Hints for Parents

Kids with ACM1 and or Sensory Integration in the Public School System

  • Allow child to be in a small class setting to avoid as much noise as possible
  • Speak clearly and give the child additional time to process what has been said.
  • Tell the child what you are going to be teaching before you teach it.
  • Keep the amount of repetitive work to a minimum. Once a concept/skill has been grasped move on to the next one
  • Provide the child with a way to indicate that he/she needs help when he/she is not comfortable raising hand to ask for help
  • Provide with alternative challenging activities during class activities that he/she finds not challenging.
  • Children with processing disorders have a tendency toward two major problems regarding sitting: Lack of focus and the inability to sit or stand for a long period of time. Their brain tends to “under register” movement, and without that ability they can’t focus. In the classroom the child should be allowed to make non-disruptive movements (bouncing legs, twirling pencil in hand, chewing gum) these things will help to improve focus.
  • Outside the classroom the child should be allowed heavy or crashing play (weightlifting, wrestling, football.) these thing can help to improve focus for several hours. NOT FOR CHILDREN WITH ACM
  • note: if child has a constant need for touch and has difficulty sleeping at night. the use of a weighted blanket is often beneficial 
  • Limit homework to 30 minutes a day
  • Children with visual processing disorders: although eye exams reveal no problems with eyesight it is the brain that is not processing what it sees. Several everyday factors can lead to rapid mental fatigue, such as following words in a book without loosing your place, transferring information from a black board or overhead projector to paper, clutter, bright colored decorations in a room, overhead lights (especially fluorescent) flooring with a pattern. Child should be allowed to sit near a window (natural light) and or wear a hat or sun glasses (obscure fluorescent light.) Use a place marker when reading. cool colored decorations are better. WHEN NOTE TAKING IS NECESSARY THE TEACHER WILL PROVIDE A COPY OF THEIR OWN NOTES TO THE CHILD. an alternative to note taking is to allow the child to record all class discussions
  • Using signals (I.e. sign language) to inform child that he/she needs to be quiet, look at the teacher, etc 
  • Chunk information: give one or two directions, wait for those to be 
  • followed, then give one or two more
  • Simplify worksheets and tests by keeping graphics to a minimum, targeting one skill at a time and one format (I.e. vertical 
  • equations only, horizontal equations only, multiple choice, etc)
  • Allow child to periodically get up from his/her seat and move around
  • Be direct, explicit, and concrete with directions Literalness and/or requests.
  • When using abstract terms, sarcasm, figurative speech, Literalness 
  • idioms, slang, analogies or metaphors make sure child understands it and if not explain it. (every time)
  • Assign homework for the week
  • Provide with alternatives to handwriting Sensory motor answers when the objective of the assignment is not 
  • improving penmanship
  • Use social stories to provide child with guidance on Social skills 
  • how to recognize cues and how to respond in different situations
  • Tactile dysfunction: A child with a tactile dysfunction often shows displeasure to a soft touch. As well as discomfort from clothing, and certain textures. Frequent breaks to wash hands are helpful.
  • Develop and implement a behavior intervention plan
  • Make sure ALL adults that work with child understand his/her disabilities and how they affect his/her behaviors. Do not assume the child has a lower IQ than others. The ability to learn is there but requires a multi-sensory teaching approach.


                    Treatment for a Chiari malformation:

Specific treatment for a Chiari malformation will be determined by your child's physician based on: 

  • your child's age, overall health, and medical history 
  • the extent of the condition 
  • the type of condition 
  • your child's tolerance for specific medications, procedures, or therapies 
  • expectations for the course of the condition 
  • your opinion or preference 
  • Medical management consists of frequent physical examinations and diagnostic testing to monitor the growth and development of the brain, spinal cord, skull, and backbones.
  • Some types of Chiari malformations may require surgery to relieve increased pressure inside the head or neck area, or to help drain excess cerebral spinal fluid from the brain.
  • Parents are instructed to watch for any changes that may affect the child's neurological status, including the following:
  • breathing problems 
  • degree of alertness 
  • speech or feeding problems 
  • problems walking 
  • uncoordinated movement 

Life-long considerations for a child with a Chiari malformation:

The full extent of the problems associated with a Chiari malformation are usually not completely understood immediately at birth, but may be revealed as the child grows and develops. Children born with a Chiari malformation require frequent examinations and diagnostic testing by his/her physician to monitor the development of the head as the child grows. The medical team works hard with the child's family to provide education and guidance to improve the health and well-being of the child. 
Genetic counseling may be recommended by the physician to provide information on the recurrences for Chiari malformation and any available testing.

Medical and Educational Recommendations for Children Diagnosed with Chiari I Malformations

Chiari I Malformation is a congenital malformation of the skull characterized by a small posterior cranial fossa and impaired spinal fluid flow.  The result is a series of chronic and often debilitating symptoms including, but not limited to: headaches, ocular symptoms, otoneurologic symptoms such as vertigo and imbalance, cranial nerve and brain stem disturbances, bowel and or bladder dysfunction and other
nonspecific systemic symptoms.  This disease and its complications are characterized by remissions and exacerbations, even after surgical repair.  This condition is life long and can affect every aspect of one's life.

We request that you provide the student with accommodations based on
Section 504 of the Rehabilitation Act of 1973
(http://www.wrightslaw.com/info/sec504.index.htm) and Individuals with
Disabilities Act (IDEA 2004) (http://www.wrightslaw.com/idea/index.htm).

1. If possible the child should be placed in a small class, if that's not possible then a para-professional may be needed to ensure that they are monitored and assessed for proper body positioning, maintain neutral neck position during all activities, and monitor for signs and symptoms of headache, neck pain and/or numbness or tingling in the hands.

2. If the child moves between classes, if possible, classes should be grouped together to minimize excessive walking between classrooms which would increase fatigue.

3. The child should be given extra time for test taking and if
necessary provided a test reader and/or note taker.  Patients may have difficulty with their daily functioning because of headache and/or vision problems.

4. The child should be provided with a second set of text books to prevent carrying books back and forth between home and school for homework.

5. The child should undergo additional psycho-educational testing to see if they may need other academic services, as well as possible physical and occupational therapy services.

6. Adaptive Physical Education - the student should not participate in any activities that may produce a whiplash-like injury, e.g. dodge ball, other contact sports, trampolines, roller coasters, bumper cars, horseback riding or climbing over 5 feet.  Swimming is allowed, but not diving. Weight training and/or strengthening is permissible, but weights must be kept to a maximum of 10 to 15 pounds.

From: http://www.freewebs.com/matthewschiari/helpfulinfoforparents.htm  Written by Roger W.Kula, M.D.,  Medical Director of the Chiari Institute