Educational Strategies for
Students with CHARGE Syndrome
Holly Cooper, Ph.D.
Texas Deafblind Project
Best Practices in Instruction
Hearing and vision impairments are common, be
sure assessment information is in place and
that sensory needs are addressed with the
appropriate aids and accommodations:
• Communication assessment (from an SLP or AI)
• Functional vision evaluation (from a TVI or O&M)
• Learning media assessment (from a TVI)
• Orientation and Mobility evaluation
• Assessment of Deafblind Access to Manual Language
Systems (ADAMLS, if appropriate)
Best Practices in Instruction
Make sure the communication mode is accessible
to the child and
you have the child’s visual attention when you
communicate, especially if sign language is the
communication mode.
Best Practices in Instruction
Be sure the student knows the meaning of the
words or signs you are using.
If the student doesn’t understand, teach him or
her!
• Use real objects, pictures, drawings, and real life
experiences.
• During experiences, be sure you introduce new signs in
context,
• Repeat the sign often in natural communication
opportunities.
Best Practices in Instruction
If the student is using sign language as their
primary communication mode:
• It may be helpful to pair a new sign with a picture or
photograph of a familiar person making the sign so the
student can have a static image.
• Students with visual impairments often need to look a
word, sign, or picture longer because their visual
processing is slow.
• Line drawings are highly abstract and may not be
understandable to some students.
• If the student is learning to read print, pair the picture with
a word.
Best Practices in Instruction
If the student is using oral language,
• Use real objects
• Real experiences
• Tactile symbols
• Photographs or picture symbols
• Pair spoken words with print or braille words
To teach the meanings of words and concepts.
Best Practices in Instruction
Language experience stories are appropriate for a
variety of students.
• Introduce the vocabulary to students before doing an
activity, be sure to have it in print or on print and picture
symbol cards if this media is appropriate for the student.
• After an activity, do some writing along with the student
about the event. You can discuss and use printed words
and sentences written along with the discussion, or use
picture symbols or tactile symbols along with print or
braille words to tell the story of the event.
• Read again a few times to reinforce the new vocabulary
learned or new print or symbols learned.
Best Practices in Instruction
Problems with behavior can also be addressed
with educational strategies:
• Teach organizational skills
• Keep a daily schedule with the student
• Give the student choices when possible
• Encourage turn taking and sharing in structured
situations
• Select activities or offer choices interesting to the student
• Give student choice of who they will work with
• Give tasks which can be done independently
• Allow partial participation
Behavior issues
Individuals with CHARGE frequently have some of
the following behavior problems
• Attention problems
• Self-stimulatory or self-abusive behavior
• Obsessive-compulsive behavior
• Tantrums or aggressive outbursts
• Passivity or refusal to cooperate
• Social skills problems
• Difficulty sharing or understanding other’s point of view
Behavior issues
Some may be the result of physical problems
kids with charge commonly experience:
• Sleep deprivation
• Hunger or digestive problems
• Pain or discomfort
• Fatigue
• Balance problems
• Difficulty self-regulating (resting when tired, etc.)
Behavior issues
Unpredictable behavior can be due to long term
issues including
Post-traumatic stress disorder due to:
pain
illness
multiple hospital stays
medical procedures
Behavior issues
Individuals with CHARGE can experience
Paradoxical reactions to medications
and
medications that are ineffective after a period of
use
Behavior issues
Can be induced or made worse by stress:
• Low vision
• Communication problems
• Changes in routine
• Classroom expectations
Behavior issues
Sensory problems may result in apparent
“uncooperative behavior:”
• Ambient noise
• Glare or too much light
• Too much movement or distractions in the environment
• Problems with glasses or hearing aides
• Fatigue
• Seating issues
Behavior issues
Sensory Issues can cause stress leading to
unexpected outbursts or passivity in students.
• Sensory deprivation
• Sensory overload
• Sensory processing
• Lack of sensory load awareness until the load becomes
critical
Behavior issues
Tantrums and aggressive outbursts may result
from:
• Frustrations with communication
(not understanding what is said to them or not being able
to express their wants and needs)
• Being told to discontinue a favored activity
• Being told to do an activity they dislike
• Being pushed to do work at a more challenging level
Behavior issues
Refusal to comply with directions may be due to:
• Communication issues
• Fatigue
• Trouble regulating arousal levels
• Postural insecurity
• Vision or hearing deficits
• Developmental level
Behavior issues
Students with CHARGE also experience stress
and behavior problems for the same reasons as
other kids:
• Teasing or bullying by other students
• Puberty and hormone changes
• Allergies, especially respiratory
• Problems at home
Best Practices in Instruction
• Know what’s happening in your student’s life
and health
• Give preferential seating if appropriate
• Adjust lighting
• Try an FM amplification system
• Check for understanding during instruction
• Give ample opportunities for hands-on learning
Best Practices in Instruction
• Use a multisensory teaching approach
• Slow down, and repeat
• Use the student’s interests and preferences to
engage them in learning
• Know when you can push them, and don’t if it’s
not necessary
• Structure opportunities to share or interact with
other students
• Give clear and explicit limits
Best Practices in Instruction
Use a team approach to education
Behavior problems are part of the disability
• Develop a behavior intervention plan if needed
• Individualize instruction, meet their unique needs
• Communicate with parents and family members
Best Practices in Instruction
Take a Break!
• Let them lay down
• Move around
• Do an errand
• Sit in a beanbag chair in a secluded area
Give them time to recover their physical and
mental energy
The end