Four Vital Systems That Your Organization Can't Do Without

By Ira Jacobs
Managing an organization that provides services to individuals with developmental disabilities is, in my opinion, a difficult task. Managing the organization can be facilitated by employing an array of systems that, in many ways, protect the organization's operations.

I believe that every organization in the developmental disability field, irrespective of its size, should have these four systems in place:

1. A Corporate Compliance Plan
2. A Strategic Planning Process
3. A Program Evaluation or Outcomes Management system
4. A Performance Improvement System

The organization should also have a "working knowledge" of Quality Tools and know how to use them in the most appropriate manner.

A Corporate Compliance Plan is an absolute necessity. The plan when fully implemented will go a long way to ensure that an agency is in compliance with the rules and regulations promulgated by governmental regulatory agencies. In addition, a viable corporate compliance plan may be the best defense against audits by the Office of the Medicaid Inspector General, OMIG.

A Program Evaluation system will tell you how your programs are doing, whether they are achieving their goals, and performing as they are supposed to perform.

A Performance Improvement system will be the driving force behind improving those areas that have been identified as needing improvement, or simply bring an area to its optimal level.

Strategic Planning is an ongoing process that assists the organization to fulfill its mission and reach the vision that has been identified by the organization's leadership.

Perhaps one of the most important "systems" is a process that I call Factor Analysis Modeling or FAM. This not the statistical Factor Analysis, and has no resemblance to that process. It is a standardized method of producing a situational analysis of an organization. The FAM gives us a "snapshot" of the organization as it exists at one point in time...NOW."

Factor Analysis Modeling (FAM) is the "launching pad" for all subsequent Corporate Compliance, Strategic Planning, Performance Improvement, and Program Evaluation / Outcomes management systems.

Program Evaluation, Performance Improvement, and Strategic Planning systems should be blended to produce optimal results. Thinking of these three systems as one larger total system, and utilizing the fact that they overlap in many areas, will go a long way towards guaranteeing the success of your organizations quest for optimal service delivery.

Dr. Ira Jacobs has been in the field of developmental disabilities for over fifty years. He has covered a wide array of positions ranging from physical therapist to CEO of a large multi services treatment center. He believes that systems are the key to organizational optimal

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Learning Disability

By Pady N
Every one has a problem or difficulty in learning. For some, this difficulty is a disorder of the brain. The brain, being a very small, yet, complex structure of our body, sometimes processes the information it receives in a different way. Learning disability is a problem which affects the brain's ability to process the information

it receives. There are many kinds of learning problem such as talking, reading, writing. Just because one has a trouble in understanding the subjects doesn't necessarily mean that they are down with a learning disability. It should not be confused with difficulty in understanding a subject or topic.

Not many kids are diagnosed with a learning disability at the very beginning. We can hardly find out by the looks of a person if he/she is suffering from any. We identify that there is a problem only when the child is not able to follow the writing, unable to grasp the meaning of the words spoken, unable to write as a child of his/her age group is expected to.

A child with a learning disability doesn't mean that the child will never be able to learn anything. We just need to change our approach while teaching a child. We cannot expect the child to follow all that we teach. We need to set aside sometime from our schedule to tutor the child. You can start teaching the child various games to improve vocabulary, some signs and boards to help the child to learn the words...

We can find that some of the successful people we admire and adore, had a learning disability at some point of time in their life. One such example is Albert Einstein. He was weak in math as a child and became one of the greatest mathematicians. Other famous people, Da Vinci, Edison, Tom Cruise, who we know today to have excelled in their career, had a learning disability. This didn't stop them from succeeding in this world, where normal is the word of life.

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Farm Dust - The Dangers of Inhaling and Need for Respiratory Protection Through FFP2 Masks

By Lewis Thompson
Farm dust refers to anything from grain dust to mould spores released from hay and straw. Human exposure to this dust can have detrimental effects on our health with many of us completely unaware of the risks.

It is not only farmers that have reported respiratory problems that have been linked to farm dust. Many equine owners have no idea that activities such as mucking out, sweeping and filling hay nets, result in the release of large amounts of dust and spores which are easily inhaled. Horse owners are aware of equine respiratory problems associated with dusty bedding and hay, but for the most part, when these high risk activities take place, the horses are turned out.

COPD (Chronic Obstructive Pulmonary Disease) seen primarily in horses (rather than other farm animals) and Farmer's Lung, a condition seen in humans, are both allergic conditions that have long been associated with mouldy hay and straw (George and Lacey 1968). An occupational disease of farmers exposed to dust from mouldy hay was first described in Cumberlandin 1932. Since then awareness has continued as subsequent evidence has presented itself in many areas where farming practice and climatic conditions lead to exposure (Fuller CL1953, Dickie HR and Rankin J 1958)

As the occurrence of asthma increases, protection for those suffering from respiratory diseases becomes paramount, but whether the responsibility for protection sits with the employer or the individual is still a grey area. A study conducted at a stables in 2009 report by the Division of Environmental Epidermiology, showed that 'dust, endotoxin* and beta (1->3) glutan exposure is considerable in horse stables' (Samadi A, Wouters IM, Houben R, Jamshidafard AR, Van Erdenburg F, Heederik DJ 2009)

The endotoxin* exposure levels in this study were well above the Dutch proposed standard limits.

*an endotoxin is a toxin that is a structural molecule of the bacteria that is recognised by the immune system (Wikipedia).

The facts are clear - protection is necessary (particularly for those with underlying respiratory conditions), awareness is limited and regulation is just not there! I strongly advise those who spend time on farms to acknowledge their personal risks and take advantage of proper available dust protection.

I recommend the use of the FFP2 (EN149 = 94% filtration)mask for protection against dust. However, you are more likely to require the FFP3 (EN149 = 99% filtration) if you are dealing with airborne chemicals such as fertilisers, pesticides and fungicides.

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Down Syndrome - Three Tips for Educating Your Down Syndrome Child

By Craig Kendall
One of the most daunting questions about having a child with Down syndrome is how to best educate them. A child with Down syndrome will have more specific educational needs than a typical child.

Mental retardation is the general rule for kids with Down syndrome, so you will be entering a whole new world of special education. But don't despair! There are many systems set up to make sure that your Down syndrome child receives the best education possible, tailored to his or her needs.

Laws Guarantee Your Down Syndrome Child's Education

The first thing you should know about Down syndrome education is that every child in the U.S. is entitled to what is called a free and appropriate education. That means that your child will be educated in the public school system in a way that fits his or needs, and this is guaranteed by law.

When your child enters school, testing will be done to see what kind of services your child needs. An IEP, or Individualized Education Plan, will be written to address your child's unique needs. If the school is not able to provide for your child's needs, there is a process by which you may be able to get the school to pay for a special school that can.

There are many different therapies and accommodations that the school can provide for your Down syndrome child. The specifics, in terms of which services are appropriate for your child, will be decided at your first IEP meeting.

An IEP does the following:

* Identifies your child's disability, and lays out how it affects their ability to be educated.
* Lists goals that the child should be able to accomplish during the school year - both academic and functional, such as life skills goals.
* Provides a mechanism for how these goals will be measured and assessed.
* Specifies the specific aids and services that will be needed to meet these goals - for instance, tape recorders, sensory aids, note takers, aides, a modified curriculum and so on.

A helpful website to learn more about IEP meetings is http://www.wrightslaw.com. IEP meetings are usually conducted once a year so adjustments can be made to your child's services as he or she changes, if needed.

Three Things to Look for in Your Child's School

Most kids with Down syndrome are educated in public schools and receive special services. If you have a choice between public schools, or want to choose a private school instead, here are some things to think about.

1. Will your child be educated in an inclusive environment or a self-contained classroom?

A lot of schools these days educate Down syndrome kids in the same classes as other kids, pulling them out for specialty services like speech and occupational therapy. They have an aide to help them navigate the mainstream environment. This helps them learn better how to interact with their typical peers, and their peers how to better interact with people who have disabilities. Some still use self-contained classrooms, where people with disabilities are grouped together. Some use a mixture of both.

Look into what transition support services the school offers for making the move from high school to beyond high school. This will become important later on.

2. Supports Your Child May Need in School

There are several different areas that your Down syndrome child may need support in once he or she enters school, and you will want to be aware of all of these.

* Academic support is an obvious one, but you will also want to make sure your child has support out on the playground.
* He will need help interacting and feeling integrated with his classmates, and you will want someone there to make sure that no bullying is going on.
* Some kids with Down syndrome will still need help in the bathroom, using the toilet, at least at the very beginning of their school years.

Other areas of support can be added once you observe how your child is doing in school.

3. Another Option - Private Schools for Down Syndrome Children

If you feel your child cannot cope or thrive in a regular educational setting, there are private special education schools just for kids with Down syndrome. There are not a whole lot of them, and it is not the most common way to do things, but they do exist. (There are a lot of special education schools that accept kids with all sorts of disabilities, but fewer dedicated to only Down syndrome.) One example of a school dedicated to the education of Down syndrome kids is Pathfinder Village in Edmeston, New York.

Education for Down syndrome kids can seem confusing and overwhelming at first, but you'll get the hang of it. There are many resources available to guide you: books, websites, teachers, and other parents who have been there. This is where a support group with other Down syndrome parents will come in handy to share experiences with what works. With a little legwork, you will be well on your way to ensuring a wonderful educational experience for your Down syndrome child.

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Down Syndrome - Five Essential Services Help Young Adults Live Independently With Down Syndrome

By Craig Kendall
When kids with Down syndrome are still kids, the services they are entitled to are a lot more clear cut than for adults with Down syndrome. There are early intervention programs, mandatory special education programs, speech therapy, occupational therapy and so on. Therapies can take up a lot of time in a child with Down syndrome's life.

But what about when they get older? What about when kids with Down syndrome become adults with Down syndrome? What services are available to help then? If you have a child in high school, these are questions that have probably been on your mind.

Adults with Down Syndrome

Many adults with Down syndrome will continue to live with their parents after they finish high school. In some cases, they can live in apartments, often with other people who have Down syndrome or other disabilities, along with a caretaker who helps take care of their needs. Some will live in group homes. Sometimes they can even live on their own with only a little outside help.

Services to Help Adults with Down Syndrome

Adults with Down syndrome are usually eligible for disability payments, which will help pay their living expenses. They are also usually eligible for food stamps to help with food expenses, and aides that can come and help with cooking and self-care tasks, as well as with budgeting and nutrition.

1. Adult "Foster Care"

Another situation is that sometimes adults with Down syndrome are placed with other adults who don't mind helping to care of them in exchange for some extra income - sort of a "foster parent" system for the over 21 crowd. There are many different living options for adults with Down syndrome. This environment, where another adult helps with the needs of a Down syndrome adult is fairly innovative - but it may be ideal given your situation.

2. Jobs for Down Syndrome Adults and Vocational Rehabilitation

What, you may ask, will adults with Down syndrome do with their time? Some will be able to get jobs - perhaps working in restaurants, or at banks, or in the service industry. There are organizations called sheltered workshops that provide employment to people with disabilities, or day programs that your adult with Down syndrome can go to.

Vocational Rehabilitation, also known as Voc Rehab, can help adults with Down syndrome who want to find a job that is suited to their skill level and abilities. They can also provide job coaches. Job coaches learn the job with you and help provide guidance and instruction on the job.

3. Food Stamps

Food stamps: if you make below a certain income level, then you are eligible for food stamps. Food stamps can help you purchase food for the month. Instead of actual stamps, like they used to do, you will get an electronic debit card that you can use at most major food retailers to buy food. A certain amount is put on your card once a month. The amount differs quite a bit from state to state, and it also depends on how much income you have. Amounts generally range between $1-200 a month for a single person, but again, it varies.

4. Section 8 Housing

Some people with Down syndrome do move out on their own. For those who need assistance with paying for housing, and who live in the U.S., you can apply for a Section 8 Housing voucher. The waiting lists for these vouchers are usually quite long, unfortunately, so you should apply as soon as you know you might need help, and be prepared to wait. If approved, though, these vouchers can help a lot. Another thing to look for to help pay for housing costs are apartment buildings that have their own subsidies attached. These are apartments where if you qualify, you will only have to pay a certain percentage of your income to live there.

5. Medicare and Medicaid

Both of these programs are U.S. national health insurance programs that can help you pay for health insurance if you are either very low income, disabled, or both. Most people who receive disability payments usually get health insurance as well through one of these programs. This can help you pay for your doctors' visits, prescription medications, and any hospital stays that you have.

Your local branch of the Department of Human Services will best know how to direct you to the appropriate services that your young adult with Down syndrome is eligible for. Be sure to take advantage of whatever programs your city and state have. With a little help, your adult with Down syndrome can have a healthy and happy life for many years to come.

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Down Syndrome - Five Things You Should Know About Down Syndrome and Sexuality

By Craig Kendall
You may be surprised to find an article on Down syndrome and sexuality as few doctors bring this up and it is not often included in the typical prognosis and diagnosis of Down syndrome. You shouldn't be surprised, however.

Common perceptions are that people with disabilities do not have either interest or ability for the adult relationships the rest of us take for granted. This is, however, completely false.

People with Down syndrome go through puberty just like everyone else, and they have the same feelings and desires as everyone else. This is nothing to be afraid of, however. With a little education tailored to their particular needs, adults with Down syndrome can learn to be smart about their sexuality and learn how to minimize the risk of dangerous situations.

1. Sexuality is a Part of Everyone's Life

When we talk about sexuality and Down syndrome, we are not just talking about teenagers and adults. All humans go through many different stages of sexual development, starting when they are babies.

The first stage is to develop emotional bonds with parents and family members. School age kids deal with the beginnings of modesty and the desire for privacy. Of course, adolescents enter puberty and start feeling sexual desire. It is nothing to be ashamed of, but proper education needs to be given to teenagers with Down syndrome to make sure they know how to handle these feelings in an appropriate way.

2. The Decline of Institutionalization Led to More Opportunities for People with Down Syndrome

Up until the 1960s and 1970s, people with Down syndrome were most often institutionalized in single sex buildings, and did not have much opportunity to interact with the opposite sex at all. Now, people with Down syndrome have independence and opportunities available to them, and it only follows that they should also want what is available to all other members of society - the right to develop and pursue meaningful relationships.

3. Additional Difficulties Exist for People with Down Syndrome in Relation to Sexuality

There are, of course, added difficulties when we talk about people with Down syndrome and sexuality. It is probably obvious that there is a lot more prejudice towards people with Down syndrome who engage in sexual behavior.

Parents have a lot more anxiety about it, too. There is good reason for this anxiety, unfortunately. People with Down syndrome have cognitive deficits that make them more likely to be a victim to sexual abuse, unwanted pregnancies, or sexually transmitted diseases. Women especially are vulnerable to issues of abuse and exploitation. They may not know the difference between "good touch" and "bad touch". They may not know how to say no if something is making them uncomfortable. They may be lonely and willing to put up with inappropriate behavior in order to get attention.

The isolation and issues with communication that many with Down syndrome face may make it harder for them to access sources of support that will help them make decisions that are right for them.

4. There Are Ways to Prevent Exploitation and Abuse

The best way to help young people with Down syndrome be smart about their sexuality is to start educating them when they are still young. Sexual education for kids with Down syndrome should start in junior high, and should focus on personal safety.

Kids should be taught the difference between good touch and bad touch, and how to "just say no" to advances or touching they don't want. A concept called "Circles" can be used for older or more cognitively advanced kids. Circles represent different levels of personal relationship and intimacy. Students learn what the appropriate touching behaviors are for each level. They then learn that sometimes a friend might want to be closer than they want, in which case they have to tell them very clearly "STOP."

Sex education should be individualized for each student with Down syndrome depending on their ability to understand the material. It is important, however, to cover all the things that would normally be covered in sex ed, because chances are, teenagers with Down syndrome will need to know these things sooner rather than later, in order to keep themselves safe.

The more you talk openly and honestly with your Down syndrome teenager or young adult about sexuality, the safer they will be. The more they understand, the better you will both feel about this aspect of their lives.

Dating is also something that teenagers with Down syndrome will often want to try out for themselves. There are certain social skills required to be able to date, and these skills can be taught if needed.

5. People with Down Syndrome Can Get Married.

Marriage is by no means common for people with Down syndrome, but it is still growing increasingly more common. Many scoff at the idea, and wonder how two people who still need aides to function in the world could live together and manage household tasks, but it can be done.

The Wall Street Journal did an article addressing some of the issues in marriages with Down syndrome.

"There is a growing sense of the need to catch up, with junior highs and high schools starting to offer sex-education and social skills courses tailored to teens with Down syndrome and other cognitive disabilities. "There is no reason to think that they have a different libido," says William I. Cohen, who runs the Down syndrome Center of Western Pennsylvania at Children's Hospital of Pittsburgh. "They want what we all want: friendship, companionship, love." ("A Young Woman Plans Her Wedding," Amy Marcus, Wall Street Journal, October 2005)

Marcus also reports on a discussion one young woman with Down syndrome had with her mother on her upcoming marriage to another young man with Down syndrome:

"At one point, she raised the issue with her daughter: Didn't she worry that after they married, Ms. Bergeron might have to take care of Mr. Desai?"Don't you take care of Daddy? Doesn't Sujeet's mother take care of her husband? Isn't that what wives do?" her mother says Ms. Bergeron responded. "She put me in my place," Mrs. Bergeron said. "I backed off."

Fertility Issues

Most males with Down syndrome are infertile (although not all). Most females have reduced fertility but are still quite fertile. It will be important to teach the couple about how to use birth control responsibly.

Romantic love and relationships can be a wonderful thing. There is no reason why people with Down syndrome should have to miss out on one of life's biggest perks, especially when they are biologically and psychologically capable of it. You just need to take some extra precautions to make sure your loved one with Down syndrome is prepared by educating them on sexuality and for all that this might entail.

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Down Syndrome - Learn An Innovative New Way to Communicate With Your Down Syndrome Child

By Craig Kendall
How would you like it if you could communicate with your Down syndrome child before he or she was even able to talk? Children with Down syndrome often have delayed speech, so communicating can be particularly frustrating for parents.

Most of the tantrums and behavior problems of toddlerhood are caused by kids not being able to adequately communicate what they need or want. Not to worry, though, there is a potential solution to these communication woes - and it is called baby sign language.

Baby Sign Language Helps Down Syndrome Children

Baby sign language is catching on all over the country. By teaching your Down syndrome baby or toddler a few key signs, you will have a way to communicate with them long before they are old enough to be able to use actual speech. Fewer communication problems means both child and parents are calmer and happier.

Teaching Sign Language to a Down Syndrome Baby

Some may be surprised by the idea of teaching sign language to a baby. It is, after all, quite a new idea. But once you get past the novelty and read studies and articles about it, you will realize that it really can work.

Some people will claim erroneously that teaching sign language will delay the onset of verbal language. This is not true. Signing actually stimulates certain areas of the brain that are used for verbal language development.

Studies have shown that kids who signed before they talk actually have increased language development and verbal ability when they do start to talk - and they usually do start to talk on time.

Most Babies Can Pick Up Signs Before They Are Able To Speak

Most babies can hear you speak and have desires and things they prefer even at a very young age, so not being able to express these things is very frustrating to them. Most babies can pick up signs before they are able to speak. A baby is not usually developmentally ready for speech (fine motor skills) until at least a year of age or more, but they are able to use their hands to make signs usually at around six months (gross motor skills).

Since Down syndrome babies often have delayed speech and may not talk until two or three years of age, sign language can make a world of difference while you are waiting. Sign language also naturally increases self-esteem in a child, since they feel good about being able to communicate.

How do I teach my baby to sign?

You may be a little overwhelmed at this point, wondering how you are going to teach your Down syndrome baby to sign a language you do not know! There are, however, many resources available to help you. There are many books on baby sign language; online tutorials that will talk you through what you need to learn; and even baby sign classes that you can take.

Baby sign is based off of American Sign Language (ASL), but you don't need to know all of ASL to be able to sign with your baby - just perhaps the 15 or 20 most common words you think your baby should know to communicate with you.

Pick Basic, Useful Words

Think about what signs would be most useful to your child. Most people start off with things like milk, more, eat, drink, and sleep.

You will want to use the sign as often as you can. You should speak the actual word when signing it, as this will help with your child's language development. So, if you were sitting down to dinner, you might sign the word for "eat," several times. Then you might show your child how to use her hands to make the sign.

If the child does make the sign back, be sure to praise her and offer positive reinforcement. The more excited and happy you are when she uses her signs, the more she will want to do.

Be Enthusiastic!

You should be as enthusiastic as possible. The signs might not come out just right at first, but they will improve in time. In no time, your Down syndrome baby will have a way to communicate with you.

Elaine, parent of a 13 month old, says,

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Down Syndrome - Top Six Visions Problems, Their Causes and Solutions in Down Syndrome Children

By Craig Kendall
Children with Down syndrome are unfortunately vulnerable to a number of medical and health issues that go along with the disorder as your doctor, no doubt, has told you. One of them is problems with vision. Down syndrome can affect the way that eyes develop, which can impact overall vision.

Over half of people with Down syndrome have eye problems of some sort. As you probably already know, there are characteristic features in the eyes present in all or most people with Down syndrome. The eyelids slant upwards; there are folds of skin between the person's eye and nose; and there are often small white spots on the iris of the eye, which are called Brushfield's spots.

Five Common Down Syndrome Vision Problems

1. Refractive error is the most common eye issue in people with Down syndrome

Why do so many people with Down syndrome need glasses?

This is the result of something called a refractive error, which is the most common eye issue in people with Down syndrome. When someone is short-sighted, they have trouble seeing things that are in the distance. Long-sighted means that you have trouble seeing things close up. Both of these are refractive errors that can be treated with prescription eyeglasses.

2. Accommodations

There are other problems that could require the use of eyeglasses. Accommodation refers to problems focusing one's eyes on tasks nearby. People are able to change the focus of their eyes by having the muscles in the eyes change the shape of the elastic lens inside the eyes. This is not a problem of short or longsightedness. It is not usually helped by wearing glasses, but sometimes can be helped by wearing bifocals.

3. Astigmatism

Another common problem is astigmatism. Astigmatism happens when the curve of the cornea is not symmetrical. This causes the vision to be blurred no matter what the distance is. Fortunately, this can be helped by glasses that can help correct for the different curves of the cornea.

4. Tear Duct Abnormalities

Many kids with Down syndrome have tear duct abnormalities. This shows itself in discharge and tearing from the eyes. Massage of the tear sac region, between the eye and nose, can sometimes help this condition. Ask your doctor or therapist for specific instructions on addressing tear duct abnormalities in your Down syndrome child.

5. Strabismus or Squinting is Common in Down Syndrome Children

Something called strabismus, or squinting, is also common with people who have Down syndrome. Because there is not enough muscle coordination between the eyes of someone with Down syndrome, it sometimes causes the eyes to point in different directions. This may cause double vision, loss of depth perception, or vision in only a single eye. The eyes are misaligned, one might say.

Sometimes glasses can help strabismus, but your doctor or other medical specialist may recommend surgery on the eye muscles as a therapy to cure this problem.

6. The Risk of Cataracts in Down Syndrome

Perhaps the most severe problem that can affect the eyes of someone with Down syndrome is cataracts. A cataract is a clouding of the lens, resulting in blurred vision, glare when facing light, and double vision. Cataracts can often be present in older people, but with Down syndrome, babies will often have them at birth, or a very young age.

The problem with having cataracts so early in life (not that you really want to have them at any point in life), is that a young Down syndrome child who is not able to see well when they are first developing runs a risk of never being able to see well, even after the cataracts are removed. This is because if the brain doesn't learn how to see early in the development of the child, it won't be able to later, either. This is known as deprivational amblyopia. Babies and kids with Down syndrome should thus be screened regularly for eye problems.

Watch for Changes in Behavior as Signs of Visions Problems

Some kids with Down syndrome will not be able to tell you if they are having problems with their vision. If there is a change in their behavior, their cognitive function, or the activities they will participate in, these may be signs an eye exam is warranted. Other signs to look for may be squinting, tilting the head in an unusual way, or light sensitivity.

Eye issues are common in people with Down syndrome, so it is something you will want to watch out for. Most eye problems have treatments, though, so it is nothing to worry too much about and you should consult your doctor or other medical specialist to help your Down syndrome loved one. Your Down syndrome child can still thrive even if they do have some of these vision problems, so work with your doctor on therapies and cures.

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