, No-Fee Sunday Program for Ages 5-21, No-Fee After School Program 3 days a week for ages 5-21, Handicapped Accessible, Transportation provided, take children not toilet trained JCC of the Greater Five Towns Address: 207 Grove Avenue Cedarhurst, New York 11516 Phone: (516) 569-6733 Website: www.fivetownsjcc.org Programs Offered: Provides many different programs for people with special needs (children – adults), including a Snoezelen Room, after-school and Sunday programs. Jewish Board of Family and Children’s Services/Mishkon Address: 1358 56th Street Brooklyn, New York 11219 Phone: (718) 851-7100 Website: www.jbfcs.org Programs Offered: Medicaid Waiver, Family Support Services, Respite, Res-Hab 96

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Kids of Courage Address: 13158 Broadway, Suite 207 Hewlett, New York 11557 Phone: (888) 9-KIDSOC Website: www.kidsoc.org Programs Offered: Family Support services to parents and siblings, Respite, Overnight respite Kaplan JCC on the Palisades Address: 411 East Clinton Avenue Tenafly, NJ 07670 Phone: (201) 408-1448 Ages: 3-21 Programs Offered: After School Program three days a week (Sunday, Tuesday and Thursday) Gender: Males & Females Groups: Mixed Population Served: Mild to Severe developmental delays, Autism/PDD Addl. Info: Kosher Food, Handicap Accessible, NJ DDD Qualified Provider, Special Education and related services not provided on site. Kulanu Torah Acadamy Address: 620 Central Avenue Cedarhurst, New York 11516 Phone: (516) 569-3083 Programs Offered: Respite, Sunday program, Family support, Recreation, services for parents and siblings

Programs Offered: Medicaid Waiver, Respite, Overnight respite, Sunday Program: males and females ages 8+, mixed groups, Handicap accessible, Transportation provided, Kosher food provided, Take children not toilet trained, There is a fee for the program. Population: Mild to moderate to severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Multiply Handicapped Recreation: Males and Females ages 3+, mixed groups, Transportation provided at times, Kosher food provided, fee for program, open to families as well as special needs children, Program is once a month in Brooklyn, NY, NJ. OHEL Children’s Home & Family Services, Bais Ezra Address: 4510 16th Avenue Brooklyn, New York 11204 Phone: (800) 603-OHEL Website: www.ohelfamily.org Programs Offered: Medicaid Waiver, Respite, Overnight respite, After School Program, Sunday Program, Family support services for parents & siblings, Recreation

Los Niños Services Address: 535 8th Ave, 2nd Floor, New York, New York 10018 Phone: (212) 787-9700 Website: www.losninos.com Programs Offered: Provide Service Coordination in NYC and Westchester County, NY & trainings. We present the Annual Young Child Expo & Conference with Fordham University’s Graduate School of Education. We offer other trainings.

Otsar Family Services Address: 2334 West 13th Street Brooklyn, New York 11223 Phone: (718) 946-7301 Website: www.otsar.org Programs Offered: Medicaid Waiver, Parent Support Groups, Respite, Overnight Respite, Parent Information Workshops Sunday Program: For male & female ages 5-21, Mixed groups, Handicap accessible, Transportation provided, Kosher food provided, Take children not toilet trained

National Jewish Council for Disabilities/Yachad (NJCD) Address: 11 Broadway, 13th Floor New York, New York 10004 Phone: (212) 613-8229 Website: www.njcd.org

Pesach Tikvah-Hope Development Address: 18 Middleton Street Brooklyn, New York 11206 Phone: (718) 875-6900 Website: www.pesachtikvah.org

Programs Offered: Medicaid Waiver, Camp Reimbursements, Respite, Overnight Respite, Holocaust Survivor Program/Geriatric Programs. Sunday Program: for male & female ages 5-21, Mixed groups, Handicap accessible, Transportation provided, Kosher food provided, there is a fee for the program. Population: Mild to moderate to severe developmental delays, Autism/PDD, Multiply Handicapped After School Program: for male & female ages 5-21, Mixed groups, 4 days a week, Handicap accessible, Transportation provided, Kosher food provided Population: Mild to moderate to severe developmental delays, Autism/ PDD, Multiply Handicapped Resources for Children with Special Needs, Inc. Address: 116 E. 16th Street, 5th Floor, New York, NY 10003 Phone: (212) 677-4650 Website: www.resourcesnyc.org, www.resourcesnycdatabase.org Programs Offered: Information and advocacy center for parents and professionals looking for any type of help pertaining to children birth to 26 with any disability. Holds a Special Camp Fair every January and we conduct many workshops throughout the city. Shema Kolainu – Hear Our Voices Address: 4302 New Utrecht Ave, Brooklyn, New York 11219 Phone: (718) 686-9600 Website: www.shemakolainu.org Programs Offered: Medicaid Waiver, Residential Habilitation The Special Children’s Center Address: 1400 Prospect Street Lakewood, New Jersey Phone: (732) 367-0099 Ages: Any Age Programs Offered: Respite, Overnight respite Sunday Program: males and females ages 0-22, separate and


RESOURCES DIRECTORY MEDICAID WAIVER, RESPITE & OTHER PROGRAMS CONTINUED… mixed groups, Handicap accessible, Transportation provided, Kosher food provided, Take children not toilet trained, After School Program: Males and Females ages 0-22, separate and mixed groups, Transportation provided, Handicapped accessible, Kosher food provided, fee for program. Population: Mild to Moderate to severe developmental delays, Autism/PDD, Speech & Language impaired, Learning disabled, ADD/ ADHD, Emotionally Disturbed, Hearing impaired, Visually impaired, Multiply handicapped Special Care for Families and Children’s Services Address: 1421 East 2nd Street Brooklyn, New York 11230 Phone: (718) 252-3365 Programs Offered: Medicaid Waiver, Respite STEP (Special Torah Education) Address: 3005 Avenue L Brooklyn, New York 11210 Phone: (718) 252-8822 Programs Offered: Sunday Program

UCP of New York City Address: 80 Maiden Lane, 8th Floor, New York, NY 10038 Phone: (877) 827-2666 Website: www.ucpnyc.org Programs Offered: Medicaid Waiver, Family support services for parents, In-home respite for individuals on Medicaid waiver, Overnight Respite, After School Program, Recreation UCP of New York City: The Parent’s Place Address: 160 Lawrence Avenue Brooklyn, NY 12230, Room 205 Phone: (718) 436-7979 xt. 704 Website: www.ucpnyc.org Programs Offered: Free weekly workshops for parents and families, translation in Spanish is available. Women’s League Community Residences, Inc. Address: 1556 38th Street Brooklyn, New York 11218 Phone: (718) 853-0900 Website: www.womensleague.org Programs Offered: Medicaid Waiver Community Habilitation and Supported Employment

Yad Hachazakah – The Jewish Disability Empowerment Center Inc. Address: 25 Broadway, Suite 1700, New York, NY 10004 Phone: (212) 284-6936 Location: Office, Agreed upon location Ages: 12 through older adulthood Population: Self-directing people with obvious or hidden disabilities/conditions and their loved ones. Services: Personal Coaching and Mentoring, Peer Networking, Advocacy, Resource Navigation, Dating and Marriage Consultation Addl. Info: Led by professionals and lay persons with disabilities under Orthodox Rabbinic Supervision. Yedei Chesed Address: 48 Scotland Hill Road, Chestnut Ridge, NY 10977 Phone: (845) 425-0887 Website: yedeichesed.org Programs Offered: Medicaid Waiver, Family Support Services for parents and siblings, Respite, Overnight Respite, Sunday Program, After School Program

YAI Network Address: 460 West 34th Street New York, New York 10001 Phone: (212) 273-6182 Website: www.yai.org Programs Offered: Medicaid Waiver, Family Support Services for parents & siblings, Respite, Overnight Respite, Sunday Program for all ages, male & female, After school program in Queens 5 days a week for boys & girls ages 6-17, Recreation for male & female ages 6-adult on various weekdays, weekends, and holidays, Medical/ Dental/specialty practice for people with developmental and learning disabilities and their families, Clinical and family services, parent support groups, in-home training, rehabilitation programs, employment training and placement programs, socialization programs, travel, and much more. Yeled V’Yalda Early Childhood Center Address: 1312 38th Street Brooklyn, New York 11218 Phone: (718) 686-3700 Website: www.yeled.org Programs Offered: Respite

OTHER SERVICES Beineinu-Connecting Parents of Children with Special Needs Address: 48 West Maple Avenue Monsey, New York 10952 Phone: (347) 743-4900 Website: www.Beineinu.org Services Provided: Parent Matching, Internet research for medical information for internet-free families, Translation of medical information into Hebrew, Zichron Yehuda Equipment Exchange, Growing International database of Resources, Information of Interest to those dealing with various special needs, Library of Chizuk and Inspirational articles, pictures and videos. Dovi’s Playhouse for Children with Special Needs Address: P.O. Box 290-524,

Brooklyn, New York Phone: (646) 736-2816 Services Provided: Tutoring Services for Children with Special Needs – provides tutors after school to children at home. E-tree Address: 736 Lakeview Road Cleveland, Ohio 44108 Phone: (877) 865-5235 Website: www.treeofknowledge.us Services Provided: Interactive Online Learning System for k-12 Euro-Peds National Center for Intensive Pediatric PT Address: 461 W. Huron St. #406 Pontiac, MI 48341 Phone: (248) 857-6776

Website: www.europeds.org Services Provided: Europeanbased model of therapy for treating children with non-progressive gross motor disorders such as Cerebral Palsy, Traumatic Brain Injury and Spina Bifida. It was the first clinic outside of Europed to offer this type of therapy when it opened in 1999 out of a Michigan hospital, Doctor’s Hospital of Michigan. Hand in Hand Family Services Address: 390 Kings Highway Brooklyn, New York 11223 Phone: (718) 336-6073 Website: www.hihfs.org Services Provided: Psychological and Psychosocial Evaluations

HorseAbility / Center for Equine Facilitated Programs Address: SUNY College at Old Westbury / PO Box 410-1 / Old Westbury, New York 11568 Phone: (516) 333-6151 Website: www.horseability.org Services Provided: HorseAbility is the only PATH International Premier Accredited Center on Long Island, and the only one at a convenient driving distance from the five boroughs of NYC. PATH International is the Professional Association of Therapeutic Horsemanship International pathintl.org.

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RESOURCES DIRECTORY OTHER SERVICES CONTINUED‌ JCC Therapeutic Nursery Address: 411 East Clinton Avenue Tenafly, NJ 07670 Phone: (201) 408-1448 Location: Center Services Offered: Toddler Socialization Group Mommy & Me for ages 2-3 years old, not an early intervention program. Program offers sensory integration, age appropriate group activities, help with parenting skills, facilitation of age appropriate play, social interactions and communication skills, Mondays and Wednesday 9:30AM-11AM.

Phone: (888) 9-KIDSOC Website: www.kidsoc.org Services Provided: Fully medically supervised travel and recreation program for seriously sick children and young adults. All participants are cognitively appropriate for age. Trips include resort, door to door travel, touring and shabbatons. There is no cost to participants. It is all volunteer. They provide advocacy for medical treatment as well as medical accompaniment to medical treatment destinations on commercial airlines.

Kids of Courage Address: 13158 Broadway, Suite 207 Hewlett, New York 11557

BInuryni Parent Support Network Address: HASC Center Inc 5601 First Avenue

Brooklyn, New York Phone: (718) 436-4087 Programs Offered: Monthly Support Groups for Mothers, Special Events, Guest Speakers, Open to all parents with special needs. Orthocraft, Inc. Address: 1477 E. 27th Street Brooklyn, NY 11210 Phone: (718) 951-1700 Website: www.orthocraftinc.com Services Provided: Orthotic and prosthetic evaluation, fabrication of durable medical equipment. Pediatric, geriatric, and everyone in between. Most insurances accepted. Providers go to home, school, therapy and doctors' offices.

Paul Stadler MS OTR/L NDT (INPP) Address: 359 Ridgewood Avenue Phone: (347) 247-6835 Website: paulstadler.net Services Provided: Sensory Integration Certified (SIPT) Certified, Licentiate of INPP, INPP one day course Instructor. Works with children diagnosed with Dyspraxia, DCD, Aspergers Syndrome, Dyslexia, ADD, panic disorder, anxiety disorder, agoraphobia, and children with reading problems, writing problems, copying problems, academic underachievement.

ADVOCACY AHRC NYC Address: 83 Maiden Lane New York, New York 10038 Phone: (212) 780-2500 Website: www.ahrcnyc.org Region: Five boroughs Provides representation: IEP meetings, impartial hearings, and appeals Imagine Academy for Autism Address: 1465 East 7th Street Brooklyn, New York 11230 Phone: (718) 376-8882 Website: www.imagineacademy.com Region: All Provides representation: IEP meetings, impartial hearings, and appeals Michael Inzelbuch Esq. Address: 555 Madison Avenue Lakewood, New Jersey 08701 Phone: (732) 905 2557 Region: New Jersey Provides representation: IEP Meetings, Impartial Hearings, and appeals

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National Jewish Council for Disabilities/Yachad (NJCD) Address: 11 Broadway, 13th Floor New York, New York 10004 Phone: (212) 613-8229 Hotline: (212) 613-8127 Website: www.njcd.org Region: NY, NJ, National Provides representation: IEP, Impartial Hearings Otsar Family Services Address: 2334 West 13th Street Brooklyn, New York 11223 Phone: (718) 946-7301 Website: www.otsar.org Region: NYC Provides Assistance: IEP meetings, Impartial Hearings Project LEARN Special Education Affairs – Agudath Israel of America Address: 42 Broadway, New York, New York Phone: (212) 797-9000, ext. 308/325 Region: Primarily NY City and State, available to consult on questions on a national level Provides representation: IEP meetings, Impartial Hearings, and Appeals

Resources for Children with Special Needs, Inc. Address: 116 E. 16th St. 5th Floor, New York, NY 10003 Phone: (212) 677-4650 Website: www.resourcesnyc.org, www.resourcesnycdatabase.org Region: All 5 boroughs Provides representation: IEP meeting, Impartial Hearings, and Appeals SEAD - Special Education Academy of Deal Address: 1 Meridian Road Eatontown, New Jersey 07724 Phone: (732) 460-1700 Website: www.seadprogram.org Region: New York & New Jersey Provides representation: IEP meetings & Impartial Hearings TAFKID Address: 977 East 17th Street Brooklyn, New York 11230 Phone: (718) 252-2236 Website: www.tafkid.org E-mail: tafkid@aol.com Region: New York Provides representation: Educational planning and case consultation, assistance with letter writing

and paperwork, IEP Meetings and Impartial Hearings Thivierge and Rothberg, P.C. Address: 5 Hanover Square, Suite 1201 New York, New York 10004 Phone: (212) 397-6360 Website: www.trspecialedlaw.com Region: New York & New Jersey Provides representation: IEP Meetings, Impartial Hearings, and Appeals Yedei Chesed Address: 48 Scotland Hill Road Chestnut Ridge, NY 10977 Phone: (845) 425-0887 Website: yedeichesed.org Region: Rockland County Provides representation: IEP Meetings UCP of New York City Address: 80 Maiden Lane, 8th Floor New York, NY 10038 Phone: (877) 827-2666 Website: www.ucpnyc.org Region: Bronx, Bklyn, Manhattan and S.I.


RESOURCES DIRECTORY ISRAEL LISTINGS Acha/ADI: The Israeli Association for the Deaf Main Office & Tel Aviv Branch: 13 Sderot Yad Lebanim, Yad Eliyahu P.O.B. 9001 Tel Aviv, 61090 Tel/Fax: 03-730-3355 Website: http://www.deaf.org.il/ A voluntary organization, which creates special Deaf Clubs where activities take place on a regular basis for the membership. ACHLA: Association for the Quality of Life for Individuals with Special Needs Phone: 02-650-5276 Website: www.achlah.org.il ACHLA runs the HEYANUT Center, a holistic center in Israel that provides support for individuals with complex special needs and their families. AKIM: National Association for the Habilitation of the Mentally Handicapped in Israel 19 Yad Harutzim St., Suite 304 P.O. Box 53409, Jerusalem 91533 Phone: 02-672-8731 Website: www.akim.org.il/ They are a nonprofit organization that provide services for children and adults with mental disabilities and other developmental disorders.

Givatyaim, 53583, Israel Phone: 03-571-8188 Website: http://www.alut.org.il/ They are a nonprofit organization that work with autistic or PDD children and provides support services for their families. ALYN: Pediatric & Adolescent Rehabilitation Center Shmaryahu Levin Street Kiryat HaYovel P.O.B. 9117, Jerusalem 91091 Phone: 02-649-4222 Website: http://www.alyn.org/ They are an official registered nonprofit organization treating physically handicapped children and adolescents, and offers services for a broad range of physical disabilities. The organization has helped children who have been injured in road accidents and terror attacks, children suffering from congenital conditions and children suffering from physical limitations due to various illnesses. Beineinu Beineinu is an organization that connects Jewish parents of children with special needs. Phone: 072-230-5368 (Israel Office) Website: www.beineinu.org Beit Issie Shapiro Issie Shapiro St. P.O. Box 29, Ra'anana 43100, Israel Phone: 09-770-1222 Website: www.beitissie.org.il They are an organization that provides a range of services for children with developmental disabilities and their families. These services include therapeutic daycare and treatment, special education and paramedical treatment, and innovative new approaches such as hydrotherapy, complementary medicine and multi-sensory treatment.

Aleh 12 Aharonovitz St., POB 435 Bnei Brak 51103 Phone: 03-617-1888 Website: http://www.aleh.org/ Provide top quality medical, educational and full-time rehabilitative residential care to severely disabled Jewish children in Jerusalem, Bnei Brak, Gedera and the Negev. They care for children with medical conditions such as autism, cerebral palsy and Down syndrome, as well as genetic disorders including Tay-Sachs, Canavan disease and Rett syndrome. Beit Ofek/Beit Eckstein - Job Training for Olim with AspergAlut: Israeli Society for Autistic ers Syndrome Children Phone: 03-648-6477 1 Corazin Street They are an organization whose

goal is to improve the quality of life for people with Aspergers Syndrome, with a goal of preparing members for independent living and training them for a role in the work-force. Chimes Israel Executive Offices Yehudit and Meir Rubanenko Campus 13 Ha'Arad Street Tel Aviv, Israel 69710 Phone: 03-644-2427 Website: www.chimesisrael.org.il They are an international, multiservice agency for individuals of all ages with developmental delays and other disabilities. Branches in Tel-Aviv, Ariel, Yafo, Kfar Saba, Herziliya and Taybeh, with different branches serving different needs. Gan Sulam 116 Sanhedria Murchevet P.O.B. 18206 Jerusalem, 91181 Phone: 02-633-8400 Website: www.sulamisrael.org They are an acknowledged leader in the treatment of developmental and learning disabilities, PDD/autism, Down syndrome, and other rare and debilitating medical conditions. They currently has six branches in Jerusalem, Beit Shemesh, and the surrounding areas. These include a rehabilitative daycare program for babies and toddlers, an observation kindergarten program for children for children aged 3-7, and elementary school, and a high school.

bral palsy, multiple sclerosis and other neuromuscular diseases. The Institute for the Advancement of Deaf Persons in Israel 63 Laguardia Street P.O. Box 9235 Tel Aviv 61091 Phone: 03-631-1595 Website: www.dpii.org They provide professional, educational and rehabilitation services for deaf and hard-of-hearing children, youth and adults. Israel Elwyn 20 Henrietta Szold St. Jerusalem, 96502 Phone: 02-641-5448 Website: www.israelelwyn.org.il They are an organization that helps children and adults with special needs integrate and become active partners in Israeli society. LESHEM: Association for the Advancement of Learning Disabled Students in Higher Education P.O.B. 4403 Jerusalem 91044 Phone: 052-365-9956 Website: leshem.telhai.ac.il

Multi-Service Center for the Blind (Mercaz Rav Sherutim L'Eiver) Mercaz Rav Sherutim L'Eiver is dedicated to the mission of making life easier in every aspect for individuals who are blind. Jerusalem Office: Binyan Sha'arei Hair 216 Rechov Yaffo Phone: 02-538-8955 Tel Aviv Office: ILAN-Israel: Association for 10 David Hachmi Street Handicapped Children & Adults Tel Aviv 67778 Main Office: 9 Rechov Gordon Phone: 03-791-5555 Tel Aviv 63458 Website: http://www.blinds.org.il/ Phone: 03-524-8141 Website: www.ilan-israel.co.il Tishma, School and Center ILAN, Israel's Foundation for for Autism the Handicapped, cares for thou- Address: Kanaei Hagalil 31/Even Haezel sands of physically impaired 21 / P.O.B 57329 Jerusalem 91573 adults and children suffering Phone: 02.6483042, from diseases that affect the Revital.Tishma@gmail.com muscles and nerves such as cere- Website: www.Tishma.org December 2012

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BULLETIN BOARD Compiled By Elisheva Stein

2012 ICare4Autism International Autism Conference in Jerusalem

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uring our recent conference in Jerusalem, our speakers from all over the world covered a vast array of topics including research and education. Initiating the research findings, Dr Eric Hollander, chairman of ICare4Autism Advisory Committee, from the United States, spoke about a study in which evidence showed that intravenous and intranasal administration of oxytocin show promise in enhancing social cognitive and improving repetitive behaviors. It is known that autism is a complex heterogeneous neurodevelopmental disorder characterized by deficits in social interaction. Dr. Mike Snape of the United

(L.-R.) Dr. Eric Hollander, Chairman of the ICare4Autism Advisory Council, Dr. Shekhar Saxena, Director, Dept of Mental Health and Substance Abuse, World Health Organization (WHO), Mrs. Marta Linares de Martinelli, First Lady of the Republic of Panama, Nir Barkat, Mayor of Jerusalem

Kingdom indicated that autism appears in many cases to be a disorder of neuronal or synaptic connectivity and potentially involves neuroinflammatory processes. Dr. Hakon Hakonarson, of the US, indicated that although autism is strongly heritable and several variants have been associated with autism, they only explain a small fraction of the disease. In addition, Agatino Battaglia, M.D., of Italy, spoke about increasing evidence that autism spectrum disorders can arise from rare highly penetrant mutations and genomic imbalances. Dr. Eli Hatchwell, of the UK and Israel

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claims that despite the relatively high heritability of Autism Spectrum Disorders, only a small percentage of the heritability is currently explained on the basis of known genes. Population Diagnostics has implemented a general and powerful approach to the problem of ASD genetics and has uncovered substantial number of novel causal genes. Dr. Mady Horning of the United States discussed how growing evidence suggests that the environment plays a role in the pathogenesis of autism, while Kamila Markram of Switzerland said that autism covers a wide spectrum of disorders for which there are many views, hypotheses and theories. She spoke about how the Intense World Theory aims to be a unifying neurobiological theory of autism. Dr. Jose Humberto Nicolini-Sanchez of Mexico gave a lecture on the current state of research into the genetics of compulsive behaviors in autism spectrum disorders. Dr. Sagiv Shifman from Israel spoke on studies into the genetics of ASD have implicated both common and rare variants, including de-novo mutations, as risk factors for ASD. On the educational side, Dr. Pamela Wolfberg of the US, spoke about how children on the autism spectrum face significant challenges in social, communication and play development, which places them at high risk for being neglected and rejected by peers. Dr. Robert Didden, of the Netherlands, discussed that Applied Behavior Analysis (ABA) has contributed significantly to the literature on improving functioning and well-being of children with asd and/or intellectual disability. Dr. James Partington, of the United States, went on to say that specific techniques used to develop effective programs in both the home and school settings will be presented for individuals at both the early learner and more advanced student levels. Dr. Stephen Shore, professor at Adelphi

University, focused on children with autism in the music curriculum and teaching them how to play a musical instrument. That music can be used as the means of communication or to help organize verbal communication skills. It also leads to identifying talents and abilities that can help a person with ASD join the workforce. Dr. Joshua Weinstein of the United States opened the conference talking about how ICare4Autism is a global non-profit organization headquartered in New York City with branches throughout the world and the organization’s mission is to drive the worldwide research necessary to discover the etiology of autism and its biologic and environmental causes. The organization is currently focusing on the development of the Global Autism Center, which will be located in Jerusalem at Mount Scopus. A major part of the Center’s activities will be the world’s first global comprehensive autism workforce development initiative. The initiative will encompass four components: (1) workforce entry services for high school students and college entrance exam training (2) vocational and employment services for semiskilled (3) vocational and employment services for high functioning and (4) high level employment services for persons with Asperger’s Syndrome to obtain jobs in the technology sector. The initiative will occur in Israel but is expected to create an urgently needed replicable model that can have a global impact.

(L._R.) Nir Barkat, Mayor of Jerusalem, Mrs. Marta Linares de Martinelli, First Lady of the Republic of Panama and Dr. Joshua Weinstein, CEO & Founder of ICare4Autism.


BULLETIN BOARD H

HASC Center Recognition Week

ASC Center acknowledged their very dedicated staff during Staff Recognition Week. This is an annual event during which the dedicated staff of this premier agency recognizes the dedication, commitment and hard work of all its’ employees. The kickoff for the week took place amidst a wonderful spirit and socialization at a catered reception for the entirety of the HASC Center agency. The assemblage was addressed by Samuel Kahn, Executive Director, Dr. Chaim Wakslak, Clinical Director and Abe Eisner, President of the Board of Directors. HASC Center was honored by the presence of several senior OPWDD representatives headed by Donna Limiti, Associate Commissioner who expressed her special admiration for the staff and the work that HASC Center does on behalf of those they

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serve. Special awards were presented to the outstanding staff members who were selected by their peers for this recognition. Penina, one of the people who reside at a HASC Center residence addressed the audience from the perspective of what her years at HASC Center have meant to her. HASC Center Recognition Week places value upon every staff member regardless of their position, title or responsibility. It is clear that the success, growth and advancement of every man, woman or child who either lives in a HASC Center residence or attends one the various program offerings is a consequence

of an integrated team effort, with everyone playing a vital role. Staff Recognition Week, at HASC Center, is a time where the focus is upon expressing gratitude and appreciation for the hard work that often times goes unacknowledged or is taken for granted. On a daily basis, during this special week, staff will receive surprise treats placed at their desks, or at their place of work. A photographer taking the employee’s picture, a caricaturist illustrating the employee and their special interest, hourly raffles, coupons for discounted merchandise and services all represent small tokens which reinforce the appreciation that HASC Center has for these hard working individuals.

The Pirchei Seeach Choir: Making Major Inroads in Community Integration

ntegration of the special-needs community in mainstream society reached new heights this summer when ten young men with special needs performed in front of a 10,000 strong audience at the English Siyum Hashas which took place this summer in Yerushalayim. The Pirchei Seeach Choir, a choir under the auspices of Seeach Sod, a pioneering special ed. organization in Israel, was honored to perform at the English Siyum HaShas on August 5th in the Binyanei Ha’muah auditorium. As the choir got on stage and began singing Carlbach’s classic “Tov L’hodos”, the crowd started singing, dancing and clapping along with avid enthusiasm.

Believe it or not, the main soloist in the choir is severely autistic. Avemel is not verbally responsive, yet he carries a tune beautifully and his melodic voice moves listeners from all walks of life. One member of the audience remarked, “The performance last night was nothing short of magnificent. The singing electrified the crowd. Everyone was clapping, singing, dancing… It was one of the most heartwarming sights I have ever seen.” A woman who watched the performance on a live hookup in the women’s hall relayed the following message to the choir members: “Your singing was beautiful and very inspiring. The Seeach

Sod choir was one of the best parts of the Siyum HaShas for me! Thank you for being there and singing for everyone. I hope to see the choir at other events.” What an incredible achievement and merit to have special boys participate in the Siyum Hashas along with the rest of Klal Yisrael! Who could have imagined such an achievement, just three decades ago? Society has certainly come a long way in mainstreaming the specialneeds community!

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BULLETIN BOARD CALENDAR OF UPCOMING EVENTS: December 30, 2012 Ohel Sibshops Chanukah Party Yeshiva of Flatbush 1609 Avenue J Brooklyn, New York Alyse_appelbaum@ohelfamily.org 718.686.3497 2:00-4:00 pm Post Chanukah party and carnival for the boys and girls who attend all branches of Ohel’s Sibshops or who would like to join. December 30-January 10, 2013 YACHAD Birthright Trip to Israel 212-613-8266 Nichole Bodner bodnern@ou.org YACHAD and Taglit Birthright have joined to provide an opportunity for participants with physical, cognitive, or developmental disabilities aged 18 to 26 to enjoy a 10 day supervised group trip to Israel. This fully accessible trip will visit Jerusalem, Northern Israel, Masada, ride camels, and other exciting activities around the country. January 6, 2013 OHEL Sibshops for Boys—Brooklyn Brooklyn, New York www.ohelfamily.org alyse_applelaum@ohelfamily.org 718.686.3497 4:30-7:00 pm Sibling support group for Jewish boys ages 7-12 from Brooklyn. Reservations requested. Down Syndrome Support Group for Parent of Infants & Toddlers at Gigi’s Playhouse New York New York 646.801.75291 nyc@gigisplayhouse.org www.gigisplayhouse.org/newyork 10:00 am Join other new parents to discuss their experiences. Make connections, receive support and learn about resources helpful to the Down syndrome community. This is for anyone with a child in Early Intervention (ages 0-3). Future dates - February 3, March 3, April 7, May 5 and June 2. January 12, 2013 / New York City Ohel Sibshops for Teen Girls— Five Towns: Far Rockaway, New York 718.686.3497

www.ohelfamily.org alyse_applelaum@ohelfamily.org 7:30-10:00 pm Sibling support group for Jewish teenage girls ages 13-16 from the Five Towns. Reservations requested. January 13, 2013 OHEL Sibshops for Girls—Brooklyn Brooklyn, New York www.ohelfamily.org alyse_applelaum@ohelfamily.org 718.686.3497 4:30-7:00 pm Sibling support group for Jewish girls ages 7-12 from Brooklyn. Reservations requested. January 16, 2013 Neurofibromatosis / Schwannomatosis Support Group Meeting Portland, Oregon www.ctf.org 212.344.6633 January 19, 2013 Ohel Sibshops for Teen Girls Brooklyn, New York 718.686.3497 www.ohelfamily.org alyse_applelaum@ohelfamily.org 7:30-10:00 pm Sibling support group for Jewish teenage girls ages 13-16 from Brooklyn. Reservations requested. January 20, 2013 OHEL Sibshops for Boys Five Towns: Far Rockaway, New York www.ohelfamily.org alyse_applelaum@ohelfamily.org 718.686.3497 4:30-7:00 pm Sibling support group for Jewish boys ages 7-12 from the Five Towns. Reservations requested. January 27, 2013 OHEL Sibshops for Girls Five Towns: Far Rockaway , New York www.ohelfamily.org alyse_applelaum@ohelfamily.org 718.686.3497 4:30-7:00 pm Sibling support group for Jewish girls ages 7-12 from the Five Towns. Reservations requested.

International Conference on Eating Disorders Jerusalem, Israel 02.652.0574 conventions@isas.co.il Conference sponsored by the Israeli Association of Eating Disorders, featuring a number of experts in the field. April 15-17, 2013 ARC Disability Policy Seminar Washington DC www.disabilitypolicyseminar.org April 17-19, 2013 Young Child Expo & Conference New York, New York 212.787.9700 ext 333 www.youngchildexpo.com The Young Child Expo & Conference will provide early childhood professionals & parents the latest information about early childhood development, services, resources, and products to help all children reach their full potential. In one unique event, this conference integrates learning about a wide variety of important topics affecting typically developing children as well as those with special needs, including autism. April 18-21, 2013 Neurofibramatosis Forum Nashville, Tennessee www.ctf.org 212.344.6633 The NF Forum is a weekend-long patient and family support meeting open to all people living with NF and their families. NF Forum attendees learn about he latest medial advancements in neurofibromatosis, get practical advice on NF related issues, and learn about resources provided by the Children’s Tumor Foundation. May 2-3, 2013 Abilities Expo—New York Edison, New Jersey www.abilitiesexpo.com Abilities Expo is the place for people with disabilities to find solutions. They showcase the latest in products and services, as well as solutions for physical, sensory, learning, and developmental disabilities. Vendors are on hand to demonstrate their products. Activities include workshops and sports demos. Free admission. Courtesy OF

Connecting Parents of Children With Special Needs

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BULLETIN BOARD sory room are to provide a welcoming environment that can promote interaction, relaxation and calm but can also provide:  Sensory Stimulation  Relaxation  Development of skills  Improved hand/eye coordination  Explore cause and effect  Encourage communication and the use of language The MSR environment is safe and nonthreatening. Children and adults with disabilities or other limiting conditions enjoy gentle stimulation of the primary senses. Participants experience self-control, autonomous discovery, and exploration – achievements that overcome inhibitions, enhance self-esteem, and reduce tension. Multi-Sensory Rooms have been used in the following areas:

Visit us at: www.buildingblocksmagazine.com

ASPERGER

IEP

ADHD

A SPECIAL NEEDS MAGAZINE

SERVICE COORDINATION

REDEFINING SPECIAL NEEDS

EVALUATION

RELATED SERVICES

EARLY INTERVENTION

SENSORY PROCESSING DISORDER

THERAPY

Join Us Again For Our Next Big Issue June 2013

 Profound Multiple Disabilities Autism Spectrum Conditions (ASC)  Pediatrics  Physical Disabilities  Mental Health  Alzheimer’s/Dementia Call Today to get started! SensoryCritters. com 866-749-2737 www.SensoryCraver.com With a Brush of Love 240-506-1716 www. brushoflove.com.

AUTISM

ensoryCritters.com and With a Brush of Love can design your new Multi-Sensory room for any budget. Their experts have designed thousands of rooms, and are now offering to include Sensory Designer / Color Consultant Lauren S. Henry to complete their design team for your home or facility. From a Relaxation room designed to calm and de-escalate people who are agitated or upset, to an Interactive Multi-sensory room to aid in the development of life skills including switching, gross and fine motor skills, cause and effect, color, number and shape recognition, tracking, hand to eye coordination and much more, the experts assist in designing and creating the ideal sensory room for your requirements. The purposes and aims of a sen-

RES-HAB

S

SensoryCritters.com

DATE NDROME UPand much G: DOWN SY more… ES ALSO FEATURIN MI EE PR T OU ALL AB GO TO PL ACES SPECIAL EDUCATION

MEDICAID WAIVER

December 2012

June 2013 A Supplement of the

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RECRUITMENT FRUM SOCIAL WORKERS & PSYCHOLOGISTS NEEDED After-School Hours

Positions available for Community Hab trainers with experience. Well paying jobs with special needs individuals. P/T late afternoon hrs Mon-Thurs & Weekends: Email resumes to Shanie@otsar.org

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• Outpatient counseling centers • Male & female staff needed • Evening and Sunday hours available • Full or part-time, fee-for-service providers • Post-graduate training & supervision provided

Responsibilities include: • Providing psychotherapy to children and adults in individual, family, couples, and group treatment modalities • Maintenance of clinical charts

Job requirements: • LMSW/LCSW, PsyD, or PhD, Licensed Psychologist • Computer competency for all positions • Bilingual in Yiddish, Russian, Spanish, or Hebrew preferred To apply, send resumes to fwilbur@jbfcs.org or fax (718) 854-5495


RECRUITMENT To advertise in this section of the June 2013 Building Blocks, please contact David at: davidh@jewishpress.com or 718.330.1100 ext. 372

Want to make a huge difference - in someone else’s life? - in your own life? BECOME A VOLUNTEER!

Celebrating 15 years of service!

Helping kids do their best! Positions available for E.I., preschool & school-aged children: SLPs, OTs, PTs Licensed Psychologists $100 Special Educators—ABA Sign-on Service Coordinators bonus!

BILINGUAL A PLUS

Geographical Areas: Nassau, Suffolk, Queens, Brooklyn

Apply online at www.mksalomon.com

Spend just one hour per week with a child or adult with disabilities.

Boro Park/Flatbush group home settings. Read, learn, play a game/music, walk together, be a friend, share a hobby, etc.

Male and Female volunteers welcome, ages 16 and up.

Contact Shaindy Womens League Community Residences 718-853-0900 ext. 308

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INDEX OF ADVERTISERS

2nd Nature Acupuncture

89

Human Care Services

Abilities Expo

59

JBFCS - Jewish Board of Family &

P’TACH 42

The Ability Center

85

SensoryCritters.com

7, 104

Children’s Services

25, 104

Preferred Services

Back Page

69, 72

AdaptiveClothingShowroom.com 68

Jumpstart Early Intervention

Ahava Medical & Rehabilitation 4, 104

Rabbi Reuven Kamin MA

91

Special Care for Families &

American Discount Medical

Kaplen JCC on the Palisades

79

APR - Advanced Professional

Kaplen JCC on the Palisades

Resources

79, 105

Shema Kolainu/Hear our Voices 49 Children’s Services

Spirit! Magazine

Camp Tikvah

87

48, 91

Kaplen JCC on the Palisades

Blanche Kahn Medical Center

43

Bussani Mobility Team

69

Kew Gardens SEP

Camp Kaylie

50

Ilene Klass MS, OTR/L

89

Camp Ruach Hachaim

24

Dana Ledereich, MA OT/L

87

TTI - Testing &

Therapeutic Nursery

83 31, 105

Associates, Inc.

Maxi-Health Research Inc.

EDUC.A.R.E 89

Ohel Bais Ezra

eTree / Tree of Knowledge

37

Ohel Children’s Home &

Gutman Physical Therapy, PC

78

107

9, 55

Community Residences

105

Yachad / National Jewish Council for Disabilities

15, 85

89

Yachad / NJCD

83

Yachad Family Shabbaton

53

Yad B’Yad Academy

33

Paul Stadler - INPP Method See Insert

Yedei Chesed

81

Young Child Conference

61

Orthocraft, Inc.

Hand in Hand Family Services

Otsar Family Services

87, 104

HASC Pre-School Programs

8

Paul Stadler - INPP Method

57

HASC School Age Program

39

Portable Wheelchair Ramps

70

BECOME A PART OF THE NEXT

A SPECIAL NEEDS MAGAZINE

To Be Published June 2013 To have pictures of your events posted free of charge in this section.

EARL INTERV Y ENTION

ALSO FEATUR ING: PLACES TO GO

ER

MEDICA

ID WAI

DOWN SYNDRO ME UPDATE ALL ABOUT PRE much EMIES and more…

EVALUA TIO

SENSOR PROCES Y SI DISORD NG ER

VER

SPECIA EDUCAT L ION

June 2013 A Supp lement of the

Contact Eli Stein at: elistein@aol.com

ASK THE EXPERT

ORGANIZATIONAL LISTINGS

To ask a question of one of our therapists, advocates or educators.

To be included in the next directory free of charge, request a submission form at

Contact Chaya Klass at: ileneklass@aol.com

S MAG AZINE

ASPERG

REDEF SPECIA INING L NEEDS

RELATE SERVIC D ES

RES-HA B

For a member of a family with a special needs individual to submit an anecdote, advice, or comment.

NEED

Y

BULLETIN BOARD

A SPE CIAL

SERV COORDI ICE NATION

THERAP

FAMILY FORUM & SIBS SPEAK

Contact Ruchi Eisenbach at: ruchieisenbach@gmail.com

104

ADHD

Hamaspik 2 21, 104

11

Training International

Women’s League

Family Services

Hearing Center

105 3, 20

87

Touro College Speech &

Challenge Early Intervention Center 78

83

Thivierge & Rothberg P.C.

AUTISM

81

HASC Center

Therapro 73

Marion K. Salomon &

Resources

85

Tafkid

Beineinu 35

CBR - Creative Business

105

buildingblocks@jewishpress.com Note - a form must be submitted to update any previously published listing.

* All submissions become the property of Building Blocks and may not be returned. Publication is subject to the discretion of the editors. Please do not submit previously published material.

For further information or to advertise please contact: Moshe Klass at 718.330.1100 ext. 352 or sales@jewishpress.com 106

December 2012

IEP

73

104

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December 2012

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