INVENTING
THE FUTURE TOGETHER
RESEARCH BOOK JANUARY 20, 2021
INTRODUCTION
executive project directory summary
GOVERNING BOARD MEMBERS
CORE TEAM MEMBERS
Rachel Garcia
Gina Canon
Dr. Troy Whalen
Dr. James Gunnell
Micki Bohac
Diane Ponce
Dr. Blair Nuccio
Dr. Maggie Lesniak
Ruben Almendarez (Secretary)
Ted Arnold
Mr. Joseph Matise
Joshua Sears
Tim Burke
Dr. Daniel Riordan
Trish Saunders (President)
Mary Zofkie (Vice-President)
Mr. Tom O’Malley
ragarcia@aerosped.org Summit School District 104
mbohac@aerosped.org Willow Springs School District 108
ralmendarez@aerosped.org Indian Springs School District 109
jsears@aerosped.org Central Stickney School District 110
tsaunders@aerosped.org Burbank School District 111
gcanon@aerosped.org Evergreen Park School District 124
dponce@aerosped.org Argo Community School District 217
tarnold@aerosped.org Reavis School District 220
tburke@aerosped.org Oak Lawn Community School District 229
mzofkie@aerosped.org Evergreen Park School District 231
twhalen@aerosped.org Summit School District 104
bnuccio@aerosped.org Indian Springs School District 109
jgunnell@aerosped.org A.E.R.O. Special Education Cooperative
mlesniak@aerosped.org A.E.R.O. Special Education Cooperative
jmatise@aerosped.org Ridgeland School District 122
driordan@aerosped.org Reavis School District 220
tomalley@aerosped.org Evergreen Park School District 231
Jeannie Reising
jreising@aerosped.org Ridgeland School District 122
EXECUTIVE BOARD MEMBERS
DESIGN TEAM MEMBERS
Dr. Troy Whalen
Kristin Aardsma
Megan Matura
James Wiegel
Dan Chiarito
Christine Putlak
Dr. James Gunnell
Melissa Fary
Judy Rokaitis
Dr. Maggie Lesniak
Lisa Hart
Allison Thiele
Rob Wroble
Carli Hochstetter
Sarah Valentine
Robin Randall
Dana Klein
Michele Wangler
twhalen@aerosped.org Summit School District 104
Mr. Frank Patrick (President) fpatrick@aerosped.org Willow Springs School District 108
Dr. Blair Nuccio
bnuccio@aerosped.org Indian Springs School District 109
Erin Hackett
ehackett@aerosped.org Central Stickney School District 110
Dr. Franzy Fleck
ffleck@aerosped.org Burbank School District 111
Mr. Joseph Matise
jmatise@aerosped.org Ridgeland School District 122
2
Dr. Margaret Longo and Lela Bridges (Interim)
mlongo@aerosped.org lbridges@aerosped.org Evergreen Park School District 124
Dr. William Toulios
wtoulios@aerosped.org Argo Community School District 217
Dr. Daniel Riordan (Secretary) driordan@aerosped.org Reavis School District 220
Dr. Michael Riordan
mriordan@aerosped.org Oak Lawn Community School District 229
Mr. Tom O’Malley
tomalley@aerosped.org Evergreen Park School District 231
Introduction
kaardsma@aerosped.org A.E.R.O. Therapeutic Center
dchiarito@aerosped.org A.E.R.O. Therapeutic Center
mfary@aerosped.org A.E.R.O. Therapeutic Center
lhart@aerosped.org A.E.R.O. Therapeutic Center
chochstetter@aerosped.org A.E.R.O. Therapeutic Center
dklein@aerosped.org A.E.R.O. Therapeutic Center
mmatura@aerosped.org A.E.R.O. Therapeutic Center
cputlak@aerosped.org A.E.R.O. Therapeutic Center
jrokaitis@aerosped.org A.E.R.O. Therapeutic Center
athiele@aerosped.org A.E.R.O. Therapeutic Center
svalentine@aerosped.org A.E.R.O. Therapeutic Center
mwangler@aerosped.org A.E.R.O. Therapeutic Center
jwiegel@aerosped.org A.E.R.O. Therapeutic Center
jgunnell@aerosped.org A.E.R.O. Therapeutic Center
mlesniak@aerosped.org A.E.R.O. Therapeutic Center
rwroble@legat.com Legat Architects
rrandall@legat.com Legat Architects
INTRODUCTION
1
2
3
table of contents
INTRODUCTION Project Directory 2 Table of Contents 3 Executive Summary 6-9
4
FUNDAMENTAL USERS Introduction 12 Students 13-24 Teachers, Interventionists, Staff 25 Parents 26-27
KEY PERFORMANCE FACTORS Sensory Loading Transitions Overlapping Geographic Stressors Biophilia Care
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30 31 32 33 34 35
6
APPROACH Health Intelligence & Consultation Assistive Technologies & Adaptive Education Tools Teacher & Staff Wellness Visual Clutter Color Movement Nutrition Natural Lighting Artificial Lighting Acoustics
38-39 40-41 42-43 44-45 46-47 48-49 50-53 54-55 56-57 58-59
SPECIALTY SPACES Introduction Lobby Classrooms Consultation Spaces Corridors Gymnasiums OT / PT / Rehabilitation Spaces Multipurpose Sensory
62-63 64 65 66 67 68 69 70 71
APPENDIX Text Source Image Source
AERO Therapeutic Center
74-80 81-83
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1
INTRODUCTION Executive Summary
6-9
INTRODUCTION
executive summary
Design Vision Statement The A.E.R.O. Therapeutic Center will be... • • • •
A supportive, nurturing environment that celebrates students’ achievements, large and small. A warm, welcoming place that fosters independence and learning without boundaries. An inclusive, resilient environment supporting neurodiversity, equity, and dignity. A place to THRIVE for all who cross this THRESHOLD.
What does it mean to be Therapeutic? By definition, therapeutic means to have a beneficial effect for the body and mind. For a school focused on special education, the meaning of therapeutic becomes more encompassing and holistic. A special education facility should aspire to be more than just a place where students with specific needs go to learn but should be a supportive, nurturing environment that celebrates the achievements, large or small while improving the life of everyone who crosses the threshold. When a parent brings their child for their initial evaluation, it is a stressful time. The unknown about the future can be overwhelming. Any therapeutic center for education should be a safe-haven for students; a place where students can focus on their goals for improvement with the comfort of knowing that all other concerns can be pushed aside. It should be a warm welcoming environment that fosters independence and resilience for what their future
6
Introduction
may hold while maintaining dignity. Self-regulation and self-reliance should be the goal for anyone. The role of the architecture is to foster that sense of equilibrium to allow student to be at their best. The criteria to evaluate the design is critical to understanding the factors for success. What do we know about the students? What do we know about the staff? Each student has unique challenges. One way to categorize the challenges is to understand basic functions that the students need to be successful, but these functions aren’t always physical. How does the design facilitate the ease of education? Can the design make the efforts of the educators easier? The criteria to begin to solve all of these challenges can be a set of phenomena with the overall goal of reducing stress for students and teachers alike. The importance of reducing stress and self-regulation is critical to the therapeutic approach in that it allows the students to find their own equilibrium move forward with their education. It allows the student to be more receptive to teaching. It creates more engaging environments that foster learning. The challenge with any school is you might have students with different neurodiversities within the same classroom needing different responses to support education. It is imperative for the classroom to be as diverse and flexible as the students. It is this flexibility that will improve education when dealing with students with a wide range of neurodiversities, it is important to consider six fundamental strategies. It will be these strategies that allow the design to be mindful of different conditions and needs and get to the core of being therapeutic. The goal is to develop a campus and classrooms that control the amount of sensory loading differently to allow every student the opportunity to find peacefulness. The design must create an ease of transition from one space to another to create a positive
pattern and a sense of knowing of what comes next. People perceive the relationship of the built environment around them, exteroception. By creating overlapping spaces this allow students to find their safety and security within the greater whole. The design must be mindful of geographic stressors in the circulation pattern and look for ways to reduce their impact. Given the important role nature plays in reducing stress, it is critical the design embraces biophilia, the human tendency to be connected to nature so as to create restorative spaces for all users. The design must support the care of the students and staff alike. The design of the building should support the reduction of stress. It needs to support healing in every sense. As we develop the design of the therapeutic center, there are nine approaches we have explored in the research to further
SENSORY LOADING
GEOGRAPHIC STRESSORS
TRANSITIONS
BIOPHILIA
OVERLAPPING
CARE
understand their architectural implications. To optimize care, health intelligence and consultation is important to ensure student, parent, staff, and teachers are unified in the goals of treatment. If students and families are engaged in goal setting, there is a greater probability of success. Goal setting needs to be clearly understood and easily achieved. Areas for consultation and family education are required to support health literacy. OT/PT spaces and courtyards provide small challenges such as ramps, textures, level changes as easily achievable goals. Students with diverse abilities need the necessary tools to accomplish everyday tasks. Assistive technologies and adaptive education tools give the students the ability to be able to focus on their education in their skill set and move forward learning without boundaries. Storage and fitting zones need to be identified in the new therapeutic center as this is an area that is growing each year. Day-to-day stress is significantly higher for special education teachers because there are multiple services required, multiple individual student needs, learning at different levels with different styles. The new facility requires dedicated teacher and staff wellness zones. Teacher work areas and lounges can benefit from access to nature and natural views directly near by with areas to walk in nature to reduce stress. Teachers will also have access to quiet rooms to collect their thoughts and calm throughout the day. Many students with special needs are stronger visual learners. Images can be powerful to them and stick in their long-term memories far better that descriptions can. Visual clutter can be disruptive to learning and confusing to students. Consistent clear visual clues reduce stress and improve wayfinding. Consolidating
AERO Therapeutic Center
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INTRODUCTION
executive summary
visual stimuli in one area of the classroom can limit distractions and help students focus on learning. Color is a key component of visual messaging and neutral colors create calm and grounded-ness. A color palette inspired by nature can be timeless and support biophilic stress reduction.
HEALTH INTELLIGENCE & CONSULTATION
VISUAL CLUTTER
NATURAL LIGHTING
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ASSISTIVE TECHNOLOGIES & ADAPTIVE EDUCATION PROCESS
MOVEMENT
ARTIFICIAL LIGHTING
Introduction
TEACHER & STAFF WELLNESS
NUTRITION
ACOUSTICS
Exercise can improve mood and self-esteem, increase mental alertness while reducing anxiety. The benefits of movement are widely documented, including increased health, improved comprehension, increased self-perception, and extended endurance. The new facility will provide a variety of spaces that encourage movement and exercise, both planned and spontaneous. Outdoor environments such as courtyards, playgrounds, play fields, and a site perimeter walking loop will make movement fun. Diet, when coupled with exercise, are important components of a therapeutic approach to care. Proper nutrition can stabilize and minimize mood swings. Lifestyle, culture, and knowledge are sometimes the cause of poor nutrition. The new facility can demonstrate how nutrition impacts behavior and health in a variety of spaces including life skills, demonstration kitchen spaces, and cafeterias. An office for a nutritionist has been included in the project adjacent to the preparation kitchen to encourage healthy eating at the facility. Some students maybe sensitive to different lighting and acoustical conditions. Natural lighting, artificial lighting, and acoustics are design elements given particular attention within the new facility. Solar shadow studies and design for daylighting will maximize natural lighting and minimize direct
solar gain. Average classrooms can be zoned artificial lighting to provide a variety of lighting conditions in the classrooms and educational areas. Sensory rooms will be equipped for light therapy with multiple color lamps. Acoustics can be measures and exterior envelope construction can be tuned to reach the right level of exterior noise resistance based on measured frequencies. Sounds masking can help muffle and focus concentration. Extensive research in acoustics has been documented to promote wellness. Students will have a variety of choices and can self-select environments that are most conducive to their moods and learning styles. An overarching goal for the Therapeutic Center is for the architecture to support the reduction of environmental stress for all users. A parent coming with their child to the center for the first time needs to feel supported, comforted, and hopeful. The lobby is the first space to establish the calming arrival sequence. It should be the kind of space that allows everyone to catch their breath before their next steps. Classrooms are the core of the center and should provide adaptable spaces to control the surrounding environment. Flexible seating and moveable furniture allow students and teachers to reset the classroom for different activities. Communication can be stressful, and consultation spaces need to provide calming and peaceful environments. The setting needs to feel secure for both families and therapists. Corridors are the main arteries of any facility and transitions to and from spaces can be stressful. Corridors can foster an opportunity for social engagement and exploration with clear wayfinding. To avoid visual clutter, storage of assistive technology needs to identified off corridors and in transition zones. A variety of spaces to work on gross motor and fine motor skills, hand eye coordination, and just
letting off excess energy. Exercise rooms, gymnasiums, and OT/ PT/rehabilitation spaces provide a space to for these activities and need to have the ability to control lighting and acoustics to support students trying to achieve sensory equilibrium. Multipurpose rooms are similar in requirements but also need flexible furniture to allow the room to be reset for educational training, general meetings, intervention, and therapy. Sensory rooms have multiple controls to adjust lighting and acoustics to offer a playful and soothing environment. Sensory can happen in a quiet corner of a classroom and in specialty designed spaces that can we scheduled by the educators. Ultimately, the importance of designing a therapeutic center for education is inclusion and understanding. All of the factors mentioned herein, will help everyone. We are all part of a greater collective of neuro and physically diverse individuals. We all have our challenges big and small. The design factors are a way to support everyday life for every individual. It is just that these design factors will help these students and educators more. Impact is critical and memorable. Being impactful sets the foundation for success. For the design to make a positive impact, it must restore and promote dignity. It must support nurturing and caring for the individual. The therapeutic center must give these students equal standing to give them every opportunity every other student has. The therapeutic center is an environment to thrive.
AERO Therapeutic Center
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FUNDAMENTAL USERS Introduction Students Teachers, Interventionists, Staff Parents
12 13-24 25 26-27
FUNDAMENTAL USERS
introduction
A therapeutic center needs to be a community. When a supportive community comes together, everyone thrives. Communities by their nature are complex network; made up of diverse individuals. Each of those individuals have unique characteristics and challenges that need to be met. When we design a facility meant to be a therapeutic community, the role of the architecture is that it needs to support the diversity. To do that, it is imperative to explore the various user types. When dealing with special education, there is an understanding that many students will have multiple diagnoses which creates individual challenges of how the spaces should support growth. As part of this, there is the understanding that everyone does not learn the same way every day. It cannot be assumed that students can always control their actions or behaviors. An exploration of the diversity is essential to understanding how to craft the solution to meet the various needs by creating flexible spacing.
Figure 1
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Figure 2
Fundamental Users
FUNDAMENTAL USERS
students
What makes a good classroom for ADHD / sensory students? • • • • • • • • • • • • • •
Natural light Natural materials Flexible furniture Controlled movement tools / equipment Furniture wide spacing Quiet zone Reduced visual clutter Novelty, new moments Visual cues Organizational tools Visible timer Reward systems / recognition of accomplishment “Chill out space” Optimal Noise Level: 55 dB for introverts, 75 dB for extroverts
Figure 3
Figure 4
AERO Therapeutic Center
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FUNDAMENTAL USERS
students
What should we know about ADHD students? •
• • • • • • • • • • • •
They do not have just ADHD. They probably have additional diversities such as anxiety, processing disorders, impulsivity, inattentiveness, oppositional defiance disorder, proprioceptor processing disorders, etc. Can be both hyper focused at times and unfocused. Can have a need for sensory tools to keep their mind busy. Tend to always be listening even though they might not seem like it. Frustrations can come on quickly with cortisol / norepinephrine response in Amygdala. Goes to “fight or flight” more quickly than an average student. 3% - 5% of the general population has it. (In architecture, it is assumed that number might be closer to 40%). Often times, individuals can be self-conscious which can trigger anxiety. Can be great at rapid task shifting (no such thing as multitasking). Structure & process is helpful – students need to develop their own patterns for success and learn how to develop their own structures. It changes daily. Sometimes something as simple as your clothes are extremely frustrating. Your skin is your largest organ & tons of nerve endings. Work on difficult tasks earlier in the day – temporal component to learning – structure focus work in morning and physically active work in the afternoons.
Figure 5
14
Fundamental Users
What makes a good classroom for students with anxiety? • • • • • • •
Natural light Natural materials Remove environmental stressors Students want elements to control Private discussion spaces for teacher student interaction Smoother transitions between spaces Video production for presentations.
What we should know about students with anxiety? • • • • • • • • • • •
Structures and known outcomes are important for success. Frustrations can come on quickly with cortisol / norepinephrine response in Amygdala. Goes to “fight or flight” more quickly than an average student. Anticipation of unstructured events can trigger anxiety. Communication of expectations is critical for success of the student. Can sometimes result in selective mutism in uncomfortable situations. Can result often result in chronic digestive issues or headaches due to stress. 6% - 10% of the general population has anxiety, 24% of the population suffers from depression. That means in a standard class, potentially a minimum of 2-3 students have it. Often times, individuals can be self-conscious which can trigger anxiety. Can be great at rapid task shifting (no such thing as multitasking). Students do not like attention being drawn to them. Might be better served making videos rather than presenting in person.
Figure 6
Figure 7
AERO Therapeutic Center
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FUNDAMENTAL USERS
students
What makes a good classroom for students with autism? • • • • • • • • • • •
Controlled natural light Natural materials Remove environmental stressors Acoustics Spaces for repetitive movements Private conversation spaces Clear interpersonal communication Self-regulatory spaces Reduced visually cluttered Visual cues Tactile stimulation
Figure 8
Figure 9
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Fundamental Users
What should we know about students with autism? • • • • • • • • • • • • •
Sometimes spaces become too big. Organization can be difficult. Repetitive actions and movements are extremely calming. Tend to always be listening even though they might not seem like it. Frustrations can come on quickly with cortisol / norepinephrine response in Amygdala. Goes to “fight or flight” more quickly than an average student. 3% - 5% of the general population has it. (In architecture, it is assumed that number might be closer to 40%). Students are not self-conscious. They are matter of fact which sometimes people take as being rude. Some students could be non-communicative and cannot always express issues. Some students are great and memorizing from sight or hearing but might not understand verbal directions. Structure & process is helpful – Students need to develop their own patterns for success and learn how to develop their own structures. It is hard to express feelings sometimes. Sometimes something as simple as your clothes are extremely frustrating. Your skin is your largest organ & tons of nerve endings so sometimes the smallest things can be annoying – 5 senses sometimes do not work in harmony. Figure 10
AERO Therapeutic Center
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FUNDAMENTAL USERS
students
What makes a good classroom for students with bipolar disorder? • • • •
Quiet room for transitions Reduced visual clutter Private discussion areas Family consultation spaces
What we should know about students with bipolar disorder? • • • • • • • • •
18
Organization can be difficult. Has trouble sleeping / can be exhausted in class – can lead to irritability. Has extreme mood swings – from silliness and playfulness to anger. Anger & frustration can trigger quickly. Frustrations can come on quickly with cortisol / norepinephrine response in Amygdala. Goes to “fight or flight” more quickly than an average student. Impulsive by nature – they can cause disruptions – risk taking – drugs, alcohol, sexual behavior. Depressive state often. Can lead to suicidal thoughts. Can often also have ADHD, ODD & Conduct Disorder. Can worry a lot. Deep concerns about many things, sometimes not necessarily about school. Very self-conscious & often has low-self esteem.
Fundamental Users
Figure 11
• • •
Can have different speech patterns at times – sometimes rapid, sometimes slow. Can have difficulties finding supportive medicines. Can result in reactiveness. About 2.8% of the population has Bipolar Disorder, the numbers skew to 4.7% in teens.
What makes a good classroom for students with depression? • • • • •
Quiet room for transitions Natural light Private discussion areas Family consultation spaces Dietary intervention
• • • • •
Can have difficulties finding supportive medicines. Can result in reactiveness. Could suffer from Seasonal Affective Disorder – need more daylight in winter. Higher probability of eating disorders – medicines sometimes lead to over-eating. Often suffers from nausea & headaches. About 2.8% of the population has Bipolar Disorder, the numbers skew to 4.7% in teens.
What we should know about students with depression? • • • • • • • • • •
Has trouble sleeping / can be exhausted in class – can lead to irritability. Has mood swings from quiet to anger – Anger & frustration can trigger quickly – Tantrums. Frustrations can come on quickly with cortisol / norepinephrine response in Amygdala. Goes to “fight or flight” more quickly than an average student. Often missing dopamine and serotonin in their brain chemistry. Drug Use, alcohol, sexual behavior abuses – trying to feel something or numb feelings. Can lead to suicidal thoughts. Could have had a traumatic experience in the past that they struggle dealing with - PTSD. Can often also have ADHD, ODD & Conduct Disorder Can worry a lot. Deep concerns about many things, sometimes not necessarily about school. Very self-conscious & often has low-self esteem.
Figure 12
AERO Therapeutic Center
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FUNDAMENTAL USERS
students
What makes a good classroom for students with Disruptive Mood Dysregulation Disorder (DMDD)? • • • •
Quiet room Natural light Private discussion areas Family consultation spaces
• •
Needs cognitive behavioral therapy, parental training, dialectical behavioral therapy Approximately 5.2% of adolescents exhibit DMDD behavior; & up to 9% is seen in Juvenile Detention Centers adolescents, Children under twelve are approximately 5% but diagnosis is trending upward as it is a new diagnosis and gaining understanding.
What we should know about students with DMDD? • • • • • • • •
Has trouble sleeping / can be exhausted in class – can lead to irritability. Has mood swings from quiet to anger – anger & frustration can trigger quickly – extreme tantrums. The student can seek disruptive attention in the classroom when I feel ignored or heard. Family therapy is helpful to establish consistency of approach to modify behaviors. Organization & structure helps keep students self-regulated, no surprises. This was added to the DSM in 2013. Prior to that kids were given the diagnosis of Bipolar Disorder or Oppositional Defiance Disorder. 77% share traits with ADHD & 92% share traits with ODD. Students struggle to communicate at times, often not making eye contact. Students can exhibit stubborn behavior
Figure 13
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Fundamental Users
What makes a good classroom for students with Oppositional Defiance Disorder (ODD)? • • • •
Quiet room Natural light Private discussion areas Family consultation spaces
• • • • • •
Can exhibit risk taking behavior to prove they are correct. Often direct frustration and anger to people in charge openly. There is a pediatric and an adolescent onset version of this. This is a condition tied to brain development. This child can pick fights or instigate fights of others. Approximately 3.2% - 4.6% of children have ODD. It is approximately 10.2% for adults. It is relatively consistent between men and women.
What we should know about students with ODD? • • • • • • • • • • •
Has trouble sleeping / can be exhausted in class – can lead to irritability. Has mood swings from quiet to anger – anger & frustration can trigger quickly – tantrums. Depending upon the severity, the student can seek disruptive attention in the classroom when I feel ignored or heard. Can refuse to comply with requests. Can be depressed and / or have ADHD as well as comorbidities. Deliberately picks on people, bullies others & blames others for problems. Family therapy is helpful to establish consistency of approach to modify behaviors/ Organization & structure helps keep students self-regulated, no surprises. Students can exhibit stubborn behavior. Vigorous activity and intermittent movement Potentially needs special dietary intervention – medicines can cause depressed eating habits, there are certain foods / probiotics that help reduce inflammation.
Figure 14
AERO Therapeutic Center
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FUNDAMENTAL USERS
students
What makes a good classroom for students with down syndrome?
• •
• • • •
•
Need room to work with dedicated aide Adjustable desks for comfort could be beneficial. Reduced visual clutter Keyboard / Computer usage
What we should know about down syndrome students? • • •
• • • • • • •
Down syndrome students sometimes need help with social boundaries. Down syndrome students tend to be visual learners. Down syndrome students are very successful with repetitive tasks and would struggle with complex tasks. There is a need to have instructions broken down into smaller parts – They have very short working memories. There are sometimes fine motor skill issues. Down syndrome students are literal learners. Down syndrome students might have problems with writing. Down syndrome students often struggle with hearing and sight impairment. Down syndrome students benefit from classroom accommodation plans – audio, visual, kinesthetic Curiosity and acknowledgment are crucial for engagement. Students might need additional time to complete tasks.
• • •
Thrives on interaction and engagement with peers. Prevalence – 1 child in 691 has Down Syndrome 95% of those students have Trisomy 21, 4% of Mosaic DS and 1% with Translocation DS. 400,000+ people in the US have down syndrome. Often there is factors co-presenting such as dyslexia or dyspraxia. Sometimes has issues with joint laxity and muscle hypotonia. Down syndrome students can be prone to sinus infections, thyroid and heart issues. There are also potential issues with seizures. Down syndrome students express pain slower than the neurotypical student. Aides have to look for signs of distress.
Figure 15
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Fundamental Users
What makes a good classroom for students with physical disabilities (Cerebral Palsy, Muscular Dystrophy, Multiple Sclerosis, etc.)? • • • • •
Accessibility, clear movement Storage needs for assistive technology Accessible toilet rooms Multiple presentation formats Room for ventilators or special breathing apparatus
What we should know about students with physical disabilities? • • • • • • • •
Potentially needs special dietary intervention – food prep and sink areas needed. Can utilize sip / puff (SNP) systems which need cleaning and maintenance. Students potentially have learning disabilities as well. Communication with students can be difficult. Consistency of care is important. In some cases, speech can be impacted. Can often develop heart and lung problems due to lack of physical activity. Students can become depressed as conditions worsen or if there is a lack of perceived successes; accomplishments matter and need to be celebrated. Students might struggle with organization. Figure 16
AERO Therapeutic Center
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FUNDAMENTAL USERS
students
• • • • • •
Figure 17
24
Writing can be difficult for some students. Speech therapy and gross motor therapy needed at times. Can get very tired from exertion. Might need more breaks than other students. 40% more likely to be male rather than female. Health-Related Quality of Life (HRQOL) is typically lower than other students. Consistency of care from home to school is critical to good quality of life. Parent teacher partnership is essential.
Figure 18
Fundamental Users
FUNDAMENTAL USERS
teachers, interventionists, staff
What makes a good classroom for teachers, interventionists and staff? • • • • • • • •
Flexible and stable furniture Quiet rooms Easy access to materials and technologies Good acoustics Sightlines and visibility Storage Natural light Natural materials
What we should know about teachers, interventionists and staff? •
• • • • • •
• • • • • •
A feeling of “Lack of support from colleagues / supervisors” is a critical factor. Day-to-day stress is significantly higher for special education teachers because there are multiple points of potential disruption to monitor. Para-educators and teachers should have shared goals with students – communication. Proactive teamwork strategies lesson the communication gaps that lead to frustration. Role-based training can be helpful to having a shared approach to interventions with students so that teamwork can be consistent. Emotional intelligence and self-awareness by the educator are important to be able to better understand how they will react in a given situation.
Special educators & facilitators suffer “burnout” at a higher rate than regular teachers – +50% leave the profession within 5 years and 75% leave the profession in 10 years – the average teacher (40% within 5 years). Lack of communication is a critical issue – from administration & from parents. Educators need quiet rooms to de-stress. Educators who get more training, have better engagement. A discussion of purpose is helpful for re-centering. Student expectations can often lead to feelings of failure – set more realistic goals with students. Time management can be difficult due to the amount of paperwork and planning. Automation / Talk to Text technology could be beneficial.
Figure 19
AERO Therapeutic Center
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FUNDAMENTAL USERS
parents
What makes a good therapeutic center for parents? • • • • •
Covered drop-off zone Welcoming entrance & reception Comfortable waiting room Easily accessible conference areas Happy students who want to go to school
What we should know about parents of AERO students? • • • • • • • •
26
Education of parents about the student’s condition, researching effective treatments and care. Parents often need to cope with higher emotional and physical demands. Parents often lead discussions on interventions, accommodations and placements. Parents often have financial issues due to the cost of healthcare and treatment. Parents often are under great stress due to the demands of their daily life and the care. Parents often harbor guilt due to the stress of wondering if they are doing enough or if they are getting the best care for their children. Isolation is a big concern for parents as often they do not have normal socialization patterns due to life demands or fear of criticism nor judgement from others. Parents often have grief over missing what they had in their minds as the ideal parenting moments they feel they are missing and loss of hopes for their children.
Fundamental Users
• • • • • • • •
Support groups and parental interaction with others who have similar challenges has been proven beneficial, build a community. About 40% of Parents of students with ADHD have ADHD themselves. Screening for parental symptoms has been proven to be helpful to increase children therapy outcomes. Mothers often have to be treated for depression more than ADHD. Autism is often hereditary – passed down from fathers. This often leads to guilt and detachment thus increasing the burden on mothers. Sometimes parents do not know they are a carrier of a mutation, this often results in guilt. Self-care and support are critical for parents. Parents need to identify their limitations and specify their abilities as part of the care model to allow for greater intervention effectiveness.
Figure 20
Figure 21
AERO Therapeutic Center
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KEY PERFORMANCE FACTORS Sensory Loading
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Transitions
31
Overlapping
32
Geographic Stressors
33
Biophilia
34
Care
35
KEY FUNDAMENTAL FACTORS
sensory loading
CONCEPT 1
Sensory Loading Concept: •
Neuro-typical approach: Immerse the neuroatypical students in normative environments in order to encourage adaptation and simulate realworld environments. This is the approach of the original AERO facility.
•
Sensory design approach: favorably designing the sensory environment can be conducive to positive and constructive behavior. Uses a “graduated” approach of sensory spaces from the highly adapted to the typical to allow for gradual skill development. This is the approach of the new AERO Therapeutic Center.
NEURO-TYPICAL APPROACH All environments are neuro-typical
SENSORY DESIGN APPROACH Environments are on a graduated scale from highly adapted to neuro-typical
30
Key Performance Factors
KEY FUNDAMENTAL FACTORS
transitions
CONCEPT 2
Sequencing and Transitions Concept: To align the daily schedules of students and their affinity for routine with the spatial layout of the building. This can be employed to great effect when combined with effective way-finding and sensory zoning. • • • •
•
Group functions for each age group in zones through which children move progressively throughout the day. Organize functions in a one-way circulation pattern, such that back-tracking or complex navigation is not required. Design these transitions such that students are not exposed to unnecessary distraction or sensory-rich environments. Circulation patterns should be logical and clear. Students should be able to “map” their schedules without much difficulty. Returning to central circulation “nodes” can be helpful. The architecture should recognize transition points, preferably in similar consistent ways.
NOT THIS
THIS!
Figure 22
AERO Therapeutic Center
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KEY FUNDAMENTAL FACTORS
overlapping
CONCEPT 3
Overlapping Approaches Concept: The following strategies benefit multiple user types. • •
• • • • •
Acoustics: reduce noise levels, echo, mechanical noise. (Benefits to neuro-typical, ADHD, and Autism-spectrum users) Spatial sequencing: affinity for routine, provide logical entry and access sequence based on scheduled use of spaces. One-way circulation where possible, minimal disruption and distraction. Escape space: respite from over-stimulation, small partitioned area or “crawl space.” Conpartmentalization: provide distinct sensory cues for each type of activity, to clearly define functions and expectations. Transition zones: recalibration of senses Sensory zoning: see compartmentalization Safety: avoid sharp edges and corners, “fingertraps”, pay more close attention to furniture, equipment, and danger points
Figure 23
Figure 24
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Key Performance Factors
KEY FUNDAMENTAL FACTORS
geographic stressor
CONCEPT 4
Geographic Stressors Concept: Physical points in the school building may inherently cause stress in students. •
•
• •
Drop off & pick-up: the transition from car/bus to the school entrance can be an intimidating and stressful experience. Break down to reduce scale and contrast of the entrance. Oppose “monumentality.” Corridors: passing between classes is most often the noisiest and most sensory-rich time in a students day, so any effort to curtail this experience would be useful to maintaining focus. Offset passing periods, wider hallways, acoustic treatment in the area are strategies to consider. Classroom entrance: the classroom entrance may induce anxiety as a result of social concerns or performance anxiety. Cafeteria & gym: Dining rooms and other large spaces can be loud, sensory-overloading situations. There are multiple decision points and social interactions to navigate. This also applies to other large social gatherings like assemblies, beginning of day line-ups, and mass examinations.
•
Avoidance: For students with OCD or GAD, avoidance of locations of prior anxiety attacks may be common.
Figure 25
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KEY FUNDAMENTAL FACTORS
biophilia
CONCEPT 5
Biophilia Concept:
Multiple user types will benefit from access to biophilic moments at strategic points. • • •
•
Biophilia is the idea that humans possess an innate tendency to seek connections with nature. Nature is therapeutic for humans. Nature in the space: sensory exposure/access to nature, non-rhythmic sensory stimuli, access to fresh air, access to water, dynamic lighting, natural forms/patterns/materials. Nature of the space: prospect (view), refuge (escape space), mystery, risk / peril (sense of adventure).
Figure 26
Figure 27
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Key Performance Factors
KEY FUNDAMENTAL FACTORS
care
CONCEPT 6
Care
Concept: For the students and staff to benefit the most from any intervention there needs to be an effort to address their wellbeing. •
•
Engagement: When educators and staff feel appreciated, they perform better. When educators and staff are provided training on the latest topics and research, they perform better. When educators and staff are able to find time on stressful days to regain their equilibrium, they perform better. Any new facility has to take into account how to take care of their employees and provide flexible spaces. Stress reduction: Look for opportunities to create spaces and places that allow staff members and educators to be able to rejuvenate. You cannot care for others if you cannot take care of yourself. In combination with other strategies, such as biophilia, there is an opportunity to limit cortisol and norepinephrine reactions and give the ability to allow employees to center themselves.
•
Communication: An essential part of any program should be messaging and communication. Effective engagement begins with a culture of open dialog grounded in the belief that everyone is working toward a common goal. Spaces should foster and host all forms of communication
Figure 28
AERO Therapeutic Center
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4
APPROACH Health Intelligence & Consultation
38-39
Assistive Technologies & Adaptive Education Tools
40-41
Teacher & Staff Wellness
42-43
Visual Clutter
44-45
Color
46-47
Movement
48-49
Nutrition
50-53
Natural Lighting
54-55
Artificial Lighting
56-57
Acoustics
58-59
APPROACH
health intelligence & consultation
When developing a therapeutic model of care, health intelligence and literacy are critical for success. A unified approach to care equals the best result where teachers, interventionists, students and parents are working toward goals. Goal setting is critical. The Guide to Physical Therapist Practice recommends that therapists should identify the patient’s goals and objectives during the initial examination in order to maximize outcomes. (Baker, 2001) Studies support higher outcomes with participant involvement in goal setting. In therapeutic model, this is the parent and the student. The more they are both involved the greater the engagement in the process.
we need professionals who are able to speak the language and understand the culture of their students. (Dr. Benjamin, 2010). In that, goal setting needs to be understood and easily achieved. Simple language is necessary.
Architectural Implications • •
Areas for consultation & parent education OT / PT spaces & courtyards have small challenges such as ramps, textures, level changes as easily achievable goals.
A significant challenge is parental alignment and understanding creating the continuum of care. Sometimes it’s not possible to do everything that schools can do. There are outside factors that prevent the same level of care. It is critical that care can be maintained. Health information can be confusing even for those with advanced literacy skills. It’s easy for those of us working in health care to forget that we speak our own language that patients can’t always easily understand. Most of us can recall times when we believed that we shared information with a patient and family member or caregiver and assumed they understood our instructions, only to later discover confusion or misunderstanding (Federico, 2014). Economics play a significant role. Affordability can be an issue. To optimize care, health literacy is as important for care givers as it is for the parents and students. To bridge the gap between the medical and care information provided and its implementation,
38
Approach
Figure 29
Key Points •
The more students and parents are engaged in the goal setting, there is a greater probability of success – it becomes more bespoke to the individual resulting in greater ownership. The student and families have greater engagement and feel a better sense of purpose.
•
The more frequent the consultation and communication, the better the results.
•
Much of this can occur online as that has become more effective for working parents.
•
Better engagement in goal setting often trends toward better behavior in class and better teacher morale.
•
Greater understanding of homework/classwork assignments for parents which helps to reduce at-home stress.
•
Goal-setting time frames have to be realistic but also have to be flexible to deal with real life situations. The more students and parents are knowledgeable of the underlying conditions and what to look for, there is a better ability to address triggers. This will lead to more proactive medicine and responses in lieu of reactive response.
•
Often, the parents have cultural barriers and/or their own education issues and have not been communicated successfully in private by medical professionals to help the student be successful in treatment/therapy.
Figure 30
•
The more sharing of information leads to making better choices and helps teachers/counselors to help specific tasks as the student is better able to advocate for themselves.
•
Better health literacy leads to better prioritization of goals.
•
Better health literacy leads to the ability of “Teach-Back” moments where the student can lead discussion on their needs and goals.
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APPROACH
assistive technologies & adaptive education tools
Students with diverse abilities need the necessary tools to accomplish everyday tasks. For students with serious conditions it is important that we give proper functionality to make their lives easier to complete tasks. Assistive technology gives the students the ability to be able to focus on their education in their skill set, rather than fighting the barriers that prevent them from moving forward. Assistive technology also helps the educators during the course of the normal day, overhead rail systems, various types of sitting in standing apparatus, all support healthy living for students with mobility challenges and in most cases help to create a sense of dignity. The future of assisted technology could make radical changes to therapy. In the future, wearables could help deliver vital health information to caregivers that could lead to the switch from reactive medicine to predictive medicine and thus minimize highs and lows of student behavior. There are new studies that suggest Augmented Reality and Virtual Reality can support neurobiology rehabilitation. (Benyoucef, 2017) Virtual and Augmented Reality can help in the development of synaptic connections that foster greater neuroplasticity in the brain. When combined with Exoskeletons or other movement devices, VR / AR can help those with mobility challenges rehabilitate in controlled environments while tackling simulated tasks. Other wearable devices allow students to control computers with eye movement or simple gestures that help develop their gross motor skills and hand eye coordination in Occupational Therapy. (Pepe & Talalai, 2016). Wearables also can encourage reluctant students to explore and move. Speech to text software supports those who struggle to get
40
Approach
Figure 31
their thoughts out or have challenges typing. Low tech solutions such as movement chairs and visual timers help transitions. Adaptive education is an exercise in fluency over repetition. Students with behavioral issues can benefit from adaptive education theory by constantly switching ideas and only working on enough problems to get to the point of fluency. The goal is to keep students moving forward without becoming bored. Students with behavioral issues when bored, oftentimes become disruptive. In a way, adaptive education tools become almost like game playing. They become fun. Giving students goals to work toward, in a quick and efficient manner is helpful for allowing students to maintain their equilibrium.
Architectural Implications • •
Storage for assistive technology within classrooms. Assistive technology fitting zone should be flexible.
Figure 32
AERO Therapeutic Center
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APPROACH
teacher and staff wellness
The AERO Therapeutic Center should provide zones for teacher & staff wellness and destressing. Job-related stress negatively and substantially affects the classroom environment, the teaching-learning process, and the attainment of educational goals and objectives. Each student brings with them their blueprint, as documented in their Individual Education Plan (IEP), which may include mandates to provide a variety of related services to help support students to progress. Many students have multiple services and classifications and are often years behind academically. This means even one small, self-contained class can have students within a three-year age span, with multiple individual needs, learning at different levels and with different styles. That is a daunting task. (Harnett. 2018)
Parental support is also important for teacher engagement. The more alignment between parents and teachers with regards to the student, the better for the student. The continuum of care and setting realistic goals essential to reducing stress.
Architectural Implications • •
Giving teachers access to nature and natural views reduces stress. Access to quiet rooms for teachers to collect their thoughts.
There are many reasons why educators leave the profession. Safety is a big concern when dealing with behavioral issues. These students have been diagnosed with a behavioral disability; their actions are a manifestation of their disability. Consequently, they cannot be held to the same standard as a regular education student. They can assault you one day, and be back in your class the next, with a big smile on their face. (Lynch,2018) Helping students develop coping strategies are essential to reducing the stress in the classrooms. Reasonable goal setting and communication are essential to relieving stress. Collaboration and training are important to providing guidance for Teachers. In general, if you show value in your employees in wanting to give them the ability to improve, then student engagement improves.
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Approach
Figure 33
Key Points •
Special educators & facilitators suffer “burnout” at a higher rate than regular teachers – +50% leave the profession within 5 years and 75% leave the profession in 10 years – the average teacher (40% within 5 years).
•
Lack of communication is a critical issue – from administration & from parents
•
Educators need quiet rooms to de-stress.
•
Educators who get more training, have better engagement.
•
A discussion of purpose is helpful for re-centering.
•
Student expectations can often lead to feelings of failure – set more realistic goals with students.
•
Time management can be difficult due to the amount of paperwork and planning. Automation/ Talk to Text technology could be beneficial.
•
A feeling of “lack of support from colleagues / supervisors” is a critical factor.
•
Day-to-day stress is significantly higher for special education teachers because there are multiple points of potential disruption to monitor.
•
Para-educators and teachers must have shared goals with students - communication.
•
Proactive teamwork strategies lesson the communication gaps that lead to frustration.
•
Role-based training can be helpful to having a shared approach to interventions with students so that teamwork can be consistent.
•
Emotional Intelligence and self-awareness by the educator are important to be able to better understand how they will react in a given situation.
Figure 34
AERO Therapeutic Center
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APPROACH
visual clutter
Many students with special needs are stronger visual learners. Images can be powerful to them and stick in their long-term memories far better than descriptions can. For the students who have difficulty communicating, visual learning is critical to their success. A successful visual learning environment would be one where there is minimal clutter of visual imagery. This would allow the students to remain focused on the task at hand. The lighting for classrooms is critical so that visual learning can remain clear. Proper light levels and the overall quality of light has to be established so as to not contribute to eye strain and glare. Both can contribute to missing key information. Visual cues can be lost if there are too many distractions in the range of view of students. Visual confusion is the result. Focus can shift to non-important tasks. Even worse, visual clutter and confusion can lead to contributing to stress reactions in the students. Once an individual begins to have a stress-reactions, it can take five minutes or more to get a neurotypical student back on task. For the neurodiverse student, it can take even longer. In addition to getting back on task, there is also coping that has to be considered. In a high stimuli environment, the student having an adverse reaction has to self soothe or cope with the stimuli. Staff is also vulnerable to stimuli which can lead to increased anxiety and stress. Visual clutter can leave students and staff seeking a dopamine serotonin response. This can lead to irritability and aggressive behavior. The hope is for students and staff to achieve equilibrium in constructive ways. Color also plays a critical role in creating visual balance.
44
Approach
The color we normally perceive helps us understand information better. Color becomes part of the visual language that conveys information. Therefore, new color patterning or cueing in building helps establish visual spatial learning. This can occur in the classroom, but this can also be helpful in the transitions around the facility. Using color to convey wayfinding information in a clear manner also helps to reduce stress and create familiarity. It is important for this cuing to be consistent and deliberate across a facility to minimize the effects of geographic stressors.
Architectural Implications • •
Consistent clear visual clues deduce stress and improve wayfinding. Consolidating visual stimuli to one area in the classroom.
Key Points •
The use of visuals in eLearning can improve retention by up to 400%.
•
40% of learners respond better and engage with visuals versus text.
•
Visual information tends to stick in long term memory
•
The experiments reported show that under conditions of visual clutter human observers tend to perceive stimuli to be more strongly tilted on error trials than they do when the stimuli are presented in isolation.
•
Visual cues can be lost due to the amount of visual clutter in a space.
•
Visual clutter creates potential for visual confusion.
•
Visual overstimulation can result in focusing on non-specific tasks.
•
Visual overstimulation can result in the release of stress hormone cortisol.
•
Clutter can lead to overstress which leads to unhealthy coping responses – overeating, drug or alcohol use, etc. This is a search for dopamine and serotonin in an ill-advised way to selfregulate.
Figure 35
AERO Therapeutic Center
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APPROACH
test clutter visual
The use of color is very important when designing a therapeutic environment for students with learning or behavioral disabilities Especially when there are multiple types of users sharing learning spaces Not one approach tailors to all The need for a space such as, a classroom or therapy room to be flexible is overwhelmingly imperative Intrinsically, there are several key points to keep in mind when a design involves color: •
Diverse users respond differently to color spectrum.
•
It is important to create a low contrast environment between materials and colors to support visual learning.
•
An imbalance of colors can lead to overstimulation of the brain if not careful.
•
Student color perception changes with age.
•
Lighting and color play a key role in supporting low stress environments for students and staff.
•
Low color contrast environments support eye health and reduce the probability of headaches.
•
Color choices should support color perception abilities.
Age
Student color perception changes with age. In general, younger students respond to warmer colors whereas adolescent students respond better to cooler tones. (Engelbrecht, 2003). Student’s neurodiversity supersedes the typical reactions. It is important to tune the spaces to fit the needs of the students while keeping it flexible for future user groups as demands change. All users respond well to natural materials.
46
Approach
Lighting
Since color plays such an important role in the ability of students to visually see content, the lighting needs to coordinate with the color selections so as to provide the space proper color rendition. Cool colors paired with cool fluorescent lighting produce a cold, quiet and large appearance. Warm colors under warm incandescent lighting make a space feel small, active and louder (Gaines and Curry, 2011). Paint and Materials will have to be reviewed under the various lighting conditions prior to installation to determine the most suitable conditions.
Autism Spectrum Disorder
Scientists have discovered that people with autism spectrum disorder (ASD) have irregularities in their eye structure. The rod and cone cells undergo variations due to chemical disproportions and neural deficiencies (Ertem, 2017). Many people in the spectrum perceive colors more vigorously in comparison to those displaying typical neuro-development. Thus, it is best to avoid patterns and high contrast between surfaces as it can become busy and distracting for a person suffering from sensory overload. Colors with high luminance such as yellow, red and pink should be used minimally (Chon Fu, 2020). A study on color preference in young boys with ASD found that brown, blue and green were favored while yellow was strongly avoided (Grandgeorge and Masataka, 2016 ). It is no surprise that colors which are also found in nature are those being gravitated toward. Natural scenes support relaxation and recovery, especially after experiencing stress (Tchounwou, 2015).
Attention Deficit / Hyperactivity Disorder (ADHD)
Students with ADHD have distortion along the blue-yellow spectrum. They are challenged in processing color compared to neuro-typical students. This color distortion occurs in the structure of the eyes/brain which can lead to a worsening of symptoms. Sometimes, color preferences in ADHD learners are varied – some are comfortable with bright colors while others find these colors to be over-stimulating. Overall, color stimulation, in a balanced capacity, improves attention and motor skills which are often found to assist in academic performance (Gaines and Curry, 2011).
Depression
Students with depression display a reduced visual contrast sensitivity. This means that the vibrancy of colors is altered (Bubl, Kern, Ebert, Bach and Tebartz van Elst, 2010). However, this does not mean to create dull and monotone environments as that approach could worsen depression. Cool colors can also lead to more introverted behavior which may be non-beneficial in a classroom environment. Students with depression can have increased heart rates in rooms with red colors which then can be hypothesized that it begins to hamper ability to focus (Morton, 1998).
Muscular Dystrophy or Downs Syndrome
Students with Muscular Dystrophy have been found to have red and green impairment which then causes challenges to contrast and visual learning (Costa, Oliveira, Feitosa-Santana, Zatz, 2007). Similarly, Downs Syndrome often causes contrast sensitivity as well as, acuity difficulties. Natural daylight, which is a whiter light source can help to improve contrast compared to artificial light (Cairns, 2017).
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APPROACH
movement
Movement and exercise can also improve your mood and self-esteem, increase mental alertness while reducing your anxiety. (Dr. Sharma, 2006) As a society, exercise has been widely known to promote physical health and conditioning. Humans have celebrated physical activity for centuries through sports and play. It has been widely accepted that for seniors there is an abundance of research indicating positive relationships between physical activity and overall cognitive function. For students and special needs students, the importance of exercise is often overlooked. For students with mood disorders, evidence suggests that less than 50% of Mental Health Professionals prescribe regimented exercise as part of a treatment program. (Philips, 2017) Physical activity allows the brain to better optimize neuroplasticity, or the brain’s ability to adapt to challenges. Exercise increases synaptic function and numbers. It is this change and growth that allow for greater behavioral modification. Research, led by Charles Hillman, the director of the Neurocognitive Kinesiology Laboratory, at University of Illinois, suggests that physical activity increases the flow of blood to the brain which directly increase students’ cognitive control - or ability to pay attention - and also result in better performance on academic achievement tests. In the image below we see two different brain scans. After twenty minutes of walking, the human brain is more active resulting in better cognitive abilities, reading comprehension and increased creative thinking. Based upon the results of numerous tests and studies, Dr. Hillman recommends educators integrate simple movement into the typical classroom education.
Dr. Hillman also indicates that as little as twenty minutes of exercise can equate to twelve hours of positive mood enhancement. Mood enhancement via physical activity is becoming more prevalent as part of overall strategies for treating Bi-polar disorder, depression and anxiety. Exercise has been shown to reduce symptoms. Endorphins are released with exercise that help counteract the effects of mood disorders and result in more positive self esteem. (Mayo Clinic, 2020) As much as 30 minutes a day of moderate exercise three to five days a week results in significant improvement depression and anxiety symptoms. More intense exercise over shorter periods of time have a similar effect. Reasonable goals and expectations are important for long term care. Practicality of approach for any prescribed movement program will be more readily tolerated and thus will increase adherence.
Figure 36
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Approach
APPROACH movement
For many students, movement is difficult. People with movement challenges are 57% more likely to be obese. (US HHS, 2017) There are many factors that result in a lack of physical activity for students with disabilities. First and foremost, assistance is critical. Many have a fear of falling or a lack of energy due to how much they have to exert normally for daily tasks. For some, there are social stigmas, fear of being teased and general anxiety that reduce the desire to exercise in public. Access is another major factor. Consultation is critical. It sets up a safe environment. It sets reasonable goals and expectations and reduces frustration. Group exercise and play also result in better exercise engagement by building a sense of community and fellowship.
Benefits of Movement • • • • • • •
Increased heart and lung health Reduces stress and anxiety Improved mood and emotional wellbeing Improved reading comprehension Increased self-perception Group play has social benefits Increased endurance
Architectural Implications • •
Provide a variety of spaces that encourage movement and exercise. Outdoor environments including courtyards, playgrounds, playfields and walking loop make movement fun.
Figure 37
AERO Therapeutic Center
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APPROACH
nutrition
Diet, when coupled with exercise are components of a therapeutic approach to care. Knowledge and consultation about choices are important so students make positive choices to support their own success. In a 2007 study, athletes with disabilities who were provide nutrition education performed significantly better than athletes who continued their personal regimens. (Rastmanesh, 2007). It stands to reason that for the average student, the same holds true. Knowledge is important to preventing nutrition-related problems. Variations in mental health may contribute to or impair healthy eating habits. (Polivy, 2005) The challenge for many households can be access to healthy foods. Some families have limited to access to fresh foods because they live in areas with limited resources. Cost of fresh foods can also contribute to unhealthy eating habits. Culture sometimes play a role. Time constraints at home sometimes lead to eating more processed or fast food options rather than fresh food. This often leads to diets high in saturated fats and lacking the necessary nutrients. Often, students with anxiety or depression do not always keep the best eating schedules or potentially binge on foods looking for a dopamine high. Researchers studied the diet and mental health of 850 girls between the ages of 12 and 18, and found that consumption of fast foods, including ramen noodles, hamburgers, pizza, fried food and other processed foods, was associated with an increased risk of depression (Monroe, 2018). When coupled with students already prone to anxiety, depression or other neuro-diverse conditions, poor nutrition can amplify negative behaviors and Figure 38
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Approach
lead to increased probability of losing self-control of their emotions or actions. The food we eat allows our bodies to develop and maintain. For the neuro-diverse, development of the brain can be unique. We know foods high Omega 3 fatty acids help with brain development and are good for some patients whose brains are slower to develop when compared to the neurotypical student. The role of the balanced diet plays a significant role in mood stabilization. Low glycemic diets have been shown to improve mood in those with Anxiety, ADHD patients. Conversely, chronic deficiencies of certain vitamins like Vitamin D and minerals such as zinc, iron, magnesium, selenium and iodine and insufficient dietary intake of long-chain polyunsaturated fatty acids may have a significant impact on the development and deepening of the symptoms of ADHD in children. (Konikowska, 2012). Certain man-made additives can also trigger negative responses. A balanced, low glycemic index diet of natural foods are the best at supporting positive mood enhancement.
Figure 39
A goal of any diet should also be to include food that helps reduce inflammation. Most of these types of foods are part of a low glycemic diet. Inflammation has been shown to complicate some behavioral conditions such as depression and anxiety. Inflammation is often increased in patients with mood and anxietyrelated disorders due to environmental challenges such as die and lifestyle, physical illness and psychosocial stress. (Felger, 2018).
Figure 40
AERO Therapeutic Center
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APPROACH
nutrition
For some students, a proper diet is fuel for physical therapy; giving students what they need for strenuous exercise and muscle development. Obesity can be a challenge for those with movement impairments. Paraplegics often struggle to lose weight. Uncontrolled weight gain can lead to the onset of diabetes. Finding the right balance of nutrition along with the proper portions at the appropriate times of day becomes a job in and of itself. When you have students in wheelchairs with limited mobility, there is a need to balance caloric intake and nutrition since muscle use and overall exertion is lower than an able-bodied individual. For individuals with feeding tubes, working in concert with the medical professionals is important to providing nutrition that supports the continuation of care.
Architectural Implications • •
Life skills, kitchen educational space, and cafeteria spaces can encourage healthy eating habits. Office for a nutritionist has been included in the project. Adjacent to the preparation kitchen. Figure 41
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Key Points •
Lifestyle, Culture and Knowledge are sometimes the cause of poor nutrition.
•
Proper nutrition will stabilize and minimize mood swings.
•
More natural, nutrient-dense foods are preferred.
•
Processed foods can trigger inflammation.
•
Inflammation due to poor diet can affect the Amygdala and Cingulate Cortex and increase disruptive behaviors and anxiety.
•
Portion control is often as important the types of food someone eats and should be aligned to student’s physical condition.
•
Nutrition Education has been shown to have a direct effect on nutrition choices and performance. Figure 42
AERO Therapeutic Center
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APPROACH
natural lighting
Architectural Implications
•
• Avoid visual glare. Direct, unattenuated light from the sun can exacerabate issues in sensitive students and distract all students. Design overhangs, light boxes, or openings to filter and diffuse light coming into the classroom. Perform solar studies to avoid “hot spots. Design for daylighting: Subsets of the student population will thrive in direct sunlight, but it will irritate others. Provide opportunities for students to be able to self-select these areas.
Figure 43
54
Figure 44
Approach
Figure 45
AERO Therapeutic Center
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APPROACH
artificial lighting
Architectural Implications
•
• Avoid glare. Direct, unattenuated light from bulbs or fixtures can exacerbate issues in sensitive students. • Average classrooms may be equipped for “zoned” lighting to provide additional sensory cues for different educational zones. Sensory rooms to be equipped for light therapy.
Figure 46
Figure 47
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Figure 48
AERO Therapeutic Center
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APPROACH
acoustics
Architectural Implications • • •
• • •
Typical Classroom are 50-60 decibels WHO says classroom noise goal = 35 db WHO recommends an outdoor noise level of 45 db at night and 55db during the day • Typical classroom partitions should be STC50 Average classrooms may be equipped for “zoned” acoustics to provide additional sensory cues for different educational zones. Noises to think about: door slamming, PA noise, mechanical initiation, exterior noise intrusion, equipment sounds. Employ sound masking to muffle environmental sounds
Exterior wall construction can be “tuned” to reach the right level of exterior noise resistance based on measured frequencies.
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ADHD: stochastic noise helpful for concentration ASD: intermittent noise harmful for concentration, speech clarity is a primary concern. SFA: sound field amplification
Acousticians to create a schedule of rooms and specific acoustical recommendations.
ACOUSTICS
LIGHTING
BIOPHILIA
AERO Therapeutic Center
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5 60
Approach
SPECIALTY SPACES Introduction
62-63
Lobby
64
Classrooms
65
Consultation Spaces
66
Corridors
67
Gymnasiums
68
OT / PT / Rehabilitation Spaces
69
Multipurpose
70
Sensory
71
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SPECIALTY SPACES
introduction
A Therapeutic Center is made up of special spaces that reinforce and support growth and progress. Ultimately, there are many kinds of spaces to support the various functions. For these spaces to be successful, they have to be created with the key performance factors in mind so that they have the maximum benefit. These spaces have to be designed for the students, the parents, the teachers and therapists. The overarching goal for the Therapeutic Center is for the architecture to support the reduction of environmental stress for all users. By doing so, the building supports therapy and progress. A Therapeutic Center should be a place where people look forward to going. The following space types make up the key functions of the Therapeutic Center.
Key Functions • • • • • • • •
Figure 49
62
Specialty Spaces
Lobby Classrooms Consultation spaces Corridors Gymnasiums OT / PT / rehabilitation spaces Multipurpose spaces Sensory
Figure 51
Figure 50
Figure 52
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SPECIALTY SPACES
lobby
A parent coming with their child to the Therapeutic Center for the first time needs to feel comfort. It is an extremely stressful moment in their family’s life. They need support and hope. The lobby is the first space they experience. The arrival sequence needs to help establish a calm steady influence. It needs to feel like a safe space. The space needs to feel hopeful. When a family parks their car, they need clear wayfinding to help them get to the reception and start their process without impediment. For the families that have been there before, the lobby should feel comforting and familiar. Hope is one of the most restorative feelings. There should be various levels of light so families can find a comfortable setting. There should be great visibility to allow people to feel like they control their environment. Security is a major concern. There needs to be protective barriers but at the same time, those barriers need to not be obvious. The lobby should be a warm environment, with natural finishes and proper acoustics. It should be the kind of space that allows everyone to catch their breath before their next steps.
Figure 53
64
Figure 54
Specialty Spaces
SPECIALTY SPACES
classrooms
Figure 55
Figure 56
Classrooms are the core of what makes a Therapeutic Center. This is where the students spend the majority of their time and receive their care. The goal of any space is to control the environment well enough to effectively reduce the environmental stressors for the students and staff alike; taking in mind acoustics, lighting, and thermal comfort. When a student is having a cortisol response to a frustration or an overstimulation there should be a space that allows the student to center themselves. The classroom should have adaptable spaces to control the surrounding environment. Flexible spaces to allow students the opportunity to find their own equilibrium. While controlling daylight, views should be afforded to nature to help in creating supportive, warm environments. Whether you have younger or older students, most students in a more self-contained classroom or resource classroom are going to benefit from clear boundaries in the room. Furniture is a key component to set workable boundaries and define areas. Being able to break out into individual learning sessions or for group learning requires flexible seating and adaptable furniture; easily moveable and operable by student and teacher. The classroom needs to be set up for clear communication.
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SPECIALTY SPACES
consultation spaces
Figure 57
Figure 58
An important part of any Therapeutic Center are the consultation spaces. During the course of the year, every family has multiple IEP meetings. Teachers and therapists meet with students daily. Communication is a fundamental component of education. The spaces that support development need to support proper communication. They should be acoustically superior so that all communication is as clear as possible. The spaces should have enough functionality to be teaching spaces when needed. Successful communication needs supported spaces. Communication can be stressful. The spaces for communication and consultation need to be peaceful. Lighting and temperature control are important. Often tensions can be high coming into these discussions and these spaces are for parent teacher alignment but there are times when they are not aligned. Frustrations can be high. Consultation spaces need to feel secure for teachers and therapists so that they have peace of mind. The setting of the spaces needs to be one that focuses on calmness.
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Specialty Spaces
SPECIALTY SPACES
corridors
Corridors are the main arteries of any facility. They can be a bustling environment full of energy and activity. Given a population of neuro and physically diverse students, this level of activity can create unwanted stress and complication. It is important for corridors to support the therapy model. It is important for intersections8 to be extension the classroom giving the students a sense of familiarity so that they may find their way in a hectic environment supports the therapy model. On any given day the energy of a corridor maybe overwhelming. Creating opportunities for students to find their own equilibrium before they venture forth is important. Corridors are an opportunity for social engagement that should be fostered. The corridor often becomes the storage area for assistive technology. Giving the educators and students easy access to assistive devices while not impeding the movement of others is a critical factor in the success of a corridor.
Figure 59
Figure 60
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SPECIALTY SPACES
gymnasiums
For a Therapeutic Center there needs to be a variety of spaces to work on gross motor skill, hand eye coordination or sometimes simply to get the energy out. The overall goal is to achieve the necessary milestones for development. It is not about just doing the movements but it is about doing the movements with purpose and how your brain tells your body to move. Timing of the movements is key. The exercise spaces need to support the practicing of these movements while providing a fun and safe environment. There are also spaces and equipment to practice practical skills. Movement is beneficial to overall health and well-being. As with classrooms, gymnasiums and exercise spaces need to have the ability to control the lighting and acoustics. Well lit spaces, especially with daylight promote activity. Not all students can tolerate bright lighting or hot temperatures. Thermal control is important to making comfortable environments so students can focus on activities and not be distracted. Outdoor exercise spaces provide a change of scenery to do different activities. Fresh air and space allow for active play and can give confidence in acclimating to real world scenarios.
Figure 61
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Figure 62
Specialty Spaces
SPECIALTY SPACES
OT / PT / rehabilitation spaces
Figure 63
Figure 64
The spaces used for Occupational Therapy and Physical Therapy need to have a level of environmental control and flexibility to support students trying to achieve sensory equilibrium. These are spaces where therapists and students work on creating alignment of mind and body to achieve tasks. To achieve these tasks, the students need to be in the correct frame of mind. The goal is to have multiple accessible spaces that allow for the development of both gross motor and fine motor skills. Development of those skills is not always linear and progress is not always large. So these spaces should also be a place where students and therapist can celebrate victories, both big and small. A real risk that exists are injuries. Fall protection and other safeguards need to be in place to ensure safety for all users for physical therapy. Fatigue is an issue with any therapy. The challenge is balancing the efforts with the outcomes. For occupational therapy, outdoor opportunities are important for students to practice real world applications in real weather conditions. Therapy does not necessarily have to occur in designated spaces. Corridors can be optimized to practice low impact gross motor skills and develop endurance through repetition.
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SPECIALTY SPACES
multipurpose
Multipurpose rooms are flexible environments for education and training that can be used as gymnasiums, training suites, general meetings, and therapy. Acoustics and lighting are important to their success. The space needs to feel quiet even though it could be bustling with activity. The flexible space need to have the ability to be adaptable and functional. Furniture is an important component that allows the room to change its functions quickly. Built-in storage adds to ease of use transformations. Connection to nature is important to control stress, having natural views is one of the ways that this space can be calm and comforting for the users. When used for a training function, the multipurpose room needs to have clarity in addition to ease of communication. Information must be visible to all users. When multi-purpose spaces are used as a gymnasium it is important that they provide soft comfort for students for safety and security. Having a smaller comfortable space for students to expel energy and practice movement skills is important for their development.
Figure 65
70
Specialty Spaces
SPECIALTY SPACES
sensory
To the average person, a sensory space might seem like a playground full of colorful lights and unique toys. But to students with sensory issues this fanciful space can be a quiet soothing place. While it can be a calm space where the student can regain control of their emotions, a sensory room can also provide a low-stress, fun environment for an individual to work through their emotions and reactions to certain stimuli. While the sensory room cannot necessarily take away a student’s brain’s sensitivity to certain stimuli, the room can train their brain to overcome its sensitivity and develop coping mechanisms that will serve them well. Every brain is different, and everyone’s response to stimuli is also different. This change from the normal world leads to exploration and calm. Having multiple ways to explore a space that utilizes all five senses in diverse ways provides unique opportunities. These spaces allow the brain to be positively stimulated in multiple ways with different textures that are soft, hard surfaces, and flexible jumping surfaces. Sensory can happen in a quiet corner of a classroom and a specialty designed space.
Figure 66
The lighting is a critical component to sensory spaces having the abilities to change the light colors to allow students in staff to find comforting levels of light allows their brains to process information differently. Ideally, the environment should offer multiple light sources that will flexibly meet the needs as the tasks within the room change. Giving the student the ability to be control of their environment is enough to be restorative.
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6
APPENDIX Text Sources
74-80
Image Sources
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APPENDIX
text sources
Fundamental Users - ADHD / Sensory Students
ADHD Institute. “Gender in ADHD Epidemiology.” ADHD Institute, 28 Feb. 2020, adhd-institute.com/burden-of-adhd/epidemiology/gender/. Armstrong, Thomas. “Time in Nature for Kids with ADHD | Thomas Armstrong, Ph.D.” American Institute for Learning and Human Development, 25 Apr. 2018, www.institute4learning.com/2018/04/25/7-ways-to-use-nature-tocalm-and-focus-kids-with-adhd/. Barkley, Russell. “Classroom Accommodations for Children with ADHD.” Dr. Russell A. Barkley - Dedicated to Education and Research on ADHD, www.russellbarkley.org/factsheets/ADHD_School_Accommodations.pdf. Brain Forest Centers. “5 Ways ADHD Affects Learning in the Classroom.” Brain Forest, 26 Sept. 2018, www.brainforestcenters.com/news/5-ways-adhd-affects-learning-in-the-classroom. CHADD. “Classroom Accommodations.” CHADD, 24 May 2018, chadd.org/for-educators/classroom-accommodations/. Dunckley, Victoria. “Nature’s Rx: Green-Time’s Effects on ADHD.” Psychology Today, 20 2013, www.psychologytoday.com/us/blog/mental-wealth/201306/natures-rx-green-times-effects-adhd. FamilyEducation. “The Best Classrooms for Children with ADHD.” FamilyEducation, 15 Mar. 2006, www.familyeducation.com/school/classroom-modifications/best-classrooms-children-adhd. Hitti, Miranda. “Nature Helps Fight ADHD.” WebMD, 27 Aug. 2004, www.webmd.com/add-adhd/childhood-adhd/news/20040827/nature-helps-fight-adhd. Kuo, Frances, and Andrea Taylor. “A Potential Natural Treatment for Attention-Deficit/Hyperactivity Disorder: Evidence From a National Study.” PubMed Central (PMC), www.ncbi.nlm.nih.gov/pmc/articles/PMC1448497/. LD OnLine. “Helping the Student with ADHD in the Classroom: Strategies for Teachers.” www.ldonline.org/article/5911/. Mayo Clinic. “Attention-deficit/hyperactivity Disorder (ADHD) in Children - Symptoms and Causes.” Mayo Clinic, 25 June 2019, www.mayoclinic.org/diseases-conditions/adhd/symptoms-causes/syc-20350889. Meyer, Harold, and Susan Lasky. “School-Based Management of Children with Attention-Deficit/Hyperactivity Disorder: 105 Tips for Teachers.” ADD Resource Center, 31 Aug. 2017, www.addrc.org/disorder-105-tips-for- teachers/. Morin, Amanda. “Classroom Accommodations for ADHD.” Understood, 27 Sept. 2019, www.understood.org/en/school-learning/partnering-with-childs-school/instructional-strategies/classroom-accommodations-for-adhd. Segal, Jeanne, and Melinda Smith. “Teaching Students with ADHD.” HelpGuide.org, www.helpguide.org/articles/add-adhd/teaching-students-with-adhd-attention-deficit-disorder.htm. Accessed Sept. 2020. U.S. Department of Education. “Identifying and Treating Attention Deficit Hyperactivity Disorder: A Resource for School and Home.-- Pg 4.” U.S. Department of Education, 13 Feb. 2009, www2.ed.gov/rschstat/research/pubs/ adhd/adhd-identifying_pg4.html. U.S. Department of Education. “Teaching Children with Attention Deficit Hyperactivity Disorder: Instructional Strategies and Practices-- Pg 5.” U.S. Department of Education, 7 Oct. 2008, www2.ed.gov/rschstat/research/pubs/ adhd/adhd-teaching_pg5.html. Watson, Angela. “6 Classroom Organization Tips to Help Kids with ADHD.” The Cornerstone For Teachers, 16 Aug. 2017, thecornerstoneforteachers.com/6-classroom-organization-tips- to-help-kids-with-adhd/.
Fundamental Users - Students with Anxiety
ADAA. “Anxiety Disorders at School.” Anxiety and Depression Association of America, ADAA, 2020, adaa.org/living-with-anxiety/children/anxiety-disorders-school. Buchler, Robin. “Anxiety-Reducing Strategies in the Classroom.” ScholarWorks at WMU, Western Michigan University, Aug. 2018, scholarworks.wmich.edu/cgi/viewcontent. cgi?article=1182&context=dissertations. Crisis Text Line. “Text CONNECT to 741741| FREE Help for Anxiety.” Crisis Text Line, 23 May 2020, www.crisistextline.org/help-for-anxiety/?gclid=Cj0KCQjwgJv4BRCrARIsAB17JI5_vklANc5d U8eCybjV4UKKzJRYjcHBk4tYPYzeDpcqHxVw6JR76EaAob8EALw_wcB. Hasan, Shirin. “Anxiety Disorders Factsheet (for Schools).” Nemours KidsHealth - the Web’s Most Visited Site About Children’s Health, May 2019, kidshealth.org/en/parents/anxiety-factsheet.html. Hurley, Katie. “Anxiety at School - Accommodations to Help Your Anxious Child.” Psycom.net - Mental Health Treatment Resource Since 1986, 26 Sept. 2018, www.psycom.net/classroom-help-anxious-child-at-school/. IBCCES. “Top 10 Signs of Student Anxiety In The Classroom.” IBCCES, 17 Apr. 2020, ibcces.org/blog/2019/05/08/signs-student-anxiety-classroom/. International OCD Foundation. “Anxiety Signs and Symptoms.” Anxiety In The Classroom, 26 Sept. 2020, anxietyintheclassroom.org/school-system/i-want-to-learn-more/anxiety-andocd-symptoms/. International OCD Foundation. “I Want to Learn More.” Anxiety In The Classroom, 17 Sept. 2020, anxietyintheclassroom.org/school-system/i-want-to-learn-more/?gclid=Cj0KCQjwgJv4BRCrARIsAB17JI5Oc1qHq3ebW- ciQADxSQLo5JSbDEUE9TGKJGLODvbvUCSEHOZh6qIaApy8EALw_wcB. Rogers Behavioral Health. “How to Identify and Manage Anxiety in Students.” Rogers Behavioral Health, 12 Sept. 2018, rogersbh.org/about-us/newsroom/blog/how-identify-and-manage-anxiety-students. Ting, Sarah. “Students and Anxiety Problems.” UCLA School Mental Health Project, UCLA Dept. of Psychology, 2015, smhp.psych.ucla.edu/pdfdocs/anxiety.pdf.
Fundamental Users - Students with Autism
American Autism Association. “What Is Autism? — American Autism Association.” American Autism Association, 2020, www.myautism.org/what-is-autism?gclid=Cj0KCQjwgJv4BRCrARIsAB17JI4gQsivToZnvBw3Uvoh78Afo7MB htiyKP0qfBI012mL7ybWqUxf6dcaAhGGEALw_wcB. Applied Behavior Analysis Programs. “30 Things All Teachers Should Know About Autism in the Classroom.” Applied Behavior Analysis Programs Guide, 16 Aug. 2018, www.appliedbehavioranalysisprograms.com/what-all-
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teachers-should-know-about-autism-in-the-classroom/. Autism Speaks. “Autism Statistics and Facts.” Autism Speaks, 2020. https://www.autismspeaks.org/autism-statistics. Colihan, Kelley. “Autism in the Classroom.” WebMD, 10 Dec. 2008, www.webmd.com/brain/autism/features/autism-in-the-classroom. DFTM. “Programs.” Dreams Fulfilled Through Music, 17 Sept. 2019, dftm.org/programs/?gclid=Cj0KCQjwgJv4BRCrARIsAB17JI6MCNpan2yCeKMLG9db_USg7qL02CKAvWwXfvpZNTZLwGxmMLEjUyMaArQdEALw_wcB. Douglas, Karen, and Shannon Steffen. “Strategies that Work for Students with Autism Spectrum Disorder in Inclusive Classrooms.” College of Education - Illinois State, 2016, education.illinoisstate.edu/downloads/ntcon/ Douglas1.pdf. Fowler, Scott. “News & Events.” Organization for Autism Research, December 31, 2020. https://researchautism.org/inclusion-in-the-classroom/. Goodall, Craig. “How do we create ASD-friendly schools? A dilemma of placement.” PANAACEA, 2015, www.panaacea.org/wp-content/uploads/2016/05/How-do-we-create-ASD-friendly-schools-A-dilemma-of-placement.pdf. Howell, Erica Joy. “Elementary School Children with Characteristics of Autism Spectrum Disorders: Predictors of the Student-Teacher-Relationship,” February 8, 2013. https://escholarship.org/uc/item/1333d2s7. IRIS Center Peabody College Vanderbilt University. “Page 2: Autism Spectrum Disorder Characteristics.” IRIS, Vanderbilt University, 2021, iris.peabody.vanderbilt.edu/module/asd1/cresource/q1/p02/. National Education Association. “Student Success.” National Education Association | NEA, 2021, www.nea.org/assets/docs/Autism_Guide_final.pdf. Sack, James. “Life Journey Through Autism: An Educator’s Guide to Autism.” Research Autism, Organization for Autism Research, 1 May 2014, researchautism.org/wp-content/uploads/2016/11/An_Educators_Guide_to_Autism. pdf. VDOE. “Model of Best Practice in the Education of Students with Autism Spectrum Disorders.” Virginia Department of Education Home, May 2011, www.doe.virginia.gov/special_ed/disabilities/autism/technical_asst_documents/ autism_models_of_best_practice.pdf.
Fundamental Users - Students with Bipolar Disorder
American Academy of Child and Adolescent Psychiatry. “Bipolar Disorder In Children And Teens.” Home, 2021, www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Bipolar-Disorder-In-Children-AndTeens-038.aspx. Hall-Flavin, Daniel. “Bipolar Disorder in Children: Is It Possible?” Mayo Clinic, 4 Jan. 2017, www.mayoclinic.org/diseases-conditions/bipolar-disorder/expert-answers/bipolar-disorder-in-children/faq-20058227. Hvilivitzky, Tanya. “8 Signs Your Child Might Have Bipolar Disorder.” BpHope.com, 17 June 2020, www.bphope.com/kids-children-teens/8-signs-your-child-might-have-bipolar-disorder/. JBRF. “JBRF Supports Children & Families.” Juvenile Bipolar Research Foundation, 19 Nov. 2020, www.jbrf.org/. Miller, Caroline. “Is It ADHD or Bipolar Disorder?” Child Mind Institute, 8 Jan. 2020, childmind.org/article/is-it-adhd-or-bipolar-disorder/. NIMH. “NIMH Bipolar Disorder in Children and Teens.” NIMH Home, 2020, www.nimh.nih.gov/health/publications/bipolar-disorder-in-children-and-teens/index.shtml. WebMD. “Children and Teens With Bipolar Disorder.” WebMD, 25 Mar. 2005, www.webmd.com/bipolar-disorder/guide/bipolar-children-teens. Read, Kimberly. “Could Your Child Have Bipolar Disorder?” Verywell Mind, 5 Jan. 2021, www.verywellmind.com/symptoms-of-bipolar-disorder-in-children-378860. The National Institute of Mental Health Information Resource Center. “Bipolar Disorder.” NIH Mental Health Information. Nov. 2017, https://www.nimh.nih.gov/health/statistics/bipolar-disorder.shtml#:~:text=An%20estimated%20 2.8%25%20of%20U.S.,%25)%20and%20females%20(2.8%25).
Fundamental Users - Students with Depression
Bhatia, Richa. “Childhood Depression.” Anxiety and Depression Association of America, ADAA, 9 July 2018, adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/childhooddepression. CDC. “Anxiety and Depression in Children.” Centers for Disease Control and Prevention, 14 Apr. 2020, www.cdc.gov/childrensmentalhealth/depression.html. Children’s Health. “Signs of Depression in Children & How to Help - Children’s Health.” Children’s Health – Making Life Better for Children in Texas, 2020, www.childrens.com/health-wellness/signs-of-depression-in-children. Cleveland Clinic Medical Professional. “Depression in Children: Symptoms, Suicide Signs & Treatment.” Cleveland Clinic, 17 Nov. 2020, my.clevelandclinic.org/health/diseases/14938-depression-in-children. Epstein, Norman, and Donald Baucom. “APA PsycNet.” APA PsycNet, 2002, psycnet.apa.org/record/2003-04003-000. Mayo Clinic Staff. “Cognitive Behavioral Therapy.” Mayo Clinic - Mayo Clinic, 16 Mar. 2019, www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610. Schimelpfening, Nancy. “What Parents Should Know About Childhood Depression.” Verywell Mind, 4 Jan. 2021, www.verywellmind.com/childhood-depression-1066805. WebMD. “Depression in Children: Symptoms and Common Types of Child Depression.” WebMD, 20 Nov. 2001, www.webmd.com/depression/guide/depression-children#1. Fundamental Users - Students with DMDD American Academy of Child and Adolescent Psychiatry. “Disruptive Mood Dysregulation Disorder (DMDD).” Home, May 2019, www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Disruptive-Mood- Dysregulation-Disorder-_DMDD_-110.aspx.
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text sources
Elmaadawi, Ahmed. “Disruptive Mood Dysregulation Disorder: A Better Understanding.” MDedge, 1 Nov. 2018, www.mdedge.com/psychiatry/article/178296/bipolar-disorder/disruptive-mood-dysregulation-disorder- better?sso=true. Greenstein, Luna. “Beyond Growing Pains: Children and Mood Disorders.” NAMI: National Alliance on Mental Illness, 31 May 2018, www.nami.org/Blogs/NAMI-Blog/June-2018/Beyond-Growing-Pains-Children-and-Mood- Disorders. Grohol, John M. “Disruptive Mood Dysregulation Disorder Symptoms.” Psych Central, 17 May 2016, psychcentral.com/disorders/disruptive-mood-dysregulation-disorder/. Mroczkowski, Megan, et al. “Disruptive Mood Dysregulation Disorder in Juvenile Justice.” Journal of the American Academy of Psychiatry and the Law, 1 Sept. 2018, jaapl.org/content/46/3/329. Tudor, Megan, et al. “Cognitive-Behavioral Therapy for a 9-Year-Old Girl With Disruptive Mood Dysregulation Disorder.” PubMed Central (PMC), 22 Sept. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5658126/. NIMH. “Disruptive Mood Dysregulation Disorder: The Basics.” NIMH Home, 2020, www.nimh.nih.gov/health/publications/disruptive-mood-dysregulation-disorder/index.shtml. Watson, Stephanie. “What Is Disruptive Mood Dysregulation Disorder?” ADDitude, 8 June 2020, www.additudemag.com/disruptive-mood-dysregulation-disorder-and-adhd/.
Fundamental Users - Students with ODD
American Academy of Child and Adolescent Psychiatry. “Oppositional Defiant Disorder.” Home, Jan. 2019, www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Children-With-Oppositional-Defiant- Disorder-072aspx. CDC. “Behavior or Conduct Problems in Children.” Centers for Disease Control and Prevention, 10 Apr. 2020, www.cdc.gov/childrensmentalhealth/behavior.html. EAACAP. “ODD A Guide for Families by the American Academy of Child and Adolescent Psychiatry.” Home, 2009, www.aacap.org/App_Themes/AACAP/docs/resource_centers/odd/odd_resource_center_odd_guide.pdf. Ehmke, Rachel. “What Is Oppositional Defiant Disorder?” Child Mind Institute, 21 July 2020, childmind.org/article/what-is-odd-oppositional-defiant-disorder/. Gotter, Ana. “What Is Oppositional Defiant Disorder (ODD)?” Healthline, 2020, www.healthline.com/health/oppositional-defiant-disorder. Johns Hopkins Medicine. “Oppositional Defiant Disorder (ODD) in Children.” Johns Hopkins Medicine, Based in Baltimore, Maryland, 2020, www.hopkinsmedicine.org/health/conditions-and-diseases/oppositional-defiant- disorder. Mayo Clinic Staff. “Oppositional Defiant Disorder (ODD) - Symptoms and Causes.” Mayo Clinic, 25 Jan. 2018, www.mayoclinic.org/diseases-conditions/oppositional-defiant-disorder/symptoms-causes/syc-20375831. NCBI. “Prevalence of Oppositional Defiant Disorder and Conduct Disorder - Mental Disorders and Disabilities Among Low-Income Children - NCBI Bookshelf.” National Center for Biotechnology Information, 28 Oct. 2015, www. ncbi.nlm.nih.gov/books/NBK332874/. Rodden, Janice. “What Does Oppositional Defiant Disorder (ODD) Look Like in Children?” ADDitude, 9 Oct. 2020, www.additudemag.com/oppositional-defiant-disorder-symptoms-in-children/.
Fundamental Users - Students with Down Syndrome
Cicerchia, Meredith. “Modifications for Students with Down Syndrome.” Touch-type Read and Spell (TTRS), March 2, 2020. https://www.readandspell.com/us/modifications-for-students-with-Down-syndrome. Courtney. “5 Tips for Including Students with Down Syndrome in a General Education Classroom.” Inclusion Evolution, August 6, 2019. https://www.inclusionevolution.com/5tips/. Daunhauer, Lisa, Deborah Fidler, and Elizabeth Will. “School Function in Students with Down Syndrome.” The American journal of occupational therapy : official publication of the American Occupational Therapy Association. The American Occupational Therapy Association, Inc., 2014. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4012569/. The Down Syndrome Association of Minnesota. “Education Resource Packet.” Education Resource. The Down Syndrome Association of Minnesota, October 2006. http://www.dsamn.org/wp-content/uploads/2012/03/ EducationResource2006.pdf. Down Syndrome Ireland. “Supporting Children with Down Syndrome in Primary School.” Down Syndrome. Down Syndrome Ireland, 2011. https://downsyndrome.ie/wp-content/uploads/2018/03/Supporting-Children-with-Downsyndrome-in-Primary-School.pdf. Dreamscape. “6 Things You Probably Didn’t Know About Down Syndrome.” Dreamscape Foundation, February 15, 2019. https://dreamscapefoundation.org/6-things-you-didnt-know-down-syndrome/?gclid=CjwKCAjw5p_8BRBU EiwAPpJO6_teyWJh_fMWZIJbA-kMgP7CC0p26DMN1U_b-q5eJQMOwbznJhttps%3A%2F%2Fdreamscapefoundation.org%2F6-things-you-didnt-know-down-syndrome%2F%3Fgclid. DSAGSL. “Supporting the Student With Down Syndrome in Your Classroom.” Supporting the Student with DS Information for Teacher. Down Syndrome Association of Greater St. Louis, 2014. https://dsagsl.org/wp- contentuploads/2019/02/Supporting-the-Student-With-DS-Information-for-Teachers-2014new.pdf. Hughes, Julie. “Inclusive Education for Individuals with Down Syndrome.” Down Syndrome News and Update. Down Syndrome Education International, January 1, 2006. https://library.down-syndrome.org/en-us/news- update/06/1/inclusive-education-individuals-down-syndrome/. Kabashi, Lema. “Educating a Child with Down Syndrome in an Inclusive Kindergarten Classroom.” Journal of Childhood & Developmental Disorders, April 5, 2019. https://childhood-developmental-disorders.imedpub.com/ educating-a-child-with-down-syndrome-in-an-inclusive-kindergarten-classroom.pdf.
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KCDSG. “Down Syndrome Guild of Greater Kansas City.” KCDSG, 2015. https://www.kcdsg.org/files/content/DSG%20Accommodations%20Checklist.pdf. Lorenz, Stephanie. “Making Inclusion Work for Children with Down Syndrome.” Down Syndrome News and Update. Down Syndrome Education International, January 1, 1999. https://library.down-syndrome.org/en-us/newsupdate/01/4/making-inclusion-work-down-syndrome/. Pinantoan, Andrianes. “Modifying Your Curriculum For Individuals With Down Syndrome.” InformED, March 11, 2013. https://www.opencolleges.edu.au/informed/teacher-resources/teaching-individuals-with-down-syndrome/ modifying-your-curriculum/.
Fundamental Users - Students with Physical Disabilities
AMBOSS. “Multiple Sclerosis.” ambossIcon. AMBOSS, December 7, 2020. https://www.amboss.com/us/knowledge/Multiple_sclerosis. Buxhoeveden, Stephanie. “Tips for Being a Successful Student Who Happens to Have MS.” Multiple Sclerosis, November 6, 2014. https://multiplesclerosis.net/living-with-ms/tips-successful-student-just-happens-ms/. Carnevale, Franco A et al. “Daily living with distress and enrichment: the moral experience of families with ventilator-assisted children at home.” Pediatrics vol. 117,1 (2006): e48-60. doi:10.1542/peds.2005-0789 Gupta, Rupal Christine, ed. “Muscular Dystrophy Factsheet (for Schools) (for Parents) - Nemours KidsHealth.” KidsHealth. The Nemours Foundation, January 2015. https://kidshealth.org/en/parents/md-factsheet.html. Ministry of Education. “Physical Disabilities.” Physical Disabilities Booklet. Ministry of Education, January 2015. https://www.inclusive.tki.org.nz/assets/inclusive-education/MOE-publications/MOESE0042Physicaldisabilitiesbooklet.pdf. Model Farms High School. “Muscular Dystrophy.” Muscular Dystrophy - Teaching for Inclusion, 2021. http://web1.modelfarms-h.schools.nsw.edu.au/disabilities.php?page=muscular-dystrophy. Muscular Dystrophy Association. “School Accommodation Recommendations.” School Accommodations Guide. Muscular Dystrophy Association, n.d. https://www.mda.org/sites/default/files/Guide_SchoolAccommodations- DMD2.pdf. National Council for Special Education. “Strategies for Learning and Teaching.” National Council for Special Education - CPD and In-School Support, 2021. https://www.sess.ie/categories/physical-disabilities/muscular-dystrophy/ tips-learning-and-teaching. Normand, Andrew. “Multiple Sclerosis.” Accessibility, 2021. https://www.unimelb.edu.au/accessibility/guides/multiple-sclerosis. Noyes, Jane. “Health and quality of life of ventilator-dependent children.” Journal of advanced nursing vol. 56,4 (2006): 392-403. doi:10.1111/j.1365-2648.2006.04014.x Raina, Parminder, et. “The Health and Well-Being of Caregivers of Children with Cerebral Palsy.” Pediatrics. U.S. National Library of Medicine, June 2005. https://pubmed.ncbi.nlm.nih.gov/15930188/. Stevens, S E, C A Steele, J W Jutai, I V Kalnins, J A Bortolussi, and W D Biggar. “Adolescents with Physical Disabilities: Some Psychosocial Aspects of Health.” The Journal of adolescent health : official publication of the Society for Adolescent Medicine. U.S. National Library of Medicine, August 19, 1996. https://pubmed.ncbi.nlm.nih.gov/8863089/. Silva, Patricia. “Student Changes Life Plans to Help Others with MS.” Multiple Sclerosis News Today, May 8, 2015. https://multiplesclerosisnewstoday.com/multiple-sclerosis-news/2015/05/08/student-changes-life-plans-helpothers-ms/. UCSF Benioff Children’s Hospital. “Multiple Sclerosis and School Concerns.” UCSF Benioff Children’s Hospital, 2021. https://www.ucsfbenioffchildrens.org/education/multiple_sclerosis_and_school_concerns/. U.S. Department of Health & Human Services. “Adolescent Health.” OPA Office of Population Affairs, 2021. https://www.hhs.gov/ash/oah/adolescent-development/physical-health-and-nutrition/chronic-conditions-and- disabilities/resources.html. U.S. Department of Health & Human Services. “Adolescent Health.” OPA Office of Population Affairs, 2021. https://www.hhs.gov/ash/oah/adolescent-development/physical-health-and-nutrition/chronic-conditions-and- disabilities/characteristics.html.
Fundamental Users - Teachers, Interventionalists and Staff
Berry, Rachel. “Special Education Teacher Burnout: the Effects of Efficacy Expectations and Perceptions of Job Responsibilities .” Western CEDAR. Western Washington University, 2011. https://cedar.wwu.edu/cgi/viewcontent. cgi?article=1126&context=wwuet. Brandt , Susie, Deana Burgess, and Debra Watts. “Is the Level of Teacher Burnout More Significant Among Elementary Special Education Teachers or Elementary General Education Teachers? .” The Corinthian, 1999. https:// kb.gcsu.edu/cgi/viewcontent.cgi?article=1118&context=thecorinthian. Brown, Josh. “What Really Causes Special Education Teachers to Burn Out? .” Education Week. Education Week, December 3, 2020. https://www.edweek.org/ew/articles/2019/03/13/what-really-causes-special-education- teachers-to.html. Dedrick, Charles. “The Special Educator and Job Stress.” Files, April 1990. https://files.eric.ed.gov/fulltext/ED323723.pdf. Ferry, Melissa. “The Top 10 Challenges of Special Education Teachers - Friendship Circle - Special Needs Blog.” Friendship Circle -- Special Needs Blog, November 14, 2014. https://www.friendshipcircle.org/blog/2012/02/01/ the-top-10-challenges-of-special-education-teachers/.
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Goetzinger, Eleanor. “Burnout among Special Educators: Do Experience, Certification, Caseload, and School Size Make a Difference?” Share Ok. University of Oklahoma, 2006. https://shareok.org/bitstream/ handle/11244/1086/3237516.PDF?sequence=1&isAllowed=y. Goldstein-Harnett, Ilene. “5 Ways to Reduce Burnout for Special Education Teachers.” Frontline Education, June 21, 2019. https://www.frontlineeducation.com/blog/special-education-teachers-reduce-burnout/. Hale, Lee. “Behind The Shortage Of Special Ed Teachers: Long Hours, Crushing Paperwork.” NPR. NPR, November 9, 2015. https://www.npr.org/sections/ed/2015/11/09/436588372/behind-the-shortage-of-special-ed-teacherslong-hours-crushing-paperwork. Kulberg, Jenna. “Primary Factors Impacting Burnout in Special Education Teachers.” The Repository at St. Cloud State, May 2019. https://repository.stcloudstate.edu/sped_etds/70/. Lynch, Matthew. “Why Special Educators Really Leave the Classroom.” The Edvocate, June 21, 2019. https://www.theedadvocate.org/why-special-educators-really-leave-the-classroom/. Reeve, Christine. “5 More Things Special Educators Can Do To Prevent Burnout.” Autism Classroom Resources, March 9, 2020. https://autismclassroomresources.com/prevent-burnout/. Schwab, Richard, Susan Jackson, and Randall Schuler. “Educator Burnout: Sources and Consequences.” Educational Research Quarterly, 1986. https://smlr.rutgers.edu/sites/default/files/documents/faculty_staff_docs/ EducatorBurnout.pdf. Tapp, Fiona. “Teacher Burnout: Causes, Symptoms, and Prevention.” Hey Teach!, November 11, 2020. https://www.wgu.edu/heyteach/article/teacher-burnout-causes-symptoms-and-prevention1711.html. Walker, Tim. “Teacher Burnout or Demoralization? What’s the Difference and Why It Matters.” NEA, January 18, 2018. http://neatoday.org/2018/01/18/teacher-burnout-disillusionment/.
Fundamental Users - Parents
Halladay, Alycia. “Autism Predisposition among Children of Adult Siblings.” Autism Speaks, November 30, 2012. https://www.autismspeaks.org/expert-opinion/autism-predisposition-among-children-adult-siblings. Alfano , Andrea. “Where Does Autism Come from When It Doesn’t Run in the Family?” Cold Spring Harbor Laboratory, April 7, 2016. https://www.cshl.edu/labdish/where-does-autism-come-from-when-it-doesnt-run-in-the-family/. FSAO. “Important Announcement.” Faculty Staff Assistance Office Parenting Children with Special Needs Comments, 2021. https://www.bu.edu/fsao/resources/parenting-children-with-special-needs/. GARD. “Asperger Syndrome.” Genetic and Rare Diseases Information Center. U.S. Department of Health and Human Services, 2021. https://rarediseases.info.nih.gov/diseases/5855/asperger-syndrome. Miller, Caroline. “When Parent and Child Both Have ADHD.” Child Mind Institute, January 25, 2019. https://childmind.org/article/help-for-parents-with-adhd/. Muñoz, Alicia. “Self-Care Tips for Parents of Special Needs Children.” Good Therapy Blog, August 9, 2017. https://www.goodtherapy.org/blog/self-care-tips-for-parents-of-special-needs-children-0810175. Starck, Martina, Julia Grünwald, and Angelika Schlarb. “Occurrence of ADHD in Parents of ADHD Children in a Clinical Sample.” Neuropsychiatric disease and treatment. Dove Medical Press, March 3, 2016. https://www.ncbi. nlm.nih.gov/pmc/articles/PMC4780663/#:~:text=Parental%20ADHD%20seems%20to%20be,parent%20with%20clinical%20ADHD%20symptoms. Thompson, Dennis. “Uncles, Aunts May Increase Child’s Odds for Autism.” WebMD. WebMD, May 27, 2020. https://www.webmd.com/brain/autism/news/20200527/uncles-aunts-may-increase-childs-odds-for-autism. Warren, Matt. “Autistic Children May Inherit DNA Mutations from Their Fathers.” Science, April 19, 2018. https://www.sciencemag.org/news/2018/04/autistic-children-may-inherit-dna-mutations-their-fathers.
Assistive Technology
Pepe, Courtney. “Implementing Wearable Technology at Schools Boosts Engagement, Motivation.” Technology Solutions That Drive Education, September 15, 2020. https://edtechmagazine.com/k12/article/2016/10/ implementing-wearable-technology-schools-boosts-engagement-motivation. Benyoucef, Yacine, Pierre Lesport, and Amani Chassagneux. “The Emergent Role of Virtual Reality in the Treatment of Neuropsychiatric Disease.” Frontiers in neuroscience. Frontiers Media S.A., September 5, 2017. https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC5591848/. University of Maryland. “People Recall Information Better through Virtual Reality.” ScienceDaily. ScienceDaily, June 13, 2018. https://www.sciencedaily.com/releases/2018/06/180613162613.htm.
Health Intelligence
Baker, S M et al. “Patient participation in physical therapy goal setting.” Physical therapy vol. 81,5 (2001): 1118-26. Benjamin, Regina. “Improving Health by Improving Health Literacy.” Public health reports. Association of Schools of Public Health, 2010. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2966655/. Boaler , Jo, and Tanya LaMar. “A Better Way to Teach Students with Learning Disabilities.” Time. Time, February 28, 2019. https://time.com/5539300/learning-disabilities-special-education-math-teachers-parents-students/. Federico, Frank. “8 Ways to Improve Health Literacy.” Institute for Healthcare Improvement, October 15, 2014. http://www.ihi.org/communities/blogs/8-ways-to-improve-health-literacy. Intervention Central. “Teaching Children With Developmental Disabilities: Classroom Ideas.” Teaching Children With Developmental Disabilities: Classroom Ideas | Intervention Central, 2020. https://www.interventioncentral.org/ behavioral-interventions/special-needs/teaching-children-developmental-disabilities-classroom-ideas. NIH. “Health Literacy.” NNLM, 2020. https://nnlm.gov/initiatives/topics/health-literacy. Picarddr, Danielle. “Teaching Students with Disabilities.” Vanderbilt University. Vanderbilt University, June 20, 2018. https://cft.vanderbilt.edu/guides-sub-pages/disabilities/.
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Saint Joseph’s University. “Creative Ways to Engage Special Education Students.” online.sju, February 11, 2020. https://online.sju.edu/graduate/masters-special-education/resources/articles/six-creative-ways-to-engage-specialeducation-students. The SHARE Team. “Effective Teaching Strategies for Special Education: Resilient Educator.” ResilientEducator.com, April 6, 2018. https://resilienteducator.com/classroom-resources/effective-teaching-strategies-for-specialeducation/.
Movement
CDC. “Physical Activity and Health: A Report of the Surgeon General.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 2021. https://www.cdc.gov/nccdphp/sgr/disab. htm#:~:text=Benefits%20of%20Physical%20Activity,-Reduces%20the%20risk&text=Can%20help%20people%20with%20chronic,and%20pain%20associated%20with%20arthritis. Mayo Clinic Staff. “Depression and Anxiety: Exercise Eases Symptoms.” Mayo Clinic. Mayo Foundation for Medical Education and Research, September 27, 2017. https://www.mayoclinic.org/diseases-conditions/depression/indepth/depression-and-exercise/art-20046495. Phillips, Cristy. “Physical Activity Modulates Common Neuroplasticity Substrates in Major Depressive and Bipolar Disorder.” Neural plasticity. Hindawi, 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5424494/. Sharma, Ashish, Vishal Madaan, and Frederick Petty. “Exercise for Mental Health.” Primary care companion to the Journal of clinical psychiatry. Physicians Postgraduate Press, Inc., 2006. https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC1470658/. University Of Illinois At Urbana-Champaign. “Exercise Appears To Improve Brain Function Among Younger People.” ScienceDaily. ScienceDaily, December 20, 2006. http://www.sciencedaily.com/ releases/2006/12/061219122200.htm.
Nutrition
Felger, Jennifer. “Imaging the Role of Inflammation in Mood and Anxiety-Related Disorders.” Current neuropharmacology. Bentham Science Publishers, 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5997866/. Groce, N, E Challenger, R Berman-Bieler, A Farkas, N Yilmaz, W Schultink, D Clark, C Kaplan, and M Kerac. “Malnutrition and Disability: Unexplored Opportunities for Collaboration.” Paediatrics and international child health. Maney Publishing, November 2014. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4232244/. Konikowska, Klaudia et al. “The influence of components of diet on the symptoms of ADHD in children.” Roczniki Panstwowego Zakladu Higieny vol. 63,2 (2012): 127-34. Monroe , Jamison. “The Impact of Sugar and Poor Diet on Teen Mental Health.” U.S. News & World Report. U.S. News & World Report, October 24, 2018. https://health.usnews.com/health-care/for-better/ articles/2018-10-24/how-sugar-and-poor-diet-affect-teen-mental-health. MyHandicap. “Stable Weight Thanks to Healthy Eating.” MyHandicap, 2021. https://www.myhandicap.com/en/information-disability-chonical-illness/health/physical-impairment/nutrition/. Polivy, Janet, and Peter Herman. “Mental Health and Eating Behaviours.” Canadian Journal of Public Health, August 2005. https://europepmc.org/articles/pmc6975888/bin/41997_2005_bf03405201_moesm1_esm.pdf. Rastmanesh, Reza, Furugh Azam Taleban, Masood Kimiagar, Yadolah Mehrabi, and Moosa Salehi. “Nutritional Knowledge and Attitudes in Athletes with Physical Disabilities.” Journal of athletic training. National Athletic Trainers Association, 2007. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1896079/. Robberecht H, Verlaet AAJ, Breynaert A, De Bruyne T, Hermans N. Magnesium, Iron, Zinc, Copper and Selenium Status in Attention-Deficit/Hyperactivity Disorder (ADHD). Molecules. 2020 Sep 27;25(19):4440. doi: 10.3390/ molecules25194440. PMID: 32992575; PMCID: PMC7583976.
Teacher Burnout
Brandt , Susie, Deana Burgess, and Debra Watts. “Is the Level of Teacher Burnout More Significant Among Elementary Special Education Teachers or Elementary General Education Teachers? .” The Corinthian, 1999. https:// kb.gcsu.edu/cgi/viewcontent.cgi?article=1118&context=thecorinthian. Brown, Josh. “What Really Causes Special Education Teachers to Burn Out?” Education Week. Education Week, December 3, 2020. https://www.edweek.org/ew/articles/2019/03/13/what-really-causes-special-education- teachers-to.html. Goldstein-Harnett, Ilene. “5 Ways to Reduce Burnout for Special Education Teachers.” Frontline Education, June 21, 2019. https://www.frontlineeducation.com/blog/special-education-teachers-reduce-burnout/. Lynch, Matthew. “Why Special Educators Really Leave the Classroom.” The Edvocate, June 21, 2019. https://www.theedadvocate.org/why-special-educators-really-leave-the-classroom/.
Visual Clutter
Administration. Studies Confirm the Power of Visuals to Engage Your Audience in eLearning, July 9, 2014. https://www.shiftelearning.com/blog/bid/350326/studies-confirm-the-power-of-visuals-in-elearning#:~:text=Visuals%20 have%20been%20found%20to,to%20process%20the%20information%20faster.
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Bavin, Edith. “Spatio-Visual Memory of Children with Specific Language Impairment: Evidence for Generalized Processing Problems.” Taylor & Francis, July 3, 2009. https://www.tandfonline.com/doi/ abs/10.1080/13682820400027750#.V1CfSWQrIfE. Fanguy, Will, Natasya Sunarto, Guest Author, and Gosia Kieszkowska. “5 Psychology Studies Show How People Perceive Visual Information.” Piktochart, September 29, 2020. https://piktochart.com/blog/5-psychology-studiesthat-tell-us-how-people-perceive-visual-information/. Gago, Débora. “Effects of Pleasant Visual Stimulation on Attention, Working Memory, and Anxiety in College Students.” Scielo, December 2013. https://www.scielo.br/scielo.php?script=sci_ arttext&pid=S1983-32882013000300012. Jandhyala, Dana. “Visual Learning: 6 Reasons Why Visuals Are The Most Powerful Aspect Of ELearning.” eLearning Industry, April 27, 2020. https://elearningindustry.com/visual-learning-6-reasons-visuals-powerful-aspectelearning. Jeeves, M. “Hemisphere Differences in Response Rates to Visual Stimuli .” Jeeves Dixon, 1970. https://link.springer.com/content/pdf/10.3758/BF03329048.pdf. Kouyoumdjian, Haig. “Learning Through Visuals.” Psychology Today. Sussex Publishers, July 20, 2012. https://www.psychologytoday.com/us/blog/get-psyched/201207/learning-through-visuals. Mayooshin. “How Clutter Causes Stress and Anxiety (and What You Can Do About It).” The Smarter Brain, August 18, 2020. https://www.mayooshin.com/clutter-causes-stress-anxiety/. Manzi A, Durmysheva Y, Pinegar SK, Rogers A, Ramos J. Workspace Disorder Does Not Influence Creativity and Executive Functions. Front Psychol. 2019 Jan 15;9:2662. doi: 10.3389/fpsyg.2018.02662. PMID: 30697176; PMCID: PMC6340966. Mcleod, Saul. “Visual Perception Theory.” Visual Perception | Simply Psychology, 2018. https://www.simplypsychology.org/perception-theories.html. McMains S, Kastner S. Interactions of top-down and bottom-up mechanisms in human visual cortex. J Neurosci. 2011 Jan 12;31(2):587-97. doi: 10.1523/JNEUROSCI.3766-10.2011. PMID: 21228167; PMCID: PMC3072218. Morin, Amanda. “Classroom Accommodations for Visual Processing Issues.” Understood. Understood, October 22, 2020. https://www.understood.org/en/school-learning/partnering-with-childs-school/instructional-strategies/at-aglance-classroom-accommodations-for-visual-processing-issues. Rehman, Amna. “Neuroanatomy, Occipital Lobe.” StatPearls [Internet]. U.S. National Library of Medicine, July 31, 2020. https://www.ncbi.nlm.nih.gov/books/NBK544320/. Repetti, Rena, and Darby Saxbe. “No Place Like Home: Home Tours Correlate With Daily Patterns of Mood and Cortisol.” SAGE Journals, November 23, 2009. https://journals.sagepub.com/doi/abs/10.1177/0146167209352864. Schwartz S, Vuilleumier P, Hutton C, Maravita A, Dolan RJ, Driver J. Attentional load and sensory competition in human vision: modulation of fMRI responses by load at fixation during task-irrelevant stimulation in the peripheral visual field. Cereb Cortex. 2005 Jun;15(6):770-86. doi: 10.1093/cercor/bhh178. Epub 2004 Sep 30. PMID: 15459076. Vartanian, Lenny, Kristin Kernan, and Brian Wansink. “Clutter, Chaos, and Overconsumption: The Role of Mind-Set in Stressful and Chaotic Food Environments.” SSRN, January 7, 2016. https://papers.ssrn.com/sol3/papers. cfm?abstract_id=2711870.
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Figure 1 Eredics, Nicole. “8 Tips for Introducing a Student with Disabilities to an Inclusive Classroom.” Friendship Circle - Special Needs Blog, September 28, 2017. https://www.friendshipcircle.org/blog/2017/09/28/8-tips- introducing-student-disabilities-general-education-classroom/. Figure 2 Smith, Melinda, and Jeanne Segal. “Teaching Students with ADHD.” HelpGuide.org, September 2020. https://www.helpguide.org/articles/add-adhd/teaching-students-with-adhd-attention-deficit-disorder.htm. Figure 3 Low, Keath. “8 Simple School Strategies for Students With ADHD.” Verywell Mind, June 29, 2020. https://www.verywellmind.com/help-for-students-with-adhd-20538. Figure 4 ADHD Institute. “Psychiatric Comorbidities in Patients with ADHD.” ADHD Institute, April 10, 2019. https://adhd-institute.com/burden-of-adhd/epidemiology/comorbidities/. Figure 5 Workable. “Special Education Teacher Job Description Sample: Workable.” Recruiting Resources: How to Recruit and Hire Better, February 3, 2020. https://resources.workable.com/special-education-teacher-job- description. Figure 6 Gruben, Mallory. “Special Needs Students Learn alongside Peers in Longview Inclusion Classroom.” Longview Daily News, February 5, 2019. https://tdn.com/news/local/special-needs-students-learn-alongside-peersin-longview-inclusion-classroom/article_ddab98b9-da92-53c5-aaa5-ae106c97fa30.html. Figure 7 Danneman, Ilana. “Six Tips to Make Sure Your Child Does Not Get Lost in the Classroom - Friendship Circle - Special Needs Blog.” Friendship Circle - Special Needs Blog, April 28, 2015. https://www.friendshipcircle. org/blog/2015/04/28/how-parents-can-keep-their-child-with-special-needs-focused-in-the-classroom/. Figure 8 Formaspace. “Classroom Enhancements for Students w/ Autism Spectrum Disorders.” Formaspace, December 4, 2019. https://formaspace.com/articles/education/classrooms-for-students-with-autism-spectrum- disorders/. Figure 9 Waterford. “15 Activities, Teaching Strategies, and Resources for Teaching Children with Autism.” Waterford.org, April 2, 2020. https://www.waterford.org/education/15-activities-teaching-strategies-and-resources-forteaching-children-with-autism/. Figure 10 Autism Spectrum Australia. “Supporting Students with Autism in the Classroom.” 2018 Aspect Autism in Education Conference - AIE 2018, October 30, 2017. http://www.autismineducation.org.au/supporting-studentswith-autism/. Figure 11 Waterford. “15 Activities, Teaching Strategies, and Resources for Teaching Children with Autism.” Waterford.org, April 2, 2020. https://www.waterford.org/education/15-activities-teaching-strategies-and-resources-forteaching-children-with-autism/. Figure 12 Waterford. “15 Activities, Teaching Strategies, and Resources for Teaching Children with Autism.” Waterford.org, April 2, 2020. https://www.waterford.org/education/15-activities-teaching-strategies-and-resources-forteaching-children-with-autism/. Figure 13 Livingstone, Sonia. “What’s the Role of the School in Educating Children in a Datafied Society?” Connected Learning Alliance, September 3, 2019. https://clalliance.org/blog/whats-the-role-of-the-school-in-educatingchildren-in-a-datafied-society/. Figure 14 Schatz Alton, Nancy. “Cool, Calm, Kinetic: Classrooms For Every Learner.” ParentMap, September 14, 2016. https://www.parentmap.com/article/kinetic-classrooms-for-every-learner. Figure 15 Watson, Sue. “Best Practices for Teaching Students with Down Syndrome.” ThoughtCo, July 31, 2019. https://www.thoughtco.com/teaching-students-with-down-syndrome-3110772. Figure 16 Brookes Publishing. “7 Steps to Teaching Writing Skills to Students with Disabilities.” The Inclusion Lab, February 28, 2017. https://blog.brookespublishing.com/7-steps-to-teaching-writing-skills-to-students-with- disabilities/. Figure 17 Levine, Hallie. “As School Returns, Kids With Special Needs Are Left Behind.” The New York Times. The New York Times, September 16, 2020. https://www.nytimes.com/2020/09/16/parenting/school-reopening- special-needs.html. Figure 18 “Portrait of school kids holding book in classroom” © Wavebreakmedia used under QEUBKWPLS4 Figure 19 Raising Children Network. “School Support: Children with Disability.” Raising Children Network, January 19, 2018. https://raisingchildren.net.au/disability/school-play-work/school/school-support-disability. Figure 20 “Family Reading Story Book” © Andrea Piacquadio, retrieved from https://www.pexels.com/photo/family-reading-story-book-3820203. Figure 21 Raising Children Network. “Routines and Children with Disability.” Raising Children Network, January 9, 2019. https://raisingchildren.net.au/disability/family-life/family-management/routines-disability. Figure 22 AIA. “Chengdu International School.” AIA, 2021. https://www.aia.org/showcases/147501-chengdu-international-school?utm_term=38076135--5da99a8e-37fc-476d-ba44-b37afcdb907a. Figure 23 Aguilar, Cristian. “Jardim De Infância / Jungmin Nam.” ArchDaily Brasil. ArchDaily Brasil, July 24, 2016. https://www.archdaily.com.br/br/791854/jardim-de-infancia-jungmin-nam. Figure 24 Society of Interior Designers. “Contact.” Society of Interior Designers, January 8, 2021. https://mdasid.org/. Figure 25 Golisano Foundation. “Strengthening Community at Golisano Autism Center amid Pandemic.” Golisano Foundation, 2021. http://www.golisanofoundation.org/Golisano-Foundation/Newsroom/News2019/News_ GolisanoAutismCenterOpens.aspx. Figure 26 Praeuner , Lauren. “Encapsulating Educational Design for Students with Autism Spectrum Disorder .” Digital Commons, March 18, 2020. https://digitalcommons.unl.edu/cgi/viewcontent. cgi?article=1224&context=honorstheses. Figure 27 Lighting Associates. “Daylighting and Windows.” National Best Practices Manual for Building High Performance Schools, 2002. https://www.lightingassociates.org/i/u/2127806/f/tech_sheets/schools_daylight_and_
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windows.pdf. Figure 28 Westfield Intermediate School. Westfield Intermediate School / Homepage, 2021. https://www.wws.k12.in.us/wis. Figure 29 Raising Arizona Kids Magazine. “Early Diagnosis and Intervention.” Raising Arizona Kids Magazine, March 10, 2020. https://www.raisingarizonakids.com/special-needs-resources-arizona/special-needs-early- diagnosis-and-intervention/. Figure 30 Pulrang, Andrew. “What You Should Tell Your Kids About People With Disabilities.” Forbes. Forbes Magazine, September 14, 2020. https://www.forbes.com/sites/andrewpulrang/2020/09/14/what-you-should-tell-yourkids-about-people-with-disabilities/?sh=30c1b352e18d. Figure 31 Badam, Ramola Talwar. “Assistive Technology Helps Children with Disabilities in Dubai Thrive.” The National. The National, October 31, 2017. https://www.thenationalnews.com/uae/assistive-technology-helps- children-with-disabilities-in-dubai-thrive-1.671843. Figure 32 Goodrich, Kristine, Courtesy Colleen Depuydt, and Courtesy Kelli Milbrath. “Special Education Parents Struggle but Feel Supported during Pandemic.” Mankato Free Press, May 31, 2020. https://www. mankatofreepress.com/news/local_news/special-education-parents-struggle-but-feel-supported-during-pandemic/article_8058b15e-a1f2-11ea-a7a9-0b5b698ceeec.html. Figure 33 GradePower Learning. “Parent-Teacher Conference Tips For Parents.” GradePower Learning, May 28, 2019. https://gradepowerlearning.com/parent-teacher-conference-tips/. Figure 34 OECD Education and Skills Today. “Classroom Practices and Teachers’ Beliefs about Teaching.” OECD Education and Skills Today, September 17, 2015. https://oecdedutoday.com/classroom-practices-and-teachersbeliefs-about-teaching/. Figure 35 eLearning. “The Power of Visuals in ELearning Infographic,” August 2, 2015. https://elearninginfographics.com/power-visuals-in-elearning-infographic/. Figure 36 Altucher, James. “What Your Brain Looks Like After A 20-Minute Walk.” Business Insider. Business Insider, February 11, 2014. https://www.businessinsider.com/your-brain-after-a-20-minute-walk-2014-2. Figure 37 Guinn, Kali. “Incorporating Movement with Zumba Kids.” Nearpod Blog, October 21, 2020. https://nearpod.com/blog/zumba-brain-breaks/. Figure 38 Piedmont Health. “WIC- Women, Infants, and Children.” Piedmont Health, 2021. https://www.piedmonthealth.org/wic/. Figure 39 Tagtow, Angie, and Rebecca Dickenson. “Food and Nutrition Education: Growing Healthy Bodies and Minds.” USDA, February 21, 2017. https://www.usda.gov/media/blog/2016/03/01/food-and-nutrition-educationgrowing-healthy-bodies-and-minds. 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