Bb june 2013 by Building Blocks Magazine

AUTISM

REDEFINING SPECIAL NEEDS

EVALUATIO

EARLY INTERVENTION

SENSORY PROCESSING DISORDER

THERAPY

RELATED SERVICES

RES-HAB

ASPERGER

IEP

SERVICE OORDINATION

ADHD

A SPECIAL NEEDS MAGAZINE

E T A D P U E M O R D SYN N W O D  and much : G N I R U T S more… E I ALSO FEA M E E R P T U O  ALL AB O G O T S  PL ACE SPECIAL EDUCATION

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INTRODUCTION Enhancing, Therapeutic and Melodious

here are many facets to education. There is the need to acquire the most basic knowledge to successfully manage independently in today’s society, also called daily living skills. There are those who already possess those basic skills, but seek to acquire additional information as a means of further enhancing those skills, thus advancing their real-world opportunities. The effort to acquire these skills begins practically at birth. If everything goes as “planned,” an individual goes the common route of schooling – elementary, secondary and university [including beit hamedrash or seminary] levels – culminating in a successful entry into modern society’s workforce with suitable skills. Yet for some parents, there is

that dreaded call: “Little Dovid is falling behind. He has little or no comprehension of the material being taught. He does not communicate with others, or if he does, it is in a very different manner.” Then come a battery of tests and evaluations, with the resulting diagnosis: “Dovid is an atypical learner / on the autism spectrum / in need of Special Education.” Many parents and teachers are at a loss as to how to proceed from that point to find a successful plan of treatment and education. An additional factor to consider is that some learning difficulties are due to psychological issues such as low esteem – manifested in the guise of shyness -which can have a powerful influence on a child’s performance in school or social settings.

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June 2013

We are fortunate that today that there is greater understanding in the educational system of such challenges, and there is a greater available infrastructure of educational facilities to help overcome them. Yet depending on the severity of the condition and the complexity of the diagnosis, helping the child to succeed can require anything from minimal, yet, skilled tutoring to very aggressive and intensive treatment techniques. There is one avenue that should not be overlooked and which, if utilized, can result in dramatic results in both typical and special needs students: music therapy. In addition to nurturing progress in areas like language development, auditory processing, sensory sensitivity, and even fluency in physical movement, music therapy has been proven to be an effective way to help individuals who suffer from a melancholy temperament. In fact, we find such responsiveness in our Scriptural and Midrashic annals. The Midrash conveys that our father Jacob mourned for many years for his beloved son Joseph. When it came time to reveal the discovery of his long lost son, the tribes of Israel sought a gentle means to convey this message to their melancholy father, fearful of causing him undue distress or shock. They chose the musical route. Serah, the daughter of Asher, son of Jacob, was an accomplished musician. Sitting at the feet of her grandfather, she played a calming tune with the lyrics “od Yosef chai , v’chi hu moshel b’eretz mitzrayim – Joseph yet lives and he is the ruler of Egypt” [parashat Vayigash 45:26]. The Midrash records that Jacob then readily accepted the message and was so thankful that he even blessed with eternal life. We find as well in the prophets (I Samuel Chapter 16) that after his rebuke at the hand of the

By Rabbi Yaakov Klass

prophet Samuel, King Saul suffered from severe bouts of melancholia, and the only one who was able to relieve these bouts was a talented young man, [future king] David, son of Jesse. While we don’t know many details about Serah’s life, we do know that she was yet living so many generations later. It was through her verification to the sages of the proper role of Moses as Israel’s redeemer, that she played an instrumental role in the deliverance of the Jewish People from Egypt. She used her music to serve others more than herself. It enabled her to function as a “therapist,” with her grandfather Jacob as the patient. King David, on the other hand, led a very tumultuous life and surely he too benefited greatly from his own music – so much so that down through the ages, his scriptural verse (Psalms) has served and even today continues to serve as the lyric core of multitudes of Jewish music. When I have been privileged to speak before groups which include those with various learning and physical disabilities, I usually relate a ma’amar Chazal – a teaching of our sages in the form of a story – and then complete my presentation with some musical renditions. I can’t tell you, my dear readers, how often those in attendance not only relate to the music, but quickly learn both music and lyrics and join in the singing. Indeed, the love of music is not only enhancing and melodious, but also highly therapeutic. When learning is taught in a manner that is as enjoyable as music, it can unlock the vast reserves that are found inside the soul of every individual, on every intelligence level. Rabbi Yaakov Klass, rav of Congregation K’hal Bnei Matisyahu in Flatbush, Brooklyn, is Torah Editor of The Jewish Press. He can be contacted at yklass@jewishpress.com.

CONTENTS JUNE 2013

INTRODUCTION

Enhancing, Therapeutic and Melodious

From the Editors

EDUCATION Inclusion for the Individual Child

History of Special Education

The Transition to a Mainstream Setting

Home Schooling

Rabbi Yaakov Klass

Rabbi Dr. Yisrael Rothwachs

30 12

A ISSUES & ANSWERS

Redefining Special Needs

“Love Your Neighbor as Thyself ”

Barry Katz

Avigael (Stephanie) Saucier Wodinsky, PhD, MEd, MBA, GAC-ABA, GAC-AI Rabbi Dr. Mordechai Salfer

Yaakov Kornreich

Rabbi Chaim Wakslak, PhD

32 34

FAMILY

Coordination Between EI and OPWDD Services

DIAGNOSIS Medical Advances in Down Syndrome

Early Diagnoses of Autism

Münchausen’s Syndrome by Proxy

Marc R. Katz, MA and Pamela Kahn-Alperin, MSW

Sandy Eller

Helping Children Learn Appropriate Behavior

Joshua Weinstein, Ph.D., M.B.A.

Stephen Glicksman, Ph.D

Accessible Summer Vacations Golda Turner

Rabbi Mayer Waxman, MA

Building Social and Behavior Intelligence In Your Child

Rabbi Yechiel Kaufman, MA Ed.

Taking Care of Your Newborn Preemie

24-

Family Forum

Ita Yankovich

TREATMENT Therapy in the NICU

Feeding Tubes

Dana Ledereich, MA, OT/L

Dr. Tuvia Marciano

June 2013

CONTENTS JUNE 2013

CONTINUED

TREATMENT

Is It Sensory?

How to Incorporate Sensorimotor in the Classroom

PRODUCT REVIEWS 60

Book Reviews

Paul Stadler

Nutritional Supplements for Health and Wellbeing

RESOURCES DIRECTORY

ASK THE EXPERT

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Esther Hornstein, L.Ac., Dipl.

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Yitty Rimmer, MA OTR/L

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June 2013

INTRODUCTION

s the Special Needs community continues to mature and diversify, caregivers and health care professionals continue to develop new and fresh approaches to dealing with the challenges confronting our children with Special Needs, and understanding the root causes of their disabilities. In this issue of Building Blocks, we focus on this continuing evolution, and the consequences of the changes that result. For example, our cover story explores how the new knowledge and theories developed by researchers and practitioners over the past 19 years have fundamentally changed the way that Autism Spectrum Disorders and other conditions are defined in the newly published DSM-5 manual, and how this, in turn,

impacts those children whose diagnosis may have been changed in a meaningful way. At the same time, we look at the process of diagnosis itself, and how crucial it is to the proper treatment of our children that we truly understand the root causes of their symptoms. We look at the very youngest of our children, those who are born prematurely, and the remarkable process of giving these extremely fragile babies various forms of therapy while they are still being nurtured in a neonatal ICU. There are always concerns when a person with Special Needs “graduates” from a more protective environment to one in which they will be much more on their own. We learn how this applies to children who are “mainstreamed” out of their Special Education

classroom into the general student population, and those living in group residences who venture out into local synagogues and homes to participate with other members of the community in the activities of Jewish life. We investigate the fascinating issues of sensory perceptions and integration, and the complex interactions involved in even the simplest of body movements. Keeping up with the leading edge of technology, we look at a newly developed, non-invasive technique for screening expectant mothers for Down Syndrome, and the broad range of devices available today that provide support and assistance to those needing help to stand erect. We also explore the techniques available to teach our growing children the basic social skills

they will need in order to interact successfully with their peers in all types of situations, as well as effective, non-confrontational ways to modify our child’s inappropriate behavior by changing their environment in such a way as to eliminate the incentives for engaging in that behavior. Finally, we learn about the puzzling phenomenon of Munchausen’s by Proxy, and the very real damage it can do to its innocent victims. If you are seeking to learn more about the world of Special Needs, you have come to the right place. And if you are just seeking new information and insights whose utility extends into the larger world, you won’t be disappointed, either. So let’s get started by turning the page!

From the Editors

June 2013

A ISSUES & ANSWERS

Redefining Special Needs

n William Shakespeare’s romantic tragedy, Juliett asks Romeo “What’s in a name? That which we call a rose by any other name would smell as sweet.” But because Romeo was from the family of Montague and Juliet was a daughter the blood feuding Capulet family, their love was doomed. They could not, in the end, escape the consequences of their respective names. The same is true today in the world of Special Needs, where the names which have been assigned to the disabilities of our children, their diagnoses, will ultimately determine how much and what kind of help these children and their families will receive. On the most basic level, the diagnosis will determine the type and amount of treatment they will receive, and the services which the federal, state and local governments will fund. The first step in trying to help a child in whom signs of disability have been detected is to conduct a thorough professional evaluation in which the child’s physical status and functional development throughout various categories, are measured. These include their motor skills, the ability to think and learn, the development of their language skills, their ability to integrate the input from their five senses, their social and emotional development, and their ability to master basic living skills. These are then compared to the pace of development of a so-called “typical” child. The second step is far more difficult. It is the process of comparing the results of a child’s evaluation to the defined criteria for recognized conditions, which, if they are similar enough, becomes the basis for a specific diagnosis. With some conditions, like Downs syndrome, scientists have identified a specific genetic 8

June 2013

defect, whose presence can be confirmed by test, as the cause, leaving no question about the accuracy of the diagnosis. The same is true in cases of Traumatic Brain Injury, in which we can identify physical impairments to areas of the brain which control the specific functions. But with other conditions, such as autism, where there is no real understanding of the underlying cause linking the symptoms together, the criteria for

which currently serve as the basis upon which thousands of children across the country are receiving government-funded services today. These include Asperger's Syndrome (for high functioning children with autism); PPD-NOS (pervasive developmental disorder, not otherwise specified, for those with somewhat ambiguous symptoms of autism); and childhood disintegrative disorder (for children who experience a severe regression in their development

“Their diagnoses, will ultimately determine how much and what kind of help these children and their families will receive…“ diagnosis are much less precise. They are based upon a consensus among researches upon a pattern of functional delays and behaviors which are used to define the condition. That consensus can change in the light of further research and treatment experience, and with it, the criteria determining whether a child qualifies for treatment and services under that diagnosis. This has just happened in May, with the publication of the DSM5, the Diagnostic and Statistical Manual of Mental Disorders, by the American Psychiatric Association (APA). The manual is the accepted authority by most government programs and insurance companies defining the criteria for the diagnosis for all psychiatric and behavioral disorders. There is great controversy in the Special Needs community over the new edition’s elimination of several of the established diagnoses on the autism spectrum,

after the age of 3). These are now lumped together under a much more general diagnosis of Autism Spectrum Disorder (ASD). The changes in the diagnostic criteria for these versions of autism have generated concern among parents who have built their efforts to take care of their child upon the services for which their child had qualified, based upon definitions which have now been discarded. This has resulted in angry protests against adoption of the new diagnostic criteria. More than 8,000 people signed an online petition against the DSM5 circulated by the Global and Regional Asperger's Syndrome Partnership. A similar petition sponsored by Asperger's Association of New England generated 5,400 signatures. The task force of APA experts which was responsible for the new definitions of autism claimed that the old definitions

By Yaakov Kornreich

were too ambiguous. As a result, there was no consistency in the way in which practitioners in the field would decide, for example, that a child should be diagnosed with Asperger’s Syndrome rather than PDD-NOS. The authors of the new DSM-5 autism categories claim that they are likely to make it easier for high-functioning children with these types of symptoms to receive services, noting that in some states a diagnosis of Asperger’s does not currently qualify them for government help, whereas those who have been diagnosed with other forms of autism do. The APA task force circulated its proposed changes to autism definitions for more than a year before the DSM-5 was published, giving a chance for many practitioners in the field to voice their objections before the manual was finalized. For example, a 2012 survey of more than 500 health and educational professionals in Australia found that more than 90% of them agreed that Asperger’s was distinct enough from other forms of autism that to justify maintaining its current separate definition. Simon Baron-Cohen, the director of the Autism Research Center at Cambridge University, claims that his research has found evidence that 14 specific genes might be directly associated with Asperger’s, which, if confirmed, would force the APA to reconsider its new definitions. For the parents of children diagnosed with Asperger’s, this is as a highly emotional issue. Some have voiced suspicions that motivations other than pure science may be behind the DSM5's new definitions. They suggest that the APA task force may have been influenced by political pressure to reduce the number of high- functioning children with

ISSUES & ANSWERS Q &A autism qualifying for government-funded services. Since the previous edition, the DSM-IV, was published 19 years ago, the percentage of children diagnosed with autism has exploded. Once a relatively rare condition, the various forms of autism make up the fastest growing Special Needs diagnosis today. According to a CDC report, autism was diagnosed in the US at a rate of 20 per 1,000 children in 2012, up from 11 per 1,000 in 2008. There have been many explanations offered for this dramatic increase. Some have speculated that many of the increased prevalence of an autism diagnosis is the result of a pervasive attitude which encourages professional to diagnose autism in cases with borderline symptoms that previously would have been attributed to other causes. Whatever the reason for the

increase, every parent of a child newly diagnosed with autism immediately becomes an advocate for more government-funded autism services. While they have vastly improved the level of public awareness of autism, their advocacy has also created feelings of hostility and resentment, within a certain segment of the population, towards those receiving government-funded services for their children. Some autism activists suspect that those resentments, combined with government pressure to control the burgeoning cost of providing services to autistic children, were a hidden motive behind the new autism definitions in the DSM-5. Mark Olson, the father of an autistic daughter and the founder of LTO Ventures, a nonprofit organization that develops residential communities for autistic

adults said, “There are those of us who see this as a blowback to the increased awareness generated by advocates.” Tom Hibben, father of a 10-year-old boy with Asperger's who writes about the subject on his blog says, “it really seems to us like they’re changing the guidelines to affect the prevalence rate.” Bryan King, the director of Seattle Children’s Autism Center who served on the APA task force which revised the diagnostic definitions in the DSM-5, vigorously denies that the recommendations of the committee were swayed by those influences. King also says that those children who have qualified for services under a diagnosis of Asperger’s under the old criteria should be able to qualify for services under the new system of definitions “automatically,” says King, noting that

the publications of the DSM-5 should not be taken as, “an administrative mandate for rediagnosis.” That may have been the intent of the APA in drafting the new standards, but that doesn’t prevent school districts and insurance companies from taking advantage of it as one way to control their costs of treatment. On the other hand, Hannah Fjeldsted, a high-school senior who is diagnosed with Asperger's, explained in a guest blog post on the Autism Speaks web site why she will regret the loss of the distinction that goes with the separate definition because it gave her a certain elite status to be lumped together with geniuses like Albert Einstein and Isaac Newton who appeared to have exhibited the symptoms of Asperger’s. “The label of Asperger’s at least gives obKornreich Continues on Next Page ➘

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servers the impression of intelligence and ability,” Hannah wrote, “but when most people think of ‘autism,’ they think of someone who should be institutionalized.” Tom Hibben also worries about what the loss of his separate Asperger’s diagnosis will do to his son’s self-esteem as he grows older. “Now it’s almost cool to have Asperger’s,” Hibbens says, because the superior intellectual abilities, as well as the personality quirks of those with the Asperger’s, are now being highlighted in the popular entertainment media. There is an opposite reaction being expressed by some parents with children whose autism is far more severe and disabling. They fear that lumping higher functioning children with their own will soften the public’s perception of the seriousness of autism, and weaken political support for the continuation of services for their children at current levels. The authors of the DSM-5 respond that the new definitions include, for the first time, a scale for grading the severity of an autism diagnoses based upon the level of its individual symptoms. But advocates for autism worry that government officials under political pressure to cut costs by reducing spending on services to children with autism will ignore the distinctions and reset the services being provided at levels appropriate for those with a minimal diagnosis under the new definitions. With the publication of the DSM-5, the public debate has just begun. Thomas Insel, the director of the National Institute of Mental Health Director has dismissed the DSM for its “lack of validity,” adding that “patients with mental disorders deserve better.” Psychology Today reports that there is already a movement under way to reject the new DSM-5 standards in the US, England, France, Australia, Spain, and Italy, and not just those with regards to its 10

June 2013

new definitions for Autism Spectrum Disorders (ASD). Critics note that the number of separately recognized psychological diagnoses has grown from 106 when the first edition of the DSM was published in 1952 to 297 in the DSM IV published in 1994 (including the first official definition of Asperger’s Syndrome). In response, David Kupfer, the chairman of the DSM-5 task force announced before its publication that the total number of disorders would not increase. There are many new diagnoses

sleep apnea, which occurs when the airway is temporarily blocked during sleep. “Caffeine intoxication” is also defined as a new psychological disorder comprised of at least five symptoms which result after consuming the caffeine equivalent about three cups of coffee, including restlessness, digestive problems, sleeplessness, nervousness, and elevated heartbeat. Coffee lovers beware! Controversies over the definitions of new behavioral and psychological disorders are hardly new. There has been an ongoing

appearing for the first time DSM5, but the authors employed a clever technicality to avoid increasing the total number by defining most of the new diagnoses as “subtypes” of previously recognized disorders. In this way, the DSM-5 continues the long term process by which the professional psychological community has been reclassifying what were once considered to be quirky but not abnormal behaviors into treatable forms of mental disorder. According to a 2005 study, based upon the definitions in the DSMIV, 46 percent of the American people were expected to have a diagnosable mental illness at some point in their lifetimes, and based upon the new criteria in the DSM-5, that percentage seems certain to grow a to majority of the population. Some of the new diagnoses in the DSM-5 are not strictly psychologically based. These include "breathing-related sleep disorder," which is a based upon a medical diagnosis of obstructive

debate since the 1970's over the possible misdiagnosis of many children with a certain pattern of behavioral symptoms as having Attention Deficit Hyperactive Disorder (ADHD). The critics say that once diagnosed, the children are routinely overmedicated with powerful drugs such as the stimulant, Ritalin, which treats the symptoms instead of searching for and treating the underlying causes of the symptom. They also claim that the long term use of such stimulants to treat children diagnosed with ADHD has led to higher rates of schizophrenia and bipolar disorder later in life. They also accuse the experts who continue to advocate drug therapy for ADHD of being influenced by the payments they receive from drug companies to subsidize their research. The ADHD controversy has been investigated by the National Institute of Mental Health and other government agencies. They have concluded, based upon the professional literature, that ADHD is a valid clinical con-

“46 percent of the American people were expected to have a diagnosable mental illness at some point in their lifetimes…“

dition. However, there persist those who support alternative approaches to explain the symptoms of ADHD, which claim that it is not a mental illness at all, or that it can be corrected or controlled without recourse to powerful medications. These controversies highlight the fact that in the absence of a directly observable cause, such as a faulty gene or a specific physical defect or injury, diagnosis is still an art as well as a science. The combination of symptoms present in a child in real life often do not exactly match the textbook (DSM-5) definitions. Sometimes they can be explained by more than one diagnosis, and may respond better to a very different kind of treatment than the one indicated by the more popular diagnostic choice. When there is such ambiguity, parents and diagnosticians will tend to choose the diagnosis which is most advantageous to the child and its family, by qualifying them for the most generous services (i.e. autism). Others will choose the diagnosis with which they are most familiar, or which they believe would be the easiest to treat (i.e. Ritalin for the symptoms of ADHD). Just because such diagnoses are advantageous or familiar does not necessarily make them incorrect. But it is important for parents to consider the possibility that other explanations and causes for the symptoms of their child may have been overlooked, and deserve investigation rather than dismissal out of hand. Paul Stadler, an OT who specializes in sensory integration, supports the opinion expressed by researchers in the 2008 book, “Capute and Accardo’s Neurodevelopmental Disabilities In Infancy and Childhood: Neurodevelopmental Diagnosis and Treatment,” that there should be more emphasis on finding the source cause of the symptoms which we attribute to conditions

ISSUES & ANSWERS Q &A such as neurodevelopmental disabilities before classifying them in a specific way. With regard to his own investigations as to whether there may be deeper causes underlying sensory issues in children, Stadler believes that “the current DSM-5 definitions may yet evolve in the future to reflect the findings of researchers into such causes,” which he believes is the right place to start, but which the DSM-5 does not currently address. Despite these reservations about the DSM-5, we should be thankful for the great progress that it represents in the treatment of children with Special Needs, however they are defined. At the same time, we need to be aware that labeling more of our children as having Special Needs comes with significant costs, not only to JPBB 7.875 5.25but also government and x society,

to the child himself. We in the Jewish community believe that all of our children are “special,” in the most positive sense, and that all of their needs therefore deserve our full attention. But we should do this, whenever possible, in such a way as to avoid labeling our child for life with a diagnosis that may damage their self-esteem or subject them to social discrimination. Not that many years ago, there was a powerful stigma within our community directed against the family of any child who had been publicly diagnosed with Special Needs. The tragic result was that many children with Special Needs who could have benefitted greatly from treatment were never even diagnosed. Such children suffered because their parents had succumbed to fear of the stigma, despair over the possibility that

treatment could be effective, or denial that their child could even have such a serious condition. Today, the stigma is being lifted. We as a community have gained a better understanding of how these disabilities can be treated effectively, and how much the quality of life for children with Special Needs can be improved as a result. There is no longer the need for despair or denial. We have developed ways to teach most of our children who previously could not learn, to communicate with those who could not talk, to give mobility to those who could not walk, and to restore hope to parents who had all but given up hope for their child’s future. These are great blessings. Thanks to laws passed by our generous society, these effective services and treatments are generally

available to the children who need them most at government expense. That generosity must not be abused. Our health care professionals must use their power to redefine the disabilities that make children eligible for Special Needs services judiciously. Government resources for this purpose are not unlimited. To protect the services that we have today, we must take care not to increase the burden of properly caring for these children so much that our society and governments will no longer be willing to bear it. Yaakov Kornreich is the Senior Editor of Building Blocks and the Health and Living Supplement of the Jewish Press. He has been writing for Jewish publications and organizations for more than 40 years. Most recently, he is the co-author of "Young Israel at 100" recently published by the National Council of Young Israel.

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A ISSUES & ANSWERS

“Love Your Neighbor as Thyself ”

pproximately a half a century ago, public exposure of the deplorable conditions in institutions led to dramatic changes in society's treatment of persons with developmental disabilities. Instead of being institutionalized, these individuals would be placed in community homes. The public policy of finding homes for these special needs persons in the community was greeted with enthusiasm from the public but only at a distance. When people discovered that persons with mental retardation were moving in next door, enthusiasm quickly waned and opposition set in. Neighborhood opposition to group homes was often justified on the basis of specific fears. It is argued, for example, that group homes lower property values, increase traffic, and change the character of neighborhoods. Residents of homes, critics claim, can be a nuisance, or worse, a danger to a neighborhood. While society may have a duty to provide decent homes for persons with mental retardation, it has no right to arbitrarily impose the costs of doing so on particular neighborhoods, while the rest of the community is spared. On the other hand, those who supported the establishment of group homes in neighborhoods argue that there is no basis to the claims made by opponents of group homes, and, consequently, that there are no good reasons for treating group homes and their residents differently from other homes and families in a neighborhood. First, the claim that group homes, unlike other homes, cause surrounding property values to decline is false. Numerous studies investigating the impact of group homes on housing markets show that group homes have no significant effect on nearby housing prices. In fact, 12

June 2013

By Rabbi Chaim Wakslak, PhD

some studies have reported that property values of surrounding homes increase. Nor is there evidence to support the claim that group homes harm the "character" of neighborhoods. Surveys show that group homes are maintained

eas have provided persons with developmental disabilities with the obvious benefit of being able to live in familiar community settings, to participate in the normal rhythm of community life. Life in a group home gives them an opportunity to win acceptance with-

time, they win acceptance and are embraced unconditionally by other members of the shul, and are encouraged to participate to the best of their abilities. Those who can recite the brachos are routinely called up to the Torah for an aliyah, and those who are

as well, if not better, than other neighborhood homes, and are unlikely to cause an increase in traffic or congestion. Finally, residents of group homes are no more likely than other people to be dangerous. Like the rest of us, persons with developmental disabilities may spend their days working or participating in a Day Habilitation program, and in their free time they, like us, go shopping, are active in communal religious life or civic groups, eat out, go for walks, and visit friends. Our experience proves that the fears of those who oppose the presence of group homes are unfounded, while overwhelmingly confirming the mutual benefits of group home development to our local neighborhoods. Group homes in residential ar-

in the community, not just as “our neighbors” but also as our friends. When under the auspices of Orthodox Jewish agencies, the atmosphere in group homes set in religious communities is virtually identical to the private homes in the neighborhood. They maintain the same high standards of kashrus, all of the customs and observances of Shabbos and Yom Tov are strictly adhered to. The furniture typically includes a well-stocked bookcase of frequently used “seforim” and the walls are decorated with pictures of Gedolim. The men and women who reside in these homes attend local shuls and stieblach; some of them on a daily basis, to daven with a minyan three times a day, while others go to shul only on Shabbos and Yom Tov. Over

unable to recite the brachos are honored with gelilah or taking the sefer Torah from and returning it to the aron kodesh. On Simchas Torah they dance enthusiastically, just like everyone else. Some members of these shuls say that the presence of special needs mispallelim actually enhances and inspires their own tefilah. The residents attend shul functions and are often invited to the family simchas of their fellow congregants and neighbors. It is not unusual for them to be invited into a neighbor’s home for a Shabbos or Yom Tov meal. In group homes where only women reside, it is not uncommon for a neighbor to volunteer to come in to make kiddush on Friday night, or havdalah on Motzaei Shabbos. The residents of these group homes, in turn, often go out of

ISSUES & ANSWERS Q &A their way to reciprocate the kindness and warmth extended to them by their neighbors. When one of the residents has a special occasion to celebrate, such as a siyum or a birthday, they will often invite the neighbors to join them in an open house party, where they are treated to refreshments prepared by the residents themselves. On Purim, they send Shaloch Manos, and on Shavuos, they send flowers. In short, their special needs do not prevent them from making friends in the community, or from playing an active role in its social life. Most who oppose new group homes for individuals with developmental disabilities in their neighborhoods do so because of the inaccurate stereotypes which have led them to believe that such individuals are fundamentally “not like us.” These

opponents will often realize that they had been mistaken about their new neighbors, once they actually meet and get to know them. In any event, their "psychological discomfort” is certainly not a morally sufficient

group homes in our neighborhoods will lead to meaningful personal contact and interactions between their developmentally disabled residents and their neighbors. This will eventually break down the harmful stereo-

“When people discovered that persons with mental retardation were moving in next door, enthusiasm quickly waned and opposition set in…“

the rest of society. The acceptance of group homes in our neighborhoods promotes the Torah’s social ideal of a Chesed-driven community that is responsive to the needs of all of its members. The track record of such group homes in our communities is proof that our responsibility to promote the welfare of others need not be perceived as a burden. Rather, their presence in our midst is an opportunity to improve our characters, broaden our perspectives, make new friends and enrich our own lives by discovering that their residents really are “like us” in all the ways that are really important.

reason for excluding persons with developmental disabilities from our neighborhoods. Over time, the presence of

Rabbi Dr. Chaim Wakslak is a Clinical Psychologist who serves as Clinical Director of HASC Center Inc. and the Rabbi of the Young Israel of Long Beach.

types that have for so long stigmatized persons with intellectual limitations or physical disability, and unjustly excluded them from

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FAMILY By Marc R. Katz, MA and Pamela Kahn-Alperin, MSW

Does Age Really Matter?

Understanding the Coordination between Early Intervention and OPWDD Services

“D

oes Early Intervention Services impact my child’s enrollment in OPWDD?” “What OPWDD Services is my child eligible for, when aging out of Early Intervention? “How do I apply for such services and how long will it take for services to start?” These are some of the questions asked by parents of young children with global developmental delays, as they embark on the long and tedious process of establishing their child’s eligibility and enrollment for services from The Office for People with Developmental Disabilities (OPWDD). Parents’ exposure to much needed services for their child begins with Early Intervention (EI), as it offers a comprehensive array of therapeutic and related supports to infants and toddlers with developmental needs. When children with developmental delays age out of EI, when they turn 3, their parents are faced with the new challenge of negotiating the next step they need to take to receive services for their child. OPWDD offers a separate system of services for which children with disabilities may be eligible, not just when your child ages out of

EI, but sometimes simultaneously with EI services. Even though EI and OPWDD are two separate and distinct systems, the transition between

the right information and an understanding of key points regarding the eligibility criteria, parents can take charge of the process, maximizing the services they re-

them does not have to be daunting or stressful for parents. With

ceive and removing obstacles that could unnecessarily extended the qualification process. IS MY CHILD ELIGIBLE FOR OPWDD SERVICES BEFORE THE AGE OF 3 YEARS OLD? Depending on the severity of your child’s delay, he or she may be eligible for OPWDD services. Early Intervention defines a developmental delay when a child fails to meet expected developmental milestones, even though progress occurs in the anticipated sequence (unlike a developmental disability). Should the nature of the child’s delay be defined as a developmental disability then they can access OPWDD services as well. According to the NYS Mental Hygiene

AT A GLANCE: OPWDD ELIGIBILITY GUIDELINES  A Psychological Evaluation (within the past year) consisting of:  A Standardized IQ test, within the past year, that consists of a Full-Scale IQ Score under 70 that substantiates qualitative cognitive impairment. There are some exceptions, including those with a diagnosis of Asperger’s Syndrome and Familial Dysautonomia. Children diagnosed with Autism at times require further testing that further substantiates the diagnosis.  An Adaptive Behavior Scale that consists of an overall composite score under 70 to reflect a substantial handicap in various areas of everyday functioning, such as communication, socialization, motor skills, and daily living skills.  A Psychosocial Report (within the past year) that shows the developmental history of the child.  A Medical Report (within the past year) that includes the child’s health status and diagnostic findings to support the diagnosis should also be included in all eligibility requests. 14

June 2013

Law (the legal base for eligibility determination): A developmental disability is defined as:  A condition that results in impairment of one’s general intellectual or adaptive functioning  Can be expected to continue indefinitely  Constitutes a substantial handicap in one’s everyday functioning Although OPWDD will determine if an infant or toddler is eligible for services, they are generally provided with provisional eligibility until the age of eight. At that point the family can pursue permanent eligibility for services, by obtaining updated clinical evaluations. WHAT ARE THE DIFFERENT TYPES OF OPWDD SERVICES MY CHILD CAN QUALIFY FOR, WHEN ENROLLED IN OR AGING OUT OF EARLY INTERVENTION? There are two main types of OPWDD funded services: (1) Family Support Services (FSS) and (2) Home and Community Based Waiver Services (HCBS). Enrollment in FSS is generally easier and shorter, which can be helpful in times of crisis, such as when a family member or loved one becomes ill, or when things get difficult at home. HCBS offers a wider range of services than FSS to meet individual and family needs, especially as your child ages and his/ her everyday needs change over time. The following are commonly referred services:  Non-Medicaid Service Coordination (FSS): As a family first learns about OPWDD services, the process of exploring their available options can become overwhelming. This short-term service provides information and linkages to provide easier access to OPWDD services. The service coordinator

FAMILY will primarily focus on Medicaid enrollment to create greater opportunities for Medicaid Waiver services to help the individual live as productively as possible.  Plan of Care Support Services (PCSS) (HCBS): Since children participating in EI receive their own service coordination as well as an Individualized Family Service Plan (IFSP) for their EI services, they are not eligible for OPWDD’s Medicaid Service Coordination (MSC) program. PCSS is an alternative form of service coordination for those children enrolled in EI. PCSS is delivered by a qualified Service Coordinator who assists families to review and update their child’s Individualized Service Plan (ISP) in order to maintain one’s Waiver eligibility and enrollment. Once your child officially ages out of EI, then one can pursue enrollment into the MSC program or remain enrolled in PCSS.  Family Reimbursement (FSS) offers families who have a member with a disability the opportunity to receive limited reimbursement for various goods and services related to his or her care. In these difficult economic times, many parents are under extraordinary financial stress to provide for the special needs of their child, and welcome the relief that it affords them.  In Home Respite Services (FSS or HCBS): The focus of this program is to provide much needed relief to families and caregivers. While providing this respite, trained counselors work with children with disabilities on a 1:1 basis, providing socialization and skill building activities.  Environmental modification & adaptive equipment (HCBS): Specialized equipment, or changes to the living environment can be provided that enable individuals with physical disabilities or limited communication to lead more independent lives. Examples include wheelchair ramps, adaptive strollers and

communication devices. WHY SHOULD I APPLY NOW? WHAT IS THE TIMEFRAME FOR MY CHILD TO RECEIVE OPWDD SERVICES? In the past, when applying for Medicaid Waiver Services, one first chose a voluntary agency provider. Intake specialists initially assisted families in navigat-

dite the process:  Complete all the required forms and don’t be afraid to ask questions  Schedule evaluations and submit them in a timely manner  Ensure accurate reporting of your child’s strengths and needs so that they are accurately reflected in the documented reports

“Understanding of key points regarding the eligibility criteria, parents can take charge of the process…“ ing the maze of the eligibility and enrollment process. Today, the OPWDD system is in the midst of a major transformation, referred to as the Front Door Initiative, with state-wide implementation expected in June 2013. Thus, families of children with special needs who are seeking services for the first time now will be the first to use this new process. The Front Door process guides families through eligibility determination, assessment, identification of service needs, service authorization, and implementation. Families will first contact the OPWDD regional office that covers their county for assistance. Despite the ongoing discussions about redesigning Medicaid Waiver, the eligibility guidelines remain the same. Please see “At a GlanceOPWDD Eligibility Guidelines” for more detailed information. The time frame for determining eligibility and enrollment can vary widely. That process for FSS can take up to 3-4 weeks. However, it takes approximately 5-6 months for a child to be enrolled into Medicaid Waiver services (HCBS). Even though parents may feel that the waiting time is out of their hands, there is a lot that they can do to expe-

 Make yourself available for meetings and interviews with your intake coordinator to complete required documentation. For parents of a young child

with developmental disabilities, OPWDD Services offers a lifeline of support. Age does not significantly impact your child’s eligibility and enrollment for OPWDD services (regardless of whether your child is enrolled or aging out of Early Intervention). In other words, with regard to OPWDD services, “age is only a number.” Marc R. Katz, a NYS Certified School Psychologist, is a Director at OHEL Bais Ezra. Pamela Kahn-Alperin, MSW, is also a member of the Senior Management Team at OHEL Bais Ezra. For more information about evaluations, intake, or referral of services, please call 1.800.603. OHEL, visit www.ohelfamily.org, or e-mail askohel@ohelfamily.org. OHEL delivers a breadth of community and residential services through OHEL Bais Ezra, OHEL Lifetime Care, OHEL Foster Care, OHEL Mental Health Services, OHEL Institute for Training, Camp Kaylie, and Etta at OHEL.

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FAMILY By Stephen Glicksman, Ph.D

The Easy Way to Help Children Learn Appropriate Behavior

s a developmental psychologist, parents often come to me to discuss “behavior management” issues. I have noticed over the years, however, that when parents say they would like ideas on how to “manage their children’s behavior”, what they usually mean is that they would like to know how to “change their children’s behavior.” The challenge with this mindset is that it is really, really hard to change another person. At the end of the day, if your child wants to yell in a store, he will yell in the store. If she wants to refuse to get dressed in the morning, she can. The fact is that we, as parents, have little control over our children’s behavior. Our power does not lie in being able to control our children, but rather in our ability to control the environment. I have a friend (really, it’s me; I just don’t want my kids to know what I am about to tell you) who had a son who would yell across the house whenever he wanted his father’s attention. A guest was over one day and heard the child yell, “Aaaaabbbbbaaaaaa!!!!” from his upstairs bedroom. The father exhibited no response to his child’s shout for attention. After a second “Aaaaabbbbbaaaaaa!!!!,” the friend politely said, “I think your son is calling you,” to which the father replied, “I don’t hear shouts from across the house.” After the third “Aaaaabbbbbaaaaaa!!!!,” the son calmly came downstairs and said, “Abba, can I go to Reuven’s house after lunch on Shabbos?” Think about what just happened. A child was engaging in a behavior that a parent wanted changed. The parent could have gone upstairs and said, “If you want my attention, come to me and speak in a nice voice,” at which point it is very likely that the child would have responded, 16

June 2013

“I’m sorry. Can I go to Reuven’s house after lunch on Shabbos?” Or, the parent could have yelled at the child for yelling, which would have been an ironic response, at best. However, instead of trying to change the child’s behavior, either through direct teaching or through intimidation, the father in this story changed the environment, thereby giving his child an

opportunity to learn something very important: In our house, yelling doesn’t work. The child, in turn, learned this lesson independently and acted upon his newly acquired knowledge by changing his behavior, on his own, to something more effective. Changing the environment is not only a more effective way to help our children learn how to behave appropriately, but it is also much easier than trying to change the person. In our story, the father never had to go upstairs, never had to raise his voice, and, most importantly, never had to try to convince someone to do something that he or she did not feel was necessary. Instead, by changing the environment, the parent was left with the role of a person who responds appropriately to appropriate behavior, thus giving the child the opportunity to learn, on his own, what

behavior works and what behavior does not. Think about other scenarios where changing the environment allows children to naturally learn how or how not to behave. Here’s an extreme case: A two-year old hits his mother because he doesn’t want to take a bath. Parents often respond to this very serious transgression by saying something like, “Don’t hit me, it hurts! Now you have to go to your room until you are sorry!” While I totally empathize with a parent who was just hit by their two year old, I also know that when you say, “Don’t hit me, it hurts!” you are telling your child something he already knows. Of course hitting hurts. That’s why he’s hitting you. So, telling him that “hitting hurts” is not teaching him anything new. Furthermore, by sending him to his room, without having taken a bath, you have, in fact, inadvertently given him the opportunity to learn a very valuable lesson: Hitting works. So, if I don’t want to take a bath, all I need to do is hit my mom (not only that, but if I hit my mom, wait fifteen minutes, and then say, “I’m sorry”, I’ll probably get a hug!). How could this have been treated differently? By changing the environment from one in which hitting works to one in which hitting doesn’t work. The easiest way to do this, of course, is to ignore the hitting. Of course, getting hit in the nose even lightly can hurt tremendously. So, how do we avoid that? By changing the environment: Instead of facing your child with your front directly towards him, stand sideways while looking at your child when saying, “It is time to take a bath”. This way, if he hits you, it is more likely that he will hit a less sensitive place, like your shoulder or arm, allowing you to ignore the behavior, thereby showing

your child that hitting doesn’t work to avoid taking a bath. And what about the important and valuable lesson that hitting is, indeed, “wrong”? That will come later. Right now, let’s just teach him that hitting doesn’t work, because most older children that hit others do not do so because they want to be “mean”; they do so because they learned from an early age that, for whatever reason, hitting works. The principle of changing the environment instead of trying to change the child is effective not only for enforcing discipline but also for simple behavior management. For example, if your child asks you “when will we get there” twenty times on every road trip, instead of telling him “I told you already, don’t ask me again”, or “I don’t know. We’ll get there when we get there,” showing him how to read a GPS would be much easier for both of you, and make the trip much less stressful for everyone. Similarly, trying to convince a child to not turn on a radio on Shabbos (a behavior that many parents of children with disabilities ask me about) is much more difficult than simply taking the batteries out of the radio so turning the dial simply no longer works. Another example of this approach would be to point out to your child the natural repercussions of inappropriate behavior; For example, if a child refuses to get dressed on a school day by themselves, you can tell them that “I will dress you, but I then won’t have time to make your favorite breakfast.” When I give over this approach to parents of children with specialized needs, this is the point when they often say, “It makes a lot of sense, but my child has a cognitive delay, and this is high level stuff you are asking him to figure out. I don’t think he’s

FAMILY up to that.” My response to that concern is this: Responding to reality is not a high level cognitive activity. Indeed, it is just the opposite; telling your child to refrain from a behavior even though it is working for him does take some higher level reasoning skills. Having your child learn to behave appropriately by creating a reality in which appropriate behaviors work and inappropriate behaviors do not work, however, relies on only a very concrete way of thinking. Think of it this way: If a child sees his favorite dish coming out of the oven, which takes more abstract reasoning on his part- holding back from reaching out for the food because you tell him it is hot, or holding back from reaching for the food because the last time he reached out for it he burnt his finger? Of course, I’m not recommending we allow our children to burn their fingers once so that they don’t touch hot dishes after that. What I am saying, though, is that actually experiencing reality is a much more concrete way of learning than simply learning to follow abstract rules. And, for that very reason, trying to teach our children to follow rules “because we say so”, while a valid parenting approach, is not as easy in the long run as creating an environment where our children behave appropriately because behaving inappropriately simply doesn’t work. Another example of this was once described by Dr. Arnold Miller, a psychologist with extensive experience working with children with autism. Dr. Miller once observed that if you watch a child significantly impacted with Autism, you might see that child running back and forth in a room. And, to an outsider, it may appear as if that child is, “lost in his own world”. You will notice, however, that while the child may seem oblivious to his surroundings, and may not respond to your social overtures, that

profoundly impacted child with autism never runs into the wall. And if there was a table placed in the middle of the room, that profoundly impacted child with autism will never trip over the table. And the reason for that, Dr. Miller stated, is because the wall is reality. The table is reality. And as much as that child may be non-responsive to many, many aspects of his environment, he can’t argue with reality. As adults, we construct the reality our children live in. If I want to play music on Shabbos, and turning on the switch allows that to happen, and my disability makes it hard from me to refrain from turning on the switch, then I might find myself climbing over the furniture to get to that radio, regardless of how many times mom and dad tell me not to. If, however, I am allowed to turn on the radio all week long, and come Friday night, when I turn on the switch, nothing happens, then it won’t take me long to learn that the radio doesn’t work on Shabbos. Of course, each behavior is different and every child is unique. Some general rules, however, apply to all behaviors and all children, as well as all adults: If a behavior works, people keep doing it; if it doesn’t work, people stop doing it. And our power as parents lies in our ability to control the environment. By creating an environment- by creating a reality- in which inappropriate behaviors do not work to meet the child’s needs and fulfill her wishes while appropriate behaviors do work to get the child what she wants, our children will learn how to behave appropriately much more quickly and effectively, all by themselves. Stephen Glicksman, Ph.D. is the Developmental Psychologist at Women’s League Community Residences and Jumpstart Early Intervention in Brooklyn, New York, and has a private practice in Teaneck, New Jersey. He can be reached by calling Women’s League at 718.853.0900, or at sglicksman@womensleague.org.

Did you know…

Yachad is celebrating its 30th bIrThdaY this year! on average, 40,000+ commUnITY members and participating peers experience Yachad programming each year 52 individuals with disabilities Traveled To Israel with Taglit-birthright Israel in summer 2012 and Winter 2013 more than 750 maraThon rUnners around the world have proudly worn “Team Yachad” jerseys as they ran to raise funds for Yachad ThoUsands of sTUdenTs in more than 100+ schools across the Us have benefited from Yachad sensitivity training for schoolaged children In march 2013 Yachad hosted a Job faIr with more than 500 participants resulting in at least 38 individuals finding employment Yachad has 18 chapTers across the Us, canada and Israel In summer 2012 Yachad enabled 210 campers, 52 typical high school students and 147 staff members to participate in 9 dIfferenT sUmmer programs. In summer 2013 Yachad will be partnering with 5 new summer camps our Way sponsors shabbatonim and provides support and resoUrces To 1,500 JeWIsh deaf across the nation Yachad travels to WashIngTon, d.c. to lobby congress for pro dIsabIlITY legIslaTIon

There are many ways that you can help and support these important programs and services, visit www.yachad.org for more information

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June 2013

FAMILY

ith summertime coming, many families are busily planning their vacations. No matter how many or few days you have, how many kids to squeeze into your vehicle, or what “different ability” you have to take into consideration, there are plenty of wonderful places to enjoy spending time creating special family memories.

NIAGARA FALLS, CANADA Niagara Falls is an experience that is comparable to no other. The first time that we went, one son complained, “Why are we driving so many hours just to see a waterfall? Why can’t we go somewhere fun?!?” Well, we not only had fun, but went back many times since then for a repeat performance. Though you need to have proper documentation to cross the Canadian border, it is definitely worth ‘going the extra mile’. The Falls area is beautifully landscaped, full of family friendly things to do, and mostly wheelchair accessible. Many of the attractions are located in the same general area. Many hotels have wheelchair accessible rooms, available by request. The website www.Accessibleniagara.com was a great help in planning our trip. June 2013 18

Accessible Summer Vacations Though our son, Meir Efraim, has Cerebral Palsy and is wheelchair bound, we have always treated our many children to a family vacation trip. We have traveled both by van and by mobile home, and have been fortunate to find many places that are family friendly, enjoyable for all ages, and reasonably accessible. When planning your trip, you

Kosher meals and a minyan are available in the summer season through Chabad Niagara (Rabbi Zalman Zaltzman, 905.356.7200, www.JewishNiagara.com). Discount admissions to many attractions can be obtained through Chabad Niagara either online or at the minyan. Some coupons are available in local tourist leaflets. Here are some of our family favorites:  NIAGARA FALLS VIEWING The entire Niagara Falls in all of its splendor can be seen from the long promenade facing the breathtaking falls. The area is a beautifully landscaped park, where you can enjoy the spectacular view, relax, jog, take beautiful pictures, and enjoy the day together. Nighttime brings the ‘illumination of the Falls’, where the Falls are bathed in changing colors of

need to take into consideration availability of Kosher food and minyan, ages and interests of your family members, and any special accommodations needed. Do you need wheelchair accessibility? Do you have a child who does not do well with too much noise and big crowds, or cannot wait long on lines? Does the attraction issue a pass which gives your special

By Golda Turner

needs family member priority by letting you skip the line? Bear in mind that guidebooks and websites may not have accurate accessibility information. Too often, only part of an attraction is actually wheelchair accessible. It always pays to call ahead and speak to a live person who is more familiar with the individual attraction.

lights for your viewing pleasure.  MAID OF THE MIST This ship takes you for a ride up the river up and gets very close to both the American and Canadian Falls.

cessible attraction costs $14.95 adults, $9.95 child, under 5 free. Entrance is by the Table Rock Welcome Center. www.niagaraparks.com

It is an awesome experience, as it rides straight into the powerful turbulence and spray of the Falls. Be prepared though- they hand you a souvenir disposable raincoat to wear, you will get wet! The ship is accessed through a ramp, and is wheelchair accessible. Cost is $19.75 for adults, $12.65 for children, under 5 free. 905.358.5781, www.maidofthemist.com.  JOURNEY BEHIND THE FALLS This is a ride down an elevator to tunnels carved out of the cliff behind the falls. You can actually stand in openings right behind one of the falls, and see the full power of the falling water. This wheelchair ac-

 BUTTERFLY CONSERVATORY This was a favorite for all ages. It is the most fascinating feeling to have a large, colorful butterfly sit on your hand, shoulder, or head. Multiply that experience by 10, or 20, or 30, and you will get an idea of the fun we all had at the Butterfly Conservatory. In this rainforest housed in a huge, wheelchair accessible dome, over 2,000 of the most beautiful butterflies roam free, often landing on their astonished guests. Cost is $12.95 adult, $8.25 child, under 5 free. Located at the Niagara Parks Botanical Gardens. www.niagaraparks.com/gardentrail/butterfly-conservatory.html.

FAMILY  CLIFTON HILL This is the tourist area, with various small attractions of all kinds. Some are accessible, while others are not. However, be aware that the street is quite steep, and may be difficult to push up and down. www.cliftonhill.com.  MARINELAND THEME PARK This is a combination amusement park and aquarium, with something for everyone. The dolphin show is one of the best we have seen, with accessible viewing. There are also the usual whale and animal feedings, plenty of rides (some accessible), and other activities. Outside food is allowed. Cost is $42.95 adult, $35.95 child, $20.95 handicapped upon request, under 5 free. Located at 7657 Portage Rd. 905.356.9565 www. marineland.com

 SKYLON TOWER A 755 foot high observation tower on a mountain overlooking Niag-

deck. The basement area contains a shopping mall, arcade, and other activities. Located at 5200 Robinson St., 905.356.2651, www.skylon.com  KONICA MINOLTA TOWER A 500 foot high tower with a 360 degree view of the Canadian Horseshoe Falls and the Niagara area seen through floor to ceiling, wall to wall specially treated non-glare glass windows on the 25th floor Observation Deck. On a clear day visitors can

NIAGARA FALLS, CANADA SERVICES FOR SPECIAL NEEDS

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 Pharma Shield 905.356.8482 Call ahead to reserve.  Cupolo Sports & Rental 905.356.4850  Dell Lewis & Krall Home Health Care 800.563.6482, 905.732.4456

Accessible Taxis

 Niagara River Taxi 905.658.3030 Based in Niagara Falls. Does short trips in area & wine tours. Vans for scooters & wheelchairs  Elite Taxi 866.309.TAXI, 905.356.9990 Based in Niagara Falls. Rear loading wheelchair vans.  Brock-Q-Taxi 805.935.5000 Based in St. Katherines. Rear loading vans.  5-0 Taxi 800.268.7429, 905.685.5464 Based in St. Katherines Serves the entire Niagara region. Wheelchair vans and accessible buses

Accessible Tours

 NIAGARA SKYWHEEL A large ferris wheel located on Clifton Hill providing a view of Niagara Falls. Wheelchair accessible cars are available which have room for other passengers, too. Cost $10.99 adults, $6.99 children. Under 3 free. www.cliftonhill.com.

ara Falls. Small yellow elevators glide up the sides of the tower to the observation deck, where there is an unsurpassed view of the area. Cost $11.99 adult, $6.99 child, handicapped $5.75 for the mobility impaired who can only access the glass enclosed observation deck, not the open air

see as far as Toronto, Niagara-onthe-Lake and Buffalo. Cost $5.00 adult, $2.50 children under 12. 905.356.1501 or 1.800.461.2492, www.niagaratower.com As you can see, it is easy to enjoy quality time with your family while building cherished memories. Differing abilities should never hold you back from having fun together. If you can dream it, you can do it! Golda Turner is the director of Beineinu, an organization providing information and support to families and professionals dealing with special needs. Their website, www.Beineinu. org, contains a wealth of information related to all type of special needs. Golda can be reached at 347.743.4900 or Golda@Beineinu.org.

 Gray Line of Niagara Falls (Majestic) 877.285.2113 4 hour tours of Niagara Falls; can take 2 wheelchairs; Wheelchair reservations must be made two days in advance. Emergency Medical Care  Falls Urgent Care Clinic 905.371.1881 6150 Valley Way • Suite 104 Niagara Falls, Ontario

Broken Braces or Artificial Limbs

 Niagara Orthotics and Prosthetics 905.688.2553 If after hours, leave message.

Oxygen— must have pescription  Medigas 866.446.6302, 905.641.5272 Will deliver anywhere in Niagara  Vitalaire 800.567.0202, 905.641.8141 Will deliver anywhere in Niagara

Respite Care Suite

 Ridley Terrace 905.641.4911 448 Louth Street St. Catherines, Ontario Attendant care available. Roll in shower, handheld shower head, ARJO lift. Call to inquire. June 2013

FAMILY By Rabbi Yechiel Kaufman, MA Ed.

Building Self Directed Social and Behavior Intelligence in Your Special Child

alka P. is overwhelmed by any transition or change. She hides in a corner or cubby and will not speak for long periods until she relaxes Leiby V. can only think about himself. He must win every game, get what he wants immediately and feels little concern for others Chaim G. has difficulty going to a party. He becomes overly excited and can become disruptive. These stories are examples of the type of issues many parents must deal with in bringing up their child. Whether the issue is called ADHD, or High Functioning DD, PDD or OCD or just being difficult, the real problem is an inability to understand and ne-

June 2013

gotiate their environment. Does Malka understand her own feelings so that she can make better decisions on whom to approach as she eases into the group? Does Leiby know or care about another person’s feelings? Does he realize the consequences of his behavioral style? Does Chaim realize how other people evaluate what he is doing? There are many behavioral and therapeutic approaches that try to deal with these issues. For most families it is the social and behavioral issues that are most disruptive and affect the siblings the most. Normally we try teaching relaxation, we teach rules of behavior, and we teach how to deal

with specific situations. Yet when the child is placed in a new situation, the problems re-emerge and significant difficulties remain. We have created and tested a new successful therapeutic technique, the SBI (Social Behavioral

needs and recognize when their desires need to take a back seat. SBI teaches the child the executive processes that work in all situations. It uses active learning and questioning techniques to help the child become actively

Intelligence) Self Directed method that helps the child to develop the skills he/she needs to apply in all social and behavioral situations. A typical child knows how to  interpret the environment  recognize and interpret their own feelings  recognize the requirements of the situation they are in  make a decision on how to behave.  they also need to recognize when they have made a mistake and how to modify their approach. When the child develops these skills, they can be confident and appropriate in all situations. They are also able to evaluate their own behavior and be flexible. They do not need to get emotional and upset with an intensity that is out of proportion to the event. They are alert to another person’s

involved in gaining a sense of control over their environment. Instead of giving answers, SBI guides them through an exploration of themselves and the social milieu in order to learn the skills that others pick up naturally from their day to day interactions. We all have good and bad days. We modify our behaviors according to these feelings, to escape our bad mood or enjoy an event. We are flexible and therefore we can change ourselves. These children do not have that internal flexibility. The SBI Self Directed method teaches flexibility. As Ernst Kris said “the hallmark of being a healthy person is flexibility”. A flexible child can accurately report what is bothering them. They can have a conversation

FAMILY that successfully deals with the challenges the child is facing. The child does not feel trapped and does not act out due to a sense of frustration or hopelessness. The child uses their behaviors as a way of communicating their feelings, but this is usually ineffective because it just makes other people upset, and the real issues are generally not dealt with. The SBI Self Directed method gives a voice to these feelings that can then be discussed and negotiated, helping to find a mutually acceptable solution. Malka did not want to leave her cubby area and participate. Traditional methods of encouragement were tried and after a few hours, she would emerge usually for a short time. When the next change occurred, the process needed to be repeated. The SBI Self Directed method taught

Malka how to evaluate the situation, and address her own worries and concerns about the other children in the group. As she began to understand her motivators, she was able to use strategies for dealing with new situations. After some time, she was able to become an active participant in all events and activities. Leiby was taught the concept of understanding the other person. He learned how to recognize what another person was feeling and how important it was to them. He was then able to compare it to his own feelings and make appropriate decisions about his actions. Leiby learned the difference between the momentary event and the long term consequence. He also learned to accurately evaluate his own needs and not let them overwhelm him. Leiby is now able to make and keep friends.

Chaim learned that even the largest groups are composed of individuals, and that he could apply the same rules for relating to a person as he would to a group. He learned how to explore the environment before entering it, how to pick out an activity or person to connect to before entering, and then how to execute the action. He learned how to monitor his own feelings and therefore did not become overwhelmed. The proof of his improvement was his ability to handle a family wedding without any incident, to the great joy of his parents. The SBI Self-Directed method is based upon the proverb, â&#x20AC;&#x153;Give a person a fish and he eats for a day. Teach a person to fish and he eats for a lifetime.â&#x20AC;? We donâ&#x20AC;&#x2122;t only teach what to do today; we teach the skills that a person can always carry from situation to

situation. This method teaches the child to become an active member of the family and society, by learning the skills needed to deal with the complexities that exist within all relationships. Rabbi Yechiel Kaufman MA Ed. has worked with the special needs population for over 40 years and has developed numerous programs for special children throughout NYS. He is the director of the Special Care for Family and Childrens Services Perachim Program. SCFCS provides Community Habilitation, Respite services, Medicaid Service Coordination. The Perachim Program will provide an after school Medicaid waiver program with free Behavioral Assessment, ongoing parent and sibling training, behavior consultation, outreach and behavior training to schools and professionals on the SBI self-directed social and behavioral intelligence method. For more information call 718.252.3365 ext. 111or e-mail at perachimprograms@aol.com

June 2013

FAMILY Taking Care of Your Newborn Preemie

ongratulations, you just had a baby! He/she may have arrived earlier than expected but now it’s time to take your bundle of joy out of the cold and sterile environment of the NICU

and into your warm and loving home. In the U.S., the number of premature babies has increased by 30% since the 80’s, and the good news is that their survival rate has improved dramatically.

They may look delicate and fragile, but premature babies are resilient. With the knowledge supplied to you by healthcare professionals, and your unwavering love, you are fully

By Ita Yankovich

equipped to handle this blessing, so enjoy them and don’t panic. Ita Yankovich is a freelance writer/reporter. She also teaches English and Literature at Kingsborough and Touro College.

FEEDING AND FORMULA Preemies are prone to infection, so breast milk is preferred when it comes to nourishment. Additional advantages of breast milk over formula is its inclusion of extra calories, vitamins, proteins and live cells. If breast feeding is impractical, your baby may need a special preemie discharge formula, such as Similac Neosure, Enfamil Enfacare and Cow & Gate Nutriprem 2. They have more protein and calories than regular formula, and are available at most supermarkets and through WIC with a doctor’s note. Highly enriched formula milk is better for the development of premature babies’ brains than breast or standard formula milk, according to research. In the NICU, most premature babies receive 2 to 3 oz (60 ml to 90 ml) of formula during every feeding once the gavage tube is re-

moved and they are sent home. To determine how much you should be feeding your premature baby at home, it is best to ask the NICU staff how much your baby was consuming at the hospital. Neonatologists calculate how many calories each preemie should be eating for good growth, and won't discharge a baby until he is eating at least that much. Preemies will give cues as to when they are ready to eat, such as being quiet and alert with their eyes open. They may not be ready to eat if they are sleepy and turning their heads away. Most doctors advise giving premature babies solid food between four and six months after the original due date rather than the date the baby was born. Premature babies may choke if given solid food before that, because they may not have developed the ability to swallow yet. If your baby has medical problems, a special diet may be helpful.

STROLLERS The parents of a newborn preemie should purchase a stroller which fully reclines since not every preemie passes the oxygen test they need for doctors to allow them to come home in a car seat. Some preemies will need a special carbed to lie flat. There is some danger in having an occluded airway, so placing the baby flat is best.

June 2013

FAMILY BATHING

BEDDING

You shouldn’t bathe preemies daily since their skin is very sensitive and gets dry from too much bathing. Professionals recommend washing them every two to four days. Begin with sponge baths. Before bathing your baby, take his/her temperature (a normal axillary (under the arm) temperature is between 97.5 and 99.3° F). Preemies have a hard time regulating their body temperature, so make sure their temperature is in the normal range before bathing time. Water should be comfortably warm at approximately 100.4°F. Select baby soaps that have a neutral ph and that are preservative free. Once your baby's umbilical cord has healed, your baby will be ready for a tub bath. Fill baby's bath with no more than 2-3 inches of warm water. Follow the same procedure as for sponge bathing. Never leave a baby unattended in the tub.

Although a SIDS tragedy can happen at any time during the first year of life, the risk is highest between 2 and 3 months of age for premature babies. Because their lungs are not yet fully developed, preemies have a greater risk of contracting respiratory diseases such as RSV, so avoid toxic chemicals that can be present in baby bedding products and can harm your baby's delicate breathing system. A sleep positioner, which helps keep your preemie baby on his back while sleeping, is recommended by the Surgeon General to prevent SIDS. It is advisable to put baby to sleep in either the lateral (either on the right or left side) position or on his back. Keep the room temperature between 16-20oC (61-68oC), but ideally at 18oC (64oF).

CARSEAT Preemie infants should be seated in a car seat only for a limited amount of time. Use car seats only for travel. If the child is required to travel with additional medical equipment such as monitors or supplemental oxygen, care should be taken secure those devices in the vehicle to prevent them from becoming dangerous “projectiles” in a crash or during hard braking. Select car seats that have a shoulder height below 8 inches. This will ensure a proper fit for small babies. Look for car seats that have a shorter distance between the crotch strap and seat back, and that have harness slots low enough that the straps can be placed at or below the shoulders of the infant when seated. A small rolled towel can be added between the crotch strap and the infant, as well as between the infant and the sides of the seat to reduce the risk of the infant sliding forward under or out of the harness. A baby support cushion that cradles the body while supporting the head can keep the baby's head from rolling around during transport. Reclining the rear-facing car seat to a 45-degree angle will keep the baby's head from falling. One of the top-rated infant car seats for preemies, according to Consumer Reports, is the c. The Compass Via is another popular choice, since it has a lower shoulder height.

June 2013

FAMILY FORUM Welcome back to the Family Forum!

he Family Forum section of The Building Blocks magazine was introduced to allow parents and other relatives or even friends of those with learning or physical challenges to share ideas and information, raise concerns and take comfort in the triumphs of others over adversity. This forum can be a spring-board as a means of communication between families. Please read through each letter and share your thoughts. We look forward to hearing from you soon.

The Editors

Looking Beyond the Label

ehind every person with a label of "disability" is a person with talents, skills, abilities and passions. All too often society sees the label of disability as a â&#x20AC;&#x153;crystal ballâ&#x20AC;?, able to predict the ultimate value of that individual in the community. Often the stereotypical attributes of the particular disability get applied to that person and doors get slammed shut. It has been my experience and the experience of so many who have gotten to know children, teenagers and adults with disabilities as well as having had the great pleasure of being enlightened by their loving parents and caregivers, that communities would benefit tremendously by looking at the strengths rather than the special needs of those labeled as having a disability. At the earliest possible age, children with disabilities and neuro-typically developing children need to learn from each other. I am not at all saying that the need for very specialized intervention should be ignored. Of course provide that

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

June 2013

child with all the appropriate tools to succeed. I am talking about changing the world, giving all children the experience to know that this is a world of diversity. We can all be friends, we all share commonalities and

indeed we are all like snowflakes-unique bundles of energy, creativity, joy, sadness, anger, laughter, and all permutations of everything possible. Perhaps the future wouldn't be filled with as many closed minds if inclusion were nurtured and appreciated. Ultimately, the workforce would

benefit, as would communities, as this new breed of humanity would not think twice about hiring a person with a disability. I recall the story of Bernard Carabello who was a resident of the infamous Willowbrook on Staten Island New York. Once Geraldo Rivera exposed the horror of that institution, Bernard and all residents of that torture den, were included into more humanistic facilities in the community. Bernard's parents didn't have the tools nor the community support when he was a young child, to care for Bernard at home. His severe Cerebral Palsy was a challenge that required a multitude of services that were just not available at that time. Once released, this young man whom everyone assumed had a severe intellectual disability, began to communicate using technology. Lo and behold his mind was as sharp as could be which also meant that he was fully aware of the lack of humanity he experienced all those years in Willowbrook. He was motivated to use his passion

By Gary Shulman, MS. Ed. to let that never happen again by establishing the Self-Advocacy Association in NYS, promoting, praising and supporting the abilities and worth of people with disabilities. Children with disabilities need to see role models such as Bernard as do children and adults without disabilities. It wasn't too long ago that you couldn't find a person on TV who was Black or Asian. These choices send a strong message to vulnerable, formative minds. It speaks volumes about how we value certain people. We now need to include more people with disabilities in the media. The media is the message and reflects the value system of that society. It is a tool for education and sensitization. We are all in this big blue marble together. We need the skills, strengths and talents of all members of society. Everyone benefits! Gary Shulman is a Special Needs Consultant and Trainer and can be reached at shulman.gary@yahoo. com.

FAMILY FORUM School Bus Strikes and Styrofoam Containers

“N

ow, one product that is virtually impossible to recycle and never bio-degrades is Styrofoam. But it's not just terrible for the environment. It's terrible for taxpayers. Styrofoam increases the cost of recycling by as much as $20 per ton, because it has to be removed.” “Something that we know is environmentally destructive, that is costing taxpayers money, and that is easily replaceable, is something we can do without. So with Speaker Quinn and the City Council, we will work to adopt a law banning Styrofoam food packaging from our stores and restaurants. And don't worry: the doggie bag and the coffee cup will survive just fine.” Mayor Michael Bloomberg State of the City Address, February 14, 2013 Why is the above statement significant? To parents of students with special needs, it further confirms that our children have been far from a priority to this administration. The mayor’s speech came on the heels of a month long school bus strike which began on January 16, 2013 when two thirds of the yellow school busses in New York City ceased to operate after drivers and matrons walked off the job. The mayor boasted about how well the city is doing and spent time discussing the environment and his proposal to eliminate styrofoam containers while hardly mentioning the

school bus strike and its impact on special children and their families. He spoke of bidding out contracts to save the city money and how the drivers and matrons should come back to

number of children attending different schools and no plan for families who could not afford to put out carfare twice a day and wait for reimbursement. Even those parents who opted to take

work. Mayor Bloomberg failed to mention the fact that at the time, thousands of students with disabilities were unable to attend school for an entire month due to the strike. There are 150,000 students in New York City who receive school bus transportation, 54,000 of these students have special needs. Initially, as an alternative to yellow bus service, the city offered only Metrocards, reimbursement for taxis and car services or .55 cents a mile for parents choosing to drive their children to and from school. However, the city offered no plan for students in need of accessible transportation. There were no arrangements made to assist families with children who needed an adult to accompany them to school and did not have a parent available. No assistance was offered for families with a

a car service or taxi, the Mayor only initially authorized reimbursement for a one way trip to the school and a one way trip home. When parents arrived at their child’s school, they were left to their own devices and expense to find their way back home or to their place of work. Parents were also forced to change their work schedules to arrive late and leave early to allow sufficient time to arrange transportation to drop off and pick up their children. Parents who laid out what amounted in many cases to upwards of hundreds of dollars a week had to wait weeks to be reimbursed. Some parents requested impartial hearings. A small number of students, especially those whose parents filed for hearings, were eventually provided with direct pay vouchers. But the vouchers were

only approved for use in participating TLC cars, none of which were handicap accessible. Also, there were many neighborhoods that were not serviced by these car services. The voucher had to be reauthorized at the district every five days, placing yet another hardship on the parent. Additionally, parents were still expected to accompany their children to and from school. During the strike, Mayor Bloomberg appeared on the radio. He boasted about how “we paid for a taxi to take every kid who needed it”, and “our costs were half of what a regular bus company costs. So we saved a lot of money during that strike.” The problem was, “every kid who needed it” could not ride in the taxi, and thousands of wheelchair bound students and students with severe disabilities were stranded at home for a month because there were no accessible transportation options. The last New York City school bus strike occurred in 1979. Mayor Ed Koch took charge then and made arrangements to transport students with disabilities using Rikers Island busses with corrections officers as drivers and matrons to assist students. When some of these corrections officers were later interviewed about their special assignment, they fondly recalled time spent transporting children with special needs as one of the most meaningful experiences of their lives. Mayor Koch thought outside the box, unfortunately, Mayor Bloomberg cannot think outside the styrofoam container. We hope the new mayor will...

June 2013

FAMILY FORUM Sunday Afternoon

By Yehuda Minchenberg

(Sequel to Shabbos Afternoon)

s a follow up to my previous article about Shabbos afternoon (magnatiles are still a gift from Shamayim and I defy anyone to tell me otherwise!), it made sense to explain what the last day of the weekend in our family looks like. As I am sure it is true with many families, Sunday afternoon is the time for a family outing. However, as our children are better with routine, we have decided that it is best to go to the same place each and every week. So, you may ask, where can a family of 8 go no matter what the weather or season of the year? The answer is not as complicated as one may think. However, we must back up a step before the moment of truth can arrive. Truly speaking, all 8 of us do not get in the car as this is a perfect time for Mom to recharge the batteries and get things done around the house. This is also a good hour and a half for our oldest, Asher (15, typically developing), to get school work done which was difficult to do so beforehand. As sometimes projects need to be typed, that could become challenging in the early hours of the afternoon. This is because the computers are running episodes of Barney, Arthur, WildKratts (great nature show!), or Scooby Doo which helps entertain Tuvia (13, ADHD), Shmuel (11, Autistic), Zev (8, mildly autistic), Devorah (8, ADD), and Morechai (3, typically developing). As to

June 2013

which show gets to be watched when and how these shows can entertain children ranging 3-13, we might need to deal with that in a different article. So, in reality, Dad and 5 children get in the van (“I want to sit in the middle”, “I need help with my buckle”, “Do you have

the list?”, “Buckle”, “Can I sit in the front this time?”, “Do I have to go?”, “Shoprite is too easy”, “Shoprite…Shoprite”, “Chocolate Milk”, “Apple”, “I want Iced Tea”, “When are we getting home?”, “I want to go on the computer”, “Snack…Snack”) to make the 10 minute Trek to the local supermarket. When we get there, the question then becomes how to get all of them safely through the parking lot to the sidewalk. Since not everyone can get out at the same time, it becomes a bit challenging help-

ing some get out while keeping an eye on the others (who by nature are distractible and have limited impulse control). Basically, everyone stays in between our car and the next one, which isn’t so hard for 2 of our kids who enjoy looking at their reflection in the window of the next car and scripting their favorite show. Once everyone is out, we have one or two lines of children holding hands for 3 seconds, letting go, being reminded to hold on again, and then slowly letting go as we get to the sidewalk in front of Shoprite. At this point comes the next phase of running to a cart that can fit 3/5 of our group. Until about a year ago, the big carts were designed to have one small child facing the parent and another 2 individual seats facing that child (giving 3 children a fair amount of personal space). However, in an attempt to make things more difficult for us (I can’t think of any other reason why they would have changed the set up of the carts!), the design was changed so that now there is just one bench for the 2 children instead of separate seats. At first, this did not seem to present any problem because Zev craves sensory input so being “smushed up” against Shmuel would not be an issue. However, as Shmuel is a big

child and growing, it is increasingly difficult to fit Zev next to him and Mordechai across from him without everyone feeling squished. Of course, there is the option of having Devorah sit next to Zev, her twin, but that would mean Devorah does not get to “help” and Shmuel would not be buckled into a seat. This could create major issues as he does enjoy touching many of the things on the shelves so that I have to be keenly aware as to how the shopping cart is positioned vis-à-vis the shelves. Being too close is a recipe for trouble but being in the middle of the aisle effectively blocks other carts who are trying to get through (some of whom are understanding and some of whom are not). Soooo…we have come to the arrangement that Tuvia helps check off the items from the list (he must hold it on the way to the supermarket and throughout the trip), Devorah helps push the cart together with me, while Mordechai, Zev, and Shmuel spend most of the trip communicating in some way with each other- either entertaining one another with shows they have seen or complaining “He is squishing my fingers”, “He is too close to me”, “He is kicking me”. How is this all accomplished without causing too much of a scene in a potentially crowded store? Please stay tuned for the Sequel- “A little Chocolate Milk can go a long way!”

Doctor’s Advice

FAMILY FORUM Potty Training

“O

H NO, HE WON’T GO” …help your child who refuses to poop on the potty. If your child:  refuses to sit on the potty complains frequently of ‘tummy aches’  dances around the room trying to hold poop  cries for a pull-up or diaper to poop  hides in a favorite corner or behind a sofa to poop …Your child may be a stool withholder or have encopresis (soiling of stool)

Stool withholding or unwillingness to poop on the potty is very common and results in the build up of stool in the rectum and the eventual passage of a large stool. Stool withholding is a behavior, not a disease or medical problem, and is not related to dietary or fluid intake. A child who withholds stool is physically able to defecate but refuses, either due to  fear of pain because of a previously painful bowel movement  desire for behavioral control. Stool withholding and encop-

resis (soiling of stool) can have devastating effects on a child and family as it creates significant stress and frustration within the household. As the withholding behavior worsens over time, children face further difficulties with:  Enrollment in school  Enrollment in summer camp  Inability to swim in pools  Teasing and rejection by other children for smelling badly STOOL WITHHOLDING IS TREATABLE! Treating a child who with-

holds stool requires: A combination of safe laxatives (so your child has to poop) and a structured behavioral program (so your child poops in the right place at the right time). Treatment is best achieved by speaking to your doctor every day on the phone until success is achieved. Usually this will take one week. Fred Daum, MD, Chief, Division of Pediatric Gastroenterology Winthrop University Hospital, Mineola, New York 516.663.4939 By Sharon Shapiro-Lacks

“Special” Does Not a Disability Make

s a woman who has lived with Cerebral Palsy all my life, I pay close attention to the terminology that is applied to people with disabilities. Words such as “invalid,” “cripple,” “dumb,” or “retard” have always hurt me deeply and most people today understand why. But the term “special needs” and the word “special” (as in “these special children”) have disturbed me and many others with disabilities for years. Yet, this nomenclature has gained popularity in our community and beyond, especially among our well-intentioned parents and helping professionals. Some justify using the term “special needs” as a convenient way of referring to a segment of people with diverse characteristics and needs. However, there is a deeper motivation. By using the term, “special needs” they avoid using the term “disability” which, for some, emphasizes a lack or deficit of which one may be ashamed. They, thereby, mask the disability behind the “special need,” trying to avoid being perceived as lacking. Thus, any subcon-

scious feelings of (unwarranted) guilt, embarrassment, or feelings of personal failure that they might feel about having a disability, or having a family member with a disability, can be concealed as well. However, by using the term “special needs”, we, persons with disabilities, become known specifically for our imagined limitless needs. Our neediness, in particular, is showcased, thereby shaping perceptions of us as receivers rather than contributors. Also, why are our needs more “special” than the needs of our siblings or friends? Everyone has special needs in one circumstance or another, so why is our demographic – persons with disabilities -- set apart with the “special needs population” label? Perhaps, we should be attentive to all individuals’ “special needs” whether or not they have disabilities. Also, since our needs are considered “special”, we, children and adults with disabilities, by extension, often become known as being “special”, imbued with “special” midot, characteristics. Why are we identified as “special” in con-

tradistinction to others who endure, successfully handle, and grow from life’s tests and tribulations? And, if we are considered special, why aren’t shadchanim matching girls with disabilities with choice boys without disabilities? Why is the service called, Special Shidduchim reserved only for people with disabilities? If the title means what it says, then Special Shidduchim should match high quality people with high quality people, regardless of the existence of a disability or health condition. Or are we really using the term “special” as a socially acceptable way to segregate people with disabilities into separate programs, minyanim, and shidduch circles? Yes, occasionally, people with disabilities do want or require a service, program, or group that caters to specifically them. This should merely be an option in addition to the increasing number of inclusive programs. But please don’t label the participants as “special” or use the word “special” when naming the group or program. The terms “special” and ‘special needs’ do not serve our

cause and efforts to combat needless pity towards and the marginalization of people with disabilities. Whether we, our family members, or our neighbors use wheelchairs, alternate ways of learning, sign language interpreters, large print, Braille, or modified school or work schedules, we need to embrace the term “disability” as a fact of life in olam hazeh. We want society at large to continue to increase its regard for us as “people with disabilities”, an identifiable and broad demographic, who can contribute to the destiny, well-being, and growth of klal Yisroel, if we’re provided the right accommodation. May every one of us be considered “special” based upon our unique souls and our emergent good and Torahadhering characters given our challenges in life; not because of or despite them. Sharon Shapiro-Lacks is the Ex-

ecutive Director Yad HaChazakah -The Jewish Disability Empowerment Center Led by Jews with disabilities. You can visit them at www.yadempowers.org; or call them at 646.723.3955 for more information. June 2013

FAMILY FORUM The Juggling Act: Inclusion Begins at Home

aising a child with special needs is at times joyous and at times extremely challenging. There are many aspects to how this child affects the dynamics of the family unit as a whole, not just how it is affecting the child and his parents. Everyone in the family has needs and challenges: everyone in the family has a specific role in that family. How does one juggle each member of the family unit in order to give everyone the time and needs that he/she deserve? Let’s begin with the child himself. The child may exhibit a variety of challenges, from the diagnosed disability, to emotional stability, to behavioral issues. Once the diagnosis has been made (and this is not always a straightforward process and can take a tremendous amount of time and effort), we can access the needs for the child at that moment (and look into the future as best we can), and try to meet those physical, social, emotional, and educational needs. But we must also deal with emotional frustrations, upheavals, and outbursts. Guidance from a mental health professional, social worker, or case manager can help in these areas. So now you are exhausted! You turn around and find your other children waiting for their time, their needs, their attention. Where do you find the time and energy to bond with them? They have homework, are hungry, are fighting with their friends, need to talk, etc. etc. etc. Then comes your spouse. Home from work or tired from a full day with the kids! Your

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spouse needs the same time, energy, and attention as the rest of the family. And don’t forget to feed him/her as well!! By the way, are the grandparents coming? Where do they fit

how to escape! Enter juggling lessons! All of us are trying to coordinate our life and the lives around us in order to meet everyone’s needs, both physically and emotionally.

in? Uncles, aunts, cousins? Each member of both the nuclear and the extended family are pulling on you and want attention. They also want to provide their opinions and have you implement each one. The stress is undoubtedly building and you are wondering how you got into this and

Once you are not a solo individual, you are trying to blend all of the pieces and people of your life together. It is no easy task- certainly made that much harder when one of the members you are trying to blend has a special need. We all have to learn to juggle our family, social envi-

By Batya Jacob

ronment, work, and ourselves in order to survive. So here are just a few practical suggestions on how to give each member their own time. These are just some ways to juggle, not an inclusive list. Some suggestions may work for you and your family; some may not; or you may have more effective methods. Remember, fair is not always equal. This is a lesson that not only do we need to learn, but that every member of this unit needs to understand and accept. At times the other individuals within your family may resent this concept but they will come to accept it over time if you yourself truly accept it.  Take 15 minutes each night with each of your children individually. This special time acknowledges to the child that they are as important as each of their siblings, whether they have special needs or not. Each child is special. Each child craves parental attention and is entitled to it. It can be hard to do this when the demands of life get in the way. But your child will remember the time that you take and cherish it. Some examples of what to do during this time can range from having the child make dinner with you, helping with homework, or simply reading a book together. It does not have to be extensive; you just need to set the time aside. Fifteen minutes a night may not always work every night. Do your best; a five minute tuck in at bedtime can serve the same purpose.  Spend one night a week with a different child doing

FAMILY FORUM something “special.” This could include going out for ice cream, taking a drive, watching a favorite television program, and so on. It won’t be the entire night! It does not have to be a major trip somewhere. Just some time alone helps. Find out what your child wants to do and try to do it.  Communicate with each member of the family. Children need to be heard. They need to feel like their parents are listening and that they have a safe adult that they can speak to. Asking the child how their day was helps make them feel important. Don’t belittle what they say. Even if they are speaking against another sibling, just listen. This shows that you care and respect the child. Try to find solutions to conflicts if possible, but never forget to listen. The earlier you begin these conversations, the more your teenage and adult children will communicate with you.  Safety first. All of the members of your family need to feel that the home is a safe environment for them. If your child with special needs is prone to tantrums (or your child without special needs) create a “sensory down time” room or place in the home where they can go to cool down and get themselves together. Create a safe haven in the home where any of your children can go and shut the door. There are many times that you cannot remove the child who is acting out; it is important to give the other children a safe place where they can go while you diffuse the situation at hand. Don’t forget to talk to the children after. They are feeling a variety of emotions stemming from an outburst: embarrassment, anger, helplessness. They need to talk it out with their parents.  Social inclusion starts at home. Look for ways to include your child with special needs into family life. Have them help set the table for dinner if they are

able, ask them what they would like to watch on television, find games that they can participate in despite their disability. Every family has an activity they enjoy. Include all members of the family in this activity. Encourage your other children to include them on play dates when appropriate. Encourage play dates between your own children.  Insensitivity affects everyone in the family. Remember that when someone calls your child with special needs a name it hurts not only that child but you, the parent and your other children as well. Discuss a way to respond to the insensitivity. For some families, it may be to simply walk away. For others it is to confront the person and say that what they are saying is hurtful. But don’t lessen the hurt that your other children are feeling. Talk it out with them and explain that Hashem gives everyone challenges. Some are more visible than others. But other people can be insensitive and cruel at times. It is because they do not understand the person that they are hurting or that they just need to talk. Always acknowledge every member of your families’ feelings and work through it with them.  Date Night!! This is so important for every married couple. It is alone time with you and your spouse no matter what the pressures are. Enjoy dinner out, go to a movie, take a walk! It doesn’t matter what the activity is, just do it. Try to enjoy each other while NOT speaking about your child with special needs, your other children, the in-laws, work, money, and so forth. Just enjoy the time together.  Grandparents! They are always there to give their opinions and suggestions. At times these are helpful, at times it seems like criticism. Get them involved with the family. Have them come for Shabbat. If they are nearby, they can help drive carpools or

babysit. Give them concrete ways to help in the family. By opening up your home to them, they will get to know your children better. They will also be part of the experience. By being present in your home, they will come to better understand your life experience, the stresses, the challenges, the good and the bad time.  Take time for yourself. Seems impossible, right? It is essential to your own wellbeing and mental health. It is not the amount of time you give yourself, it is giving yourself that time. It is not about how much time, it is about doing something for yourself. Take a walk, watch a television show, go to the gym, read a book, get a manicure: Whatever works for you. This won’t happen every day but try to do something for you every week. And remember

to breathe!  Thank Hashem for the brachot that he has given you. Every child can challenge their parents. Every child can have their difficult moments. But every child has a special neshama and a purpose from Hashem. Every child brings joy in their accomplishments. Every child is a gift that Hashem has given us. As hard as it may be, step back and appreciate each child and member of your family and thank Hashem.  Lastly, enjoy your family. It is uniquely yours and can give you much happiness and nachat. Don’t let the day to day challenges overpower the fun and unique ways that defines your family. You will reap the rewards as your children grow, meet their spouses, and begin their own families.

June 2013

EDUCATION By Rabbi Dr. Yisrael Rothwachs

Inclusion Designed for the Individual Child

nclusion of children with disabilities means many things to many people. To some it connotes a drive to attain equality of rights. To others it refers to acting kindly and compassionately to those who are different. Of course, to many it is an educational philosophy that promotes the integration of children with disabilities into regular education classrooms. Yet there is another simple, but profound understanding of inclusion--one that, if recognized and embraced, could potentially impact the lives of many children who require special education. Equality and kindness are certainly prominent values of both American and Jewish cultures. These principles are so ingrained into our psyche that they may blind some from thinking outside the box and considering a type of Inclusion that is a bit different, that focuses less on straightforward equality and fairness, and more on promoting unity and harmony. The truth is that an educational model that promotes equality, rather than unity, is one that can sometimes force a “square peg in a round hole.” Educators may be compelled by that philosophy to focus more on attaining academic equality for the entire spectrum of students in a class, rather than providing the supports necessary to promote each child’s academic and emotional growth. For example, placing a student with a social anxiety disorder in a large gym class may be the “fair” thing to offer and would certainly promote equality – but this type of placement may indeed jeopardize their emotional growth. The driving force behind classroom placement often becomes more about maintaining a parallel curriculum than a student-focused decision. An alternative approach which I would like to see more schools 30

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and institutions take on is one that is thoughtful, child-centered, and flexible. At SINAI, we use an approach we have termed “Inclusion by Design™,” and it requires

the individualized perspective of Inclusion by Design™, offers the best of both worlds – it promotes the academic and social unity and integration of children with

“designing” the Inclusion experience for each individual student. Approaching the process of inclusion from the perspective of promoting unity, allows one to consider how not every child needs the same academic and social opportunities, but rather that they can best grow from inclusive experiences that are thoughtfully planned for them – experiences that will build confidence, skill and unity with the rest of the school community. Parents seeking appropriate academic placement for a child with special needs are often faced with a difficult choice: to place their child in a socially-isolated selfcontained class, or to place him in a typical general education class with inadequate academic and social support. Inclusion, from

special needs within the larger school community, but with each child’s abilities in mind. Of course, it starts with the fundamental belief that children with special needs should be full members of a larger “mainstream” community. Far from being isolated in their own schools and activities, these children should walk the same halls as their brothers and sisters, and identify as part of the larger school community. Yet Inclusion by Design™ recognizes that children who struggle with disabilities can’t always do everything at the same pace and in the same way that other children can. It requires a lot of time, effort, and planning. While many schools don’t have the resources to implement this approach,

those who use even some of these strategies have the power to radically change a child’s school experience. In order to respond to each child’s individual needs and abilities, the school must consider his or her unique academic, social and emotional profile, and allow that to inform a partnership with the parents in the “design” of the Inclusion experience for each student. Through thoughtful collaboration, administrators, teachers and parents can develop a seamless academic and social program – one that allows each individual student to grow at his or her own pace. The Inclusion plan must consider not only each child’s educational setting, but his or her social environment as well, and must be designed to drive progress via a supported approach. Through Inclusion by Design™ the inclusive experiences of the students are not indicators of a blanket policy of full integration for the sake of equality, but rather become examples of a deliberately designed Inclusion plan that promote students as valued members of a united school community, regardless of their differences. A school’s educational approach to children with learning and social challenges should not be the same as their approach to typically developing children. Successful inclusion does not have to be purely a vision of academic equality. A deliberately designed individualized Inclusion plan, however, helps to insure that each student is a valued and integral member of the greater school community. Rabbi Dr. Yisrael Rothwachs serves as Dean of SINAI Schools, a network of schools and adult programs in Northern New Jersey that provide services to children and adults with special needs. He can be reached at yrothwachs@sinaischools.org.

EDUCATION History of Special Education

hile reading a newspaper several months ago, I could not help but smile when coming across a photo of the School for Children with Hidden Intelligence, located in Lakewood, New Jersey. “How we’ve come a long way,” I marveled to myself, “since the days when special-needs children were not to be seen nor heard from. Now, not only are they being acknowledged so respectfully, but they are being given the opportunity to thrive, rather than just languish in a classroom ill suited to their needs.” This, of course, was not always the case. The United States Department of Education’s website tells the story of Allan, born in the 1940s, who had become blind at age 35 from slapping himself while sitting in the corner of a room rocking back and forth. When tested, he was found to be of average intelligence, but as a child was misdiagnosed as mentally retarded, and subsequently, institutionalized. Given the advances of special education, such a scenario is highly unlikely to occur today. Merriam-Webster Dictionary’s definition of special needs is “the individual requirements of a person with a disadvantaged background or a mental, emotional, or physical disability or a high risk of developing one.” While a handful of schools for children with special needs existed during the 19th century – such as a school for the deaf in Boston that opened in 1869 – these were few and far between in the overall landscape of educational institutions. In terms of special education becoming more mainstream, however, many attribute special education’s origins to 1904, when French psychologists Alfred Binet and Theodore

Simon devised what is considered an early form of the IQ test. This gave a standard by which to measure children’s levels of achievement. The testing was introduced in the United States in 1916, which led to classifying children by IQ scores. Thus, classes within a grade were often sorted accordingly. Another milestone took place in 1930 when President Herbert Hoover convened 1,200 educational experts for the White House Conference on Child Health and Development to discuss general child welfare. This led to the formation the Children’s Charter, which enumerated the rights children have both in and out of the classroom. Margaret Winzer, author of “The History of Special Education: From Isolation to Integration,” wrote that this was “the first time that special education received national recognition as a legitimate part of the educational community.” Optimism ensued among those in the special education community, as an entry in the Children’s Charter read: “For every child who is blind, deaf, crippled, or otherwise physically handicapped, and for the child who is mentally handicapped, such measures as will early discover and diagnose his handicap, provide care and treatment, and so train him that he may become an asset to society rather than a liability.” Yet the economic troubles brought about by the Depression often prevented schools from implementing these programs. In the 1940s, however, things began to change. Parents who were unhappy with the education provided for their special needs children formed advocacy groups. For instance, the American Association on Mental Deficiency held its first meeting in

1947. Over the next decade the Civil Rights Movement helped fuel the formation of many more organizations specific to various special needs situations. These groups increased awareness about the need for special services both to the public as well as to the governing officials, leading to a 1958 law that provided federal support for training teachers of children with mental retardation. The 1960s saw an increase of programs designed for students with special needs. For instance, in 1961 President John F. Kennedy created the President’s Panel on Mental Retardation. Four years later, President Lyndon B. Johnson signed the Elementary and Secondary Education Act, which expanded funding to public education for special needs children. Further advocacy led to Congress passing the EAHCA (Education for All Handicapped Children Act) in 1975. This act mandated that all public schools provide equal access to education for children with special needs. Furthermore, parents would have a say in which methods of education the teachers could use. Finally, if they were unsatisfied, they had access to an impartial hearing, which created a system of checks and balances for the educators. Around the same time, the IEP (Individual Education Plan) was introduced, in which the parents collaborated with the educators to create a plan specific for each child. This was a legally binding contract that ensured that the student’s rights were not violated. It also let the parents know exactly what methods of teaching the educators would (and would not) employ. The EAHCA became IDEA (the Individuals with Disabilities Education Act) in 1990. It

By Barry Katz

was reauthorized in 1997 and in 2004. As a result, any child with special needs is entitled to a “free appropriate public education” in the least restrictive environment possible. According to IDEA’s website, services are available for anyone with “autism, deaf/blind, deafness, hearing impaired, mental retardation, multiple disabilities, orthopedic impairment, serious emotional disturbance, specific learning disabilities, speech or language impairment, traumatic brain injury, visual impairment including blindness, and other health impairment.” Special needs children are perhaps better educated than they have ever been, yet there are still detractors. For instance, radio personality Michael Savage came under fire in 2008 for calling autism “a fraud, a racket.” He continued: “… In 99 percent of the cases, (autism is) a brat who hasn’t been told to cut the act out. That’s what autism is. What do you mean they scream and they’re silent? They don’t have a father around to tell them, ‘Don't act like a moron. You'll get nowhere in life.’” Although Savage said that his comments were taken out of context, critics felt that his remarks were representative of millions of Americans who are still skeptical of the advances of special education. Despite the cynics, however, special education continues to be a growing field. While no one knows what the future will bring, if the trend toward improved special education continues, the prospects are good for special needs children to continue getting the services that they need. Barry Katz is a college administrator and adjunct professor who lives in Brooklyn, NY with his wife and three children. He can be contacted at iambarrykatz@gmail.com. June 2013

EDUCATION By Avigael (Stephanie) Saucier Wodinsky, PhD, MEd, MBA, GAC-ABA, GAC-AI

The Transition to a Mainstream Setting

any parents dream of the day when their child will be able to transition from a special education environment to a “regular” education environment. Whether it is to an inclusion program or to a mainstream setting, this change can be both exciting and potentially difficult. The key to a successful transition seems to be a combination of teamwork, preparation, and communication. For some the decision to transition a child from a special education setting to a “regular” education setting can be less about the services provided and more about friends and family. Chaim, who has an autism spectrum disorder, entered a day school after four years in public school. He desperately wanted to attend the same school his siblings attended. He wanted to experience the same activities they did on a regular basis. That strong desire made him work harder to fit in and acclimate to the new environment. His parents also wanted him to have more typical peer models, as he tended to be more distracted and agitated around children with more needs. Daniel’s parents moved him to a yeshiva day school after two years in public school. They felt he was at an age where having Torah studies at school was of primary importance. They live in an area in which there are no special education Jewish programs. Daniel has ADHD. Chaim and Daniel’s parents all knew that they would have to work hard to convince their local day schools to accept their children. Each child underwent educational and psychological testing to ensure that he was able to be educated in a general day school setting. Staff from the day schools observed the children in their public school settings. 32

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Both children attended multiple “trial” days at the day schools. Chaim was accepted at his new school under the condition that if needed, a shadow would be made available. Daniel was ac-

academically than his first. His parents are pleased with the education he receives. They do feel that he would benefit from social skills training at school, as well as an opportunity to meet some

cepted to his school under the condition that he goes in with a full-time shadow. He would be weaned of the shadow as he proved himself capable of managing in the new environment. After Daniel’s first year in day school, his parents are very pleased with the Torah education he has received. He has internalized more than they ever hoped. His davening and midos have improved dramatically. They feel, however, that the shadow was a detriment to his education because he has lost some of the functional independence he had in public school. They also feel that their son’s social needs have not been met. Chaim has now completed his second year of day school. He had some difficulty the first year, as he was farther ahead academically than his peers. He skipped a grade last year in order to remain intellectually challenged. As such, his second year was better

of his sensory needs during the school day. The school provides no services for him. One of the difficulties parents often find in “regular” education settings is that they must educate the school (teachers and administration) regarding their child’s needs, and that is sometimes met with resistance or resentment. Chana, an elementary school administrator, said that fear is a barrier to administrators’ willingness to accept children from special education backgrounds into mainstream programs. Administrators may fear that their schools will not be able to adequately educate children with special needs. She did not feel that she (or the school more generally) had a sufficient fund of knowledge to make good decisions about what these children need and how to provide it. She said that organizations like Gateways in Boston are great resources for schools that do want to

work with families like Chaim’s and Daniel’s. Moshe is a child who will be moving from a “transition” class at a yeshiva day school to a mainstream class next year. His parents are excited. This is what they have been working toward for years. However, they are nervous about him leaving the more sheltered class with lower teacher/student ratios where he has been so successful. What could they learn from Daniel and Chaim’s families? Daniel’s mother suggests that Moshe’s parents attempt to be highly involved and communicative with his teachers. Chaim’s mother emphasizes the need for a current and thorough evaluation to ensure that the new setting is a good fit. Further, she advises that parents involve the child in the transition so that he can be his own advocate. Prepare the teachers and administration for the child’s needs and limitations. Have the teachers prepare current students for any behaviors by Moshe they may find to be unfamiliar. Finally, try to find one or two children who will be in the class and build friendships with them prior to starting school. While this may not always be appropriate or possible for every child making this transition, if teachers, administrators and parents are all working together, Moshe and children like him have a greater potential to fully integrate and find success in the mainstream day school environment. Dr. Wodinsky is a social skills therapist at Teaneck Speech and Language Center in Bergen County, NJ. For group or individual therapy, contact 201.862.0333 x356 or a.wodinsky@ teaneckspeech.com. She also consults privately with schools, camps, and families to promote inclusion for children with ADD/ADHD and autism spectrum disorders.

EDUCATION Home Schooling

umerous studies have been done comparing the difference in results and test scores of private school educated students versus public school educated students and many argue that it’s a toss-up. However, in regards to home-schooled students versus their peers taught in a more traditional school, home-schooled students greatly outperform their peers on standardized tests in all subjects often by more than 30 percent. In fact, research has shown that gender and minority differences usually found among traditionally educated students are almost nonexistent among home-schooled students. Boys have become better readers and girls have become better at math. This has led to a strong movement towards home-schooling and to its much more contemporary counterpart, online schooling. WHAT IS HOME-SCHOOL? Home-schooling is the education of children at home, typically by parents, by tutors, or online rather than in a formal school setting. Before the compulsory school attendance laws, this was how most childhood education occurred. There are a number of approaches, some more structured, others less or even completely unstructured (rarely or never used premade curricula and structured lesson plans). There are very different results between these two approaches and the structured approach is much more effective. An eclectic balance of both approaches is important in order to fully benefit from home-schooling. WHO IS HOME-SCHOOLING? The majority of parents who home-school are from the religious right, and are doing so as a result of their concern for the public school environment of today. Socio-economically, most homeschool participation in the general population appears in house-

holds with incomes ranging from $25,000 to $75,000 and the ranks are rising rapidly across every social strata, faith and ethnicity. WHY WOULD I HOME-SCHOOL? There are a few major reasons why parents are choosing to homeschool. In the general population, the most pressing motives are: to impart religious or moral beliefs

of information. The need for interaction socially and academically is vital to this process. This is the most often cited issue raised against home-schooling. The second is that home-schooling is a challenge and commitment that most parents cannot sustain the energy and dedication needed for the long-haul. Yet there are many advantages

“Home-schooled students greatly outperform their peers on standardized tests…“ (36%); concern for the child’s safety (21%); and dissatisfaction with academic performance (17%). Parents have also cited geographical distance, preferring non-traditional teaching methodologies or wishing to tailor classes per a particular student’s needs. Recently, in the Orthodox Jewish community, tuition has become a motivator and home-schooling offers an option. With class sizes of as large as 40 students and some children not receiving enough individualized attention, there are parents who are opting to homeschool and many are using online education for their curriculum. WHY DO HOME-SCHOOLERS OUT PERFORM THEIR PEERS? Some argue that many of the students compared in the research from traditional schools would probably have scored just as well as the home-schooled students if they had the same dedicated parents. However there seems to be a number of reasons that they outperform their traditionally educated peers. WHAT ARE THE PROS AND CONS? Education and learning is an experience, not merely the intake

to home-schooling and with many new advances in online education parents and students have a lot of support and are no longer isolated. Home-schooled children spend more quality time bonding with parents and family; they learn that they can freely ask questions; and the parent can tailor the instruction to what is most needed (and what the child is interested in learning). In addition, they can receive a more hands-on learning experience; they can experiment with what works for the child; the whole world becomes the classroom (even just going to the store shopping with mommy). They also become more independent learners (which is becoming more necessary in our computer-age, with online education rapidly becoming the wave of the future)They are not in a large class of students who are on various levels with various degrees of interest; the parent can hire a private teacher who is individually compatible with their child; and they can be more involved in community projects. There is research that has found that home-schooled students most often later become more community-minded citizens.

By Rabbi Dr. Mordechai Salfer

“BUT WHAT IF I’M NOT A TEACHER?” Online home-schooling curriculum is created as a structure that offers a range of subjects and education, which is highly interactive and fun. Another advantage is that it is available anywhere, anytime, and from any computer which eliminates the need for bulky textbooks and workbooks. The student, parent, and tutor follow the guide of the online curriculum and much of the curriculum has an option that can be read to the student. Often the child glides through the coursework and feels like he/she is playing a computer game. There is also a teacher that directs the child’s education and advises the parent, student or tutor and is available to answer questions. There are numerous homeschool networks, which have been created by fellow home-schooling parents, which guide someone who has never taught before. Many home-schooling parents who are experienced, highly qualified teachers advise other fellow home-schoolers who are new to the field of teaching. The bottom line is that the key is care and commitment. The research shows that a parent actually knows best what their child needs to learn and how best to teach it. There are many after-school sports, art, music, etc. programs which are made for home-schoolers and they offer many opportunities for socialization with other kids, which are fun and educational. Parents needn’t feel overwhelmed and that they are doing it alone. Rabbi Dr. Mordechai Salfer, PhD, is the executive director of eTree, an online K-12 schooling program with students globally and Tree of Knowledge Learning Center. He is the rosh Yeshivas Doresh, a mesivta and postHS for learning challenged boys. He holds doctorates in clinical psychology and education. Interested parties can contact rabbisalfer@gmail.com or 216.233.0065. June 2013

DIAGNOSIS Medical Advances in Down Syndrome

ith nearly one of out every 691 babies born each year in the United States born with Down syndrome, research continues to uncover promising leads in the study of the most common chromosomal abnormality in humans. Babies are usually born with twenty three pairs of chromosomes. Down syndrome is a genetic disorder caused when an individual has all or part of a third copy of chromosome twenty one, the smallest chromosome present in humans, resulting in a total of forty seven chromosomes instead of the usual forty six. Although Down syndrome causes delays in physical and intellectual development, many people with Down syndrome have only mild to moderate impairments. Scientists continue to study the disorder in order to further improve the quality of life for individuals with Down syndrome. Protein Associated with Down Syndrome Identified: A recent study performed by researchers at the Sanford-Burnham Medical Research Institute in La Jolla, California revealed that both mice and humans with Down syndrome were lacking in a protein called sorting next 27, or SNX27. A molecule on chromosome twenty one typically inhibits the production of SNX27. The fact that individuals with Down syndrome have an extra copy of chromosome twenty one further limits SNX27 production, which, in turn, disrupts brain function. “In the brain, SNX27 keeps certain receptors on the cell surface, receptors that are necessary for neurons to fire properly,” said Huaxi Xu, Ph.D., Sanford-Burnham professor and senior author of the study. “In Down syndrome, we believe lack of SNX27 is at least partly to blame for develop34

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mental and cognitive defects.” Research showed that boosting SNX27 levels in mice with Down syndrome improved cognitive function and behavior. While researchers were encouraged by the progress made in mice who had their SNX27 levels supplemented, they cautioned

cise can help improve cognitive, motor and emotional function in Down syndrome teens. According to reports in Examiner.com, Shannon D.R. Ringenbach, an associate professor of kinesiology at ASU's School of Nutrition and Health Promotion, did a pilot study two years

that gene therapy of this sort had not yet yielded positive results in humans and treatments that could produce similar results in humans would likely take a long time to develop. Benefits of Exercise in Down Syndrome Adolescents: Researchers at Arizona State University (ASU) are investigating the possibility that intense exer-

ago which showed that after just one session of Assisted Cycle Therapy, adolescents with Down syndrome showed improvement in both manual dexterity and their speed of information processing. Individuals with Down syndrome tend towards more sedentary behavior and have reduced strength. Ringenbach's study boosted their exercise rate

By Sandy Eller

by making use of a stationary bicycle equipped with a motor, allowing them to exercise more rigorously at a speed of 110 revolutions per minute. In this second study, funded by a $150,000 grant from the Eunice Shriver National Institute of Child Health and Human Development, Ringenbach has a group of eight teens pedaling away three times per week. Participants are tested periodically to monitor their improvement in a number of areas. Family members are reporting increased conversation, better moods and greater social interaction. "It's really remarkable that by doing this kind of exercise they begin to think faster," said Ringenbach. "We believe they develop new brain cells. We don't know yet how long it will last. But it has the potential to dramatically change the quality of their lives. With early intervention in children with Down syndrome, it's possible it could improve their IQ." Ringenbach hopes to further expand the program by developing a smaller sized motorized bicycle for younger children and possibly create a second program at a local YMCA. Dr. Abe Kopolovich, director of rehabilitation at Brooklyn's Therapy in Motion, confirmed that he has seen positive results by encouraging exercise in Down syndrome teens. "I worked with adolescents for years at Camp HASC," Dr. Kopolovich told The Jewish Press, "and we found that for patients with Down syndrome, exercise was extremely beneficial. It helped them get stronger and gave them a sense of accomplishment." While Dr. Kopolovich questioned whether exercise offered any cognitive benefits, he felt strongly that Down syndrome

DIAGNOSIS adolescents who were involved in exercise, particularly organized sports, were rewarded with greater levels of self confidence as well as physical fortitude. New Prenatal Testing for Down syndrome to Replace Amniocentesis? A report by the Wall Street Journal reveals that new prenatal blood tests for genetic abnormalities, including Down syndrome, may raise more questions than answers. The non-invasive tests were introduced by four different companies in late 2011. While the screenings have not yet been approved by the Food and Drug Administration, hundreds of thousands are expected to be performed this year alone, and some believe they could become the new standard of care for pregnant women. Amniocentesis, a procedure in which doctors use a long needle to extract amniotic fluid, has long been the gold standard for prenatal genetic testing with a 100 percent accuracy rate. The procedure is performed approximately 200,000 times annually. Because amniocentesis carries a slight risk of complications, including miscarriage, many expectant mothers would prefer to use a safer, non-invasive testing procedure. The newly introduced blood tests, which examine the mother's bloodstream for traces of fetal DNA, scan for genetic signs of Down syndrome in the fetus. Studies funded by the companies who produce the blood tests say they have a 99 percent accuracy rate and can be performed several weeks earlier in the pregnancy than amniocentesis. However, cases of inaccurate results are being reported. In a case reported by the American Journal of Obstetrics and Gynecology, an expectant mother who received a positive test report, together with supporting preliminary results from another non-invasive procedure, terminated her pregnancy only to

be told that tissue testing of the fetus after the termination found no genetic abnormalities. Dr. Allan Bombard, chief medical officer at Sequenom, one

the prenatal blood tests for women with risk factors, while cautioning these expectant mothers about their limitations. When hospitals in Japan an-

â&#x20AC;&#x153;The possibility that intense exercise can help improve cognitive, motor and emotional function in Down syndrome teensâ&#x20AC;Śâ&#x20AC;&#x153; of the companies that produce the new tests, cautions that patients who receive positive results should undergo invasive testing to confirm the results. "False positives are not unexpected," Dr. Bombard said. Sequenom came under scrutiny in 2009 when it was discovered that data had been manipulated on its previous Down syndrome test called SEQureDx, which resulted in the dismissal of five of company officials. Athena Cherry, director of California's Stanford University Medical Center's cytogenics laboratory, checked six positive results for a genetic defect known as Edwards syndrome and found that four of them were inaccurate. Cherry criticizes test makers for failing to sufficiently drive home to its patients the need to confirm positive test results with the more conclusive invasive procedures. The American College of Medical Genetics and Genomics is urging that the new blood tests be labeled as "screenings", to better indicate that their findings should not be considered definitive results and require further confirmation. In the meantime, large health insurance companies, including UnitedHealth Group, Aetna and Wellpoint, have begun covering

nounced that they were ready to begin using the new blood tests, opposition arose from those who were concerned that the tests could result in discrimination against individuals with Down syndrome as well as un-

necessary abortions. In response, the Japan Society of Obstetrics and Gynecology has issued guidelines which state that use of the test should be limited to those who are considered to be at higher risk for genetic abnormalities and recommended that a certified genetic counselor be available for patients who underwent the blood tests. Notwithstanding the controversies, expectant mothers and doctors are excited about the new blood tests, even though everyone concedes that they are not yet accurate enough to serve as a replacement for amniocentesis. Sandy Eller is a freelance writer who has written for various websites, newspapers, magazines and private clients in addition to having written song lyrics and scripts for several full scale productions. She can be contacted at sandyeller1@gmail.com.

June 2013

DIAGNOSIS Early Diagnoses of Autism

hen a baby is born, it’s such a joyful occasion. You never want to believe that your priceless bundle has a problem. However, when it comes to autism, diagnosing it early–preferably by the age of eighteen months–makes an enormous difference. It is well known that the younger your child is when treatment begins, the more effect it will have on indications of autism. But even if your child is diagnosed at a later age, do not lose hope. Treatment can still decrease the disorder's effects and help your child to study, develop, and prosper. Autism is a closely connected category of disorders with a common and basic core of symptoms which is commonly

referred to as Autism Spectrum Disorders (ASD). The disorders appear in infancy and early childhood, causing delays in many basic areas of development such as learning to talk, play, and interact with others. The signs and symptoms of autism vary extensively, as do its effects. Some autistic children have only mild deficiencies, while others have more severe difficulties to overcome. But, every child on the autism spectrum has difficulties in the following three areas:  Communicating verbally and non-verbally  Relating to others and the world around them Thinking and behaving flexibly Opinions vary among doctors, parents, and experts about what

By Joshua Weinstein, Ph.D., M.B.A.

causes autism and how best to treat it, and there’s a lot that we still don’t know. But everyone agrees that early and intensive in-

child’s doctor will take your fears earnestly and use them as a guide in conducting a full assessment for autism or other developmen-

tervention benefits the child, and can make all the difference. EARLY DETECTION OF AUTISM IS UP TO PARENTS Parents are in the best position to spot the initial warning signs of autism. You know your child better than anyone else and can perceive behaviors and quirks that a pediatrician, in a quick examination, might overlook. Most often, it is the parents own observations and experience that detect the first signs of autism, so it is crucial for you as a parent to teach yourself to be able to recognize what’s normal and what’s not. The first rule is for you to trust your instincts as a parent. Your

tal delays. Often, even the best doctors will miss red flags or underestimate problems. If you feel something is wrong, be persistent in letting the doctor know, or ask for a referral to a child development specialist. With careful evaluation by an expert, diagnosing a child younger than 2 with autism is possible. HOW IS AUTISM DIAGNOSED? ASD differs extensively in severity and symptoms and may go unrecognized, especially in very young or mildly affected children, or when it is masked by more devastating handicaps. Indicators in very young children

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June 2013

DIAGNOSIS that necessitate assessment by an expert include:  no babbling or pointing by age 1  no single words by 16 months or two-word phrases by age 2  no response to name  loss of language or social skills  poor eye contact  excessive lining up of toys or objects  no smiling or social responsiveness. Later indicators include:  impaired ability to make friends with peers  impaired ability to initiate or sustain a conversation with others  absence or impairment of imaginative and social play  stereotyped, repetitive, or unusual use of language  restricted patterns of interest that are abnormal in intensity or focus  preoccupation with certain

objects or subjects  inflexible adherence to specific routines or rituals. Diagnosing autism as soon as possible provides families with answers to their questions about

worry with a better understanding of their child’s trials. A proper diagnosis followed by study of the disorder permits families to become more focused, enables them to find help for their child,

“When it comes to autism, diagnosing it early – preferably by the age of eighteen months–makes an enormous difference“

their children’s development. Learning about autism helps parents to understand its effects on their child and to distinguish the future in a different way. It allows families to replace concern and

and to develop an effective plan of action. Moving through this process also helps to ease the apprehension of the parents. The lifetime communal price tag of autism, including the cost

of care and lost production, has been assessed at $3.2 million per child (Ganz, 2007), with health care expenses rising dramatically (142%) over the last five years (Leslie, & Martin, 2007). Consequently, it is crucial to the individual, the family, and society that we continue to expand our efforts at early detection and to provide access to early intervention in order to diminish the impact of autism. Dr. Joshua Weinstein has been an educator and administrator for over four decades. He holds a Ph.D., two Masters Degrees in Educational Administration and Supervision and an MBA in Executive Administration. He has been the CEO in healthcare, social services, and business corporations. He’s the president and founder of Shema Kolainu-Hear Our Voices, Tishma for children with autism in Jerusalem and ICare4Autism. He can be reached via email at jweinstein@skhov.org.

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June 2013

DIAGNOSIS By Rabbi Mayer Waxman, MA

Münchausen's Syndrome by Proxy:

The Painful Truth Behind the Painful Fabrications

n July of 2009, the arrest of a frum woman in Israel for alleged child abuse of her own children set off 3 days of protests among some Charedim in Yerushalayim, capturing international media attention and culminating in riots in which two dozen people were injured and nine were hospitalized. The woman’s arrest followed her being observed, on a hidden camera, removing a feeding tube from her severely underweight three-year-old-son. The child appeared emaciated and was reported to weigh only 15 pounds. Protesters suggested the mother was wrongly targeted because she was Charedi. But perhaps the exotic psychological disorder – Münchausen's by Proxy – which was alleged to be behind the woman’s abusing her children, was what most drew attention to this story. Münchausen Syndrome is a psychiatric disorder in which sufferers feign disease, illness, or psychological trauma for sympathy or attention. Münchausen Syndrome by Proxy is a related condition in which the disordered person alleges or inflicts symptoms on another to gain sympathy or attention for themselves. Karl Friedrich Hieronymus Freiherr von Münchhausen of Boden-werder – Baron Münchausen (1720–1797) – was a member of the landed gentry with an undistinguished military career and a penchant for telling self-aggrandizing tall tales. Rudolf Erich Raspe, a young exprofessor whose academic accomplishments were behind him was a raconteur himself. In 1785 he anonymously published a compendium of humorous heroic tales based on the exaggerated exploits of the contemporary nobleman he likely never met titled 38

June 2013

“Baron Münchhausen's Narrative of his Marvelous Travels.” Funny stories, but a serious condition. In 1951, prominent doctor Richard Asher, who among other roles served as the senior physician responsible for the mental observation ward at London’s Central Middlesex Hospital, pub-

self so that the perpetrator can still reap attention. In the Diagnostic and Statistical Manual IV (DSM-IV), the American Psychiatric Association’s guidebook defining psychological disorders, Münchausen's by Proxy is referred to as “Factitious Disorder by Proxy,” which means that the symptoms

lished an article in the medical journal The Lancet. In it he described a pattern of self-harming in which individuals fabricated histories, signs, and symptoms of illness. He named this condition Münchausen's Syndrome after after Baron Münchhausen of tall tale fame. In 1977 English pediatrician Roy Meadow introduced the concept of Münchausen's Syndrome by Proxy in an article also in The Lancet. He described how several of his epileptic patients' mothers had fabricated symptoms in their children. In Münchausen's Syndrome by Proxy, the perpetrator uses the victim as a proxy – a substitute – for the perpetrator’s

arise outside of their natural course. Münchausen's is sometimes referred to colloquially as ‘hospital addiction syndrome’ or ‘thick chart syndrome.’ It is unclear whether or not people with Münchausen's draw the attention to themselves consciously. There are an estimated 2-4 cases per million in the general population. In order to meet the DSM’s diagnosis of Munchausen’s by Proxy, there must be no external incentives (such as economic gain) for the activity. Furthermore, the perpetrator must intentionally produce an illness, or the appearance of an illness, motivated by a desire to assume the sick role by proxy. This means that just the act of decep-

tively lying about and/or producing symptoms does not by itself satisfy the criteria for the diagnosis; rather the motivation behind the action is key. In that vein, some would suggest reclassifying Münchausen's in the upcoming new edition of the DSM among somatoform disorders – mental disorders which cause bodily symptoms, including pain, which can't be traced back to any physical cause – even though there is a clear perpetrator. People with disabilities are at risk of being effected by Münchausen's by proxy by nature of their being heavily dependent on caretakers and, depending upon the nature and degree of their disability, their limited ability to report on their own behalf. In 77-90% of known cases, the perpetrator was the biological mother, usually producing the symptoms or illness in her child of less than six years of age. However, there have been reported cases in which the victims were adults. Other reported perpetrators have included the father, babysitter, nanny, and grandmother. It has been noted that some perpetrators have had medical training – some seemed to have enjoyed pitting themselves against the best specialists they could find. Münchausen's by Proxy is abuse; the proxy is often put through pain and risk. Of the 2.5 million cases of child abuse reported annually, it is estimated that 1000 are related to Münchausen's by Proxy. As many as 10 percent of Münchausen's by Proxy victims die from some aspect of their ordeal – most commonly from lack of oxygen. An estimated 75% of proxies – victims – suffer physically, and even more suffer psychologically. As these proxies are present-

DIAGNOSIS ed to medical professionals as having medical issues, they are often run through numerous medical tests and procedures to determine their (non-existent) malady. Some victims develop impairment of bodily function caused by these unnecessary medical procedures. Child victims can suffer academic delays from chronic absenteeism from school, and delays in social development from their limited age-appropriate interaction with peers and adults. They may develop problems with concentration, emotions, and behaviors. The child may develop significant adjustment problems and develop a disturbed understanding of proper caretakerchild relationships. Ultimately, as is common with abuse, the victim is at risk of abusing their own child(ren) as an adult.

Doctor Meadow presented some tentative “warning signs” that may indicate a case of Münchausen's by Proxy – but these signs may also be due to a legitimate illness. Circumstances in which Munchausen’s by Proxy may be present include a patient under someone’s care who is presented as having: an illness that is unexplained, prolonged, extremely rare and/or extraordinary; symptoms and signs which are inappropriate or incongruous; symptoms only when the mother or caretaker is present. Other signs are if treatments for the apparent malady are ineffective or poorly tolerated. Take note if children/patients are alleged to be allergic to a great variety of foods and drugs or suffer seizures that do not respond normally to anticonvulsants. Scrutiny is appropriate if the mother/

caretaker is not as worried by the child’s illness as are doctors, and if mothers won’t leave their child’s side for even brief periods of time. Another warning sign of a possible Munchausen’s by Proxy situation is if a patient’s family has had sudden unexplained infant deaths, and/or many family members alleged to have serious medical disorders. The prognosis for Münchausen's by Proxy is poor. Although many child victims return to the family and survive, there is no definitive case in the professional literature demonstrating successful treatment. Regarding the alleged case in Israel, the mother was under house arrest for almost 3 years. During that time, several of the arrested mother’s children were required to stay with relatives abroad and the mother was al-

lowed to see some of her other children only in supervised visits. In January of 2012, all of the children were returned to the care of their birth parents. The mother was undergoing therapy, the situation at home was markedly improved, and welfare officials were satisfied with the mother’s state. While the news media highlighted this case, most victims of Münchausen's by Proxy – both the victimized proxies and the perpetrators who would be diagnosed with the malady if it were uncovered – go unnoticed. Rabbi Mayer Waxman, MA – (forensic psych.) – LMSW has served numerous roles in Jewish communal services and serving people who have disabilities. He is currently the Connect to Care Program Manager and Supervisor, Disaster Case Management, Rockaways for Met Council. Rabbi Waxman is a member of the Advisory Board of Building Blocks.

June 2013

TREATMENT Therapy in the NICU

he womb is a warm and supportive environment, optimal for fetal growth and maturation. When everything runs as it should, a baby is in the womb for 40 weeks and emerges ready to adapt to the outside world. But sometimes things don’t go as planned. In fact, nearly 500,000 babies are born prematurely in the United States each year. That’s 1 in 9 infants born! A baby born before 37 weeks gestation is considered premature. But there are different degrees of prematurity depending on how much the baby weighs at birth and at how many weeks gestation were they born. A baby born before 26 weeks or born weighing less than 1.12 lbs. is considered a micro-preemie. Being born prematurely creates many concerns. The most immediate are, of course, medical. Other areas of potential concern include neurological, physical, developmental and sensory issues. After a baby is born prematurely, the immediate focus is on the baby’s survival. Once the baby’s medical condition is stabilized, there will typically be a prolonged hospital stay in the NICU (neonatal intensive care unit) to maintain that stability and to protect them until they learn the basic skills needed to live at home. The baby needs to learn how to suck in order to eat. A baby’s body needs to learn how to regulate body temperature in order to live outside of the incubator. And a baby needs to learn how to tolerate the many sensory stimuli that exist in the outside world. In the womb, the baby is shielded from most sensory stimuli. It is dark, only muffled sounds can be heard and the baby is constantly soothed by the mother’s movements. Also, as the baby grows bigger in the womb, 40

June 2013

there is less and less space available so the baby is held in a fetal position with the limbs all flexed and held close to the body. This provides constant proprioceptive feedback, which helps to develop muscle tone. The womb is a warm place so the growing fetus does not have to worry about regulating body temperature. But when babies are born too early, they are prematurely torn away from this

fragile baby may not be able to tolerate direct physical contact but the neonatal therapist may be called on to educate the new parents on interacting with their newborn and to explain what is occurring developmentally. Parents are taught how to keep sensory stimuli to a minimum so as not to stress the baby. Modern NICUs typically strive to minimize sensory stimuli. Lights are kept dim and

supportive environment. They are forced to face lights, sounds and touch before they are developmentally ready. Instead of being held in a fetal position, they are forced to lie on a mattress in an incubator. This position can foster poor muscle tone and lead to other problems, such as joint contractures. In utero, a baby doesn’t have to worry about eating, as it receives all its nutrition via the umbilical cord. But once it is born that connection is severed. Many babies are initially fed through a nasal-gastric tube until they can learn how to nurse or suck on a bottle. Many NICUs have a team of therapists that work in the unit. These include occupational therapists, physical therapists and speech therapists. In an ideal situation, the neonatal therapists work in tandem with the other professionals in the unit including the doctors, neonatal nurses, respiratory therapists, social workers and the nutritionists. The neonatal therapist’s role varies depending on the medical stability and the developmental needs of the baby. A medically

voices low. Drawers and cabinets are not slammed shut but instead close gently with pads to prevent them from making a sound when they close. Babies are not moved unless they have to be. Parents are encouraged to physically touch their infants as per the baby’s tolerance. Kangaroo Care (extended duration skin-to-skin contact) is encouraged once the baby can tolerate it. The neonatal therapist will educate the parent how best to hold the baby with skin-to-skin contact. While this practice is a good one for all newborns, studies have found it to be particularly beneficial for preemies who are missing the warmth, closeness and rhythm of the mother’s body. A neonatal therapist will be called on to help position the baby in an optimal position in the incubator or crib. The therapist may fabricate splints to help maintain range of motion and prevent joint contractures. The therapist will help facilitate the sucking reflex so that the baby will learn to eat. Here too, therapists and parents work closely together so that the parents are

By Dana Ledereich, MA, OT/L

actively involved and are already preparing for the day when they can take their baby home. Babies born prematurely are not expected to catch up to their full term peers until the age of 3. So if a baby typically walks between 12-14 months, that age is calculated from the baby’s original due date and not the date he was actually born. So a baby born 2 months premature even with a good outcome is not expected to walk until 14-16 months of age. The same adjustment is made for the expected time to meet other developmental milestones for the premature baby. Once discharged from the hospital, premature babies should be closely monitored. If they are not progressing developmentally, physically or sensory, a referral should be made for a pediatric therapy evaluation. Even though a baby born after 37 weeks is not considered premature, every extra day that a baby can stay in the womb improves the prospects for the baby’s medical survival as well as for the baby’s overall development. This is why voluntary c-sections are not scheduled before 39 weeks. A baby can overstay its welcome in the womb too. At some point, the placenta starts to lose its ability to function, and the baby needs to make a hasty exit. Each pregnancy must be accompanied by prayer that everything go according to plan. But rest assured, there is a qualified team of professionals in the NICU ready to assist just in case it doesn’t. Dana Ledereich, MA, OT/L is a pediatric occupational therapist with a private practice in Brooklyn. She evaluates and treats children age birth-13 years with sensory processing issues, poor handwriting, developmental concerns and neurological issues. She is available to lecture and to mentor new therapists, and can be reached at 718.252.2939.

TREATMENT Feeding Tubes: The Ins and Outs

ne of the greatest joys for a parent is watching their child eat and enjoy. Unfortunately, some children are unable to eat by mouth. For these children there are many different options. Not all of these options are applicable in every situation and they should be discussed with your doctor. One of these options is a feeding tube. Feeding tubes have many positives but also unfortunately many downsides. Nasogastric tubes are feeding tubes that go from the nose to the stomach. These tubes are temporary in nature and can be left in for an extended period of time or placed every time a child is going to be fed. These tubes come in different lengths and different materials. A weighted silicone tube will stay in longer and tends to be, the most comfortable for the patient. These tubes allow a child to be fed easily without the need to undergo a more permanent surgical procedure. Many parents are bothered by the appearance of these tubes as they are clearly visible to everyone. They are usually taped to the face and can irritate the skin. Prior to every feeding the caregiver must check to make certain that the tube has not become displaced by using a stethoscope to listen to the stomach as air is passed into the tube using a syringe. The tube may also come out during a feeding and therefore it is important to keep an eye on a child while they are being fed. A more permanent solution to feeding a child with a tube is a gastrostomy tube. This tube can be placed either by a surgeon, a gastroenterologist, or a radiologist. Each of these specialists may use a different manner to place the tube, however, the end result is the same. The physician will create an opening from the outside stomach wall into the stom-

By Dr. Tuvia Marciano

ach. The standard, initial, gastrostomy tube is a tube of silicone with a plastic disc on the inside of the stomach and a disc on the outside which is used to hold the tube in place.

visible underneath the shirt. When the child needs to be fed, a connector is attached to the button. The major downside of this device is that it has to be changed every three to six months. The

gastro-jejunal feeding tube. This is usually done by a radiologist. This tube has two openings, one that goes into a tube that runs through the stomach into the small bowel and another that

These tubes can last a long time but will eventually need to be changed. When these tubes are replaced it is often with tubes that have an internal balloon that will make the tube easier to replace in the future. The downside to the gastrostomy tube is that it can leak at the site where it enters into the stomach. Many patients will develop something called granulation tissue, a raw piece of flesh around the stoma (hole which the tube is in). This is due to the constant rubbing of the tube against the skin. The site may also become infected. Many parents complain that you can see the tube sticking out from under their childâ&#x20AC;&#x2122;s shirt. The Mickey button has gained a large following among the special needs population. This type of feeding tube is flat on the skin so that when it is closed it is less

button can also pop out on its own and if not replaced quickly the stoma can close. Unfortunately, the Mickey button cannot be placed at the time of the initial placement of a gastrostomy tube. In order to place a button type of device initially, one has to use the Boston Scientific Low Profile Button. This device, like the Mickey button is flat on the skin. Unlike the Mickey button it does not have an internal balloon but a mushroom shaped piece of silicone to hold the tube in place. This makes the tube more difficult to change, however, the tube will need to be changed less often. Some patients may require feeding into their small intestine. All of the devices that we have discussed can be used to feed a patient into their small intestine. Sometimes a gastrostomy tube can be converted into a

opens into the stomach. This tube often becomes clogged as it is a very small in caliber it may also become dislodged. Whether a child has a nasogastric tube or a gastrostomy tube, being fed in a means other than the oral route can be a blessing. Choosing the right tube is not an easy decision and sometimes a temporary feeding tube may allow patients to become comfortable with the concept. For a more permanent solution the gastrostomy tube has many advantages. Keep in mind every patient is different and has different needs. Be sure to have a long discussion with your provider before deciding on which tube is right for your situation. Dr. Tuvia Marciano i s a pediatric gastroenterologist in Long Island, New York. He is available by appointment at 516.663.4600. Most insurances are accepted. June 2013

TREATMENT Is It Sensory?

I DOES YOUR CHILD EXPERIENCE THESE... • Dyslexia • Dyspraxia • Agoraphobia • Reading problems • Aspergers Syndrome • Coordination challenges • Attention Deficit Disorder • Anxiety and Panic Disorder • Problems in writing or math • Auditory Processing Disorder • Educational underachievement

June 2013

t is common for teachers who are confronted with children presenting with various behavioral and motor delays that interfere with the student’s learning and classroom management to make a referral to an Occupational Therapist to rule out or to treat the suspected sensory issue. While the teacher may be doing their best to get the child the help they need, the issue may be of deeper origin. A May, 2012 policy statement by the American Academy of Pediatrics on Sensory Integration suggests that other possible causes should be considered. Almost 30 years ago, Dr. Jean Ayres, the pioneer of sensory integration theory we know of today, states in her book “Sensory Integration and Learning Disorders” that, “Therapeutic results have led to the proposal that motor actions designed to elicit reflexes or automatic reactions organized primarily at one level of the brain tend to organize sensory integration at that level.” In essence, it suggests that sensory processing is dependent on motor maturity which would be influenced by the presence of primitive reflexes. Primitive Reflexes are the automatic responses developed in utero. They are fully present at birth, and should be integrated by the first 6 months of life. An example of a primitive reflex is the Palmar Reflex. When an infant is born the child should automatically wrap their fingers around an object when it comes into contact with its palm. The action is performed without thought and without voluntary control. After 6 months of life, the

infant should begin to have more control over its hand and be able to decide if he wants to close or open its hand with its own volition. If primitive reflexes are not integrated by this age, they can have wide-ranging effects from visual motor and perceptual deficits, gross and fine motor deficits, sensory deficits and poor balance to postural control. For example, if a palmar reflex is still present, a child may experience poor fine motor skills affecting handwriting, scissor skills and use of utensils. In addition, the palm of the hand may remain hypersensitive to tactile stimuli, and mouth and hand movements may not become independent. This can affect speech as well as manipulation. There may be ‘overflow’ of movements from hand to mouth, so that the mouth moves when the hands are engaged in a task, or the hands are involuntarily active while speaking (Goddard-Blythe, Sally – Attention Balance and Coordination The ABC of Learning Success). The work of INPP, the Institute of Neuro Physiological Psychology in Chester, England, developed an assessment and treatment intervention to address these symptoms which are known as Neuro Motor Immaturity (NMI). NMI can be defined By the continued presence of a cluster of Primitive Reflexes above the age of 6 months (12 months at the latest), in combination with:  Absent or under-developed Postural Reflexes above three and a half years of age Postural Reflexes are the anti-

By Paul Stadler

gravitational adaptations of a living body to the environment. This means if your body would be displaced out of center to the right, your body should want to right itself by automatically moving toward the left, opposite to the direction it is being displaced. The INPP method has been used over the last 35 years in the United Kingdom and around the world to treat children for NMI. According to current research, the presence of primitive reflexes can be found in 30-40% of children in a mainstream classroom and greater than 90% in a classroom for children with learning disabilities. The method identifies the earliest developmental motor deficit and provides a movementbased daily program which targets the specific deficits at the root of the problem. Below are 3 case studies. In two of them the INPP method was employed and in the third instance, a developmental approach was used. ARIELLA: Ariella is a 14 year old girl who’s teacher observed that she has difficulty sitting still and following instructions, appears to be uninterested, easily distracted or possibly day dreaming, shows little interest in reading, and sits in a slouched position. Ariella also demonstrated a low frustration tolerance, usually forgot the 2nd or 3rd step of a multistep direction, and lacked adequate motor coordination. Ariella has almost completed the INPP program she began about 10 months ago and has made significant academic gains. She can now complete her homework with Stadler Continues on Page 44 ➘

LET US HELP YOU DISCOVER THE PATH TO YOUR CHILD’S SUCCESS. Paul Stadler is an Occupational Therapist with over 15 years of experience evaluating and treating children from birth with a variety of developmental, neurological, and sensory issues. He is SIPT certified, trained in ABA, and a licentiate of INPP. The INPP Method is unique by being the first method of its kind linking neuro-motor immaturity (NMI) to specific learning difficulties, pioneering an assessment and treatment intervention. The success of this method has spanned around the world successfully treating 1,000’s of children by identifying the “source” of their issues. Paul has a home-based private practice consulting and treating clients across the United States. He has also lectured on early childhood development and presented nationally at the AOTA conference in 2012 and 2013 on reflex integration and Neuro-Motor Immaturity. Let’s maximize your child’s potential together. Get started by contacting Paul at 347.247.6835 to schedule a consultation or evaluation. For more information on the INPP method, visit www.paulstadler.net and complete the “Free NMI Questionnaire” on the home page.

TREATMENT Stadler Continued from Page 42 ➘

minimal distractions, has begun reading 300+ page novels with appropriate reading comprehension, sits up straight when sitting at the table or desk, has an improved grasp pattern when writing, can follow multistep directions without “forgetting,” has improved balance and posture, speaks with more confidence, has improved motor coordination, has improved her handwriting, and has improved her test scores by 10 points. NICOLE: Nicole is a 2 year old girl who was referred for occupational therapy with general concerns of sensory processing when she was 14 months old. The evaluation revealed that she had difficulty with transitions, was frequently on the go, had poor attention span to task, poor grasp patterns, and poor sleep patterns. She exhibited tactile sensitivities to food and textures, poor speech, and preferred using her left side with a frequent neglect of her right side. The evaluation attributed her challenges to poor proprioception, poor tactile processing and vestibular function. Upon first meeting Nicole, I learned the true meaning of “on the go”. After following a specific developmental exercise regimen for just 6 weeks, Nicole was tripping over her feet less frequently, suffered significantly fewer falls, and was standing much more upright, exhibiting unusually good posture for a 16 month old child. In addition, for the first time, Nicole was able to follow one-step directions, visually fixate on an object and make eye contact for longer periods of time. Eventually, she became able to walk on an uneven surface without falling. The approach was to use key developmental positions and specific skills that provide the foundation from which future skills emerge. This provided Nicole a second chance to experience the 44

June 2013

developmental transitions she had missed during her maturation from infancy. The one concern that was not successfully addressed by this ap-

we started the INPP method with him. Nathan is a child who is above average in intelligence. He was frequently on the go and fidgeted in his desk / chair at the

chair. He is getting much fewer demerits in school, because he is focusing better in class, has improved ability in right and left awareness, and seldom invades

proach was the problem with her sleep patterns. This was thought to be related to underlying gastrointestinal problems and frequent colds. Thanks to medication and changes in her diet, Nicole’s symptoms are now under control and her sleep patterns are better regulated. Her motor skills have considerably improved without the use of “traditional” equipment. Nicole now has age appropriate fine motor skills and can grasp her utensils and writing implement appropriately. She can complete shape sorters and draw both vertical and horizontal lines appropriately. She can manage her clothing. She is able to visually fixate, jump, balance on one foot for 4 seconds, jump in place and off a stair without falling over, follow 2-step directions, and recently developed expressive speech. This is but a partial list of the gains she has made over the last year after starting the developmental exercise program. NATHAN: Nathan was 7 years old when

table. He lacked the ability to be redirected back to a task once distracted. He preferred sitting on his knees, He was great on the playground, loved sports, and has many friends, but experienced some coordination issues. His parents were concerned that he was getting demerits in school for not remaining on task, poor reading skills, frequent mistakes when copying from a book / blackboard, poor handwriting and poor fine motor skills. He would frequently invade another person’s space, exhibiting poor body awareness. He also had difficulty learning to get dressed, and distinguishing right from left. In the five months since Nathan started the INPP program, he has developed the ability to sit still, and can be successfully redirected. He has developed an interest in coloring and will color in the lines using many different colors in a picture, using mature fine motor skills. He is able to complete multi-step directions, has improved eye tracking skills and sits upright at his desk /

other peoples’ space. In each of the three cases above, the challenges of the children had been labeled as sensory issues in their original evaluations. The INPP and developmental approach revealed in each case that there was a deeper, underlying cause skewing their sensory processing. Once the underlying situation was effectively addressed with a developmental approach, the children demonstrated generalized progress not limited to a specific skill. In the words of Dr. Peter Blythe, founder and pioneer of INPP and the INPP method “Don’t treat the symptom; find the cause and remove the cause.” Paul Stadler is an OT with over 14 years of experience working with children from birth to 21 years of age with varied diagnoses. He is a licentiate of INPP and instructor of the INPP school-based program for Assessing Neuromotor Readiness for Learning, as well as a presenter at the 2012 and the 2013 American Occupational Therapy Association national conference on NMI. He can be reached at 347.247.6835, paul@paulstadler.net or by visiting www.paulstadler.net

TREATMENT By Yitty Rimmer, MA OTR/L

How to Incorporate Sensorimotor in the Classroom

aakov is a bright 6 years old, but he won’t sit still in class. He sits on his chair with his feet swinging back and forth over and over again. Inevitably, he accidently ends up kicking Chaim who sits in front of him. Most of the time, his Rebbe finds him standing up near his desk stating “I just need a tissue”, or “I lost my homework sheet and I am looking for it on the floor.” Or “I forgot my pencil and I need to go back to my locker.” Yaakov is having difficulty with his sensorimotor skills. Specifically, he is having difficulty interpreting light touch and pressure, such as when he sits on a chair, and information about the position of one body part in relation to another when he is stationary. However, when he moves, his brain processes information about the movement of one body part to another, so he feels a constant need to move in order to get this information. Chani is a bright 7 year old who loves to write. However, she does not hold her pencil correctly, and her letters go way past the boundary lines on top and bottom. Usually her letters are so big, they take up two lines. She forgets to stop on the line when she draws a line for a letter and ends up going down to the end of the page. Chani is having difficulty with her sensorimotor skills. She is having trouble finding the distance between objects, using small muscle groups to control her movements, and integrating information from her eyes with the body movement of that activity. When Morah Shira starts her circle time with the usual jumping jacks and various exercise routines, Goldy has difficulty slapping her hands and feet together at the same time, and always seems to be 2 steps, and the wrong step behind her classmates. Goldy loves to sing at the

top of her lungs during davening time in her Pre 1-A classroom. Except that she likes to get up at the same time and check out the doll house Morah Shira brought in to the classroom for free play. Morah Shira can’t figure out how to keep her in the circle, or at least to continue singing along with the class as she roams the classroom. Goldy is also having difficulty with her sensorimotor

tion as a student in the classroom, and as a competent athletic peer at recess or on the playground. A child who has trouble organizing and processing sensory information can exhibit difficulty sitting in his/her chair during class, producing written work, keeping his/her schoolwork and personal belongings in one place, and using their hands and feet in a coordinated manner to play

skills. She has trouble with her internal awareness of her body, and the relationship of body parts to each other. She has difficulty moving limbs across the midline of her body, and her muscle tone or tension at rest is floppy. She has difficulty integrating sounds with what she sees. Sensorimotor skills are comprised of the child’s sensory and perceptual processing skills, neuromuscular abilities and motor skills. A child needs to be able to integrate sensory information with a motor response in order to adapt to his/her environment. Perceptual processing skills helps the child organize sensory information while the neuromuscular abilities are what help the child develop reflexes, muscle tone, strength, endurance, postural alignment and control as a foundation for motor control. By the time a child starts school, he/she needs to have a solid foundation in organizing and processing sensory information in order to func-

games at recess. There are many ideas teachers can use in the classroom to help this child organize him/herself better. Children with sensorimotor difficulties find too much auditory and visual input overwhelming. Teachers can subtlety tone down the classroom for the child with sensorimotor difficulties. Limiting the amount of material hanging on the walls, and toning down the color scheme to two colors can have a significant calming effect on the sensory child. Additionally, keeping the classroom door and windows closed as much as possible will make a significant difference in filtering extra noise coming from the hallway and the street. For the preschool classroom, delegating toys that make noise, such as heavy blocks, to a corner with a rug, produces a quieter environment. The child should be prepared ahead of time for loud bells that go off during the school day when it is time for recess, fire

drills, and dismissal to reduce anxiety when it actually takes place. One method is to give the child a vibrating stop watch or timer set to go off two minutes before the bell will ring. Seating the child on the side by a wall, away from the window and the classroom door, can enhance the child’s concentration by eliminating extraneous input. Children with sensorimotor difficulties benefit greatly from a set schedule. Knowing what to expect takes away fears and anxiety by preparing the child for transitions during the school day. Displaying the daily schedule can help the child to follow along with the order and structure of the classroom. Preparing the child ahead of time for special events can also help prevent the child from being overwhelmed, leading to negative behaviors. Children with sensorimotor difficulties benefit from frequent movement breaks throughout the day. Teachers who incorporate stretching exercises at set intervals, especially during transition times, such as after lunch, before writing tasks etc., help these children settle into the routine of the classroom. Other ways of incorporating more movement during class time is to have children “march” when they get items from their locker, or “march” to line up and “march” to the lunchroom or playground. Teachers can also help these children by organizing their class into smaller groups spread around the classroom in clusters for some learning tasks. Smaller groups provide some freedom of movement while working on a specific task. A parent once told me how her son’s Rebbe decided to set the boy up in the back of the classroom with a “shtender” and offered the child the opRimmer Continues on Page 47 ➘ June 2013

TREATMENT By Esther Hornstein, L.Ac., Dipl.

Nutritional Supplements for Health and Wellbeing

utritional supplements are getting a lot of attention lately. Competing for shelf space in pharmacies with over the counter medication, vitamins and supplements are becoming a routine part of the average health regimen. Some supplements are being praised as improving the quality of life for special needs individuals with cerebral palsy, ADHD, and muscular dystrophy to name a few. What is important to know is that even though doctors, medical professionals and popular spokespeople are recommending supplements, they are not regulated by the FDA. The Food and Drug Administration does not test such supplements for safety or effectiveness. Furthermore, pharmacies do not have a system in place to ensure that the supplements a patient buys are not contraindicated for use with the patient’s prescribed pharmaceuticals. It is important that patients and caregivers tell their health care providers about all therapies they are currently using or thinking of using to ensure there will be no harmful interactions. Many supplements interact or interfere with warfarin/coumadin (blood thinners). If one is on a blood thinner you must consult a doctor before using any supplement. Following is a brief review of popular supplements and how they are effective in treating special needs issues. ACETYL L CARNITINE: aka L Cartinine an amino acid (protein building block). It helps the body produce energy. It is important for heart and brain function, muscle movement, and many other body processes. Acetyl L Cartinine is needed to supplement children with small muscle mass, which can be caused by cystic fibrosis and kidney disorders. 46

June 2013

There is also evidence which suggests that Acetyl L Cartinine helps children with ADHD and epileptics. VITAMIN C contributes to multiple systems in the body. It plays a role in treating Cerebral Palsy by building collagen, which is necessary for healthy development of muscles, tendons, and bones, Some believe that vitamin C improves gastrointestinal and brain function in someone with autism. Therefore, it is extrapolated that Vitamin C can bring about increased eye contact, improved skin color, better sleeping

tion in the cells of the body). Improvement in symptoms is slow. Some people have to take CoQ10 for six months to get the most benefit.  Muscular dystrophy (an inherited disorder involving muscle wasting). Taking CoQ10 by mouth seems to improve physical performance in some patients with muscular dystrophy. VITAMIN D Vitamin D has been called this decade’s wonder drug. It has been hailed in treating a myriad of diseases and syndromes:  Boosting the immune system: preventing and treating autoim-

patterns and cognitive ability. There is inconclusive information to confirm whether Vitamin C is a viable treatment of ADHD or Cystic Fibrosis. However, there are many anecdotal instances that support its helpfulness. CREATINE naturally occurs in muscles. Supplementation of Creatine is used to improve muscle mass and exercise performance and for increasing strength in people with muscle diseases such as muscular dystrophy. COQ10 (COENZYME Q-10) CoQ10 is an important vitamin-like substance required for the proper function of many organs and chemical reactions in the body because it helps provide energy to cells. CoQ10 has been proven in some degree to be effective in treating:  Mitochondrial disorders (inherited or acquired disorders that limit energy produc-

mune diseases such as multiple sclerosis, rheumatoid arthritis, and preventing cancer.  Reducing the risk of multiple sclerosis: Studies show taking vitamin D seems to reduce women’s risk of getting MS by up to 40%. Taking at least 400 IU per day, the amount typically found in a multivitamin supplement, seems to work the best. SKIN CONDITIONS: including vitiligo, scleroderma, actinic keratosis, and lupus vulgaris. Vitamin D in forms known as calcitriol or calcipotriene is applied directly to the skin for a particular type of psoriasis. For the most part, large doses of Vitamin D are safe. Do not exceed taking 4000 IU of Vitamin D for long periods of time. This may cause excessively high levels of calcium in the blood. FISH OIL (AND FISH) Research has shown that many conditions can be helped

with omega3 (found in fish oil), including:  ADHD in children. Fish oil improves thinking skills and behavior in 8 to 12 year-old children with ADHD.  Raynaud’s syndrome. Fish oil can improve cold tolerance in some people with the usual form of Raynaud’s syndrome.  Bipolar disorder. Fish oil is helpful in alleviating depressive symptoms and increasing the length of time between episodes of depression. Note that fish oil doesn’t improve manic symptoms.  Psychosis. Research proves that in teenagers and adults up to 25, fish oil can prevent mild psychotic illness from transforming into severe psychosis.  Movement disorder in children (dyspraxia). Taking fish oil orally, in combination with evening primrose oil, thyme oil, and vitamin E (Efalex, Efamol Ltd), improves movement disorders in children with dyspraxia.  Developmental coordination disorder. A combination of fish oil (80%) and evening primrose oil (20%) improves reading, spelling, and behavior when given to children age 5-12 years with developmental coordination disorder. However, it doesn’t seem to improve motor skills.  Psoriasis. Administering fish oil through an IV can decrease severe psoriasis symptoms. But taking fish oil by mouth doesn’t seem to have any effect on psoriasis.  Epilepsy: Omega 3 fatty acids found in fish oil has beneficial effects on the nervous system and has been shown to reduce the frequency of seizures in epileptics.  Asthma. Fish oil may lower the occurrence of asthma in infants and children when taken by women late in pregnancy. Furthermore, fish oil improved airflow, reduces cough, and lowers the need for medications

TREATMENT in some children with asthma. However, fish oil treatment doesn’t seem to provide the same benefit for adults. ST. JOHN’S WORT Depression: St. John’s Wort’s popular function is to improve mood, treat anxiety, depression and insomnia related to depression. It can be as effective as medication in treating mild depression. However, St. John’s Wort is known to interact with many medications including birth control, so it is not deemed fit for everyone, especially those on other drugs. SOMATIZATION DISORDER: The conversion of mental experiences or states into bodily symptoms is reduced by St. John’s Wort after just 6 weeks of treatment. CHINESE HERBAL MEDICINE Chinese Herbal Medicine has established its effectiveness and has been in regular use for over 3000 years. There are hundreds of single herbs in the Chinese materia medica and thousands of ways to combine them in a formula. There is an

herbal formula for any ailment under the sun. Treating developmental delays and other pediatric issues has always been emphasized in Chinese medicine. The popular Liu Wei Di Huang formula, translated as the “Six flavor rehmannia” is a formula that was originally designed for children with any of the “five delays,” which are defined as standing, walking, hair growth, teeth development and speech. However it is also used to treat many adult issues such as diabetes, glomerulonephritis, hyperthyroidism, chronic hepatitis, back ache, certain types of headache, fatigue, tinnitus, insomnia and night sweats. A recent New York Times article told the story of a 3 year old boy who had juvenile idiopathic arthritis (J.I.A.), an autoimmune disease that causes painful swelling in the joints. J.I.A. can lead to stunted growth, disability and rarely, blindness. His caregivers were able to wean him off of Methotrexate (a very aggressive cancer medication) by putting him on a wheat, sugar, dairy free diet, and

giving him a Chinese herb formula called Si Miao San, translated as Four Marvels Powder. However, a word of caution is in order. Si Miao San may not be suitable for every child with that condition. Although available to everyone, Chinese herbals should be used and handled with the same care as Western prescription medications. A specific herbal formula must be prescribed for each case by a trained professional. Chinese Herbalist. For a list of board certified professionals, see: www.nccaom.org. Another word of caution. Just because all the ingredients are “natural” does not mean that every ingredient is safe for everyone (or kosher). Herbal medicine is very complicated with many factors contributing to the formula, and careful thought must be given to the dosing. It is very possible to be harmed by taking the wrong formula or the wrong amount. There are many ways to take Chinese herbs. The most potent way is by actually cooking the dry herb and drinking the liquid.

The next best way is by putting freeze dried granules of the herbs in any hot liquid. Tinctures are also available, especially for pediatric formulas. The least potent method is by taking tea pills. Nutritional supplements can be very effective in the treatment of those with special needs. But just because an unverified source on the Internet makes tempting claims about a particular supplement as a cure or remedy does not make it true. Remember, unlike Western prescription medicines, there is no FDA verification that a supplement is safe and effective. Make sure that every supplement you buy is through a trusted source and is approved by a professional in the medical field who is aware of all the conditions and medications of the patient who will be taking it.

Rimmer Continued from Page 45 ➘

baseball, basketball, or soccer all benefit the uncoordinated child. Teachers can play a huge role in helping these children at recess by encouraging inclusion and limiting competition. For the preschool classroom, teachers can incorporate movement in middle of circle time through songs with motions or exercises. These benefit the child with sensorimotor difficulties by allowing them to move within an organized framework. They will help these children stay a part of circle time longer. I once had the pleasure of witnessing one of my son’s nursery teachers start circle time by having every child choose a special object to hold from a box, and then following a preset circle that was taped to the floor. All the children followed the teacher, individually holding onto that special object they

had chosen, and walked around the circle following their teacher, singing a song with her. The children, who had difficulty coming to circle time initially, were able to join the walking circle and singing as soon as they were ready since the teacher walked around the circle a few times. As soon as she had the whole class with her, the teacher sat down on the circle on the floor with all the children following suit. Children with sensorimotor difficulties benefit from tactile learning in addition to visual and auditory. Teachers can incorporate modeling clay and wicki sticks for spelling activities (both Hebrew and English), letter recognition (even Rashi script), and science lessons. Sand paper letters in the preschool classroom are effective aids for teaching the alphabet (both Hebrew and Eng-

lish letters). These items are easily stored and do not generate a lot of mess, making them ideal for constant use in the classroom. With advance planning, teachers can easily incorporate these ideas into their daily lessons and schedule. All children benefit from decreased visual and auditory distractions, and increased movement and tactile activities to enhance their focus and concentration. For children with sensorimotor difficulties, streamlining a modified environment can make a big difference in helping them maintain a constant level of attention throughout the day and building their skills.

tion to either learn by his desk, or learn standing by the “shtender”, since the boy had difficulty sitting in one place. It worked beautifully. The child spent the year standing and learning in the back of the classroom, swaying back and forth but completely focused and a part of the class. This Rebbe found a way to provide the child with the steady diet of movement he needed that did not disrupt the other boys or the lesson plans. Some children with sensorimotor difficulties may not be coordinated when playing sports. Using jumping jacks as a transition exercise in class, playing organized jump rope games at recess that include all children both to turn the rope in rhythm (a skill in and of itself), as well as timed jumping to songs, or playing organized

Esther Hornstein is a wife and a mother of two children. She is licensed by New York State to practice acupuncture and is nationally board certified by the NCCAOM. Her private practice is in Brooklyn, NY, emphasizing in women’s health, children’s health and chronic pain syndromes. She can be reached acupuncturesther@gmail. com or 917.414.3831.

Yitty Rimmer has a Masters in Occupational Therapy from New York University. She currently works in her own private pediatric practice in Brooklyn, NY. June 2013

ASK THE EXPERT Expert Answers to Real-Life Questions

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

Ask the Occupational Therapist:

Over summer vacation, how do I help my five year old daughter continue to develop OT skills if her services are only during the school year?

on a bench to relax, try playing with your child and getting your child to swing or hang from the overhead bars. This develops strengthening in your child’s shoulders. Children with strong shoulder muscles, have more stability during fine motor tasks, and consequently a neater handwriting.  The beach is sandbox paradise. Early morning and early evening (after 6pm) are ideal times to go because the beach is emptier and cooler than in mid-

 Instead of taking walking hikes with your children, try taking bike rides along the same paths. In recent years, there has been a big movement to add more bike paths in big city areas. While I would not recommend biking with children on busy streets, many cities, such as New York City have exclusive bike paths without traffic. Some examples are along the Belt Parkway by the Verrazano Bridge, Brooklyn Bridge Park, Brooklyn Bridge, Governors Island, Central Park,

dle of the day. Bring along some pails, shovels, and sand molds, and let your child dig and build to her heart’s content. Digging strengthens muscles of the upper body, including the small muscles in the fingers, and sand is great for children who need tactile input.

Prospect Park, Shore Road, the West Side Highway, Clove Lake Park in Staten Island, and many areas in Queens. Bike riding increases gross motor muscle strength and improves balance and coordination.  Set up an outdoor easel and a variety of finger paints

The summer is a great time for children to boost fine motor coordination skills, gross motor skills, the ability to process sensory input, strengthen core muscle groups, and develop independent dressing skills, all within the framework of fun activities. Children naturally gravitate to exploring the outdoors. They enjoy digging in the sand and mud, splashing in the pool and sprinklers, searching for salamanders, swinging on the monkey bars and riding their bicycles from sunrise until bedtime. All these activities strengthen muscles, and increase sensory processing skills so encouraging children to spend time outdoors will naturally help them develop these skills. For more specific ideas I encourage the following:  Instead of taking your child(ren) to your local playground, and then plopping down June 2013 48

for your daughter to work with. Finger painting help children isolate finger movements to strengthen those muscles needed for fine motor activities, and it also provides children with tactile input.  Instead of splashing in a children’s pool, set up the pool with water and dishwashing detergent, and have her wash down large toys or outdoor furniture with a large sponge. Squeezing out the sponge works on strengthening the muscles in her hands and fingers, and washing down large items forces the child to move her shoulders in a wide range of motion, thereby strengthening the shoulder muscles, and the upper arm as well. Any type of water play also encourages processing tactile input.  If your daughter has difficulty with her dressing skills, setting up or taking her to water activities that she enjoys can encourage her to change herself into appropriate attire before the activity. This type of practice will help her improve her dressing skills. Whether you are spending the summer upstate in the mountains where your child will be surrounded by fresh air and outdoors 24/7, or at home in the city, summer vacation offers many opportunities for your child to continue to strengthen and develop her skills while enjoying herself at the same time. She can have fun and still be prepared for school in the fall. Yitty Rimmer has a Masters in Occupational Therapy from New York University. She currently has her own private pediatric practice in Brooklyn, NY.

ASK THE EXPERT

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

Ask the Speech Therapist:

My 9-year-old son has some speech delays. His teacher called me last night. She told me that my son has some difficulty making friends. Can his language delays be affecting his ability to make and keep friends?

Being an effective communicator is essential to interacting and socializing with others. Children crave friendships. Many children with language delays have difficulty creating and maintaining friends. It can be painful when a child desperately wants to make friends but does not know how. Luckily, a speech therapist, as well as a parent, can help a child build the necessary skills in order to become a successful friend. A child with immature social skills may display delays in one or more of the following categories: listening, talking, noticing and interpreting nonverbal language, and planning one’s own actions/reactions.  Listening is the ability to understand what others are saying. During a conversation, does your child pay attention to his friend and comment on what the other person is saying, not just on what he wants to say?  Talking is the ability to successfully communicate your own thoughts, needs, wants. When he is not understood, does he attempt to explain himself in order to clarify his intent?  Interpreting nonverbal lan-

guage is the ability to recognize facial expressions and body language. If two boys are sitting with their heads together having a private conversation, does he know not to try to join?  Equally important is the ability to plan and regulate one’s own actions. When playing with a board game, does he deal with his frustration or does he turn over the board to avoid losing? As a concerned parent, observe your child and write down what behaviors you feel are affecting his ability to interact positively with others. He may have a few skills that need to be targeted. Think about each skill

Explain the rule clearly to your child. (“We are going to practice listening and responding to what other people say.”) Provide your child with a reason as to why he will want to learn the skill. (“Your friends will want to play with you if you share your toys and let others have a turn.”) Model the skill and explain what you are thinking as you perform the skill. (“I wanted to join the conversation, so I waited for an opening and commented on what they were talking about.”) Shape the skill by having your child practice it in multiple situations. Give him a lot of positive praise. Next, talk about how he can modify the

times a day. By choosing to add exercise twice a week and to eat fewer cookies, I gave myself a better chance of reaching my goal. Similarly, to tell a child, “You will become the perfect friend by next week,” (some exaggeration on the part of the writer…) you will lose your child’s interest. By making clear and easily achievable goals, you and your child will feel more successful. Be realistic about the length of time and practice it takes to acquire a new skill. And, as with a diet, rewards are important! By working with your child’s speech therapist and targeting each goal specifically, your child should begin to feel socially suc-

and where his difficulty occurs. Is it that your child does not know the social rule? For example: Does he interrupt your private conversation because he does not know that he needs to say “Excuse me” and wait for a response? Or, is it that your child has not had a lot of practice with the social skill and therefore it does not come naturally? For instance, you respond to him when he interrupts; therefore, he does not realize that interrupting others is socially inappropriate. Once you have a list of skills you want to work on, PICK ONE!

skill in different situations. Give him a lot experience using the skill in order for it to become natural. Involve all family members and his teachers in order for him to get as much practice as possible. Make learning the new skill fun. And don’t forget: reward him with each small step! (I prefer ice cream but he may like matchbox cars!) Ever been on a diet? You haven’t? Well, I have. Although my goal was to look like a supermodel, I knew that I would not have a chance if I stopped eating completely and exercised three

cessful. If your child’s difficulties persist, you may want to request that the Board of Education reopen your child’s case in order to add counseling services to your child’s IESP. Rachel Soroka-Teller, MA, CCC/SLP, TSHH is a speech-language pathologist who specializes in treating children with hearing impairments and auditoryprocessing difficulties. She is a centerbased provider at Strivright, where she services children from newborn to age 5. Additionally, she is a supervisor for Strivright’s school-age speech therapy division. Rachel can be reached at rteller@ strivright.org June 2013

ASK THE EXPERT

Ask the Eligibility Specialist:

I am the mother of an eight year old boy with a developmental disability. Currently, I have been trying to get clear answers about obtaining the Medicaid Waiver, and it seems that everyone I talk to on the phone or via email has conflicting information. Furthermore, I heard that the system is changing. I am very concerned if these proposed changes will affect my son’s eligibility for Medicaid Waiver services. I just don't know where to begin and need immediate assistance.

Although the Medicaid Waiver system in New York is in the midst of transformational changes for a multitude of reasons, the eligibility process currently remains the same. In other words, The Office for People with Developmental Disabilities (OPWDD) still determines whether or not an individual has a developmental disability prior to enrollment of any OPWDD/ Medicaid funded service. There is a three step review process, which is still the gateway to OPWDD services. The eligibility review process begins at one of OPWDD’s five Developmental Disability Regional Offices (DDROs) that are located throughout New York State. The DDRO will review your son’s eligibility based on recent findings of the following: psychological evaluation, medical report, and psychosocial assessment in order to support a qualifying diagnosis

By Marc R. Katz of “developmental disability.” Depending on the complexity of your son’s developmental disability, a face-to-face interview may also be part of the eligibility process. With regard to the proposed systemic changes in Waiver Services, OPWDD is promoting its “Front Door” initiative, which is a single point of access to its services for families “new” to OPWDD. On the OPWDD website, they recently published the OPWDD Front Door Resource Booklet, which can be found at http:// www.opwdd.ny.gov/welcomefront-door/resource-booklet. Families will now be strongly encouraged to contact the Eligibility Coordinator at its respective DDRO to assist them in obtaining services based on their child’s individualized needs and availability of services. One of the reasons is that the OPWDD system is extremely complex and overwhelming to new families who want to

learn about the wide range of services that can benefit their child. Alternatively, in the back pages of this issue, you will find a resource directory that consists of various agencies that provide assistance with evaluations, intake, and referral of services. I highly recommend that you also contact an agency’s intake specialist who will be able to assist you in successfully navigating the maze of the enrollment and eligibility process. Good Luck! Marc R. Katz, a NYS Certified School Psychologist, is a Director at OHEL Bais Ezra. For more information about evaluations, intake, or referral of services, please call 1-800603-OHEL, visit www.ohelfamily.org, or e-mail askohel@ohelfamily.org. OHEL delivers a breadth of community and residential services through OHEL Bais Ezra, OHEL Lifetime Care, OHEL Foster Care, OHEL Mental Health Services, OHEL Institute for Training, Camp Kaylie, and Etta at OHEL.

By Dr. Zvi Gutman, DPT

Ask the Physical Therapist :

aving practiced physical therapy for over 10 years, I’m often asked about the different issues that parents face with their children’s development. Parents sometimes worry about whether their child is developing properly – especially when their child has not yet met certain developmental milestones. It is important to note that every child is unique and will develop at his or her own pace. Nevertheless, there are certain issues that require physical therapy intervention. 50

June 2013

Here are some questions that reflect the most popular issues that are often raised.

Q: A:

My son just learned to walk – but he never seemed to crawl. Is crawling really that important? Most babies learn to crawl between 6-10 months and then learn to walk at around 12 months. Some children learn to walk without having ever crawled. However, research has shown that crawling is an important developmental milestone and should not be skipped. Crawling helps with eye-hand coordination, balance, spinal alignment and visual skills. It also teaches your child to engage his entire body by using his arms and

legs to lift his core off of the floor. Children who never learned to crawl often have developmental delays that need to be addressed with physical therapy.

My pediatrician keeps telling me to give my baby tummy time but she cries whenever we place her on her stomach. How important is tummy time to my baby’s development?

‘Tummy time’ is extremely vital to your baby’s development and in fact, there is growing evidence that avoiding it can cause severe delays to fine and gross motor skills and overall sensory development. Spending time on her stomach will strengthen your child’s back, neck and arm muscles that she will need to roll over, sit,

crawl and use for the rest of her life. It supports neck development which helps with jaw movements required to talk and eat. It also reduces your baby’s risk of SIDs by helping her learn to move her head away from any breathing hazards. Teach your baby to enjoy being on her stomach by rattling toys in front of her to distract her. You can also hold her on your lap or stomach instead of placing her on the floor – she will enjoy the personal contact and forget that she is getting tummy time. Practice tummy time for about 20 minutes a day, 5 minutes at a time until she is able to tolerate longer periods. Dr. Zvi Gutman, DPT is a licensed NY physical therapist specializing in adult and pediatric physical therapy and works with Gutman Physical Therapy, P.C. He be reached at 646.481.7854 or zvigdpt@gmail.com for appointments or questions.

ASK THE EXPERT

By Stephen Glicksman, Ph.D.

Ask the Psychologist:

Q: A:

My son is six years old and still wakes up during the night. Are there any bedtime routine ideas that might help? The idea of a bedtime routine is to help your child recognize that bedtime is coming, and to get him both physically and psychologically ready to go to bed. The bedtime routine is not just what you say to your child when he gets into bed; it is all the things you do just before and up to the time you put your child to bed, including things like bathtime, brushing teeth, putting on pajamas, going to the bathroom one more time, reading a book, singing a song, saying shema, and saying “good night”. Sometimes, parents fall into some bedtime routine traps that, once pointed out, seem obvious even if you never thought about them as “traps” before. The biggest trap is not realizing that the goal of the bedtime routine is not to help your child fall asleep, but rather to get your child ready to fall asleep on his own. In other words, all children (and adults) have sleep cycles during the night that include periods of deep sleep and light sleep. The fact is, we all probably wake up a few times during the night without even realizing or remembering it. If your child’s bedtime routine includes having a parent sing a song or lie in bed with him for a few minutes and then saying good night, that gives the child a certain message:

Relax, and you will fall asleep. If, however, your child’s bedtime routine includes having a parent sing him to sleep or lie with her until she falls asleep, a very different message is being sent, namely: You need a parent with you to fall asleep. If this is the message your child is learning, then those typical episodes of waking up during the night can quickly turn into a nightmare for everyone (pun intended).

body and his mind;  The bedtime routine should be the same every night so that your child comes to anticipate sleep and associate the bedtime routine with going to sleep. Of course, this may not always work; there is often something getting in the way of consistency. But, try your best;  Use a transitional object such as a blanket or stuffed animal and/or a nightlight if that helps relax your child;  Offer some

is, but watch your child’s signals closely when making that decision;  Most importantly, leave the room while your child is still awake, because if your child needs you to fall asleep at bedtime, then when she wakes up in the middle of the night (which is normal), she will need you to fall back asleep. To conclude, kids wake up during the night. That’s normal, and should not be viewed as a prob-

So, here are some best practices that might help bedtime become a bit easier, both for you and your child:  Spend some time unwinding before you begin the bedtime routine: if a bedtime routine takes about ten or 15 minutes (longer if you include a bath), then about 15 to 30 minutes before that should be “quiet time”. No overly-active games, no fast music, and no computer or videos. Just have your child spend the time quieting down his

choices, but stay in control. Your child shouldn’t decide when bedtime is, but can decide what book to read or what pajamas to wear. And, if you feel like your child is never ready for bed when you say it is time to go to sleep, consider the possibility that you are putting him to bed earlier than he may need (this is especially true if you find that your child takes a long time to fall asleep, but is not overly tired in the morning). You should still decide when bedtime

lem. The problem is when the child requires the presence of a parent to fall back asleep. Having a well thought out bedtime routine should make nighttime easier for both you and your child. Stephen Glicksman, Ph.D. is the Developmental Psychologist at Women’s League Community Residences and Jumpstart Early Intervention in Brooklyn, New York, and has a private practice in Teaneck, New Jersey. He can be reached by calling Women’s League at 718.853.0900, or at sglicksman@womensleague.org. June 2013

ASK THE EXPERT

Ask the Advocates:

Dear Advocate, My child is turning 5 in a few months and will be aging out of her preschool at the end of August. I was under the impression that the district would be conducting up to date evaluations as my daughter has not had a psycho-educational evaluation since she was around 2 1/2 years old. I was very shocked a few weeks ago when someone from the district’s IEP team called me and told me that an IEP conference had been scheduled just two days from then. I told the district representative that I was under the impression that parents were supposed to receive at least 7 days notice before a meeting. She responded that at this point in the year, the schedule was full and if I don’t waive the 7 day notice, it will take at least a month to reschedule an IEP meeting. She also advised me to bear in mind that many of the DOE staff do not work in the summer or work on a truncated schedule. I told her that we would attend the meeting that week as I was concerned that otherwise with the summer coming, it is likely that my child might not have her IEP or placement recommendation in sufficient time for us to insure that she has the appropriate special education services in place by the time school begins in September. I attended the meeting which lasted approximately 15-20 minutes. The IEP “team” it turns out June 2013 52

By Juby Shapiro

Does IEP Really Stand for Individualized Education Program?

consisted of just a psychologist and a social worker from the district. As the meeting began, the “team” asked that I give them my child’s updated provider reports. I told them I had not been advised that I was supposed to bring these reports. The psychologist scolded me for not providing the team with the materials they needed to create an IEP. I apologized but told her I was under the impression that the CSE would conduct new evaluations and would have contacted my child’s providers. I was able

I asked about special education support and was in complete shock when I was told that the district’s “policy” is to not provide special education teacher support services to students turning 5. My child has been receiving 15 hours of SEIT in preschool. She definitely cannot remain in a general education class without special education support! The SEIT teacher’s report clearly explained my daughter’s continued need for academic and social support in class. My child has academic delays as well as difficulties with attention and focus, language and some social anxiety. This report was the only information the CSE team had at the meeting. Neither of the team members has ever met my child. There were no evaluations conducted and no one from the district has gone to observe my daughter in school this year. If an IEP is supposed to be based on a student’s individual needs, how can the CSE change or deny services with no educational basis? What can I do now?

Q: to call my child’s SEIT (Special Eductaion Itinerant Teacher) and she faxed her most recent progress report to the district. In the meantime, the team informed me that they would recommend that my daughter continue to receive occupational therapy 2x30, 1:1. The team changed speech from 3x30,1:1 to 1x30, 1:1 and 1x30 in a group of 3. When I questioned this change, I was told that it is the district’s policy now to increase grouping of services. Then

Dear Advocate, My 16 year old son has been diagnosed with cerebral palsy. He attends a school on the New York State Approved List. Up until recently, he was receiving 3x30 minute sessions of physical therapy, 2x30 minute sessions of occupational therapy and provided in school and 2x30 minute sessions of speech therapy in school. In addition, he was receiving services through RSAs (Related Service Authorizations) outside of school. He had 2x60 of physical therapy, 2x45 of occupational therapy in a sensory gym and 2x30 minute sessions

of speech therapy with a feeding therapist. These outside services are a very important part of his education. Up until recently the therapists in school agreed that these services were very helpful to his overall progress. I received a letter from the district with a date for my son’s annual IEP meeting. I obtained progress reports from my son’s outside providers and sent a copy to the district a week before the meeting. A day before my son’s IEP meeting, the social worker from his school called me. She told me that she was advised that the DOE policy has changed and they will no longer issue RSAs for outside therapies for students enrolled in NY State Approved Schools. The school could not accommodate all the additional related services. I told her that this reduction of services would be very detrimental to my son’s progress and would likely cause him to suffer loss of skills. She told me there was nothing they could do about it- they must follow policy. The next day at the IEP meeting, the school staff reviewed the goals briefly and when they finished, without any further discussion, a member of the CSE team told me that my son would remain in the same State Approved School but his related services would be changed to that which the school social worker had told me the day before. When I tried to object, I was told that if I have a problem with the recommendation, my son would not be able to continue to be placed at the school. I argued that the school is appropriate for him but he also needs the additional related services. I tried to reason with

ASK THE EXPERT them- the school has no feeding therapist and he really needs to have feeding therapy. My son needs to be stretched daily otherwise he develops painful muscle contractures. The 60 minute sessions are very critical because it takes time to do stretching exercises and part of the session includes my son being placed in a stander. My son has also benefitted from the occupational therapy he receives in a sensory gym. No matter how much I tried to explain my son’s needs to the team, the decision had been made. I was told I must choose either the school or the therapy. The meeting was over in just a few minutes and I was in shock thinking about the loss to my child either way. Nothing about this decision was based upon his needs. What are my rights?

ra v. Pawling Cent. Sch. Dist.,427 F.3d 186, at 195, quoting Walczak, 142 F3d at 130.) In both of the above cases, the DOE failed to develop appropriate IEPs for the students based upon their individual needs and as a result, they were denied an FAPE. In the first case, the CSE

The IDEA- Individuals with Disabilities Education Act (20 U.S.C. 1400-1492) ensures the rights of students with disabilities to be offered a FAPE which means a Free Appropriate Public Education that includes special education as well as related services designed to meet a student’s unique needs and prepare them for further education, employment and independent living. The "Free Appropriate Public Education" mandated by federal law must include "special education and related services" tailored to meet the unique needs of a particular child (20 U.S.C. § 1401(a)(18), and be "reasonably calculated to enable the child to receive educational benefits," (Board of Educ. v. Rowley, 458 U.S. at 207). A school district must provide “an IEP that is likely to produce progress, not regression, and …affords the student with an opportunity greater than mere ‘trivial advancement” (Cer-

had not conducted any up to date testing and did not have current information about the student when they convened their IEP meeting. Despite the lack of up to date information about the student, the district made substantive changes to the student’s IEP by removing all special eductation supports and services and changing and reducing the student’s related service mandate. A CSE team must have an educational or theraputic basis for changing or removing services that were previously on a student’s IEP. Here the team failed to notify the parents in a timely manner. At the meeting the parents did obtain a report from their child’s SEIT which supported continuation of special education services to the student. The CSE team failed to give that report proper consideration despite the fact that it was the only current information the team had about the student’s academic levels and social and emotional

needs at school. In both cases, the parents and SEIT teacher were denied meaningful participation in the development of the student’s IEP. This resulted in an IEP that does not provide a FAPE to the student because the student will be deprived of the services and supports necessary for he/ she to remain in the least restrictive setting and to make progress. In the second case, the student attends a school on the New York State Approved List and the parent is informed that a change in policy resulted in the parent seemingly having to choose beween a substantial reduction of the student’s much needed related services or having to change an appropriate placement. The only basis for any of the recommended changes to the student’s IEP and placement is the result of a beurocratic policy change and not what is apporpriate and reasonably calculated to help the student learn and make meaningful progress based on his actual needs. In both cases, the parents should tell the CSE team that they disagree with the proposed IEPs. In the first case where the student is transitioning from CPSE (preschool) to CSE (school age), if there is sufficient time prior to the start of the school year in September, the parents should write a letter to the CSE explaining that they disagree with their child’s IEP and that the parents are requesting that the CSE reconvene. The parents should send the team additional information such as progress reports from the related service providers explaining the student’s needs as well as letters from their child’s teacher, principal or doctor and that would support the services requested. If the CSE does not reconvene and hold another IEP meeting or the CSE meets but continues to deny the services for the student, the

parents may request an impartial hearing in which they should ask that the appointed Impartial Hearing Officer (IHO) order the student to receive pendency services in the interim until both sides have the opportunity to present evidence and testimony and the hearing officer issues a Finding of Fact and Decision. Pendency services are the last agreed upon or operative services either through an IEP or through an Impartial Hearing Officer’s Decision. The student’s pendency services stay in effect throughout the appeals process as well. In the second case, the parents should also request an Impartial Hearing and in their request ask that the student receive pendency services and that the IHO order that the student remain in his present placement at the New York State Approved School with related services as per his pendency (last agreed upon) IEP. It is difficult for parents to go through the process alone and it is recommended that they consult an advocate or attorney familiar with special education law. It is important that parents understand that it is their right to disagree with their child’s IEP and to request another meeting or an Impartial Hearing. If a parent disagrees with their child’s IEP and/ or placement, it is critical that they do not sign the Final Notice of Recommendation (FNR) form sent by the district. It is also important to write to the CSE to advise them of their disagreement with their child’s IEP and/or proposed placement. Juby Shapiro is a special education advocate and the parent of two children with special needs. She is the founder and director of TAFKID, a not-for-profi t organization dedicated to helping families whose children have a variety of disabilities and special needs. TAFKID can be reached at 718.252.2236 or tafkid@aol.com. June 2013

PRODUCT REVIEWS

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

Pocket Full Of Therapy Improve Skills while having Fun!

• Handwriting • Early lEarning • Visual PErcEPtion • sEnsory ProcEssing • Motor coordination • critical tHinking • FidgEty studEnts • languagE • and so much more! Free gift with online order- coupon # Jbb6 hurry exp 6/30/13

All products online-like us for facebook specials (800) PFOT-124 • (732) 462-4474 • www.pfot.com

Adaptive Clothing Showroom:

he Adaptive Clothing Showroom is a company that aims to adapt clothing and products to benefit the disabled. Three of their innovative items are presented here.  A large colorful waterproof bib with snaps – This is ideal for the older child or young adult who needs a bib during mealtimes to limit the amount of mess they may cause to themselves. It is especially useful for teachers and parents of disabled children and young adults to encourage independent eating at mealtimes. If dirtying up clothing becomes a non-issue, then the parent or teacher can allow the child to attempt to feed him/ herself. The bib allows for easy cleanup after meals, and can be washed down quickly.  Arm/Leg Protectors-These are perfect for keeping the arms or legs of children/ young adults who are confined in a wheelchair warm. Since they do not generate body heat

as well due to lack of physical movement, their extremities get colder faster. These arm and leg protectors are like a huge sock that goes over the arm. The material is very soft and fluffy, and comes in all colors. In addition, they are useful in protecting the arms from any nicks or scratches that may occur from the wheelchair use. Wheelchair armrest covers-These are very soft like fleece that wraps around the wheelchair armrest, providing cushioning and protection for the arms. It attaches easily to the armrest using a loop and a Velcro hook. It is also machine washable. This is perfect for children in wheelchairs with sensory issues who may be bothered by the hard rubberlike material normally on the armrest, or children whose sensitive skin may be compromised by prolonge d resting on the hard surface of the armrest.

Available at adaptiveclothingshowroom.com

Prices Vary

June 2013

PRODUCT REVIEWS

myCreate

yCreate is an app that enables children to create their own animated stories using the manipulatives of their choice. Designed for iPad use, children take a series of still photos using the iPad’s built-in-camera to create a moving picture! The app is user-friendly and allows children to produce their own videos. After capturing the still images, children can determine the speed in which to play back the frames. They can also add music or create an accompanying audio recording. Once complete, the video can be shared with family and friends via YouTube, Facebook, or Vimeo. At the low price of $4.99, this app is an affordable choice to allow your child to express his/her creativity. The myCreate app can also

be used as a platform to foster speech and language development. With the audio recording

This app is great for children with expressive language delays, language processing disorders, word

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

Jewish Press

option, children can narrate all of the videos they create. This is an excellent opportunity to promote the development of narrative language, whether children are retelling a story from a book or creating a story of their own.

retrieval deficits, articulation disorders, pragmatic language disorders, and so much more!

Available at icreatetoeducate.com

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

$4.99

Play Me - Animals Creator

his is a building toy in which children can use wooden screws, nuts, blocks with holes, circles, and flat shapes- both square and semi circular to build different animals. The box states that this toy is for ages 3 and up. However, when I tested this toy on a three year old, he had difficulty following the directions to build the toy. I had to lay out the parts, and then he was able to attach the pieces together. The pieces are large enough and safe enough for a three year old, and he was able to turn the screw and attach pieces together. The instructions are meant an older child, or to play together with an adult. They are not broken down to show how to place pieces in specific places. Instead on one side the pieces needed are pictured, and on the other side the completed form using those pieces are pictured.

Available at www.pfot.com

$24.95

THERAPEUTIC BENEFITS:  Develops fine motor coordination skills in children  Develops cognitive skills including attention span and focus in children  Develops visual perceptual skills for the older child, ages 7 and up who can extrapolate from a completed picture how pieces attach and where.

Central Design 732-942-0746

used in combination with the

Jaw Rehabilitation Program provides a powerful tool for developing biting and chewing skills. For more information call

Speech Pathology Associates, LLC at 207-741-2443

or visit us on the web at

www.ChewyTubes.com

June 2013

PRODUCT REVIEWS

Move About Activity Cards

hese are 60 activity cards to help children develop sensory-motor skills. These cards require some equipment to be used together with the activities such as a gym ball, a weighted ball, and gym mats. These cards are good for children who have severe sensory processing disorder, such as children on the Autistic Spectrum, as well as children with mild sensory processing disorders. Each card has one activity on it, with a simple stick figure diagram and a one sentence instruction. The cards are

linked together with a key chain making it ideal for a child to carry them around with him/her to be used as needed. Since there are 60 cards, a child can choose one activity per day for two months straight without having to repeat it, lending continued excitement to the daily exercise.

Available at www.fhautism.com

$19.95

THERAPEUTIC BENEFITS:  Improves Sensory Motor skills in children through easy to follow activities.  Provides activities for a sensory diet in children who experience varying degrees of sensory integration dysfunction.  Cards can be grouped according to types of exercises, so the child feels they have more choice in any given area.

TRUNKS

his is a memory game that requires remembering to perform a sequence of actions. This game comes with two types of cards, one is an action card, and one is a memory card. The action card is what each player draws first. The player looks at the picture on the memory card, reads it out loud, and then places it face down on the table. Then the player has to perform what the picture showed from memory, (for example, pretending to blow up a balloon.) If the player can’t remember what he/she was supposed to do, they may peek once. If the player still can’t remember, then he/she must put back the most recent card drawn and wait for the next turn. At each turn, when the player turns over a new card, they must perform all

the cards from memory in the same order that they drew them. Players continue to play until they collect each of the four sections of an elephant’s trunk. The back of each memory card contains part of the elephant’s trunk, and players need all four parts to win. The Action cards are used to help make the game more challenging for the older child, but can be left out of the game when playing with younger children. This game can be played in groups of up to 6 players making it ideal for developing social skills through playing a group game.

Available at www.therapro.com

$19.95

THERAPEUTIC BENEFITS:  Helps children build cognitive skills through memory and sequence.  Increases visual perceptual skills by identifying and matching the different section to build an elephant’s trunk, and by identifying what action needs to be executed based on the picture card.  Increases visual motor skills by having children act out the instructions that they see.  Increases social skills through a fun game that utilizes turn taking and good sportsmanship within a group setting. 56

June 2013

PRODUCT REVIEWS

ummer is a time to rest and rejuvenate. However, summer months are not to be spent without reading, especially for children who are not achieving their full academic potential. As pediatric audiologists, we often encounter parents that are frustrated by barriers their children face in a variety of developmental domains. Children who have normal hearing frequently present with learning disabilities, attention deficits, speech/language/articulation deficits, auditory processing disorders, and difficulty achieving grade level reading skills. DOES YOUR CHILD…  Have history of early otitis media (ear infections or fluid in the ears)?

Fast ForWord: A Brain Workout  Have early speech and/or developmental delays?  Have trouble learning to read?  Have trouble with understanding what they read?  Get distracted easily?  Have trouble following complex directions?  Get frustrated with school?  Need questions repeated?  Get confused in noisy places?  Have trouble paying attention?  Have trouble sounding out words?  Give slow or delayed responses?  Have trouble understanding long sentences?  Have trouble reading, understanding, or spelling? If you find yourself nodding as your read the above questions,

you cannot take the summer off. Instead, you can consider devoting this summer to your child’s future. Fast ForWord is a computer based program that can strengthen the auditory pathways in the brain, dramatically increasing their capacity to learn. Children that have completed the program are able to pay closer attention, absorb information faster, and remember what they are taught. Fast ForWord not only works on language and reading, but also develops cognitive skills, such as memory, attention, processing, and sequencing. By building cognitive skills in the areas of Memory, Attention, Processing, and Sequencing, students who have completed the program

have demonstrated achievement gains of up to two years in as little as three months and maintain an accelerated rate of learning much after the programs end. The Fast ForWord program is currently available in an off-site mode. All the training is done at home. An audiologist will check your child’s progress every time they log in, keep you updated on their progress, select the appropriate treatment plan and alter it as needed throughout the length of the program. With the Fast ForWord family of products measurable results can be achieved in as little as 8-12 weeks. For more information please call 718.421.2782 or e-mail listen-up@mail.com to find out more about this program.

June 2013

PRODUCT REVIEWS Here’s How I Write

his is actually a handwriting self assessment tool developed to help children become involved in analyzing their handwriting and determining how to help improve. What is nice about this self assessment tool is that teachers can utilize this to determine where a child is experiencing difficulty in handwriting, and to try to help the child to improve their handwriting. There is a special formulated assessment sheet for teachers to

use, as well as 25 picture cards for children to easily identify where they are having trouble. This can be a good way for teachers to identify handwriting problem areas in children and can help therapists to collaborate with both the teacher and the student to pinpoint problems and improve handwriting in children.

Available at www.therapro.com

$90

The Therapy Resource for Families & Professionals!

Picture Bingo

his toy is Bingo with a spinner that little hands will find fun to push down on, strengthening their arms and hands in the process. This game is very simple with no reading required, only the ability to recognize pictures of fruit. This game is ideal for young children, and children with developmental disabilities. It encourages turn taking and good sportsmanship because not

every turn will produce a match to the board. I tried it out on a three year old who found it easy to match the picture the spinner turned to, to the ones on his board. The game is also small and compact, making it a good addition to road trips and vacations.

Available at pfot.com

$6.95

THERAPEUTIC BENEFITS:  Improves strength in little hands through pushing down on the spinner  Improves visual perceptual skills by having children match pictures on their cards to the one the arrow turned to  Improves fine motor skills with children having to place small circle markers on designated pictures.  Improves social skills; This is a great game for children of varying abilities to play and have fun together since it does not require advanced reading or mathematical skills, only the ability to match pictures.

New! Exciting! Fun! FREE!

Serving the Community Since1979

Find out how NEW products and services could change the way you do things. Fun adaptive sports, dance and more! Try it at the Expo and keep it up through local programs. Attend workshops and hear experts offer solutions for travel, finances, wellness and so much more! Continue your Expo experience all year with Abilities365.com—our new, FREE online resource community. “Each show reminds me of what a dynamic and passionate community I am a part of because of my disability, and I continue to be inspired by the people I meet and the experiences we all share.” Kris R.

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

www.AbilitiesExpo.com Register online for priority access.

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

June 2013

Chicago

June 28-30, 2013

San Jose

Nov. 22-24, 2013

Houston

Aug.2-4, 2013

Los Angeles

Feb. 28-Mar. 2, 2014

Atlanta

Boston

Sept. 20-22, 2013

Mar.14-16, 2014

New York Metro May 2-4, 2014

“P

Write Right

inch the eyes…cover the mouth…wrap your fingers around the tail!” This is a fun way for children to develop a correct pencil grip easily. The Write Right is a mechanical pencil with a shark attached to the bottom, complete with eyes, tongue, teeth, and a tail. The shark shape is actually a grip that helps the child hold the pencil correctly. The eyes and mouth are visual cues, located where the correct placement is for fingers while writing. The tail gives children a place to grip with their ring and pinky fingers. Even the material itself that the Write Right is made up of provides a child with tactile

feedback. Write Right can be purchased for both right hand and left hand versions to match the child’s dominant side. Since the grip is attached to a mechanical pencil, the grip remains firmly in place always, never getting lost. When the pencil lead runs out, remove the eraser and insert new lead. The Write Right comes in three sides, small, medium and large to accommodate growing children between the ages of 3-10. The Write Right can be specially ordered for older children and adults as well.

Available at www. thewriteright.com

$9.99 or 3/$19.99

THERAPEUTIC BENEFITS:  Helps a child develop a proper pencil grip  Improves handwriting skills by encouraging a proper grip while writing  Helps a child grade how hard they press when writing, since the mechanical lead will snap if a child pushes down too hard.

PRODUCT REVIEWS StartWrite 5.0

he Handwriting Worksheet Wizard. This is a computer CD that allows teachers and therapists to create customized handwriting practice sheets for children. It features many different options for creating sheets with letters, words, and sentences, using various shades and amounts of dots, size of letters, and even a choice of letter thickness to trace over. This program allows teachers to add starting dots to help children know where to cor-

rectly start each letter. Students can slowly advance from a thick shade and dark dots to thinner shades, and lighter dots. This is an excellent source for teachers to create specific practice sheets for students where they need them the most. Teachers only need to print out what students need at a given time, limiting the amount of sheets that go to waste or get lost.

Available at www.therapro.com

$42.50

THERAPEUTIC BENEFITS:  Improves handwriting skills in children through individualized practice sheets.  Improves visual motor skills through sheets that encourage tracing of letters in varying shades and thickness.  Builds self confidence in children since sheets are customized to their needs, and consequently are more doable for the child.

In-Sync Activity Cards

hese 50 activity cards are based on the book “Growing an In-Sync Child: Simple, Fun Activities to Help Every Child Develop, Learn, and Grow” by Joye Newman, MA, and Carol Kranowitz, MA. The cards are large print and easy to read. They are divided into three developmentally based levels: beginner for preschoolers, intermediate for primary school aged children, and advance for elementary school aged skills. Each activity integrates many skills at the same time. There are also suggestions on each card on

how to help the child further and customize the activity to specifically meet an individual child’s needs. Additionally, each card has a picture that clearly demonstrates the activity. These cards are great for parents of children who are experiencing difficulty processing and integrating sensory input. Each activity can take as little or as long as you would like, making it ideal for parents to incorporate an activity card or two into their child’s daily schedule.

Available at www.fhautism.com

$29.95

THERAPEUTIC BENEFITS:  Helps children integrate their sensory, motor, and visual skills through fun activities  Great way to provide activities for a sensory diet in children experiencing sensory integration dysfunction  Activities can be customized and graded to meet individual child’s needs.

June 2013

BOOK REVIEWS By Bracha Holczer Bracha Holczer’s home is overflowing with books and other reading material. She and her family are often found hard at work trying to read them all. She is a reading specialist in an elementary school and can be reached at bholczer@aol.com.

PLAN B: EMPOWERING THE SINGLE PARENT!... TO BENEFIT THEIR CHILD WITH AUTISM

Author: Karra Barber-Wada Publisher: Future Horizons Inc., Arlington Texas, 800.489.0727, fhautism.com Year: 2013 ingle parenting is not something most people plan to do. Neither is parenting a child with autism. Single parents and parents of children with autism often rise to the occasion admirably and their children can flourish. Single parenting is difficult enough, but when that comes with the very challenging needs of a child with autism or Asperger’s syndrome, a single parent can easily become overwhelmed to a dangerous point. This book addresses those parents who find themselves about to or already parenting children with autism solo. In Karra Barber-Wada’s book Plan B, Empowering the Single Parent! ...to benefit their Child with Autism, the author presents a well-planned, practical template with the goal of normal functioning as much as possible, taking into account the needs of the single parent as well as the children involved. Beginning with a guide to building emotional support, and ending with a

LITERATURE-BASED THEMATIC UNITS (FIFTH BOOK IN A SERIES)

Authors: Laurie Eckenrode and Pat Fennell Publisher: Tasks Galore Publishing Inc., Raleigh, North Carolina 27616, 919.788.2757, tasksgalore.com Year: 2013 ll of the Tasks Galore books serve as excellent resources for those who teach and care for early learners and students with special needs. The activities they present are designed to be accessible to even the most reluctant and difficultto-motivate learners. One very effective way to harness the innate desire to learn and to apply learning to meaningful activities is through a solid, theme-based unit of study, and when this is literature-based, stronger reading, writing, and thinking skills result on all levels. In this book, the authors show exactly how they have integrated the core concepts found within one simple book, I’m Hungry, I’m Hungry, What Shall I Do? by Laurie Eckenrode and Michael Arrigo (see above review), across all aspects of a well-rounded curriculum: literacy, numeracy, science and social studies. Some activities involve art as well, and some contribute to improved eye-hand coordination, among other beneficial side effects. When young students and many students with disabilities experience learning and meaningful activities around a familiar theme (in

June 2013

remarkably insightful discussion about helping children with autism or Asperger’s Syndrome plan for and step into independent living, Ms. Karra Wada advises like a close friend who has been there and done that. (She actually has.) Calmly, rationally, reassuringly, she takes the reader through the steps necessary to ensure as smooth a transition as possible through potentially upsetting upheavals while acknowledging the realities of complex behavioral difficulties and budget restrictions. She anticipates issues that come up as children have to travel from home to home due to custody arrangements, financial strategy, legal matters, and social adjustments. Parents who are ending their relationship are strongly urged no matter what personal differences may linger between them to do what it takes to provide secure and supportive environments for the children. Most importantly of all, single parents are given tools and guidelines to parent their children, including those with special needs, in the newly formed family units. The collection of resources shared at the end of the book is thorough and potentially quite informative, saving parents from sifting through websites and organizations wantonly, especially for parents seeking to guide children with Autism or Asperger’s syndrome through college or career goals. this case, food), their core academic skills and knowledge are strengthened, deepened, and enhanced. Another vital benefit to a theme-based unit of study is that all children in the classroom are using the same content vocabulary within their varying levels of learning activities, which facilitates communication and fosters a feeling of community. The authors guide curriculum designers and teachers through the initial planning stages of choosing a focus or central concept and then designing activities to meet specific goals within the theme, as well as how to integrate the concepts in the cornerstone book, and then assess students learning toward the goals. A pre- and post- assessment, weekly lessons template and task vocabulary cards (reproducible) are included. One can really see how an effective and motivating literature-based themed unit of study is created. As in the previous books in this series, the learning activities and tasks represent a broad range of abilities and learning modes across the curriculum areas, using a wide variety of appealing materials. A colorful picture of each of the hundreds of activities is provided, along with a helpful description that included tips about skills involved, follow-up activities, and how to scaffold for independence. The activities presented in Literature-Based Thematic Units are fun to do, educational with clear objectives, and extend thinking about the different aspects of the chosen theme. What a valuable addition to a teacher’s toolbox!

BOOK REVIEWS Deflections and Reflections of Stigma

By Faith Fogelman

A review of STIMGA - Notes on the Management of classmates that the lecture today was especially difficult, (main point, finding academic commonality), but adds that he will better grasp the Spoiled Identify, Erving Goffman, (1963)

ood sociologists comment on societal trends, but excellent sociologists interpret those trends and add insights on collective experiences which are universal, but not usually discussed. Dr. Erving Goffman (1922 -1982) was in the latter category. His classic book, Stigma, a Greek word for tattoo or mark may have outdated terminology and passé world views, but the thrust of his treatise is as relevant today as when it was written 50 years ago. Dr. Goffman was a keen observer of interactions and the covert needs of the stigmatized which drive communication between them and so called normals –his term. For individuals who have always struggled with stigma, he provides a framework so that they better understand their discrete experiences and psychology on a broader level. The primary concept of the book is underscored in the latter half of the title. For even minimal societal acceptance, optimal stigma management on the part of stigma holders is critical. Without such management, life is a series of rejections and missed opportunities. With stigma management, the stigmatized have a chance of grabbing the crumbs thrown by the normals. The book suggests a sharp societal hierarchy in which the life-long objective, conscious or not, of the stigmatized is minimal acceptance, and the paradox is that acceptance is not frequently achieved and rarely sustained. The identity of the stigmatized is determined by the normals and not by self. Although Dr. Goffman references that we all play dual roles of both the normal and the stigmatized, some will go through life much more rooted in one camp than the other. According to Stigma, there are three categories of stigmatized people: those with physical disabilities; those with “blemishes of character” such as people with psychiatric diagnoses, substance abusers, members of the gay community, and the formerly incarcerated; and individuals with “tribal” stigmas such as race, religion, and country of origin. Although one can see similarities and differences among and between these statuses, Dr. Goffman further categorizes stigmatized individuals as the discredited or the discreditable. The former group includes those with visible or immediately known stigmas. The discreditable can hide their stigma, at least for a while, and therefore the plight of each group is different. While the discredited are supposed to put normals at ease for acceptance, the discredited employ all types of stratagems to keep their real (stigmatized) identity unknown. After all, stifled communication surfaces if normals are not comfortable or feel deceived by people they thought were normal. The discredited are given acceptance points if they introduce their stigma in casual conversation as supportive comments, rather than the main point. For example, a blind college student may comment to

points of the lecture after conferring with his note taker. That comment minimizes his blindness without denying it. A wheelchair user who makes jokes by saying that she does not walk away from bad situations is alleviating the discomfort that normals may feel in her presence. She is complying with societal standards and role expectation since self-mockery facilitates some degree of comfort for normals. Since the discreditable have stigmas not readily discernible, they want to keep it that way. They will take extreme measures to control information about their past or present situation. They live in fear of being exposed, confine their lives to environments where there is minimal risk of disclosure, and therefore have stressful lives. Stratagems employed can prove comical, all to avoid exposure. The discreditable also includes those with invisible disabilities who can “pass” for normal in most situations and straddle both the normal and stigmatized sectors. Goffman references the various tactics employed by the hard of hearing to keep the diagnoses from being known. The year of Stigma’s publication, 1963, was a year of demarcation. It was one year behind the civil rights movement and a few years behind the women’s right movement, the disability rights movement, and others. Today, the way people view themselves takes precedence over whatever labels are assigned. Society is now more willing to support the right to self-determination, including determining personal identity. Positive personal identity is more possible in today’s world where the so called are not fighting as much for acceptance and some have healthier or unapologetic ways of relating to normals. Social diversity and equalization has flattened societal hierarchy. The stigmatized referenced in the book have become vocal, visible, and proud. They fight for economic justice and equal opportunity. Social acceptance seems less important as group confidence has taken hold. Their plight for equality is through social movements on the macro level so that group members are not alone. Even normals have joined their fight, adopting a previously stigmatized group to which they lend support and advocacy. The relevance of the book is that everyone has felt stigmatized to some degree as discredited or discreditable members of groups not necessarily referenced in Stigma. Marital status, socio-economic levels, and educational degrees all comprise today’s hierarchies and we can identify with the noted stratagems we have used to gain acceptance The book provides an insightful journey of the self as it searches for its real identity despite the external mirror. Awareness, self-acceptances, and self-respect are key. They crack the external mirror. For over a decade, Faith Fogelman has directed programs for disadvantaged students, including students with disabilities, at CUNY colleges. She is a licensed social worker and an adjunct professor in human services at NYC College of Technology. June 2013

BOOK REVIEWS THE THINKING MOMS’ REVOLUTION: AUTISM BEYOND THE SPECTRUM

Editors: Helen Conroy and Lisa Joyce Goes Publisher: Skyhorse Publishing, New York, NY 212.643.6816, skyhorsepublishing.com Year: 2013 dentifiable and treatable symptoms affecting large numbers of children suffering with autism are written off by the medical community as par for the course of autism. Digestive disorders, speech disruptions and severe behavioral disruptions are just some of the symptoms this group of mothers of children with autism and related diagnosis battled head on after deciding that autism doesn’t get to sentence their children to suffer when there is a way to heal. Each powerful, emotional chapter in this forceful book washes through a reader like a tidal wave. Here you will read 23 true stories written by the Thinking Moms, a group of women who have children that were diagnosed with autism or related diagnosis and through independent serious thinking and extensive research, these moms are figuring out how to better heal their children. They have each, in their own unique way and tailored to their own child’s circumstances,

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June 2013

begun to unravel the clusters of conditions that plague children suffering from autism. Raw and ragged emotions coupled with strong intellect and reasoning have led every parent in this book on a desperate, driven search to find ways to help their child heal, symptom by symptom, from the unforgiving grip of autism. More like an inspirational support group than a how-to manual, this book offers hope on so many levels. The positive results described in many of the chapters are hard-won and infinitely meaningful. Medical, behavioral and emotional victories are unabashedly celebrated, and milestones finally reached way too late to even register on development charts are applauded as parents wrest control of their children’s care and treatment. The women who share their stories here definitely qualify as “mama bears” (plus one equally devoted father). They may have differing backgrounds but share a solid common ground - they each rethought what wasn’t working, left no stone unturned while they researched exhaustively, and then tenaciously fought for what they were convinced their children needed. Readers need to be aware that some of the stories contain salty language and sensitive topics not for the faint-hearted, and certainly not for children.

I’M HUNGRY, I’M HUNGRY, WHAT SHALL I DO?

Author: Laurie Eckenrode Illustrator: Michael Arrigo Publisher: Tasks Galore Publishing Inc. Year: 2011 his is a full-sized picture can be an overwhelming activity board book featuring a cute for a sensitive child. triangular character named As so skillfully presented in Triggy on his trip to a cafeteria. Tasks Galore’s Literature-Based There, he has to make so many Thematic Units book (see our choices: What will he eat? Drink? next review), this book can be a Have for dessert? springboard into In uncomplia themed, litercated, uncluttered ature-based unit pictures, the comof study for early mon choices are childhood or lifedepicted, offering skills students practice for chil(of course, in a dren who need literature-based help making deunit, other books cisions at lunchwill be utilized time. Practical, reas well). Food petitive language groups, colors, helps children numbers, senses, pick up useful health... all these phrases to help and more can be them communicate their desires. accessed through rich discussion The typical cafeteria scene is centered on topics in Eckenrode’s visible in some of the pictures, I’m Hungry, I’m Hungry, What serving as a good preparation Shall I Do? story before cafeteria visits which

BOOK REVIEWS A GUIDE TO CO-TEACHING: NEW LESSONS AND STRATEGIES TO FACILITATE STUDENT LEARNING (3RD EDITION)

Authors: Richard A. Villa, Jacqueline S. Thousand, Ann I. Nevin Publisher: Corwin, A SAGE Company, Thousand Oaks, CA, 800.233.9936, corwin.com Year: 2013 ncreasingly, teachers find themselves differentiating instruction for students with special needs as well as the typical range of abilities within their classes. As awareness grows, more and more students’ specific needs are being recognized and required. When the concentration of special needs places too heavy a demand for just one teacher to handle, schools may opt to have two teachers and possibly also paraprofessional aides working together within one classroom to ensure effective instruction for the wide spread of learning needs. As with any personal or workplace partnership, the relationship between these adults strongly impact successful outcomes. In their book A Guide to Co-Teaching, authors Villa, Thousand and Nevin offer a framework for various ways this teaching partnership, or more accurately, teaching team, can serve diverse students efficiently and effectively by pooling knowledge and skill. When operating at its best, co-teachers and other members of the instructional team (ex., paraprofessional aides, therapists) operate on a premise of trust and respect, communicate regularly about instructional needs of the class as a whole as well as individual students, and anticipate potential problems. Creative solutions and fair division of labor are hallmarks of a well-functioning co-teaching rela-

tionship. This book offers a strong, practical support to co-teaching teams, complete with practical plans and tools and resources to ensure communication for planning, delivering and following-up after lesson delivery. Four prevailing approaches to co-teaching are presented; supportive, parallel, complementary, and team. Each has unique pros and cons. Instructional teams often flexibly vary their method of delivering instruction according to students’ needs and extent of coordination. The authors have extensively observed co-teaching teams and present thorough vignettes depicting numerous actual lessons on elementary, middle and high school levels across these approaches. One very helpful part of the book is a research-based discussion of the roles, responsibilities, and cautions for each member of instructional teams (which may even include students!). Principals, administrators and school board members would serve their schools well to learn about the theoretical, historical, legal and scientific issues behind coteaching, and to this end the authors offer a wealth of relevant information. Benefits of co-teaching are carefully delineated, and specific administrative actions to best train and support co-teaching are masterfully presented. After considering all this, a reader will certainly realize that more than just paying two random teachers to take care of one classroom, which co-teaching may sound like to the layperson, effective coteaching ensures solid educational gains where previously a considerable amount of students’ needs would have been unfulfilled. All the encouragement and tools necessary for bringing good co-teaching to students is here for the taking!

ABOUT OUR REVIEWERS

Chaya (Ilene) Klass, MS, OTR/L, is an occupational therapist who works for the NYC Department of Education and treats children in the

community. She can be reached at ileneklass@aol.com. Bracha Holczer is a reading specialist. She has taught reading with the New York City Department of Education and currently acts as a consultant while raising her children. She can be reached at BHolczer@aol.com. Breindy Rosenblatt MS CCC-SLP TSHH is the Speech Supervisor at the Auditory Oral School of New York/StriVright to Succeed. Yitty Rimmer has a Masters in Occupational Therapy from New York University. She currently has her own private pediatric practice in Brooklyn, NY. Rachel Soroka-Teller is a speech-language pathologist at Strivright/Auditory-Oral School of New York. She services children from birth to age 5 with a variety of speech-language delays and developmental disorders. She uses technology to engage children in fun and interactive therapy sessions. She can be reached at rteller@auditoryoral.org. Yisraela Kosowsky is a speech-language pathologist at Strivright/Auditory-Oral School of New York. She services children from birth to age 5 with a variety of speech-language delays and developmental disorders. She uses technology to engage children in fun and interactive therapy sessions. She can be reached at ykosowsky@auditoryoral.org.

Building Blocks Magazine is looking for a review coordinator for our product section. Contact us at: reviews@buildingblocksmagazine.com

June 2013

RESOURCES DIRECTORY DIRECTORY LISTINGS

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

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

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June 2013

The Auditory Oral School of New York/ StriVright to Succeed Address: 3623 Avenue L Brooklyn, New York 11210 Phone: (718) 531-1800 Mail to: Jewish Press Building Blocks Magazine 4915 16th Avenue Brooklyn, NY 11204-1115 Website: www.auditoryoral.org Location: Home and Center Services Provided: Sensory integration, speech language therapy, audiological testing and central auditory processing (CAPD) evaluations, OT, PT, special instructio,n family counseling, play therapy, music therapy, educational, parent-infant toddler groups, parent support groups Challenge Early Intervention Center Address: 649 39th Street Brooklyn, New York 11232 Location 2: 70-14 141st Street, Flushing, New York 11367 Location 3: 1911 Richmond Avenue, Staten Island, New York 10314 Phone: (718) 972-0880 Location: Home and Center Services Provided: ABA, sensory integration, Medek, multidisciplinary evaluations, speech therapy, special instruction, occupational therapy, physical therapy, family counseling, social work services, family training, nutrition services, psychological services, vision services, assistive technology, audiology, service coordination, individual and group developmental services EIS LAASOIS/WIECDC Address: 22 Middleton Street Brooklyn, New York 11206

Phone: (718) 303-9400 Website: www.EISLAASOIS.org Location: Home and Center Services Provided: Floor time, Sensory Integration and NDT Hamaspik of Rockland County Address: 58 Route 59, Suite 1, Monsey, New York 10952 Phone: (845) 356-8400 Hand in Hand Development, Inc Address: 465 Grand Street, 2nd Floor, New York, New York 10002 Phone: (212) 420-1999 ext. 149 Location: Home and Center Hebrew Academy for Special Children – HASC Preschool Address: 1311 55th Street Phone: (718) 851-6100 Website: www.hasc.net Location: Home and Center Services Provided: Sensory integration, Medek, assistive technology, therapeutic yoga, music therapy, computers, family counseling, play therapy, feeding therapy, parent support groups; nursing Jumpstart Early Intervention Program Address: 3914 15th Avenue Brooklyn, New York 11218 Phone: (718) 853-9700 Location: Home Services Provided: OT, PT, Speech, Special Instruction, Nutrition, Sensory integration, Medek, family counseling, play therapy Little Wonders, Inc. Address: 88-66 Myrtle Avenue Glendale, NY 11385 Phone: (718) 850-0400 Website: www.littlewonders-ei.org Services Provided: OT, PT, ST, Family Counseling, Play Therapy, Music Therapy, Parent Support Groups, Service Coordination, Multidisciplinary Evaluations. Languages: Spanish, Polish, Russian, Italian, French, Creole, Greek, Tagalog, Hindi, Punjabi, Hebrew, Urdu and Yoruba.

RESOURCES DIRECTORY EARLY INTERVENTION APPROVED PROGRAMS CONTINUED… Los Niños Services Address: 535 8th Avenue, 2nd floor, New York, New York 10018 Phone: (212) 787-9700 Website: www.losninos.com Location: Home Services Provided: ABA, Speech therapy, PT, OT, Special Ed teachers, Social work, Psychology, Parent training, Development and Parent/ child groups, Parent support groups Omni Childhood Center Address: 1651 Coney Island Avenue Brooklyn, New York 11210 Phone: (718) 998-1415 Website: www.omnirehab.com Location: Home Services Provided: ABA, Floor time, Sensory integration, Medek Seeach Sod Address: 31 Yirmiyahu St. POB 5788 Jerusalem, Israel Phone: (972) 640-5000 Website: www.seso.co.li Location: Center Services Provided: floor time, sensory integration, Music, snoezelen, hydrotherapy, parent-child sessions Shema Kolainu – Hear Our Voices Address: 4302 New Utrecht Avenue Brooklyn, New York 11219

Phone: (718) 686-9600 Website: www.shemakolainu.org Location: Home Services Provided: ABA, Special Instruction, Speech, OT, PT, Counseling, Social Work, , Audio, vision, Evals, Service Coordination YAI Network Address: 460 West 34th Street New York, New York 10001 Phone: (866) 2-YAI-LINK Website: www.yai.org Location: Home and Center Services Provided: ABA, Floor Time, Sensory Integration Yedei Chesed Address: 48 Scotland Hill Road Chestnut Ridge, New York 10977 Phone: (845) 425-0887 Website: yedeichesed.org Location: Home Services Provided: Counseling, play therapy, music therapy, parent support groups Yeled V’Yalda Early Childhood Center Address: 1312 38th Street Brooklyn, New York 11218 Phone: (718) 686-3700 Website: www.yeled.org Location: Home and Center Services Provided: ABA, Sensory integration, Medek, play therapy, parent support groups

YOUR CHILD is struggling in school. YOU want him to be included. WE PLAN FOR IT – not only for today, but for his future.

CPSE SCHOOLS OR CENTERS (3-5) The Ability Center Address: 3521 Avenue S Brooklyn, NY Phone: (718) 336-3832 Website: Theabilitycenter.net Location: Center Population: Mild to moderate to severe developmental delays, Autism/PDD, Speech & Language impaired, ADD/ADHD, Visually Impaired, Hearing Impaired, Learning Disabled, Multiply Handicapped Services: Speech therapy, OT, PT, Sensory Integration, MEDEK The Auditory Oral School of New York Address: 3623 Avenue L Brooklyn, New York 11210 Phone: (718) 531-1800

Website: www.auditoryoral.org Location: Home, Center, will send providers to private schools Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing impaired Services: SEIT, OT, PT, Speech, Play therapy/ counseling, HES, ABA, Sensory integration, Speech-language therapy, Auditory-oral therapy, Audiological testing & central auditory processing (CAPD) evaluations Languages: Yiddish, Hebrew, Russian, Spanish, Ukrainian, Hungarian, Cantonese, Mandarin, French, ASL Addl. Info: State approved

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RESOURCES DIRECTORY CPSE SCHOOLS OR CENTERS (3-5) CONTINUEDâ&#x20AC;Ś EIS LAASOIS/WIECDC Address: 22 Middleton Street Brooklyn, New York 11206 Phone: (718) 303-9400 Website: www.EISLAASOIS.org Location: Center Population: Mild-severe developmental delays, Speech & Language impaired, Learning Disabled, ADD/ADHD, Emotionally disturbed, Visually impaired, Multiply Handicapped Services Provided: OT, PT, Speech, Floor time and Sensory Integration Languages: Yiddish Addl. Info: State Approved Gesher Early Childhood Center Address: PO Box 649 Cedarhurst, New York 11516 Phone: (516) 730-7377 Website: www.gesher-ecc.org Location: Center Population: Mild developmental delays, Speech & Language impaired, Learning Disabled Services Provided: Sensory Integration Addl. Info: Privately funded Hand in Hand Development, Inc. Address: 465 Grand Street 2nd Floor New York, NY 10002 Phone: (212) 420-1999 ext. 149 Hebrew Academy for Special Children - HASC Address: 1311 55th Street Brooklyn, New York Phone: (718) 851-6100 Website: www.hasc.net Location: Home, Center, Will send providers to private schools Population: Mild-severe developmental delays, Autism/ PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Multiply handicapped Services: SEIT, OT, PT, Speech, Play therapy/counseling, Sensory Integration, Medek, Yoga, Augmentative communication, Assistive technology, music therapy, nursing 66

June 2013

Languages: Yiddish, Hebrew, Russian, Spanish Addl. Info: State approved, Breakfast provided, Kosher meals, Transportation provided through the Dept. of Ed A Helping Hand Address: 703 East 4th St., Suite 3 Phone: (718) 435-7464 Location: Home, Will send providers to private schools Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD Services: ABA, SEIT, State Approved Languages: Yiddish, English Imagine Academy Address: 1458 East 14th Street Brooklyn, New York 11230 Phone: (718) 376-8882 Website: www.imagineacademy.com Ages Served: 3-21 Hours: 8:30AM-3:30PM Classes: Mixed Population Served: Moderate to severe developmental delays, Autism/PDD Services: OT, PT, Speech, Play Therapy/Counseling, ABA, Floor time, Pre-vocational, Art, Music, Yoga, Therapeutic Swim Languages: Hebrew Addl. Info: Privately Funded, Transportation provided through the Department of Education, Lunch provided Kiryas Joel Pre-School (Part of Kiryas Joel UFSD) Address: 1 Diner Road Monroe, New York 10950 Phone: (845) 782-7510 Location: Center, Will send providers to private schools Population: Mild to moderate to severe developmental delays, Autism/PDD, Speech & Language impaired, Learning disabled, ADD/ ADHD, Emotionally disturbed, Hearing Impaired, Visually Impaired, Multiply handicapped Services: SEIT, OT, PT, Speech, Play Therapy/counseling, ABA, Sensory Integration, MEDEK

Language: Hebrew, Yiddish Addl. Info: State Approved. Full/ Half Day Classes Los NiĂąos Services Address: 535 8th Ave, 2nd Floor, New York, New York 10018 Phone: (212) 787-9700 Website: www.losninos.com Location: Home Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ADHD, Emotionally disturbed, Hearing impaired, Visually impaired, Multiply handicapped Services Provided: SEIT, ABA Languages: Spanish, Russian, Ukrainian, Italian, Portuguese, French, and others National Jewish Council for Disabilities/Yachad (NJCD) Address: 11 Broadway, 13th fl. New York, New York 10004 Phone: (212) 613-8229 Website: www.njcd.org Location: Center, Will send providers to Private Schools Population: Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Hearing impaired Services Provided: Audiological Omni Childhood Center Address: 1651 Coney Island Ave. Brooklyn, New York 11210 Phone: (718) 998-1415 Website: www.omnirehab.com Location: Home, Center, Will send providers to private schools Population: Mild-severe developmental delays, Autism/ PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing impaired, Multiply handicapped Services: SEIT, OT, PT, Speech, Play therapy/counseling, Sensory Integration, Medek Languages: Yiddish, Spanish, Russian, Hebrew, Polish Addl. Info: State approved

Otsar Family Services Address: 2334 West 13th Street Brooklyn, New York 11223 Phone: (718) 946-7301 Website: www.otsar.org Location: Center Population: Mild-severe developmental delays, Autism/ PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally disturbed Services: OT, PT, Speech, Play therapy/counseling, ABA, Floor Time, Sensory Integration, Music therapy, Dance therapy, Parent workshops & Support groups Project Reach Address: 1257 38th street Brooklyn, New York 11218 Phone: (718) 514-8657 Website: yeled.org Location: Home Based Population: Mild developmental delays, Hearing impaired, Visually impaired. Services: Home and Hospital Based services for medically impaired children. Languages: English, Yiddish and Hebrew Add'l Info: State Approved Seeach Sod Address: 31 Yirmiyahu Street POB 5788 Jerusalem, Israel Phone: (972) 640-5000 Website: www.seso.co.li Location: Center Population: Mild to severe developmental delays, Hearing impaired, Autism/PDD, ADD/ ADHD Services Provided: OT, PT, Speech, Play therapy/counseling, floor time, sensory integration, Music, snoezelen, hydrotherapy, gymboree Languages: Hebrew, English Add'l Info: State Approved Sesame Sprout, Inc. Address: 96-08 57th Avenue Corona, New York 11368 Phone: (718) 271-2294

RESOURCES DIRECTORY CPSE SCHOOLS OR CENTERS (3-5) CONTINUED… Website: www.sesamesproutschool.com Population: Mild developmental delays Services: OT, PT, Speech Languages: Spanish Addl. Info: State approved Small Wonder Preschool Address: 90-45 Myrtle Avenue Glendale, New York 11385 Phone: (718) 849-3002 Website: www.smallwonders.org Population: Moderate to severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, Hearing impaired. Services Provided: OT, PT, Speech, Play therapy/ counseling, ABA, Parent Support Groups, Miller Method (for children on the Autism Spectrum). Languages: Spanish, Polish, Creole, Guajarati, Tagalog, Bengali, Arabic, Hindi, Punjabi, Urdu and American Sign Language, Bilingual staff. UCP of New York City Address: 80 Maiden Lane, 8th Floor New York, New York 10038 Phone: (877) 827-2666 Website: www.ucpnyc.org Location: Center Population: Mild-severe developmental delays, Speech & Language impaired, Learning Disabled, Multiply handicapped Services: Floor Time, Sensory Integration Languages: Spanish Additional Info: State Approved, Privately Funded Addl. Info: State Approved, Privately Funded

YAI Network Address: 460 West 34th Street New York, New York 10001 Phone: (212) 273-6182 Website: www.yai.org Location: Home and Center Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ADHD, Multiply handicapped Services Provided: SEIT, OT, PT, Speech, Play therapy/counseling, ABA, Floor Time, Sensory integration Languages: Spanish, Chinese, Mandarin, Cantonese Addl. Info: State Approved & State Funded Yeled V’Yalda Early Childhood Center Address: 1312 38th Street Brooklyn, New York 11218 Phone: (718) 686-3700 Website: www.yeled.org Location: Home Based, Will send providers to private schools Population Served: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ADHD, Emotionally disturbed, Hearing impaired, Visually impaired Services: SEIT, OT, PT, Speech, Play therapy/ counseling, ABA, Sensory Integration, MEDEK Languages: Hebrew, Yiddish, Russian, Spanish

Centers and Services in: • New York City • Long Island • New Jersey • California • Florida 1800-603-OHEL | www.ohelfamily.org

TAFKID

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

Services provided by TAFKID include:

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

CSE SCHOOLS OR CENTERS (5-21) Arrowsmith Program at Beth Jacob of Boro Park Address: 1371 46th Street Brooklyn, New York 11219 Addl. Info: For more information about the Arrowsmith Program at Beth Jacob of Boro Park, please contact Rachel Zimmerman at (718) 7551977 or Malkie Deutsch (917) 562-7068.

Arrowsmith Program at Jewish Educational Center Address: 330 Elmora Avenue Elizabeth, New Jersey 07208 Phone: (908) 355-4850 Addl. Info: For information about the Arrowsmith Program at the JEC contact Rabbi Eliyahu D. Teitz, Associate Dean

Arrowsmith Program at Eitz Chaim Schools Address: 475 Patricia Avenue Toronto ON M2R 2N1 Phone: (416) 225-1187 E-mail: pliner@eitzchaim.com Addl. Info: For information about the Arrowsmith Program at EitzChaim please contact Rabbi IsserPliner, Principal

Arrowsmith Program at Yeshiva Degel Hatorah Address: 111 Maple Avenue Spring Valley, New York 10977 Gender: Yeshiva DegelHatorah has a separate boys and girls Arrowsmith Program. Addl. Info: For information, please contact Marsha Feuer at (845)304-7053 or email: marshafeuer@aol.com

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

➘ June 2013

RESOURCES DIRECTORY CSE SCHOOLS OR CENTERS (5-21) CONTINUED… Arrowsmith Program at Yeshiva Tiferes Torah Address: 75 East End Avenue Lakewood, New Jersey 08701 Phone: (732) 370-9889 E-mail: yfeldmanytt@aol.com Addl. Info: For information about the Arrowsmith Program at Yeshiva Tiferes Torah please contact Rabbi Feldman, Principal C.A.H.A.L. Address: 540-A Willow Avenue Cedarhurst, New York 11516 Phone: (516) 295-3666 Website: www.cahal.org Population: Speech & Language impaired, Learning Disabled, ADD/ ADHD Ages: 5-18 Gender: Boys & Girls Classes: Separate & mixed Hours: 8:00 – 5:00 Services: OT, PT, SPEECH Addl. Info: Therapies provided on site, Lunch provided, Kosher Meals, Transportation through Dept. of Ed. Ezra Hatzvy Academy Address: 2555 Nostrand Avenue Brooklyn, New York Phone: (718) 975-1041 Website: Ezrahatzvy.com Ages: 5-21 Gender: Boys/Girls Classes: Mixed Hours: 9:00-4:00PM Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning disabled, ADD/ ADHD, Hearing impaired, Emotionally disturbed, Vision impaired, Multiply handicapped Services Provided: ABA, Floor time, Aquatics, OT, PT, SP. Languages: Yiddish Addl. Info: Privately funded, Handicapped accessible, Therapies provided on site, Transportation through Dept. of Ed. Gesher Early Childhood Center Address: PO Box 649 Cedarhurst, New York 11516 Phone: (516) 730-7377 Website: www.gesher-ecc.org June 2013 68

Population: Mild developmental delays, Speech & Language impaired, Learning Disabled Ages: 3-6 years old (nursery, kindergarten, PRE-1A) Gender: Male & Female Classes: Mixed Hours: Mon-Thurs: 8:30-3:30, Fri: 8:30-12:15 Services: Classrooms run by Early Childhood Special Education Teachers providing a dual curriculum, Related Services are provided on site thru CPSE agencies or the BOE Addl. Info: Privately funded Gesher Yehuda Yeshiva Address: 49 Avenue T Brooklyn, New York 11223 Phone: (718) 714-7400 Population: Speech & Language impaired, Learning disabled, ADD/ADHD Ages: 5-13 Gender: Male & Female Classes: Mixed Hours: 8:45-4:15 Services: ST, OT, Counseling Addl. Info: Privately funded, Transportation provided through Dept. of Ed. Ha’or Beacon School - see Ohr Dovid HASC School Age Program Address: 6220 14th Avenue Brooklyn, New York 11230 Phone: (718) 331-1624 Ages: 5-21 Gender: Male & Female Classes: Separate & Mixed Hours: 8:30-2:45 Population Served: Moderate to severe developmental delays, Autism/PDD, Multiply handicapped Services: ABA, Carbone, OT, PT, Speech, Counseling, Vision, Hearing, Medically Frail, Nurse Languages: Yiddish, Hebrew, Russian Addl. Info: State Approved, After School Program, Kosher Breakfast and Lunch, Transportation provided through the Board of Education

HASC Center, Inc. Address: 5601 First Avenue Brooklyn, New York 11220 Phone: (718) 535-1953 Website: www.hasccenter.org Location: Center Population: Mild to severe developmental delays, Autism/PDD, Speech & Language impaired

tal disabilities, Speech & Language Impaired, ADD/ADHD, ED, broad range of needs (students grouped by ability level) Services: Speech, Therapy, OT, Counseling, Travel Training, Vocational Training Addl. Info: Transportation provided from all 5 boroughs

Imagine Academy Address: 1458 East 14th Street Brooklyn, New York 11230 Phone: (718) 376-8882 Website: imagineacademy.com Ages Served: 3-21 Hours: 8:30AM-3:30PM Classes: Mixed Population Served: Moderate to severe developmental delays, Autism/PDD Services: OT, PT, Speech, Play Therapy/Counseling, ABA, Floor time, Pre-vocational, Art, Music, Yoga, Therapeutic Swim Languages: Hebrew Addl. Info: Privately Funded, Transportation provided through the Department of Education, Lunch provided

IVDU Upper School Girls Division Address: 1277 East 14th Street Brooklyn, New York 11230 Phone: (718) 677-4279 Website: www.NJCD.org Ages: 13-21 Gender: Girls Population: Learning Disabilities, Mild-moderate developmental disabilities, Speech & Language Impaired, ADD/ ADHD, ED, broad range of needs (students grouped by ability level) Services: Speech, Therapy, OT, Counseling, Travel Training, Vocational Training Addl. Info: Transportation provided from all 5 boroughs

IVDU Elementary School for Girls Address: 1277 East 14th Street Brooklyn, New York Phone: (718) 758-2999 Website: www.NJCD.org Ages: Kindergarten-grade 5 Gender: Girls Population: Learning Disabilities, Mild developmental disabilities, Speech & Language Delays, ADD/ADHD Services: OT, PT, SEIT, Speech, counseling Addl. Info: Therapies provided on site, Transportation provided from all 5 boroughs IVDU Upper School Boys Division Address: 1305 Coney Island Ave. Brooklyn, NY Phone: (718) 372-7203 Website: www.NJCD.org Ages: 13-21 Gender: Boys Population: Learning Disabilities, Mild-moderate developmen-

The Manhattan Children’s Center Address: 124 West 95th Street, New York City 10025 Phone: (212) 749-4604 Website: www.manhattanchildrenscenter.org Population: Autism/PDD Ages: 3-18 Gender: Males/Females Groups: Mixed School Hours: 8:30-2:45PM Services: ABA, OT, Speech Addl. Info: Privately funded, Therapies provided on site, Transportation provided through Dept. of Ed Ohr Dovid - formerly Ha’or Beacon School Address: 2884 Nostrand Avenue Brooklyn, New York Phone: (718) 951-3650 Population: Autism/PDD, Learning Disabled, Speech & Language Impaired, ADD/ ADHD, Emotionally disturbed Ages: 5-13 Gender: Male Hours: 9:00-4:00

RESOURCES DIRECTORY CSE SCHOOLS OR CENTERS (5-21) CONTINUED… Services: Speech, OT, PT, Counseling Addl. Info: Therapies provided on site, Privately funded, Lunch provided, Kosher meals, Transportation provided through Dept. of Ed Ohr HaLimud – The Multi-Sensory Learning Center Address: 1681 42nd Street Brooklyn, New York 11204 Phone: (718) 972-0170 Website: www.ohrhalimud.org Ages: 7-14 Gender: Girls Hours: 8:30-4:00 Population Served: Dyslexia Services: A complete transitional Bais Yaakov, uniform wearing school that utilizes the scientifically based Orton-Gillingham approach to teach all subjects with emphasis on reading, writing, and spelling in both English and Hebrew. Languages: Yiddish Addl. Info: Kosher Meals, Transportation provided through Dept. of Ed., After School Program Monday thru Thursday/Sunday, Accepts P3s. Omni Childhood Center Address: 1651 Coney Island Ave. Brooklyn, New York 11210 Phone: (718) 998-1415 Website: www.omnirehab.com Ages: 0-21 Gender: Boys & Girls Classes: Separate Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing impaired, Multiply handicapped Services: ABA, Pre-vocational Languages: Yiddish, Spanish, Russian, Hebrew, Polish Addl. Info: State approved, Therapies provided on-site, Handicap accessible, Transportation provided through Dept. of Ed P’TACH Address: 1428 36th Street #211 Brooklyn, New York 11218 Phone: (718) 854-8600 Website: www.ptach.org Population: Learning Disabled Ages: 6-18 Gender: Boys & Girls Schools: Separate schools Hours: 8:45-5:00 Services: Speech, Counseling Languages: Yiddish Addl. Info: Therapies provided on-site, Transportation provided through Dept. of Ed.

PS/IS 226-BiY Address: 6006 23rd Ave Brooklyn, New York 11204 Phone: (646)339-9041 Population: Mild-severe developmental delays, Speech & Language impaired, Learning Disabled, ADD/ADHD, Multiply Handicapped Ages Served: 11-15 Gender: Boys and Girls School Hours: 8:00-3:00PM Languages: Yiddish, Hebrew Addl. Info: Transportation Provided through Department of Education, Kosher Breakfast Provided, Handicapped Accessible Services: OT, PT, Speech, Guidance and Pre-vocational Seeach Sod Address: 31 Yirmiyahu St. POB 5788 Jerusalem, Israel Phone: (972) 640-5000 Website: www.seso.co.li Population: Mild to severe developmental delays, Hearing impaired, Autism/PDD, ADD/ ADHD Ages: 8-21 Gender: Boys & Girls Classes: Separate School Hours: 7:30-6:00PM Services: OT, PT, Speech, art, snoezelen, horse back riding, hydrotherapy, music Languages: Hebrew, English Addl. Info: State Approved, Handicap Accessible, Transportation through the Department of Education, Kosher lunch provided. Shema Kolainu - Hear Our Voices Address: 4302 New Utrecht Ave., Brooklyn, New York 11219 Phone: (718) 686-9600 Website: www.shemakolainu.org Population: Moderate-severe developmental delays, Autism/PDD, Speech & Language impaired, ADD/ ADHD, Emotionally Disturbed, Hearing impaired, Visually impaired, Multiply handicapped Ages: 5-11 Gender: Boys & Girls Classes: Mixed Hours: 8:30am-2pm Services: ABA, OT, PT, Speech Addl. Info: State Approved, Handicap Accessible, Therapies provided on-site, Transportation through Dept. of Ed.

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June 2013

RESOURCES DIRECTORY CSE SCHOOLS OR CENTERS (5-21) CONTINUEDâ&#x20AC;Ś Sinai's Rabbi Mark and Linda Karasick Shalem High School for Boys at Torah Academy of Bergen County Address: 1600 Queen Anne Road, Teaneck, NJ 07666 Phone: (201) 862-0032 Website: sinaischools.org/nyc Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ADHD, Multiply handicapped, Hearing impaired, Visually impaired Ages: 14-21 Gender: Boys Languages: Hebrew Classes: Separate Hours: 8:30am-4:30pm Services: OT, Speech, Psychological, Pre-vocational, ABA Addl. Info: Therapies provided on site, Privately Funded, Handicap Accessible, Kosher Meals provided, Private Transportation provided through Dept. of Education Sinai's Rabbi Mark and Linda Karasick Shalem High School for Girls at Ma'ayanot Address: 1650 Palisade Avenue, Teaneck, NJ 07666 Phone: (201) 862-0032 Website: sinaischools.org/nyc Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ADHD, Multiply handicapped, Hearing impaired, Visually impaired Ages: 14-21 Gender: Girls Languages: Hebrew Classes: Separate Hours: 8:30am-4:30pm Services: OT, Speech, Psychological, Pre-vocational, ABA Addl. Info: Therapies provided on site, Privately Funded, Handicap Accessible, Kosher Meals provided, Private Transportation provided through Dept. of Education Sinai Elementary at Rosenbaum Yeshiva of North Jersey, including the Riva Blatt Weinstein Judaic Studies Program Address: 666 Kinderkamack June 2013 70

Road, River Edge, NJ 07661 Phone: (201) 262-4202 Website: sinaischools.org/nyc Population: Mild-severe developmental delays, Autism/ PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Hearing impaired, Visually impaired Ages: 6-14 Gender: Boys & Girls Languages: Hebrew Classes: Separate and Mixed Hours: 8:15am-3:30pm/8:154:45PM Services: OT, Speech, art, Psychological, ABA Addl. Info: Therapies provided on site, Privately Funded, Handicap Accessible, Kosher Meals provided, Private Transportation provided through Dept. of Education Sinai Elementary at Joseph Kushner Hebrew Academy Address: 110 South Orange Ave. Livingston, NJ 07039 Phone: (862)-437-8190 Website: sinaischools.org/nyc Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ADHD, Hearing impaired, Visually impaired, Multiply Handicapped Ages: 6-14 Gender: Boys & Girls Languages: Hebrew Classes: Mixed Hours: 8:30am-3:30pm Services: OT, Speech, art, Psychological, ABA Addl. Info: Therapies provided on site, Privately Funded, Handicap Accessible, Kosher Meals provided, Private Transportation provided through Dept. of Education Sinai Maor at Rae Kushner Yeshiva High School, includeing the William Solomon Judaic Studies Program Address: 110 South Orange Ave. Livingston, NJ 07039 Phone: (862)-437-8000 Website: sinaischools.org/nyc Population: Autism/PDD, Speech & Language impaired,

Learning Disabled, ADD/ADHD Ages: 13-18 Gender: Boys & Girls Languages: Hebrew Classes: Mixed Hours: 8:30am-4:30pm Services: OT, Speech, art, Psychological Addl. Info: Therapies provided on site, Privately Funded, Handicap Accessible, Kosher Meals provided, Private Transportation provided through Dept. of Education STEP (Special Torah Education) Address: 3005 Ave L Brooklyn, New York 11210 Phone: (718) 252-8822 Population: Moderate to severe developmental delays, Autism/ PDD, ADD/ ADHD, Multiply handicapped, Emotionally disturbed, Speech & Language impaired Ages: 5-21 Gender: Boys and Girls Classes: Separate Hours: 9-4 Services: OT, PT, Speech, Counseling, Aquatic Languages: Hebrew, Yiddish Addl. Info: Handicap Accessible, Lunch provided, Kosher meals, Transportation through Dept. of Ed. UCP of New York City Address: 80 Maiden Lane, 8th Floor, New York, NY 10038 Phone: (877) 827-2666 Website: www.ucpnyc.org Population: Moderate to severe developmental delays, Multiply handicapped Gender: Boys & Girls Classes: Mixed Hours: 8-2 Services: OT, PT, Speech, Play therapy/counseling Languages: Spanish Addl. Info: State Approved, Privately Funded, Therapies provided on site, Handicap Accessible, Breakfast & Lunch Provided, Transportation through Dept. of Ed.

Yeshiva Bonim Lamokom Address: 425 East 9th Street Brooklyn, New York 11218 Phone: (718) 693-9032 Population: Mild developmental delays Ages: 5-26 Gender: Boys Hours: 9â&#x20AC;&#x201C;5 Services: OT, PT, Speech Languages: Yiddish Addl. Info: Privately funded, Therapies provided on site, Prevocational, Breakfast & Lunch provided, Kosher meals, Transportation provided through Dept. of Ed. Yeshiva Binyan Olem Address: 68 Franklin Avenue Brooklyn, New York Phone: (718) 302-5222 Population: Mild to severe developmental delays, Autism/PDD, Speech & Language impaired, ADD/ADHD, Learning Disabled. Ages: 12-18 Gender: Boys Hours: 8-6PM Services: OT, PT, Speech, Counseling Languages: Yiddish Addl. Info: Privately funded, Therapies provided on site, Breakfast & Lunch provided, Kosher meals, Transportation provided. Handicap Accessible. Yess! Yeshiva Education for Special Students Address: 147-37 70th Road Flushing, New York 11367 Phone: (718) 268-5976 Website: www.yessyeshiva.org Population: Mild developmental delays, Speech & Language impaired, Learning Disabled Ages: 5-14 Gender: Boys & Girls Classes: Mixed Hours: 8AM-3:45 & Fri. 8AM1:30 Services: OT, PT, speech, counseling Addl. Info: Therapies provided on site, Privately Funded, Handicap Accessible, Breakfast & Lunch Provided, Kosher Meals, Transportation through Dept. of Ed.

RESOURCES DIRECTORY THERAPY & EVALUATION SERVICES The Ability Center Address: 3521 Avenue S Brooklyn, New York Phone: (718) 336-3832 Website: Theabilitycenter.net Location: Center Population: Mild to moderate to severe developmental delays, Autism/PDD, Speech & Language impaired, ADD/ADHD, Visually Impaired, Hearing Impaired, Learning Disabled, Multiply Handicapped Services: Speech therapy, OT, PT, Sensory Integration, MEDEK Addl. Info: Accepts RSA’s, Handicapped Accessible Advanced Professional Resources Early Intervention Services Address: 224 Franklin Avenue Hewlett, NY 11557 Phone: (516) 791-6200 Fax: (516) 791-6026 Location: Home Services Provided: Occupational, Physical, Speech Therapy, Special Instruction, Social Work, Nutrition, Vision, Ongoing Service Coordination, Evaluations AHRC NYC Address: 83 Maiden Lane New York, New York 10038 Phone: (212) 780-2500 Website: www.ahrcnyc.org Location: Home and Center Ages: Evaluations from birth – 3 yrs. Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Multiply Handicapped Services: PT, OT, Speech/Language, Special Ed Languages: ASL, French, Japanese, Korean, Serbian, Spanish Addl. Info: No cost, EI & CPSE evals, Handicap accessible Arrowsmith Program Address: 245 St. Clair Ave, West, Toronto Phone: (416) 963-4962 Website: www.arrowsmithschool.org Population: Speech & Language impaired, Learning disabled, ADD/ADHD Services: It is available to public and private schools. It Identifies, Intervenes and Strengthens the weak cognitive capacities that affect learning through a program of specific cognitive exercises. For over 30 years the

Arrowsmith program has proven effective for students having difficulty with eading, writing and mathematics, comprehension, logical reasoning, problem solving, visual and auditort memory, non-verbal learning, attention, processing speed and dyslexia. The Auditory Oral School of New York Address: 3623 Avenue L Brooklyn, New York 11210 Phone: (718) 531-1800 Website: www.auditoryoral.org Location: Home, Center, Will send providers to private schools Ages: Birth to school age (EI – CSE) Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ADHD, Emotionally disturbed, Hearing impaired Services: SEIT, OT, PT, Speech/Language, Special Ed, Counseling, Sensory Integration, Hearing Education Services (HES) Languages: English, Yiddish, Hebrew, Russian, Mandarin, Cantonese, ASL Addl. Info: Accept RSA’s & P3’s, For audiological evaluations pending acceptance of insurance, Handicap accessible, Private evaluations Center for Hearing and Communication (formerly League for the Hard of Hearing) Address: 50 Broadway, 6th Floor New York, New York 10004 Phone: (917) 305-7700 Website: www.chchearing.org Location: Center Population: Hearing impaired Services: Psych-educational evaluations, auditory oral speech and language therapy Addl. Info: Accepts insurance EIS LAASOIS/WIECDC Address: 22 Middleton Street Brooklyn, New York 11206 Phone: (718) 303-9400 Website: www.EISLAASOIS.org Location: Home and Center Ages: 0-18 Population: Mild-severe developmental delays, Speech & Language impaired, Learning Disabled, Emotionally disturbed, Visually impaired, Multiply Handicapped Services Provided: OT, PT, Speech, Floor time and Sensory Integration Languages: Yiddish Addl. Info: Accept RSA’s

➘ June 2013

RESOURCES DIRECTORY THERAPY & EVALUATION SERVICES CONTINUED… Euro-Peds National Center for Intensive Pediatric PT Address: 461 W. Huron St. #406 Pontiac, MI 48341 Phone: (248) 857-6776 Website: www.europeds.org Ages: 1-21 Location: Center Population: Mild-severe developmental delays, Multiply Handicapped Services Provided: PT, European-based Intensive PT for the treatment of non-progressive neuromuscular disorder. Addl. Info: Accepts most major health insurances Gutman Physical Therapy, P.C. Address: 860 Cranford Avenue Valley Stream, New York 11581 Phone: (646) 481-7854 Website: www.gutanpt.com Languages: English, Hebrew and Yiddish Location: Home/Center Ages: 2-99 years Population: Mild-severe developmental delays, Autism/ PPD, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing impaired, Visually impaired, Multiply Handicapped Services Provided: PT, Sensory Integration, Will conduct private evaluations Addl. Info: Accepts RSAs and most Insurances, Handicapped accessible Hebrew Academy for Special Children Address: 1311 55th Street Phone: (718) 851-6100 Website: www.hasc.net Location: Home, Will send providers to private schools Ages: Birth – 5 Population: Mild-severe developmental delays, Autism/ PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Multiply handicapped Services: OT, PT, Speech & Language, Special Ed, Psychological, Audiological, MEDEK, ABA, Sensory Integration, Floor Time. Languages: Hebrew, Yiddish, Russian June 2013 72

Addl. Info: Handicap Accessible HASC Center, Inc Address: 1221 East 14th street, Brooklyn, NY 11230 Administration offices: 5601 First Avenue Brooklyn, New York 11220 Phone: (718) 434-4027 Website: www.hasccenter.org Location: Center Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ADHD, Emotionally disturbed, Multiply handicapped Services: OT, PT, Speech/Language, Special Education, Primary Medical Care, Neurology, Podiatry, Endocrinology, Psychiatry, Psychology Languages: Yiddish, Hebrew Addl. Info: Medicaid/Medicare, Handicap Accessible HorseAbility / Center for Equine Facilitated Programs Address: SUNY College at Old Westbury / PO Box 410-1 / Old Westbury, New York 11568 Phone: (516) 333-6151 Website: www.horseability.org Location: Center Ages: 3+ Population: Mild-severe developmental delays, Autism/ PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing Impaired, Visually Impaired, Multiply handicapped. Services Offered: Speech Language, Private Evaluations, OT/ PT, Hippotherapy, Therapeutic Riding, Equine-Facilitated Psychotherapy. Languages: AMS Addl. Info: Handicap Accessible. Jumpstart Early Intervention Program Address: 3914 15th Avenue Brooklyn, New York 11218 Phone: (718) 853-9700 Location: Home, Will send providers to private schools

Ages: 0-3 years Services: OT, PT, Speech/Language, Special Ed, Sensory Integration, MEDEK Population: Mild-severe developmental delay, Speech & Language impaired, ADD/ADHD, Hearing impaired, Visually impaired, Multiply handicapped Los Niños Services Address: 535 8th Ave., 2nd Floor New York, New York 10018 Phone: (212) 787-9700 Website: www.losninos.com Location: Home, Center, Will send providers to private schools Ages: 0-5 Population: Mild-severe developmental delays, Autism/ PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing impaired, Visually impaired, Multiply handicapped Services Provided: ABA, Private Evaluations Languages: Spanish, Russian, Ukrainian, Italian, Portuguese, French, and others McCarton Center Address: 350 E. 82nd Street New York, New York 10028 Phone: (212) 996-9019 Website: mccartoncenter.com Location: Home, Center, Will send providers to private schools Ages: 2-13 Population: Mild-severe developmental delay, Autism/PDD, Speech & Language impaired, ADD/ ADHD Services: ABA, OT, Speech/Language, private evaluations National Jewish Council for Disabilities/Yachad (NJCD) Address: 11 Broadway, 13th fl. New York, New York 10004 Phone: (212) 613-8229 Website: www.njcd.org Location: Center, Will send providers to Private Schools Ages: 5-21 Population: Speech & Language

impaired, Learning Disabled, Hearing impaired Services Provided: Audiological, Will Conduct Private Evaluations Addl. Info: Accepts Insurance, Private Evaluations provided. Omni Childhood Center Address: 1651 Coney Island Ave. Brooklyn, New York 11210 Phone: (718) 998-1415 Website: www.omnirehab.com Location: Home, Center, Will send providers to private schools Ages: 0-21 Population: Mild-severe developmental delays, Autism/ PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing impaired, Multiply handicapped Services: OT, PT, Speech/Language, Special Ed, Private evaluations, ABA, MEDEK Languages: Yiddish, Spanish, Russian, Hebrew, Polish Addl. Info: Accepts RSA’s, P3s, and all Major Insurance, Handicap Accessible Pesach Tikvah - Hope Development Address: 18 Middleton Street Brooklyn, New York 11206 Phone: (718) 875-6900 Website: www.pesachtikvah.org Location: Center Based, Will send Providers to Private Schools Ages: 5+ Population: Autism/PDD, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Multiply handicapped Services: Psychiatric and pharmacological Languages: Hebrew, Yiddish, Spanish Addl. Info: Handicap Accessible, Accepts insurance Seeach Sod Address: 31 Yirmiyahu St. POB 5788 Jerusalem, Israel Phone: (972) 640-5000 Website: www.seso.co.li Location: Center Population: Mild to severe devel-

RESOURCES DIRECTORY THERAPY & EVALUATION SERVICES CONTINUED… opmental delays, Hearing impaired, Autism/ PDD, ADD/ADHD Ages: 0-9 Services: OT, PT, Speech, Special Education, sensory Integration, MEDEK Languages: Hebrew, English Addl. Info: State Approved, Handicap Accessible, Conducts Private evaluations Shema Kolainu – Hear Our Voices Address: 4302 New Utrecht Ave. Brooklyn, New York 11219 Phone: (718) 686-9600 Website: www.shemakolainu.org Location: Home and Center Based, Will send Providers to Private Schools Ages: 0-5 Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing impaired, Visually impaired, Multiply handicapped Services: ABA, OT, PT, Speech/Language, Special Ed Languages: Hebrew, Yiddish, Spanish Addl. Info: Handicap Accessible Therapy in Motion Address: 856 - 46th Street Brooklyn, New York 11220 Phone: (718) 435-7000 Location: Center Services: MEDEK, PT Tikvah at OHEL Address: 2925A Kings Highway Brooklyn, New York 11210 Phone: (718) 382-0045 Website: www.ohelfamily.org Location: Center Ages: 3+ Population: Mild-severe developmental delays, Autism/PDD, learning Disabled, ADD/ ADHD, emotional challenges Services: Family, Couple, & Individual counsel-

ing, Child & Adult counseling, Psychotherapy, Psychiatric Evaluation, Medication Treatment Addl. Info: Accepts Medicaid, Medicare & Many other ins. On a sliding scale, Handicap Accessible UCP of New York City Address: 80 Maiden Lane, 8th Floor, New York, NY 10038 Phone: (877) 827-2666 Website: www.ucpnyc.org Location: Center Ages: 3-21 Population: Mild-severe developmental delays, Speech & Language impaired, Learning Disabled, Multiply handicapped Services: Floor Time, Sensory Integration, OT, PT, Speech/Language, Special Ed Watch Me Grow Location 1 Address: 162 West 72nd St., Suite 5, NY, NY 10023 Location 2 Address: 361 East 19th St., Suite 2, NY, NY 10003 Phone: (212) 721-5220 Website: www.WatchMeGrowNYC.com Location: Center, Will send providers to private schools Ages: 0-21 Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ADHD, Emotionally disturbed, Hearing Impaired, Visually Impaired Services Provided: OT, PT and Speech Therapy, Sensory Integration Addl. Info: Accept RSA’s, Private evaluations YAI Network Address: 460 West 34th Street New York, New York 10001 Phone: (212) 273-6182 Website: www.yai.org Location: Home & Center Ages: All

Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ADHD, Multiply handicapped Services: OT, PT, Speech/Language, Special Ed, ABA, Floor Time, Sensory integration, All therapies for children and adults of all ages Languages: varies Addl. Info: Private evaluations, Autism evaluations, Handicap Accessible Yeled V’Yalda Early Childhood Center Address: 1312 38th Street Brooklyn, New York 11218 Phone: (718) 686-3700 Website: www.yeled.org Location: Home, Center, Will send providers to private schools Ages: 0-21 years Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing impaired, Visually impaired Services: ABA, Sensory Integration, Medek, OT, PT, Speech/Language, Special Ed, play therapy/counseling Languages: Yiddish, Hebrew, Spanish Addl. Info: Accepts RSA’s and P3s

CAMPS & END OF SUMMER PROGRAMS Bonim Lamokom Address: 425 East 9th Street Brooklyn, New York 11218 Phone: (718) 693-9032 Website: BonimLamokom.com Location: Liberty, NY Duration: 8 weeks Population: Mild developmental delays Ages: 12-25 Gender: Boys Hours: 9–5 Addl. Info: Privately funded, Therapies provided on site, Kosher Food Provided

Camp HASC Address: 5902 14th Avenue Brooklyn, New York 11219 Phone: (718) 686-5930 Website: www.hasc.net/camp Location: 361 Parksville Road Parksville, NY 12768 Duration: 7 weeks Type: Sleep-Away camp Ages: 3-Adulthood Gender: Male & Female Groups: Mixed Population: Mild to moderate to severe developmental delays, Autism/PDD, Speech &

Language impaired, Learning disabled, ADD/ ADHD, Multiply Handicapped Addl. Info: Therapy provided, Kosher food provided, We also offer a day camp option for campers who wish to stay with their family in their summer home, Accept children not toilet trained, Camp after Camp program for one-week after camp (All female staff for females 5-12 years old) Therapy not provided on-site. June 2013

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RESOURCES DIRECTORY CAMPS & END OF SUMMER PROGRAMS CONTINUED… Camp Kaylie @ OHEL Address: 4510 16th Avenue Brooklyn, New York 11204 Phone: (800) 603-OHEL Website: CampKaylie.org Location: Wurtsboro, New York Type: Fully integrated camp Ages: 10-16 Gender: Male and Female Groups: Separate Population: Typical kids with no disabilities and kids with developmental disabilities Programs offered: A groundbreaking camp offering an exhilarating camp experience of unmatched sports and activities, leadership programming, state of the art facilities, magnificent grounds and a camp for kids of all abilities where campers thrive in a diverse environment nurturing personal leadership, self-confidence and an inclusive spirit Chai Lifeline / Camp Simcha Special Address: 151 West 30th Street Third Floor, NY, New York 10001 Phone: 877-CHAILIFE Website: www.ChaiLifeline.org Location: Glen Spey, NY Type: Sleep-away Ages: 7-17 Duration: 2 weeks Gender: Male and Female Groups: Separate Population: Multiply Handicapped Addl. Info: Handicap Accessible, Kosher food provided, Physical therapy provided on-site, Accept children who are not toilet trained Note Camp Simcha Special accepts children with medical illnesses and disabilities resulting from illness whose cognitive functioning is at age level. All applications must be approved by the camp’s medical director. Hand in Hand Family Services Address: 390 Kings Highway Brooklyn, New York 11223 Phone: (718) 336-6073 Website: www.hihfs.org Location: Flatbush June 2013 74

Type: Day camp Ages: 5+ Gender: Boys & Girls Population: Mild to moderate to severe developmental delays, Autism/PDD Addl. Info: Handicap Accessible, Kosher food provided, NY State Approved, Special Education and related services not provided on-site. Harmony Address: Kinor Dovid: 3820 14th Ave. Brooklyn, New York Kinor Malka: 1467 39th Street Brooklyn, New York 11218 Phone: (718) 435-8080 Website: harmonyservices.org Location: at Camp Manavu and at Camp Chedva Duration: 8 Weeks Type: Sleep-away camp Ages: 18+ Gender: Male and Female Groups: Separate Population: Mild-severe developmental delays, Autism/PDD, Speech and Language Impaired, Learning disabled, ADD/ADHD, Hearing impaired, Visually impaired Addl. Info: Kosher food provided Camp HorseAbililty Address: SUNY College at Old Westbury / Old Westbury, NY 11568 Phone: (516) 333-6151 Website: www.horseability.org Duration: 1 week Type: Day camp Gender: Male/Female Groups: Mixed *Separate programs may be offered if there is sufficient demand. Population served: Mild-severe developmental delays, Autism/ PDD, Speech & Language impaired, Learning disabled, ADD/ ADHD, Emotionally disturbed, Multiply handicapped Addl. Info: Handicap Accessible, accepts children who are not toilet trained. JCC of the Greater Five Towns Address: 207 Grove Avenue Cedarhurst, New York 11516 Phone: (516) 569-6733 Website: www.fivetownsjcc.org

Location: JCC / North Woodmere Park Duration: 6 Weeks Type: Day Camp Hours: 12:00-4:30 Ages: 5-16 Groups: Mixed Kaplan JCC on the Palisades Neil Klatskin Day Camp/Camp Tikvah Address: 411 East Clinton Ave. Tenafly, NJ 07670 Phone: (201) 408-1448/201-567-8963 Website: JCCOTP.org/NKDC Kaplan JCC on the Palisades Camp Haverim Address: 411 East Clinton Ave. Tenafly, NJ 07670 Phone: (201) 408-1448 Ages: 3-21 Gender: Males & Females Groups: Mixed Population Served: Mild to Severe developmental delays, Autism/PDD and Learning disabled. Add'l Info: Kosher Food, Handicap Accessible, NJ DDD Qualified Provider Kaplan JCC on the Palisades On Our Own Address: 411 East Clinton Ave. Tenafly, NJ 07670 Phone: (201) 408-1448 Ages: 16-30 Duration: 6 weeks Gender: Males & Females Groups: Mixed Population Served: Mild to Severe developmental delays, Autism/PDD and Learning disabled. Add'l Info: Kosher Food, Handicap Accessible, NJ DDD Qualified Provider, Special Education and related services not provided on site. Kulanu Torah Academy Address: 620 Central Ave. Cedarhurst, New York 11516 Phone: (516) 569-3083 Duration: 8 Weeks Type: Day camp Ages: 3-21 Gender: Boys & Girls Groups: Mixed Population: Mild to moderate to

severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ADHD Addl. Info: Handicap Accessible, Kosher food provided, NY State Approved, Accept children not toilet trained National Jewish Council for Disabilities/Yachad (NJCD) Address: 11 Broadway, 13th Fl. New York, New York 10004 Phone: (212) 613-8229 Website: www.njcd.org Location: PA, NY, Israel Duration: 6 weeks Type: Sleep away camp Ages: 9+ Gender: Male, Female Groups: Separate and Mixed Population: Mild-severe developmental delays, Autism/ PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Hearing impaired Addl. Info: Handicap Accessible, Kosher food provided, Accept children not toilet trained. Special education and therapy can be arranged in certain locations OHEL Children’s Home & Family Services, Bais Ezra Address: 4510 16th Avenue Brooklyn, New York 11204 Phone: (800) 603-OHEL Website: www.ohelfamily.org Location: Bklyn, Queens, Long Island Duration: 2 weeks Type: Sleep away & Day Camp Ages: 5-21 Gender: Male, Female Groups: Separate & Mixed Population: Mild developmental delays, Autism/PDD, Speech & Language impaired, Multiply handicapped Services: Family, Couple, & Individual counseling, Child & Adult counseling, Psychotherapy, Psychiatric Evaluation, Medication Treatment Addl. Info: Kosher food provided, Handicap Accessible, NY State Approved, Accept children not toilet trained

RESOURCES DIRECTORY CAMPS & END OF SUMMER PROGRAMS CONTINUED… Otsar Family Services Address: 2334 West 13th Street Brooklyn, New York 11223 Phone: (718) 946-7301 Website: www.otsar.org Location: Otsar Center in Bklyn Duration: 2 weeks Type: Day camp Ages: 5-15 Gender: Male & Female Groups: Mixed Population: Mild-severe developmental delays, Autism/PDD Camp Ruach Hachaim Address: 266 Penn Street Brooklyn, New York 11211 Phone: (718) 963-0090 Website: campruachhachaim.org Location: Bloomingburg, NY Duration: 8 weeks Type: Sleep-Away camp Ages: 7-30 Gender: Male Population: Mild to moderate to severe developmental delays, Autism/PDD, Down Syndrome, Speech & Language impaired, Learning disabled, ADD/ADHD, Hearing Impaired Addl. Info: Kosher food provided, take children from all over the world

STEP (Special Torah Education Program) Address: 3005 Avenue L Brooklyn, New York 11210 Phone: (718) 252-8822 Duration: 7 weeks Type: Day Ages: 5-21 Gender: Boys and Girls Classes: Separate Population: Mild to moderate to severe developmental delays, Autism/PDD, ADD/ ADHD, Multiply handicapped, Emotionally disturbed, Speech & Language impaired Addl. Info: Handicap Accessible, Kosher meals, Accept children not toilet trained UCP of New York City Address: 80 Maiden Lane, 8th Floor, NY, New York 10038 Phone: (877) 827-2666 Website: www.ucpnyc.org Location: 175 Lawrence Avenue Brooklyn, New York 11230 Duration: 3 weeks Type: Day camp Ages: 13-21 Gender: Male and Female Groups: Mixed Population: Mild-severe developmental delays, Autism/PDD, Multiply handicapped

Addl. Info: Handicap Accessible, OMRDD-funded, Accept children not toilet trained YAI Network Address: 460 West 34th Street New York, New York 10001 Phone: (212) 273-6182 Website: www.yai.org Type: Day camp & Sleep-away camp Location: Sleep away camp in Claryville, NY in the Catskills; day camp in Rockland County Duration: Sleep away camp 2-4 weeks, day camp 4-6 weeks Ages: Sleep-away camp: 8-18; day camp: 8-14 Gender: Male & Female Groups: Separate sleeping quarters, mixed activities Population: Mild-severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ADHD, Multiply handicapped Addl.. Info: Handicap accessible, Kosher food provided at sleep away camp Yedei Chesed Address: 48 Scotland Hill Road, Chestnut Ridge, NY 10977

Phone: (845) 425-0887 Website: yedeichesed.org Location: Monsey, New York Duration: 2 separate weeks Type: Day camp Ages: 3 & above Gender: Male & Female Population: Mild-severe developmental delays, Autism/ PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Emotionally disturbed, Hearing impaired, Visually impaired, Multiply handicapped Addl. Info: Handicap Accessible, Kosher food provided, NY State Approved, Accept children not toilet trained Yeshiva Binyan Olem Address: 68 Franklin Avenue Brooklyn, New York Phone: (718) 302-5222 Population: Mild to severe developmental delays, Autism/PDD, Speech & Language impaired, ADD/ADHD, Learning Disabled. Camp Location: Monticello Ages: 12-18 Gender: Boys Type: Sleepaway camp Duration: 8 weeks Addl. Info: Therapies provided on site, Kosher meals.

DAY HABILITATION PROGRAMS AHRC NYC Address: 83 Maiden Lane New York, New York 10038 Phone: (212) 780-2500 Website: www.ahrcnyc.org Location: Center Ages: 18+ Gender: Male & Female Groups: Mixed Hours: 9-5 Population: Mild-severe developmental delays Addl. Info: Handicap accessible, Transportation provided, Vocational Services provided, DayHab Without Walls Hand in Hand Family Services Address: 390 Kings Highway

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

Website: www.hasccenter.org Gender: Men’s Yeshiva and Young Women’s Programs Groups: Separate & Mixed Hours: 9:00 – 3:00, Extended hours until 7PM. Locations: Boro Park, Flatbush, Williamsburg. Language: Yiddish, Hebrew Population: Mild-severe developmental delays Addl. Info: Vocational services offered, Handicap Accessible, Kosher food provided, Transportation provided, Center Based, Work Readiness and Supportive Employment Offered.

Human Care Services Address: 1042 38th Street Brooklyn, New York 11229 Phone: (718) 854-2747 Website: humancareservices.org Ages: 18+ Gender: Male & Female Groups: Separate Hours: 9:00 – 5:00 Population: Mild-severe developmental delays Addl. Info: Yeshiva and Seminary day program, Pre-Vocational services offered, Handicap Accessible, Kosher food provided, Transportation provided from all boroughs & Long Island, Center Based

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RESOURCES DIRECTORY DAY HABILITATION PROGRAMS CONTINUED… Kaplan JCC on the Palisades Adult Day Program Address: 411 East Clinton Ave. Tenafly, NJ 07670 Phone: (201) 408-1448 Ages: 21+ Hours: 9:15-2:15PM Gender: Males & Females Groups: Mixed Group Size: 14 Population Served: Moderate to Severe developmental delays Addl. Info: Kosher Food, Handicap Accessible National Jewish Council for Disabilities/Yachad (NJCD) Address: 11 Broadway, 13th Fl., New York, New York 10004 Phone: (212) 613-8229 Website: www.njcd.org Ages: 21+ Gender: Male & Female Groups: Mixed Group Size: 30 Hours: 8:30-3:30 Population: Mild to moderate developmental delays Addl. Info: Handicap Accessible, Vocational Services,Transportation provided, Kosher Food Provided, DayHab Without Walls, Supplemental Day Hab also available. OHEL Children’s Home & Family Services, Bais Ezra Address: 4510 16th Avenue Brooklyn, New York 11204 Phone: (800) 603-OHEL Website: www.ohelfamily.org Ages: 21+ Gender: Male & Female Groups: Separate & Mixed Size: 3-5 Hours: 8am-4pm Population: Mild-severe developmental delays. Special programming for adults & seniors Addl. Info: Center Based, Handi-

cap Accessible, Transportation Provided, Vocational services offered, Kosher food provided, Employment training and placement services. Otsar Family Services Address: 2334 West 13th Street Brooklyn, New York 11223 Phone: (718) 946-7301 Website: www.otsar.org Ages: 21+ Gender: Male & Female Groups: Mixed Hours: 8:45-2:30 Population: Mild-severe developmental delays Addl. Info: Handicap Accessible, Kosher food provided, Transportation provided, Vocational services not provided Seeach Sod Address: 31 Yirmiyahu St POB 5788 Jerusalem, Israel Phone: (972) 640-5000 Website: www.seso.co.li Population: Mild to severe developmental delays, Autism/PDD Ages: 21 plus Gender: Males & Females Classes: Separate School Hours: 7:30-6:00PM Addl. Info: Handicap Accessible, Transportation provided, Kosher food provided. Vocational services offered. Sinai Schools Netivot Day Habilitation Address: Teaneck, NJ Phone: (201) 862-0032 Website: www.sinaischools.org Population: Mild-moderate developmental delays Ages: 18-29

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

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

RESIDENTIAL OPPORTUNITIES Hand in Hand Family Services Address: 390 Kings Highway Brooklyn, New York 11223 Phone: (718)336-6073 Website: www.hihfs.org Population: Mild to moderate to severe developmental delays, Autism/PDD, Emotionally DisJune 2013 76

turbed Addl. Info: IRA's and Supportive Apartments HASC Center, Inc Address: 5601 First Avenue Brooklyn, New York 11220 Phone: (718) 535-1953

Website: www.hasccenter.org Gender: Male & Female Population: Mild-severe developmental delays, Autism/PDD, emotionally disturbed, Hearing impaired, Multiply handicapped Addl. Info: IRA’s, Supportive

Apartments Human Care Services Address: 1042 38th Street Brooklyn, New York 11229 Phone: (718) 854-2747 Website: humancareservices.org Ages: All

RESOURCES DIRECTORY RESIDENTIAL OPPORTUNITIES CONTINUED… Gender: Male and Female Hours: 9:00 – 5:00 Population: Mild-severe developmental delays, Autism/PDD, Hearing Impaired, Visually Impaired, Multiply Handicapped Addl. Info: IRA’s, Supportive Apartments Jewish Board of Family and Children’s Services/Mishkon Address: 1358 56th Street Brooklyn, New York 11219 Phone: (718) 851-7100 Website: www.jbfcs.org Ages: All Gender: Male, Female Population: Mild-severe developmental delays, Autism/PDD Specialization: Emotionally disturbed, Hearing Impaired, Visually Impaired, Multiply Handicapped Addl. Info: IRA’s, ICF OHEL Children’s Home & Family Services, Bais Ezra Address: 4510 16th Avenue Brooklyn, New York 11204 Phone: (800) 603-OHEL Website: www.ohelfamily.org Ages: 13+

Gender: Male & Female Groups: Separate & Mixed Size: 3-5 Hours: 8am-4pm Population: Mild-severe developmental delays, Autism/PDD Specialization: Emotionally disturbed, Hearing impaired, Visually impaired, Multiply handicapped Addl. Info: IRA’s, Supportive Apts. Seeach Sod Address: 31 Yirmiyahu St. POB 5788 Jerusalem, Israel Phone: (972) 640-5000 Website: www.seso.co.li Population: Mild to severe developmental delays, Autism/PDD Ages: 16 plus Gender: Males & Females Addl. Info: Supportive Apartments Sinai School's Nathan Miller SHELI Residence for Men Address: Teaneck, NJ Phone: (201) 357-4703 Website: sinaischools.org/nyc Population: Moderate-severe developmental delays

UCP of New York City Address: 80 Maiden Lane, 8th Flr, New York, New York 10038 Phone: (877) 827-2666 Website: www.ucpnyc.org Ages: infants-adults Gender: Male & Female Population: Mild-severe developmental delays, Autism/PDD Specialization: Hearing impaired, Visually impaired, Multiply handicapped Addl. Info: IRA’s, Supportive Apts. Women’s League Community Residences, Inc. Address: 1556 38th Street Brooklyn, New York 11218 Phone: (718) 853-0900 Ages: All ages Gender: Male & Female Population: Mild-severe developmental delays, Autism/PDD Specialization: Emotionally disturbed, Hearing impaired, Visually impaired, Multiply handicapped Addl. Info: ICF’s and Supervised IRA’s, Supportive Apartments

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

MEDICAID WAIVER, RESPITE & OTHER PROGRAMS The Ability Center Address: 3521 Avenue S Brooklyn, New York Phone: (718) 336-3832 Website: Theabilitycenter.net Services: Children and Parent Groups to address the needs of families. AHRC NYC Address: 83 Maiden Lane New York, New York 10038 Phone: (212) 780-2500 Website: www.ahrcnyc.org Programs Offered: Medicaid Waiver, Family support services to parents and siblings, Respite, Overnight respite, After School Program, Recreation

Chai Lifeline, Inc. Address: 151 West 30th St., Third Floor, New York, NY 10001 Phone: (877) CHAI LIFE Website: www.chailifeline.org Services Provided: Offers emotional and social support groups for children with life threatening or chronic medical illnesses and their families. Friendship Circle of Crown Heights, New York Address: 792 Eastern Parkway Brooklyn, New York 11213 Phone: (718) 907-8835 Website: www.fcbrooklyn.com Friendship Circle of the Upper West Side, NY Address: 166 West 97th Street New York, New York 10025

Phone: (646) 789-5770 Website: ChabadWestSide.org/FCWS Friendship Circle of the Upper East Side Address: 419 East 77th Street New York, New York 10021 Phone: (212) 717-4613 Website: www.fcues.com Friendship Circle of Lower Manhattan, New York Address: 121 W19th Street New York, New York 10011 Phone: (646) 688-5300 Website: friendshipnyc.com Friendship Circle of Queens, New York Address: 211-05 Union Turnpike Queens, New York 11364 Phone: (718) 464-0778

The Friendship Circle of the Five Towns Address: 74 Maple Avenue Cedarhurst, New York 11516 Phone: (516) 295-2478 ext. 13 Website: fc5towns.com The Friendship Circle of Suffolk County, New York Address: 318 Veterans Highway Commack, New York 11725 Phone: (631) 543-1855 Website: thefriendshipcircle.com The Friendship Circle of Dix Hills, New York Address: 501 Vanderbilt Parkway Dix Hills, New York 11746 Phone: (631) 351-8672

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

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

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

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

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

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

Friendship Circle West Hempstead, New York Address: 223 Windsor Lane West Hempstead, NY 11552 Phone: (516) 564-1012 Friendship Circle of the River Towns, New York Address: 303 Broadway Dobbs Ferry, New York 10522 Phone: (914) 693-6100 Website: www.chabadrt.org The Friendship Circle of Westchester County, New York Address: 20 Greenridge Avenue White Plains, New York 10605 Phone: (914) 437-5762 Friendship Circle of Bedford, New York Address: 16 Old Village Lane Katonah, New York 10536 Phone: (914) 666-6065 Friendship Circle of Rockland County/Monsey, NY Address: 123 Route 59 Suffern, New York 10901 Phone: (845) 368-1889 The Friendship Circle of Metrowest, New Jersey Address: 66 W. Mt. Pleasant Ave. #205 Livingston, New Jersey 07039 Phone: (973) 251-0200 Website: www.fcnj.com 78

June 2013

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

Webinar, Holiday Programs, Clubs, Sports Nights, Mom’s Night Out, etc… HaMercaz at Jewish Family Service of Los Angeles Address: 12821 Victory Blvd. North Hollywood, CA 91606 Phone: (866) 287-8030 Website: www.hamercaz.org Programs and Services Offered: Family Support Services for parents and siblings, Respite when available, Sunday Program for birth to 19, mixed program for Males/Females, Handicap Accessible, Kosher food provided, will accept children not toilet trained, Monthly Recreation program from Birth to 18, Program is open to families, Fee dependent on event. Population served: Mild to Moderate to severe developmental delays, Autism/PDD, Speech & Language impaired, Learning disabled, ADD/ ADHD, Emotionally Disturbed, Hearing impaired, Visually impaired, Multiply handicapped. Hand in Hand Family Services Address: 390 Kings Highway Brooklyn, New York 11223 Phone: (718) 336-6073 Website: www.hihfs.org Programs Offered: Medicaid Service Coordination, Community Habilitation, Respite, Sunday Program for ages 5-15, separate program for Males/Females, Afterschool Program 5 days a week for ages 5-15, separate program for Males/Females Population: Mild to moderate to severe developmental delays, Autism/PDD Addl. Info: Handicap Accessible, Kosher food provided, Transportation Provided, No Fee Harmony - Kinor Dovid/ Kinor Malka Address: Kinor Dovid: 3820 14th Ave. Brooklyn, New York Kinor Malka: 1467 39th Street

Brooklyn, New York 11218 Phone: (718) 435-8080 Website: harmonyservices.org Programs Offered: Medicaid Waiver, Sunday Program, After School Program, Respite, Family Support Services HASC Center, Inc Address: 1221 East 14th Street Brooklyn, New York 11230 Phone: (718) 434-4027 Website: www.hasccenter.org Gender: Male & Female Programs and Services Offered: Medicaid Waiver, Respite, Overnight respite, Holiday Respite, After School Program, Sunday Autism Program, Family support services for parents and siblings HASC School Age Program Address: 6220 14th Avenue Brooklyn, New York 11230 Phone: (718) 331-1624 Website: www.hasc.net/camp Programs Offered: No-fee after school program 4 days a week for male & female ages 5-21, mixed groups, handicap accessible, transportation provided, Kosher food provided, take children not toilet trained HorseAbility / Center for Equine Facilitated Programs Address: SUNY College at Old Westbury / PO Box 410-1 / Old Westbury, NY 11568 Phone: (516) 333-6151 Website: www.horseability.org Programs Offered: Medicaid Waiver, Family Support Services for siblings, Respite, Sunday Program, 5-day a week After school Program and 7-day a week Recreation Program serving all ages. Gender: Male/Female Groups: Mixed *Separate programs may be offered if there is sufficient demand. Addl. Info: Handicap accessible, Accepts children not yet toilet trained.

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

Kids of Courage Address: 13158 Broadway, Suite 207 Hewlett, New York 11557 Phone: (888) 9-KIDSOC Website: www.kidsoc.org Programs Offered: Family Support services to parents and siblings, Respite, Overnight respite Kaplan JCC on the Palisades Address: 411 East Clinton Ave. Tenafly, NJ 07670 Phone: (201) 408-1448 Ages: 3-21 Programs Offered: After School Program three days a week (Sunday, Tuesday and Thursday) Gender: Males & Females Groups: Mixed Population Served: Mild to Severe developmental delays, Autism/PDD Addl. Info: Kosher Food, Handicap Accessible, NJ DDD Qualified Provider, Special Education and related services not provided on site. Kulanu Torah Acadamy Address: 620 Central Avenue Cedarhurst, New York 11516 Phone: (516) 569-3083 Programs Offered: Respite, Sunday program, Family support, Recreation, services for parents and siblings Los Niños Services Address: 535 8th Ave, 2nd Floor, New York, New York 10018 Phone: (212) 787-9700 Website: www.losninos.com Programs Offered: Provide Service Coordination in NYC and Westchester County, NY & trainings. We present the Annual Young Child Expo & Conference with Fordham University’s Graduate School of Education. We offer other trainings. National Jewish Council for Disabilities/Yachad (NJCD) Address: 11 Broadway, 13th Fl. New York, New York 10004 Phone: (212) 613-8229

Website: www.njcd.org Programs Offered: Medicaid Waiver, Respite, Overnight respite, Sunday Program: males and females ages 8+, mixed groups, Handicap accessible, Transportation provided, Kosher food provided, Take children not toilet trained, There is a fee for the program. Population: Mild to moderate to severe developmental delays, Autism/PDD, Speech & Language impaired, Learning Disabled, ADD/ ADHD, Multiply Handicapped Recreation: Males and Females ages 3+, mixed groups, Transportation provided at times, Kosher food provided, fee for program, open to families as well as special needs children, Program is once a month in Brooklyn, NY, NJ. OHEL Children’s Home & Family Services, Bais Ezra Address: 4510 16th Avenue Brooklyn, New York 11204 Phone: (800) 603-OHEL Website: www.ohelfamily.org Programs Offered: Medicaid Waiver, Respite, Overnight respite, After School Program, Sunday Program, Family support services for parents & siblings, Recreation Otsar Family Services Address: 2334 West 13th Street Brooklyn, New York 11223 Phone: (718) 946-7301 Website: www.otsar.org Programs Offered: Medicaid Waiver, Parent Support Groups, Respite, Overnight Respite, Parent Information Workshops Sunday Program: For male & female ages 5-21, Mixed groups, Handicap accessible, Transportation provided, Kosher food provided, Take children not toilet trained Pesach Tikvah Hope Development Address: 18 Middleton Street Brooklyn, New York 11206

Phone: (718) 875-6900 Website: www.pesachtikvah.org Programs Offered: Medicaid Waiver, Camp Reimbursements, Respite, Overnight Respite, Holocaust Survivor Program/Geriatric Programs. Sunday Program: for male & female ages 5-21, Mixed groups, Handicap accessible, Transportation provided, Kosher food provided, there is a fee for the program. Population: Mild to moderate to severe developmental delays, Autism/PDD, Multiply Handicapped After School Program: for male & female ages 5-21, Mixed groups, 4 days a week, Handicap accessible, Transportation provided, Kosher food provided Population: Mild to moderate to severe developmental delays, Autism/PDD, Multiply Handicapped Project Reach Address: 1257 38th street Brooklyn, New York 11218 Phone: (718) 514-8657 Website: yeled.org Location: Home Based or Hospital Population: Mild developmental delays, Hearing impaired, Visually impaired. Programs Offered: After school program one-day a week, mixed groups Languages: English, Yiddish and Hebrew Seeach Sod Address: 31 Yirmiyahu St. POB 5788, Jerusalem, Israel Phone: (972) 640-5000 Website: www.seso.co.li Programs Offered: Support groups/services are offered to Parents and Siblings; overnight respite available. Shema Kolainu – Hear Our Voices Address: 4302 New Utrecht Ave, Brooklyn, New York 11219 Phone: (718) 686-9600 Website: www.shemakolainu.org Programs Offered: Medicaid Waiver, Residential Habilitation June 2013

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RESOURCES DIRECTORY MEDICAID WAIVER, RESPITE & OTHER PROGRAMS CONTINUED… Special Care for Families and Children’s Services Address: 1421 East 2nd Street Brooklyn, New York 11230 Phone: (718) 252-3365 Programs Offered: Medicaid Waiver, Respite STEP (Special Torah Education) Address: 3005 Avenue L Brooklyn, New York 11210 Phone: (718) 252-8822 Programs Offered: Sunday Program UCP of New York City Address: 80 Maiden Lane, 8th Floor, New York, NY 10038 Phone: (877) 827-2666 Website: www.ucpnyc.org Programs Offered: Medicaid Waiver, Family support services for parents, In-home respite for individuals on Medicaid waiver, Overnight Respite, After School Program, Recreation

UCP of New York City: The Parent’s Place Address: 160 Lawrence Avenue Brooklyn, NY 12230, Room 205 Phone: (718) 436-7979 xt. 704 Website: www.ucpnyc.org Programs Offered: Free weekly workshops for parents and families, translation in Spanish is available. Women’s League Community Residences, Inc. Address: 1556 38th Street Brooklyn, New York 11218 Phone: (718) 853-0900 Website: womensleague.org Programs Offered: Medicaid Waiver Community Habilitation and Supported Employment Yad Hachazakah – The Jewish Disability Empowerment Center Inc. Address: 25 Broadway, Suite 1700, New York, NY 10004 Phone: (212) 284-6936 Location: Office, Agreed upon location

Ages: 12 through older adulthood Population: Self-directing people with obvious or hidden disabilities/ conditions and their loved ones. Services: Personal Coaching and Mentoring, Peer Networking, Advocacy, Resource Navigation, Dating and Marriage Consultation Addl. Info: Led by professionals and lay persons with disabilities under Orthodox Rabbinic Supervision. Yedei Chesed Address: 48 Scotland Hill Road, Chestnut Ridge, NY 10977 Phone: (845) 425-0887 Website: yedeichesed.org Programs Offered: Medicaid Waiver, Family Support Services for parents and siblings, Respite, Overnight Respite, Sunday Program, After School Program YAI Network Address: 460 West 34th Street New York, New York 10001 Phone: (212) 273-6182 Website: www.yai.org Programs Offered: Medicaid

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

OTHER SERVICES Beineinu-Connecting Parents of Children with Special Needs Address: 48 West Maple Avenue Monsey, New York 10952 Phone: (347) 743-4900 Website: www.Beineinu.org Services Provided: Parent Matching, Internet research for medical information for internetfree families, Translation of medical information into Hebrew, Zichron Yehuda Equipment Exchange, Growing International database of Resources, Information of Interest to those dealing with various special needs, Library of Chizuk and Inspirational articles, pictures and videos. Dovi’s Playhouse for Children with Special Needs Address: P.O.Box 290-524, Brooklyn, New York Phone: (646) 736-2816 Services Provided: Tutoring SerJune 2013 80

vices for Children with Special Needs – provides tutors after school to children at home. E-tree Address: 736 Lakeview Road Cleveland, Ohio 44108 Phone: (877) 865-5235 Website: treeofknowledge.us Services Provided: Interactive Online Learning System for k-12 Euro-Peds National Center for Intensive Pediatric PT Address: 461 W. Huron St. #406 Pontiac, MI 48341 Phone: (248) 857-6776 Website: www.europeds.org Services Provided: Europeanbased model of therapy for treating children with non-progressive gross motor disorders such as Cerebral Palsy, Traumatic Brain Injury and Spina Bifida. It was the first clinic outside of Eu-

roped to offer this type of therapy when it opened in 1999 out of a Michigan hospital, Doctor’s Hospital of Michigan. Hand in Hand Family Services Address: 390 Kings Highway Brooklyn, New York 11223 Phone: (718) 336-6073 Website: www.hihfs.org Services Provided: Psychological and Psychosocial Evaluations HaMercaz at Jewish Family Service of Los Angeles Address: 12821 Victory Blvd. North Hollywood, CA 91606 Phone: (866) 287-8030 Website: www.hamercaz.org Services Provided: HaMercaz is a one-stop resource for families raising children with special needs in the greater Los Angeles Area.

HorseAbility / Center for Equine Facilitated Programs Address: SUNY College at Old Westbury / PO Box 410-1 / Old Westbury, New York 11568 Phone: (516) 333-6151 Website: www.horseability.org Services Provided: HorseAbility is the only PATH International Premier Accredited Center on Long Island, and the only one at a convenient driving distance from the five boroughs of NYC. PATH International is the Professional Association of Therapeutic Horsemanship International pathintl.org. Paul Stadler MS OTR/L NDT (INPP) Address: 359 Ridgewood Avenue Phone: (347) 247-6835 Website: paulstadler.net Services Provided: Sensory Integration Certified (SIPT) Cer-

RESOURCES DIRECTORY OTHER SERVICES CONTINUED… tified, Licentiate of INPP, INPP one day course Instructor. Works with children diagnosed with Dyspraxia, DCD, Aspergers Syndrome, Dyslexia, ADD, panic disorder, anxiety disorder, agoraphobia, and children with read-

ing problems, writing problems, copying problems, academic underachievement. The Special Children’s Center Address: 1400 Prospect Street Lakewood New Jersey

Phone: (732) 367-0099 Ages: 0-3 Services Provided: Day Care serving all populations 9:00-2:00 or 4:00PM

Peace of Your Mind Tzirl Goldman, Life Coach Address: 1574 Carroll Street Brooklyn, NY 11213 Phone: 646-Life-711 (646-543-3711 Website: peaceofyourmind.com Services Provided: Life Coaching

ADVOCACY Ahivim Address: 6 Mountain Rd #204 Monroe, New York 10950 Phone: (845) 774-7000 E-mail: info@ahivim.org Website: www.ahivim.org Region: Orange, Rockland, Kings and Sullivan Counties Provides representation: IEP Meetings, impartial hearings, and appeals AHRC NYC Address: 83 Maiden Lane New York, New York 10038 Phone: (212) 780-2500 Website: www.ahrcnyc.org Region: Five boroughs Provides representation: IEP meetings, impartial hearings, and appeals Imagine Academy for Autism Address: 1465 East 7th Street Brooklyn, New York 11230 Phone: (718) 376-8882 Website: www.imagineacademy.com Region: All Provides representation: IEP meetings, impartial hearings, and appeals Michael Inzelbuch Esq. Address: 555 Madison Avenue Lakewood, New Jersey 08701 Phone: (732) 905 2557 Region: New Jersey Provides representation: IEP Meetings, Impartial Hearings, and appeals National Jewish Council for Disabilities/ Yachad (NJCD) Address: 11 Broadway, 13th Floor New York, New York 10004 Phone: (212) 613-8229 Hotline: (212) 613-8127 Website: www.njcd.org Region: NY, NJ, National Provides representation: IEP, Impartial Hearings

Otsar Family Services Address: 2334 West 13th Street Brooklyn, New York 11223 Phone: (718) 946-7301 Website: www.otsar.org Region: NYC Provides Assistance: IEP meetings, Impartial Hearings Project LEARN Special Education Affairs – Agudath Israel of America Address: 42 Broadway, New York, New York Phone: (212) 797-9000, ext. 308/325 Region: Primarily NY City and State, available to consult on questions on a national level Provides representation: IEP meetings, Impartial Hearings, and Appeals TAFKID Address: 977 East 17th Street Brooklyn, New York 11230 Phone: (718) 252-2236 Website: www.tafkid.org E-mail: tafkid@aol.com Region: New York Provides representation: Educational planning and case consultation, assistance with letter writing and paperwork, IEP Meetings and Impartial Hearings Thivierge and Rothberg, P.C. Address: 140 Broadway, 46th Floor New York, NY 10005 Phone: (212) 397-6360 Website: www.trspecialedlaw.com Region: New York & New Jersey Provides representation: IEP Meetings, Impartial Hearings, and Appeals

Website: yedeichesed.org Region: Rockland County Provides representation: IEP Meetings UCP of New York City Address: 80 Maiden Lane, 8th Floor New York, NY 10038 Phone: (877) 827-2666 Website: www.ucpnyc.org Region: Bronx, Bklyn, Manhattan and S.I.

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To Be Published December 2013 FAMILY FORUM & SIBS SPEAK For a member of a family with a special needs individual to submit an anecdote, advice, or comment. Contact Ruchi Eisenbach at: ruchieisenbach@gmail.com

ASK THE EXPERT To ask a question of one of our therapists, advocates or educators. Contact Chaya Klass at: ileneklass@aol.com

BULLETIN BOARD To have pictures of your events posted free of charge in this section. Contact Eli Stein at: elistein@aol.com

ORGANIZATIONAL LISTINGS To be included in the next directory free of charge, request a submission form at buildingblocks@jewishpress.com Note - a form must be submitted to update any previously published listing.

Yedei Chesed Address: 48 Scotland Hill Road Chestnut Ridge, NY 10977 Phone: (845) 425-0887

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

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

June 2013

RESOURCES DIRECTORY RESOURCES & INFORMATION ON THE WEB Compiled by Suri Greenberg

The Internet is a vast reservoir of information. Below is just a sampling of the web sites offering useful information and resources on all aspects of Special Needs, as well as detailed information on specific disorders and disabilities. However, be aware that there is no assurance that the information found on a particular web site is accurate or up to date. Therefore, it is important to check with your physician or other authoritative source that you trust before acting on any specific medical or treatment information you may find on the Internet.

FOR INFORMATION ON A VARIETY OF DISABILITIES AND DISORDERS: Centers for Disease Control and Prevention Address: 1600 Clifton Road Atlanta, GA 30333, U.S.A Phone: (800) CDC-INFO (232-4636) Developmental Disabilities Home Page Website: cdc.gov/ncbddd/dd/default.htm

IDEA Infant and Toddler Coordinators Association Address: 6129 Calico Pool Lane Burke, VA 22015 Phone: (703) 850-1187 Website: ideainfanttoddler.org A guide to Early Intervention resources

National Institute of Neurological Disorders & Stroke National Institutes of Health Address: P.O. Box 5801 Bethesda, Maryland 20824 Phone: (800) 352-9424 or (301) 496-5751 Website: ninds.nih.gov/index.htm Learning Disabilities: All Kinds of Minds Address: 2800 Meridian Parkway, Suite 100, Durham, NC 27713 Phone: (888) 956-4637 Website: allkindsofminds.org

Learning Disabilities Association of America Address: 4156 Library Road Pittsburgh, PA 15234-1349 Phone: (412) 341-1515 Website: ldanatl.org/index.cfm Hearing and Vision Disabilities: Alexander Graham Bell Association for the Deaf and Hard of Hearing Address: 3417 Volta Place, NW, Washington, DC 20007 Phone: (202) 337-5220 TTY: (202) 337-5221 Website: www.agbell.org

American Foundation for the Blind (AFB) Address: 1660 L Street, NW, Ste.513, Washington, DC 20036 Phone: (202) 822-0830 (office/TDD) Website: http://www.afb.org American Society for Deaf Children (ASDC) Address: 3820 Hartzdale Drive Camp Hill, PA 17011 Phone: (800) 942-2732 Website: www.deafchildren.org Helen Keller National Center (HKNC) Address: 141 Middle Neck Road Sands Point, New York 11050 Phone: (516) 944-8900 TTY: (516) 944-8367 Website: www.hknc.org

INFORMATION ON SPECIFIC DISORDERS: Autism Research Institute Address: 4182 Adams Avenue San Diego, CA 92116 ARI Autism Resource Call Center Phone: (866) 366-3361 Website: www.autism.com

The International Dyslexia Association Address: 40 York Rd., 4th Floor Baltimore, Maryland 21204 Phone: (410) 296-0232 Website: www.interdys.org

Autism Society of America Address: 7910 Woodmont Avenue, Suite 300 Bethesda, Maryland 20814 Phone: (301) 657.0881 or 1-800-3AUTISM (1.800.328.8476) Website: autism-society.org/site/PageServer

Muscular Dystrophy Association - USA Address: National Headquarters: 3300 E. Sunrise Drive Tucson, AZ 85718 Phone: (800) 572-1717 Diseases Home Page Website: www.mda.org/disease

June 2013

National Down Syndrome Society Address: 666 Broadway, 8th fl. New York, New York 10012. Goodwin Family Information and Referral Center at: (800)221-4602 Website: ndss.org/index.php National Multiple Sclerosis Society (NMSS) Address: 1100 New York Ave.,N.W. Suite 660 Washington, DC 20005 Phone: (202) 408-1500 Website: nationalmssociety.org

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June 2013

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Celebrating 15 years of service!

please contact David at: davidh@jewishpress.com or 718.330.1100 ext. 372

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

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June 2013

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

For further information or to advertise please contact: Moshe Klass at 718.330.1100 ext. 352 or sales@jewishpress.com June 2013

BULLETIN BOARD Compiled By Elisheva Stein

HASC Center Puts on a Show

n February 19th & 20th HASC Center Day hab Drama Club put on a magnificent play – “My Fair Lady”. It is a play about a young lady who was coached and helped to overcome a challenge, something that all the individuals at HASC Center Day hab Drama Club can relate to. Everyone was involved in every aspect of the production; they had been practicing every Friday for the past six months. They were involved in cutting up the flowers, gluing pieces together, painting the scenery and setting up chairs. All family, counselors and friends were invited and enjoyed every moment. This is the 11th year that the HASC Center Day Hab Drama Club has put on a performance. This year the show was dedicated to the memory of a dear friend, Jacob Kellman, A”H. Jacob was a

Sol Elfassy directed the past 11 shows and loves utilizing the dramatic arts to allow the actors to feel fulfilled and proud of themselves. “People tell you all your life that you cannot do something – here the Individuals did this great thing and feel so proud and accomplished.” There are Individuals who barely utter two words and are now talking in sentences. Sara Leah said “Thank you Sol, for making me feel popular!” At one point during the play one of the HASC Center Individuals, Miriam K. who is normally confined to a wheelchair was put in a stander, ropes were attached

and Miriam was pulled back and forth across the stage singing “I could have danced all night” She had the biggest smile on her face! Mr. Elfassy produced a professional show with the dedication, hard work and effort of the staff at HASC Center Day Hab, including Estherina Tafrizi who worked tirelessly on her sewing machine and made sure every actor “dressed for the part”, Shira Menczer, CoDirector who brought out the star quality in every individual. Esther Horowitz, Set Designer, Daniella Steinberg, producer, Shoshana Goldsmith, Creative consultant, Khevsi Dzhurayeva, Artistic director, Tova Chana Cohen, props Manager and Esty Gottheil, Tova Kapolovitz & Faigy Hershkowitzfor all of their tedious work and always pitching in where needed.

Young Child

e are delighted to say that the 2013 Young Child Expo & Conference was our best success yet! As a joint project of Los Niños Services and Fordham University’s Graduate School of Education, this year we had over 1100 attendees that came from around the world. Professionals such as directors, administrators, teach-

remarkable and memorable contributor to the HASC Center Drama Club over the course of many years.

June 2013

ers, ABA providers, speech pathologists, occupational therapists, physical therapists, psychologists, and social workers who work in preschools, head starts, elementary schools, children’s museums, libraries, universities, clinics and other programs attended. This year we honored Dr. Craig Ramey with the Fordham University

Excellence in Early Childhood Award for his groundbreaking Abecedarian research over 4 decades which has involved over 100,000 children and their families in 40 states. We look forward to offering another great conference in 2014. Save the Date April 23-25, 2014 in New York City.

BULLETIN BOARD O

HASC Center Events

n May 8th HASC Center held a farewell reception for Mr. Howard Wasserman, Director of Service Representative, OPWDD, on the occasion of his retirement. The reception was an acknowledgement and an expression of appreciation for the immense amount of collaborative work Mr. Wasserman

has done in conjunction with HASC Center in the development of the agency’s network of services and residences. “For this we are eternally grateful to him,” said Dr. Chaim Wakslak, Clinical Director at HASC Center. Dr. Wakslak underscored the way Howard’s contributions built the foundations for HASC Center, “At the time that Medicaid

Waiver services started, HASC Center was a fledgling agency. The administration of HASC Center under the leadership of Shmiel Kahn had little experience in the bureaucratic complexities associated with the acquisition and rehabilitation of residences. Howard was a patient, gentle teacher in the mastery of these very complex processes.” On May 9th, 2013 HASC Center welcomed local Rabbanim and community members to a Chanukas Habayis

homes is able to provide a warm environment to these individuals while at

the same time preserve every standard of Yiddishkeit for them.” Mr. Abe Eisner, President of HASC Center’s Board said that “Harav Mattisyahu Salomon said that these individuals possess Helige Neshamos, and that the staff who care for them are Malachim, Moshiach’s first stop will be at these home to greet these special Neshamos.”

& Hakamas Mezuzah ceremony for the opening of their brand new residential home in Flatbush. Harav Moshe Tuvia Lieff, Rav of Agudas Yisroel Bais Binyomin, Rabbi Yaakov Klass, Congregation Bnei Matisyahu, as well as Harav Yosef Sekula, Rav of Nachlas Yitzchok Soblov, both located a few blocks from the home affixed Mezuzos to the doors of the residence, after which community members joined in for other doors in the residence. Rabbi Lieff commented that “HASC Center, through these

June 2013

BULLETIN BOARD ICare4Autism Conference at Albert Einstein College of Medicine Attracts Over 300 People

n June 5, 2013 the International Center for Autism Research and Education (ICare4Autism) held the conference, “Autism: Cutting Edge Research and Promising Treatment Approaches,” at Albert Einstein College of Medicine in conjunction with Montefiore Medical Center. From neurology to psychology and everything in between, the speakers presented studies on the many aspects of autism research and treatment methods. Dr. Eric Hollander, Director of the Autism and Obsessive-Compulsive Spectrum Disorders Program at Albert Einstein College of Medicine/Montefiore Medical Center and Chairman of the ICare4Autism Advisory Council discussed Inflammation, Temperature and Personalized Therapeutics of ASD. His studies suggest, “Oxytocin has potent effects on social cognition and lower order repetitive behaviors and clinical response may be magnified in syndromal forms of ASD." Martha Herbert, M.D., Ph.D., of Harvard Medical School and the Massachusetts General Hospital, presented her research, Taking a Fresh Look at Autism: Chronic Dynamic State, not Fixed Trait. Dr. Herbert is the Director of the TRANSCEND Research Program (Treatment Research and Neuroscience Evaluation of Neurodevelopmental Disorders) with key interests in the concept of autism as a “dynamic encephalopathy (changeable) rather than a static encephalopathy (fixed for life)”. Dr. Gary Steinman, Chairman of the

Founder of ICare4Autism, Dr. Joshua Weinstein, with Advisory Committee Member Dr. Beth Diviney and Dr. Eric Hollander, Chairman of the ICare4Autism Advisory Committee

June 2013

Department of Biochemistry at Touro College of Osteopathic Medicine, presented Diagnosis and Treatment of Autism at Birth. Dr. Steinman’s studies suggest the potential for addressing autism

(from left to right) Steve Solender, Dr. Theoharis C. Theoharides, Dr. Gary Steinman, Dr. Alisa G. Woods, Dr. Eric Hollander, Dr. Martha Herbert, Lee Grossman, Dr. Stephen Shore, Dr. Joshua Weinstein, Jacqueline Aidenbaum, Dr. Carlos A. Pardo, and Dr. Beth Diviney at the VIP Conference Luncheon

by looking at the role of depressed IGF (insulin-like growth factor) at birth. He is collaborating internationally to develop a protocol for early identification of autism. Non-verbal until age 4 and diagnosed with autism himself, Dr. Stephen Shore of Adelphi University presented Special Ways and Techniques (SWAT) for Achieving Meaningful Inclusion. Dr. Shore is a self-advocate who promotes early intervention and educational strategies to embrace difference and access learned knowledge through unconventional, yet creative and effective, means. Carlos A. Pardo, M.D., of Johns Hopkins University School of Medicine, presented on Exploring the ImmuneBrain Interactions in Autism: A Look at Cytokines-Chemokines Networks. Theoharis C. Theoharides, M.S., Ph.D., M.D., of Tufts University School of Medicine, spoke about Activated Mast Cells Secrete Innate Pathogens Causing Focal Brain Inflammation Reversed by Methoxyluteolin. Akeksandra Djukic, M.D., Ph.D., of Albert Einstein College of Medicine and the Tri-State Rett

Syndrome Center at Montefiore Medical Center discussed Communication Deficits in Rett’s Syndrome. Dr. Nathaniel Heintz, Ph.D. of John Hopkins University School of Medicine presented A Role for 5-hydroxymethylcytosine in ASD? Dr. Sophie Molholm of Albert Einstein College of Medicine discussed Electrophysiological Mapping of Sensory Processing and Multisensory Integration in Autism and Dr. Alisa G. Woods, mother of a 6 year old with autism, presented Protein Biomarkers in Autism Spectrum Disorders. Dr. Joshua Weinstein, Founder & CEO of ICare4Autism reported on ICare4Autism Global Autism Initiatives including the Global Autism Center that will be opening in Jerusalem in 2017. The event was streaming live and is now available to view on Autism Brainstorm’s website, www.autismbrainstorm.org, as well as ICare4Autism’s website, www.icare4autism.org. ICare4Autism is a New York City based non-profit organization that works to facilitate communication and collaboration between medical and educational specialists worldwide with the aim to alleviate autism spectrum disorder. Together we can uncover the etiology of autism, design successful intervention strategies, and innovate sustainable inclusion practices for persons with autism.

Dr. Joshua Weinstein welcoming the audience to the 2013 ICare4Autism Conference at Albert Einstein College of Medicine

BULLETIN BOARD N

Jumpstart’s new ABA Home Therapy Program

ever one to rest on its laurels, Jumpstart Early Intervention Program has just added another jewel to its crown of community services. In an effort to address the unique needs of toddlers and young children with ASD (autism spectrum disorder), Jumpstart sought authorization to commence ABA (Applied Behavioral Analysis) home therapy. With 17 years of quality early intervention services under its belt, permission was forthcoming. Shoshana Gifter, MsEd, BCBA who is well known in the field of special education in general and autism in particular, has joined Jumpstart’s experienced team of professionals as the ABA Program Coordinator. She brings diverse skills and much enthusiasm to this newest undertaking. “I love what I do. It’s exciting for me to be able to take a child who looks like he has very

few skills and uncover his hidden potential by using the ABA methodology,” explains Ms. Gifter. With more than 13 years of experience in this field, and a reputation as a foremost ABA behavior consultant, Ms. Gifter is definitely the “right woman for the right job.” She has consolidated a team of ABA experienced professionals and provides close supervision which even includes her personal home visits as necessary. Communication and understanding are keys to success in this undertaking. “I’ve spoken to parents to clarify what to expect. I work on helping parents understand the diagnosis, which I think is probably one of the biggest stumbling blocks a parent faces,” avers Ms. Gifter. The Early Intervention program services babies and toddlers, age newborn through 3 years, who exhibit a

wide range of developmental delays. So for example, if your 15 – 18 month old child does not speak, does not play, and does not interact with others, take a proactive step and arrange for a professional team to evaluate him/her. You may call 311 or for more information, contact Shoshana Gifter at Jumpstart Early Intervention 718853-9700 ext. 219. All services are funded and regulated by NYS DOH and the NYC DOH/MH. Your child, and by extension your family, will be forever grateful!

Join Us Again For Our Next Big Issue December 2013 Visit us at: www.buildingblocksmagazine.com

June 2013

BULLETIN BOARD CALENDAR OF UPCOMING EVENTS: JULY 11-12, 2013 Glut1ds Conference Houston, Texas www.glut1ds.org

the family-friendly sessions there are many scientific and technical sessions.

JULY 16-20, 2013 14th International Fragile X Conference Orange County, California www.fragilex.org The National Fragile X Foundation’s biennial international conference presents a unique opportunity where researchers and parents can interact throughout the conference. Many researchers have commented on the experience of socializing with the parents of children with Fragile X, and how the experience has motivated them or reinvigorated their enthusiasm to make a difference in the lives of persons with this disability. The majority of the conference sessions are “Family-Friendly” and cover all three Fragile X-associated Disorders (FXS, FXTAS, FXPOI), with the greatest number of sessions focusing on FXS. In addition to

JULY 26-27, 2013 Treating The Whole Person With Autism— Care Across The Lifespan Columbus, Ohio 888-288-4762 atn@autismspeaks.org The Autism speaks national conference for families and professionals features scientific sessions and hands-on workshops on new approaches to care that combine behavioral and medical therapies and supports to help children, adolescents and adults with autism lead healthy and successful lives. AUGUST 2-3, 2013 ARC National Convention—Achieving Momentum Bellevue, Washington (near Seattle) www.thearc.org

AUGUST 2-4, 2013 Abilities Expo—Houston Houston, Texas www.abilitiesexpo.com SEPTEMBER 20-22, 2013 Abilities Expo—Boston Boston, Massachusetts www.abilitiesexpo.com OCTOBER 9, 2013 Loving and Raising a Child That Is Not Your Own--“Foster Issues Are Life Issues” OHEL 4510 16th Avenue Brooklyn, New York 718-972-9338 Askohel@ohelfamily.org www.Ohelfamily.org 7:00-9:00 pm COURTESY OF

Connecting Parents of Children With Special Needs

INDEX OF ADVERTISERS

2nd Nature Acupuncture

Dana Ledereich, MA OT/L

Abilities Expo

Marion K. Salomon & Associates, Inc. 85

Children's Services

The Ability Center

Maxi-Health Research Inc.

Tafkid 67

AdaptiveClothingShowroom.com 54

Yachad / National Jewish Council

American Discount Medical

for Disabilities

Arrowsmith Program

Beineinu 39 CBR - Creative Business Resources 69 Challenge Early Intervention Center 13 ChewyTubes.com 55 Eis Laasois / Williamsburg Infant & Early Childhood Dev. Center

Hand in Hand Family Services

Haor - The Beacon School

IVDU School for Special Education 11 JBFCS - Mishkon

Jumpstart Early Intervention

Rabbi Reuven Kamin MA

Kew Gardens SEP

Ilene Klass MS, OTR/L

June 2013

71 57

Special Care for Families &

Tafkid 36 65

Therapro 58

The New Seminary

Touro College Speech &

OHEL Bais Ezra

Hearing Center

OHEL Bais Ezra Sibshops

Ohel Children's Home &

Touro College - The Summer Institute 29 TTI - Testing & Training International 13

Family Services

UCP - Children's Programs

OHEL Kadimah Clubhouse

UCP of NYC - Universal Pre-K

Otsar 85

Program 37

Otsar's Chevra

UCP MyChildWithoutLimits.org

Paul Stadler - INPP Method

Women's League Community

Paul Stadler - INPP Method

Residences 84

Pocket Full of Therapy

Yachad / NJCD

Portable Wheelchair Ramps

Yachad / NJCD

Shema Kolainu/Hear our Voices 37

Yad B'Yad Academy

Sinai Ma'ayanot Program

Yad Hachazaka

7 71

BULLETIN BOARD A

New York Metro Abilities Expo a Must-Attend for the Local Community of People with Disabilities By Kevaleen Lara

bilities Expo attendance continues to climb with the New York Metro event bringing in 5,889 registered adults on May 3-5, 2013. Add in children and teens, and the real number is nearly 7,400!

test products and services from 200 exhibitors. There were also well-attended workshop sessions on travel, wellness, finances, home modifications and other important disability-related topics. On the exhibitor side, Arc of New Jersey commented, “We had an awesome time engaging with the incredible number of people who came out to learn about innovative ways to enhance life for people with disabilities! Looking forward with excitement to 2014!!”

Abilities Expo will be back at the New Jersey Convention & Expo Center on May 2-4, 2014. For those who can’t wait, the Expo will debut their Boston event at the Boston Convention & Exhibition Center later this year on September 20-22.

“We had such a great time!” said attendee Rebecca McKerns. “Looking forward to next year!” Terri McWeeney echoed her sentiments saying, “I had a wonderful day at the Expo. Learned and saw lots of new stuff.” “It is our honor and privilege to continue to provide the community of people with disabilities access to life-enhancing products, education, resources and fun,” said David Korse, president and CEO of Abilities Expo. Event highlights included an assistive technology pavilion, martial arts therapy, laughter yoga, Push Girl Auti Angel leading the popular hip-hop dance workshops, fun adaptive sports, assistive dogs, horses and more. Attendees were also able to see, touch and

June 2013

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