Understanding Special Needs
And the Disabled in the Martial Arts
One World Martial Arts Federation
• The 1WMAF aims to teach schools throughout the country the best way to
offer our services for students with disabilities and special needs
• To do this, the 1WMAF offers certification programs for instructors, schools
and individuals interested in offering superlative instruction.
• Certified schools and individuals are able to rank their students through the
1WMAF if they so desire.
Disabilities and Special Needs
What are they?
They are not the Same!
• Disability:
• : a condition (such as an illness or
an injury) that damages or limits a
person's physical or mental abilities
• : the condition of being unable to
do things in the normal way : the
condition of being disabled
• Special Needs
• : the individual requirements (as
for education) of a person with a
disadvantaged background or a
mental, emotional, or physical
disability or a high risk of
developing one
They are not the Same!
• Disabilities are CONDITIONS!
• Special Needs are RESULTS of the
conditions!
Disabilities
Clinical descriptions of common disabilities you will be teaching.
Spina Bifida
a congenital defect of the spine in which part of the spinal cord and
its meninges are exposed through a gap in the backbone. It often
causes paralysis of the lower limbs, and sometimes mental handicap.
Spina Bifida
Spina bifida is actually an umbrella term encompassing a number of
neural tube defects (myelomeningoceles) that occur during the early
weeks of gestation. During the first month of pregnancy, the spinal
column fails to fully close, exposing the developing spinal cord to
damage. Depending on the level of the lesion, conditions such as full or
partial paralysis, hydrocephalus and complications with bladder and
bowel function can develop.
Physical Management of Spina Bifida
• Physical therapy goals are most often directed at contractures of the hips and knees
and include range-of-motion and strengthening exercises. Many patients will have
muscle imbalance at the hip, interfering with proper gait. The most common effect
on the knee is flexion contracture.
• Foot deformities are the most common orthopedic abnormality, occurring in 85
percent of children with myelomeningocele.1 Progressive kyphosis and scoliosis are
common, and fractures occur in roughly 20 percent of cases, so orthotics and
splints are often employed to accompany exercises to maximize mobility. Even
children with partial and complete paralysis as a result of spina bifida can usually
walk with the help of assistive equipment.
Recreational Therapy with Spina Bifida
• Children with SB often experience limited play and recreational opportunities
because of limited movements and physical restrictions. This lack of activity
decreases the urge for normal development in all areas and it can produce a
negative effect on the patient’s dignity. For the infant and toddler with SB,
recreational therapy increases chances for environmental exploration and
interaction with other children. For the school-aged child, recreational
therapy provides chances for participation in accommodated sports and
exercise programs, which may result in a long-term interest in personal
fitness and health.
Recreational Therapy with Spina Bifida
• Recreational and physical fitness targets include enculturation, weight
control, and improved fitness (e.g., flexibility, strength, working capacity, CVS
fitness and coordination). Recreational therapy is helpful for encouraging
independence with adult living skills and often is used to help the patient
with shopping for and purchasing personal things, use of public
transportation, and development of suitable activities.
There is no cure for SB
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You will not “Fix” your student
Your goal is to create a lifetime of physical and mental health for the student.
Be supportive and realistic – do NOT over promise.
Push your CP student to their limits, but not over them.
The goal is “To be better today than we were yesterday.”
Set three month goals that are hard, make a plan to reach them, and test them on their
progress towards those goals.
• Depending on your belt structure, creating 3 month goals for belt promotion will take your
student on a 4-5 year journey towards black belt.
Cerebral Palsy
a condition marked by impaired muscle coordination (spastic
paralysis) and/or other disabilities, typically caused by damage to the
brain before or at birth.
Cerebral Palsy
Several cerebral palsy classification systems exist today to
define the type and form of cerebral palsy an individual
has. The classification is complicated by the wide range of
clinical presentations and degrees of activity limitation that
exist. Knowing the severity, location and type of cerebral
palsy your child has will help to coordinate care and fund
treatment.
What types of cerebral palsy are there?
• Below are the most commonly used classification systems understood and
used by qualified practitioners.
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Classification based on severity level
Classification based on topographical distribution
Classification based on motor function
Classification based on gross motor function classification system
Level of Severity
• Even when doctors agree on the level of severity, the classification provides little
specific information, especially when compared to the GMFCS. Still, this method is
common and offers a simple method of communicating the scope of impairment,
which can be useful when accuracy is not necessary.
• Mild - Mild cerebral palsy means a child can move without assistance; his or her
daily activities are not limited.
• Moderate – Moderate cerebral palsy means a child will need braces, medications,
and adaptive technology to accomplish daily activities.
• Severe – Severe cerebral palsy means a child will require a wheelchair and will have
significant challenges in accomplishing daily activities.
Topographical and GMFCS
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Topographical classification describes body parts affected. The words are a
combination of phrases combined for one single meaning. When used with
Motor Function Classification System, it provides a description of where and
to what extent a child is affected by cerebral palsy. This method is useful in
ascertaining treatment protocol.
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Hemiplegia/hemiparesis indicates the arm and leg on one side of the body
is affected.
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Paraplegia/paraparesis means the lower half of the body, including both
legs, are affected.
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Paresis means weakened
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Plegia/Plegic means paralyzed
Triplegia/triparesis indicates three limbs are affected. This could be both
arms and a leg, or both legs and an arm. Or, it could refer to one upper and
one lower extremity and the face.
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The prefixes and root words are combined to yield the topographical
classifications commonly used in practice today.
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Double hemiplegia/double hemiparesis indicates all four limbs are
involved, but one side of the body is more affected than the other.
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Monoplegia/monoparesis means only one limb is affected. It is believed
this may be a form of hemiplegia/hemiparesis where one limb is significantly
impaired.
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Tetraplegia/tetraparesis indicates that all four limbs are involved, but three
limbs are more affected than the fourth.
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Diplegia/diparesis usually indicates the legs are affected more than the
arms; primarily affects the lower body.
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Quadriplegia/quadriparesis means that all four limbs are involved.
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Pentaplegia/pentaparesis means all four limbs are involved, with neck and
head paralysis often accompanied by eating and breathing complications.
Spastic Cerebral Palsy
• Spastic cerebral palsy is hypertonic and accounts for 70% to 80% of cerebral palsy
cases. The injury to the brain occurs in the pyramidal tract and is referred to as
upper motor neuron damage.
• The stress on the body created by spasticity can result in associated conditions such
as hip dislocation, scoliosis, and limb deformities. One particular concern is
contracture, the constant contracting of muscles that results in painful joint
deformities.
• Spastic cerebral palsy is often named in combination with a topographical method
that describes which limbs are affected, such as spastic diplegia, spastic hemiparesis,
and spastic quadriplegia
Treating CP
Treating cerebral palsy is almost as complex as the condition is, and
there’s no cookie-cutter approach because each individual is affected
differently. Although the brain injury that causes cerebral palsy cannot
be healed, the resulting physical impairment can be managed with a
wide range of treatments and therapies. Although there is no universal
protocol developed for all cases, a person’s form of cerebral palsy,
extent of impairment, and severity level help to determine care.
Although each medical specialist may have specific care goals related to their
specialty and the individual’s unique condition, the overriding treatment goal
for those with cerebral palsy is to:
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Optimize mobility
Manage primary conditions
Control pain
Prevent and manage complications,
associative conditions and comitigating factors
• Maximize independence
• Enhance social and peer
interactions
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Foster self-care
Optimize ability to communicate
Maximize learning potential
Provide quality-of-life
Conventional, Complementary and
Alternative medicine
• Conventional treatment methods involve
systems, practices and products that have
been researched, tested and approved by
the medical community as acceptable
forms of treatment.
• Complementary medicine differs from
conventional as it has not yet been fully
tested or approved, but may be under
consideration. Complementary medicine,
when used under doctor supervision, can
be used as a complement to an existing
treatment plan.
• Alternative medicine is a treatment
method that is used to replace
conventional medicine.
• Martial arts is ALWAYS complimentary
and NEVER Alternative!
• We do not replace, we support
conventional therapy and treatment.
Working with CP in Martial Arts
• there is some risk associated with Physical Workouts. Physical therapy and
Complimentary activities like MA are meant to be restorative in nature – a teacher
more often than not will not over-work a patient. However, this can occur.
• If physical activity is taken too far in a given session, this can cause injury or
unnecessary pain, which is not the goal of Martial Arts instruction.
• The key to minimizing risks and maximizing results is open communication
between the child, his or her caregivers and physical therapists. Identify where your
student’s physical and psychological limits are. Talk to your student regularly to
discover difficult areas of training. Don’t be afraid to mention your concerns with
the therapist and parent.
There is no cure for CP
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You will not “Fix” your student
Your goal is to create a lifetime of physical and mental health for the student.
Be supportive and realistic – do NOT over promise.
Push your CP student to their limits, but not over them.
The goal is “To be better today than we were yesterday.”
Set three month goals that are hard, make a plan to reach them, and test them on their
progress towards those goals.
• Depending on your belt structure, creating 3 month goals for belt promotion will take your
student on a 4-5 year journey towards black belt.
Down Syndrome
a congenital disorder arising from a chromosome defect, causing intellectual
impairment and physical abnormalities including short stature and a broad facial
profile. It arises from a defect involving chromosome 21, usually an extra copy
(trisomy-21).
(picture of Garrett Holeve, via facebook page)
About Down Syndrome
• In every cell in the human body there is a
nucleus, where genetic material is stored in
genes. Genes carry the codes responsible
for all of our inherited traits and are
grouped along rod-like structures called
chromosomes. Typically, the nucleus of
each cell contains 23 pairs of
chromosomes, half of which are inherited
from each parent. Down syndrome occurs
when an individual has a full or partial
extra copy of chromosome 21.
• This additional genetic material alters the
course of development and causes the
characteristics associated with Down
syndrome. A few of the common physical
traits of Down syndrome are low muscle
tone, small stature, an upward slant to the
eyes, and a single deep crease across the
center of the palm - although each person
with Down syndrome is a unique
individual and may possess these
characteristics to different degrees, or not
at all.
How Common is Down Syndrome?
• One in every 691 babies in the the United States is born with Down
syndrome, making Down syndrome the most common genetic condition.
Approximately 400,000 Americans have Down syndrome and about 6,000
babies with Down syndrome are born in the United States each year.
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Source: http://www.ndss.org/Down-Syndrome/What-Is-Down-Syndrome/#sthash.OKJfJMlh.dpuf
Types of Down Syndrome
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There are three types of Down syndrome:
trisomy 21 (nondisjunction),
translocation and
mosaicism.
Trisomy 21 (nondisjunction)
Down syndrome is usually caused by an error in cell division called
"nondisjunction." Nondisjunction results in an embryo with three
copies of chromosome 21 instead of the usual two. Prior to or at
conception, a pair of 21st chromosomes in either the sperm or the egg
fails to separate. As the embryo develops, the extra chromosome is
replicated in every cell of the body. This type of Down syndrome,
which accounts for 95% of cases, is called trisomy 21.
Mosaicism
Mosaicism occurs when nondisjunction of chromosome 21 takes place in one - but not
all - of the initial cell divisions after fertilization. When this occurs, there is a mixture
of two types of cells, some containing the usual 46 chromosomes and others
containing 47. Those cells with 47 chromosomes contain an extra chromosome 21.
Mosaicism accounts for about 1% of all cases of Down syndrome. Research has
indicated that individuals with mosaic Down syndrome may have fewer characteristics
of Down syndrome than those with other types of Down syndrome. However, broad
generalizations are not possible due to the wide range of abilities people with Down
syndrome possess.
Translocation
• Translocation accounts for about 4% of all cases of Down syndrome. In
translocation, part of chromosome 21 breaks off during cell division and
attaches to another chromosome, typically chromosome 14. While the total
number of chromosomes in the cells remain 46, the presence of an extra
part of chromosome 21 causes the characteristics of Down syndrome.
What Impact Does Down Syndrome Have
on Society?
• Individuals with Down syndrome are becoming increasingly integrated into society and community
organizations, such as school, health care systems, work forces, and social and recreational activities.
Individuals with Down syndrome possess varying degrees of cognitive delays, from very mild to severe.
Most people with Down syndrome have cognitive delays that are mild to moderate.
• Due to advances in medical technology, individuals with Down syndrome are living longer than ever before.
In 1910, children with Down syndrome were expected to survive to age nine. With the discovery of
antibiotics, the average survival age increased to 19 or 20. Now, with recent advancements in clinical
treatment, most particularly corrective heart surgeries, as many as 80% of adults with Down syndrome reach
age 60, and many live even longer. More and more Americans are interacting with individuals with Down
syndrome, increasing the need for widespread public education and acceptance.
• - Source: http://www.ndss.org/Down-Syndrome/What-Is-Down-Syndrome/#sthash.OKJfJMlh.dpuf
Gross Motor Concerns of Down Syndrome
• Because of certain physical characteristics, which
include hypotonia (low muscle tone), ligamentous
laxity (looseness of the ligaments that causes
increased flexibility in the joints) and decreased
strength, children with Down syndrome don’t
develop motor skills in the same way that the
typically-developing child does. They find ways to
compensate for the differences in their physical
make-up, and some of the compensations can lead
to long-term complications, such as pain in the
feet or the development of an inefficient walking
pattern.
• The goal of physical therapy for these children is
not to accelerate the rate of their development, as
is often presumed, but to facilitate the
development of optimal movement patterns.
This means that over the long term, you want to
help the child develop good posture, proper foot
alignment, an efficient walking pattern, and a good
physical foundation for exercise throughout life.
Common Behavior Concerns
• Wandering/running off
• The most important thing is the safety of the
child. This would include a plan regarding
what each person's role would be in the
event of the child leaving the classroom.
Visual supports such as a STOP sign on the
door and/or other students asking
permission to go out the door can be a
reminder to the child or adult with Down
syndrome to ask permission before leaving
the house.
• Stubborn/oppositional behavior
• A description of the child or adult's behavior
during a typical day at home or school can
sometimes help to identify an event that may
have triggered non-compliant behavior. At
times, oppositional behavior may be an
individual's way of communicating
frustration or a lack of understanding
due to their communication/language
problems. Children with Down syndrome
are often very good at distracting parents or
teachers when they are challenged with a
difficult task.
Common Behavior Concerns
• Attention problems
• Individuals with Down syndrome can have ADHD but
they should be evaluated for attention span and
impulsivity based on developmental age and not strictly
chronological age. Anxiety disorders, language processing
problems and hearing loss can also present as problems
with attention.
• Obsessive/compulsive behaviors
• These can sometimes be very simple; for example, a child
may always want the same chair. However,
obsessive/compulsive behavior can also be more subtly
repetitive, manifesting through habits like dangling beads
or belts when not engaged directly in an activity. This
type of behavior is seen more commonly in younger
children with Down syndrome. While the number of
compulsive behaviors in children with Down syndrome is
no different than those in typical children at the same
mental age, the frequency and intensity of the behavior is
often greater. Increased levels of restlessness and worry
may lead the child or adult to behave in a very rigid
manner.
There is no cure for Down Syndrome
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You will not “Cure” your student
Your goal is to create a lifetime of physical and mental health for the student.
Be supportive and realistic about achievable short term goals.
Push your DS student to their limits, but stress the importance of proper basics.
The goal is “To be better today than we were yesterday.”
Down Syndrome students are typically able to learn and complete martial arts activities, but
“technique” and power are often lacking.
• Gross motor and fine motor issues typically result in slow growth and a school needs to
recognize that “reasonable progress” should be measured individually, not by traditional
standards.
Autism spectrum disorder (ASD) and
Autism
Autism spectrum disorder (ASD) and autism are both general terms for a group
of complex disorders of brain development. These disorders are characterized, in
varying degrees, by difficulties in social interaction, verbal and nonverbal
communication and repetitive behaviors. With the May 2013 publication of the
DSM-5 diagnostic manual, all autism disorders were merged into one umbrella
diagnosis of ASD. Previously, they were recognized as distinct subtypes, including
autistic disorder, childhood disintegrative disorder, pervasive developmental
disorder-not otherwise specified (PDD-NOS) and Asperger syndrome.
Autism spectrum disorder (ASD) and Autism
• ASD can be associated with
intellectual disability, difficulties in
motor coordination and attention
and physical health issues such as
sleep and gastrointestinal
disturbances. Some persons with
ASD excel in visual skills, music,
math and art.
• Autism appears to have its roots in
very early brain development.
However, the most obvious signs
of autism and symptoms of autism
tend to emerge between 2 and 3
years of age.
How Common is ASD?
Autism statistics from the U.S. Centers for Disease Control and
Prevention (CDC) identify around 1 in 68 American children as
on the autism spectrum–a ten-fold increase in prevalence in 40
years. Careful research shows that this increase is only partly
explained by improved diagnosis and awareness. Studies also
show that autism is four to five times more common among
boys than girls. An estimated 1 out of 42 boys and 1 in 189 girls
are diagnosed with autism in the United States.
ASD affects over 3 million individuals in the U.S. and tens of
millions worldwide. Moreover, government autism statistics
suggest that prevalence rates have increased 10 to 17 percent
annually in recent years. There is no established explanation for
this continuing increase, although improved diagnosis and
environmental influences are two reasons often considered.
What Does It Mean to Be “On the
Spectrum”?
• Each individual with autism is unique. Many of those on the autism
spectrum have exceptional abilities in visual skills, music and academic skills.
About 40 percent have average to above average intellectual abilities. Indeed,
many persons on the spectrum take deserved pride in their distinctive
abilities and “atypical” ways of viewing the world. Others with autism have
significant disability and are unable to live independently. About 25 percent
of individuals with ASD are nonverbal but can learn to communicate using
other means.
As illustrated by the graph on the right, the basic
symptoms of autism are often accompanied
other medical conditions and challenges. These,
too, can vary widely in severity.
Autism spectrum disorders (ASD) are characterized by social-interaction
difficulties, communication challenges and a tendency to engage in
repetitive behaviors. However, symptoms and their severity vary widely
across these three core areas. Taken together, they may result in
relatively mild challenges for someone on the high functioning end of
the autism spectrum. For others, symptoms may be more severe, as
when repetitive behaviors and lack of spoken language interfere with
everyday life.
Autism
a mental condition, present from early childhood, characterized by
difficulty in communicating and forming relationships with other
people and in using language and abstract concepts.
Social Challenges
• Typically developing infants are social by nature. They
gaze at faces, turn toward voices, grasp a finger and even
smile by 2 to 3 months of age. By contrast, most children
who develop autism have difficulty engaging in the giveand-take of everyday human interactions. By 8 to 10
months of age, many infants who go on to develop
autism are showing some symptoms such as failure to
respond to their names, reduced interest in people and
delayed babbling. By toddlerhood, many children with
autism have difficulty playing social games, don’t imitate
the actions of others and prefer to play alone. They may
fail to seek comfort or respond to parents' displays of
anger or affection in typical ways.
• Research suggests that children with autism are attached
to their parents. However the way they express this
attachment can be unusual. To parents, it may seem as if
their child is disconnected. Both children and adults with
autism also tend to have difficulty interpreting what
others are thinking and feeling. Subtle social cures such
as a smile, wave or grimace may convey little meaning. To
a person who misses these social cues, a statement
like “Come here!” may mean the same thing,
regardless of whether the speaker is smiling and
extending her arms for a hug or frowning and
planting her fists on her hips. Without the ability to
interpret gestures and facial expressions, the social world
can seem bewildering.
Social Challenges
• Many persons with autism have similar
difficulty seeing things from another
person's perspective. Most five year olds
understand that other people have
different thoughts, feelings and goals than
they have. A person with autism may lack
such understanding. This, in turn, can
interfere with the ability to predict or
understand another person’s actions.
• It is common – but not universal – for
those with autism to have difficulty
regulating emotions. This can take the
form of seemingly “immature” behavior
such as crying or having outbursts in
inappropriate situations. It can also lead to
disruptive and physically aggressive
behavior. The tendency to “lose control”
may be particularly pronounced in
unfamiliar, overwhelming or frustrating
situations. Frustration can also result in
self-injurious behaviors such as head
banging, hair pulling or self-biting.
Communication Difficulties
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By age three, most children have passed predictable milestones on
the path to learning language. One of the earliest is babbling. By
the first birthday, most typically developing toddlers say a word or
two, turn and look when they hear their names, etc. When offered
something distasteful, they can make clear – by sound or
expression – that the answer is “no.”
By contrast, young children with autism tend to be delayed in
babbling and speaking and learning to use gestures. Some infants
who later develop autism coo and babble during the first few
months of life before losing these communicative behaviors.
Others experience significant language delays and don’t begin to
speak until much later. With therapy, however, most people with
autism do learn to use spoken language and all can learn to
communicate.
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Many nonverbal or nearly nonverbal children and adults learn to
use communication systems such as pictures, sign language,
electronic word processors or even speech-generating devices.
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When language begins to develop, the person with autism may use
speech in unusual ways. They may speak only single words or
repeat the same phrase over and over. Some go through a stage
where they repeat what they hear verbatim (echolalia).
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Some mildly affected children exhibit only slight delays in
language or even develop precocious language and unusually large
vocabularies – yet have difficulty sustaining a conversation. Some
children and adults with autism tend to carry on monologues on a
favorite subject, giving others little chance to comment. In other
words, the ordinary “give and take” of conversation proves
difficult. Some children with ASD with superior language skills
tend to speak like little professors, failing to pick up on the “kidspeak” that’s common among their peers.
Body Language Issues
Another common difficulty is the inability to understand body language, tone of
voice and expressions that aren’t meant to be taken literally. For example, even an
adult with autism might interpret a sarcastic “Oh, that's just great!” as meaning it
really is great.
Conversely, someone affected by autism may not exhibit typical body language.
Facial expressions, movements and gestures may not match what they are saying.
Their tone of voice may fail to reflect their feelings. Some use a high-pitched
sing-song or a flat, robot-like voice. This can make it difficult for others know
what they want and need. This failed communication, in turn, can lead to
frustration and inappropriate behavior (such as screaming or grabbing) on the
part of the person with autism. Fortunately, there are proven methods for helping
children and adults with autism learn better ways to express their needs. As the
person with autism learns to communicate what he or she wants, challenging
behaviors often subside.
Repetitive Behaviors
• Unusual repetitive behaviors and/or a tendency to engage in a restricted range of activities are another core symptom of
autism. Common repetitive behaviors include hand-flapping, rocking, jumping and twirling, arranging and rearranging
objects, and repeating sounds, words, or phrases. Sometimes the repetitive behavior is self-stimulating, such as wiggling
fingers in front of the eyes.
• The tendency to engage in a restricted range of activities can be seen in the way that many children with autism play with
toys. Some spend hours lining up toys in a specific way instead of using them for pretend play. Similarly, some adults are
preoccupied with having household or other objects in a fixed order or place. It can prove extremely upsetting if someone
or something disrupts the order. Along these lines many children and adults with autism need and demand extreme
consistency in their environment and daily routine. Slight changes can be extremely stressful and lead to outbursts
• Repetitive behaviors can take the form of intense preoccupations, or obsessions. These extreme interests can prove all the
more unusual for their content (e.g. fans, vacuum cleaners or toilets) or depth of knowledge (e.g. knowing and repeating
astonishingly detailed information about Thomas the Tank Engine or astronomy). Older children and adults with autism
may develop tremendous interest in numbers, symbols, dates or science topics.
Associated Medical Conditions
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Genetic Disorders
Fragile X syndrome
Angelman syndrome
tuberous sclerosis
chromosome 15 duplication syndrome
other single-gene and chromosomal
disorders
• Gastrointestinal (GI) Disorders
• GI distress is common among persons with
autism, and affects up to 85 percent of
children with ASD. These conditions range
in severity from a tendency for chronic
constipation or diarrhea to inflammatory
bowel disease. Pain caused by GI issues can
prompt behavioral changes such as increased
self soothing (rocking, head banging, etc) or
outbursts of aggression or self-injury.
Conversely, appropriate treatment can
improve behavior and quality of life.
Associated Medical Conditions
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Seizure Disorders
Seizure disorders, including epilepsy, occur in as many as 39
percent of those with autism. It is more common in people with
autism who also have intellectual disability than those without.
Someone with autism may experience more than one type of
seizure. The easiest to recognize is the grand mal, or tonic-clonic,
seizure. Others include “petit mal” seizures (when a person
temporarily appears “absent”) and subclinical seizures, which may
be apparent only with electroencephalogram (EEG) testing.
Seizures associated with autism tend to start in either early
childhood or adolescence. But they may occur at any time. If you
are concerned that you or your child may be having seizures, it is
important to raise the issue with your doctor for possible referral
to a neurologist for further evaluation.
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Sensory Processing Problems
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Some of those with autism are hypersensitive to sounds or touch,
a condition also known as sensory defensiveness. Others are
under-responsive, or hyposensitive. An example of
hypersensitivity would be the inability to tolerate wearing clothing,
being touched or being in a room with normal lighting.
Hyposensitivity can include failure to respond when one’s name is
called. Many sensory processing problems can be addressed with
occupational therapy and/or sensory integration therapy.
Many persons with autism have unusual responses to sensory
input. They have difficulty processing and integrating sensory
information, or stimuli, such as sights, sounds smells, tastes
and/or movement. They may experience seemingly ordinary
stimuli as painful, unpleasant or confusing.
There is no cure for Autism
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You will not “Cure” your student.
Your goal is to create a lifetime of physical and mental health for the student.
Be supportive and realistic about achievable short term goals.
Push your ASD student to their limits, but stress the importance of proper basics. Find new ways to teach
the same skills!
• The goal is “To be better today than we were yesterday.”
• Autistic students are typically uninterested in martial arts for normal reasons. They may learn to enjoy the
activity and a reliable schedule is a MUST!
• Gross motor and fine motor issues typically result in slow growth and a school needs to recognize that
“reasonable progress” should be measured individually, not by traditional standards.
Asperger Syndrome
A developmental disorder related to autism and characterized by
higher than average intellectual ability coupled with impaired social
skills and restrictive, repetitive patterns of interest and activities
What Is Asperger Syndrome?
• Asperger syndrome is an autism spectrum disorder (ASD) considered to be
on the “high functioning” end of the spectrum. Affected children and adults
have difficulty with social interactions and exhibit a restricted range of
interests and/or repetitive behaviors. Motor development may be delayed,
leading to clumsiness or uncoordinated motor movements. Compared with
those affected by other forms of ASD, however, those with Asperger
syndrome do not have significant delays or difficulties in language or
cognitive development. Some even demonstrate precocious vocabulary –
often in a highly specialized field of interest.
The following behaviors are often associated with Asperger
syndrome. However, they are seldom all present in any one
individual and vary widely in degree:
• limited or inappropriate social interactions
• "robotic" or repetitive speech
• challenges with nonverbal communication
(gestures, facial expression, etc.) coupled
with average to above average verbal skills
• tendency to discuss self rather than others
• inability to understand social/emotional
issues or nonliteral phrases
• lack of eye contact or reciprocal
conversation
• obsession with specific, often unusual,
topics
• one-sided conversations
• awkward movements and/or mannerisms
How is Asperger Syndrome diagnosed?
• Asperger syndrome often remains
undiagnosed until a child or adult begins to
have serious difficulties in school, the
workplace or their personal lives. Indeed,
many adults with Asperger syndrome receive
their diagnosis when seeking help for related
issues such as anxiety or depression.
Diagnosis tends to center primarily on
difficulties with social interactions.
• Children with Asperger syndrome tend to
show typical or even exceptional language
development. However, many tend to use
their language skills inappropriately or
awkwardly in conversations or social
situations such as interacting with their peers.
Often, the symptoms of Asperger syndrome
are confused with those of other behavioral
issues and are initially diagnosed with
ADHD until it becomes clear that their
difficulties stem more from an inability to
socialize than an inability to focus their
attention.
Social Skills Deficits
• Someone with Asperger syndrome
might initiate conversations with
others by extensively relating facts
related to a particular topic of interest.
He or she may resist discussing
anything else and have difficulty
allowing others to speak. Often, they
don’t notice that others are no longer
listening or are uncomfortable with the
topic. They may lack the ability to “see
things” from the other person’s
perspective.
• Another common symptom is an
inability to understand the intent
behind another person’s actions, words
and behaviors. So children and adults
affected by Asperger syndrome may
miss humor and other implications.
Similarly, they may not instinctually
respond to such “universal” nonverbal
cues such as a smile, frown or “come
here” motion.
Social Skills Deficits
For these reasons, social interactions can seem confusing and
overwhelming to individuals with Asperger syndrome. Difficulties in
seeing things from another person's perspective can make it extremely
difficult to predict or understand the actions of others. They may not
pick up on what is or isn’t appropriate in a particular situation. For
instance, someone with Asperger syndrome might speak too loudly
when entering a church service or a room with a sleeping baby – and
not understand when “shushed.”
Physical Issues
• Some individuals with Asperger
syndrome have a peculiar manner of
speaking. This can involve speaking
overly loud, in a monotone or with an
unusual intonation. It is also common,
but not universal, for people with
Asperger syndrome to have difficulty
controlling their emotions. They may
cry or laugh easily or at inappropriate
times.
• Another common, but not universal,
sign is an awkwardness or delay in
motor skills. As children, in particular,
they may have difficulties on the
playground because they can’t catch a
ball or understand how to swing on
the monkey bars despite their peers’
repeated attempts to teach them.
Motor Issues
• A common expression of motor impairment is an inability to cross the
centerline of the body or switch from one side of the body and back again.
• Also, an inability to consciously sync the upper and lower body during
complex movements can often be observed.
• It is very important to note that the challenges presented by Asperger
Syndrome are very often accompanied by unique gifts. Indeed, a remarkable
ability for intense focus is a common trait.
Working with Asperger Syndrome
• Breaking complex movements down into their basic parts is a common strategy to teach
Asperger students with motor issues.
• A traditional class structure is exceptionally helpful for students with Asperger Syndrome –
provided you explain WHY you are doing what you do. Routine and structure create ability
to thrive and succeed.
• Educational and social support programs for children with Asperger syndrome generally
teach social and adaptive skills step by step using highly structured activities. The instructor
may repeat important ideas or instructions to help reinforce more adaptive behaviors.
• Many of these programs also involve parent training so that lessons can be continued in the
home – communication with the parents about class expectations and ways to continue
them at home are usually tremendously appreciated
There is no cure for Asperger Syndrome
• You will not “Cure” your student.
• Your goal is to create a lifetime of physical and mental health for the student, and achieve Martial Arts
Success.
• Be supportive and positive at all times.
• Push your ASD student to their limits, but stress the importance of proper basics. Find new ways to teach
the same skills!
• The goal is “To be a Black Belt. Utilize key words and concepts (ie. focus, discipline honor, integrity, etc.)”
• Most Asperger students are able to learn martial arts and are typically EXTREMELY interested in Martial
Arts due to things such as Anime, Yu-Gi-Oh, etc.
• Gross motor and fine motor issues can result in slow growth but by allowing for slow growth, you can hold
most students to traditional standards.
PDD-NOS
A pervasive developmental disorder not otherwise specified (PDDNOS) is one of the three autism spectrum disorders (ASD) and
also one of the five disorders classified as a pervasive
developmental disorder (PDD)
What is PDD-NOS?
• PDD-NOS stands for Pervasive Developmental Disorder-Not Otherwise Specified.
Psychologists and psychiatrists sometimes use the term “pervasive developmental
disorders” and “autism spectrum disorders” (ASD) interchangeably. As such, PDDNOS became the diagnosis applied to children or adults who are on the autism
spectrum but do not fully meet the criteria for another ASD such as autistic
disorder (sometimes called “classic” autism) or Asperger Syndrome.
• Like all forms of autism, PDD-NOS can occur in conjunction with a wide
spectrum of intellectual ability. Its defining features are significant challenges in
social and language development.
PDD-NOS can be placed in one of three very
different subgroups:
• A high-functioning group (around 25 percent) whose symptoms largely overlap with
that of Asperger syndrome, but who differ in terms of having a lag in language
development and mild cognitive impairment. (Asperger syndrome does not
generally involve speech delay or cognitive impairment).
• A second group (around 25 percent) whose symptoms more closely resemble those
of autistic disorder, but do not fully meet all its diagnostic signs and symptoms.
• A third group (around 50 percent) who meet all the diagnostic criteria for autistic
disorder, but whose stereotypical and repetitive behaviors are noticeably mild.
How should PDD-NOS be treated?
• As with all autism spectrum disorders,
early diagnosis and intervention offer
the best chance for optimizing
outcomes – including success in
mainstream classrooms and the
achievement of independence and a
high quality of life in adulthood.
However, it is never too late to begin
behavioral therapy.
• As previously mentioned, no two
individuals with PDD-NOS are alike.
Indeed, they can have completely
different strengths and challenges. As a
result, treatments and interventions
should be highly individualized based
on a thorough assessment. The
evaluation should consider such
factors as behavioral history, current
symptoms, communication patterns,
social competence and
neuropsychological functioning.
Working with PDD-NOS
• The relevant concern with PDD-NOS is to fully assess where the student fits
in the Mild / Moderate / Severe categories.
• After assessment, you can tailor the program in the same way you would for
Autism or Asperger Syndrome.
There is no cure for PDD-NOS
• You will not “Cure” your student.
• Your goal is to create a lifetime of physical and mental health for the student, and achieve Martial Arts
Success.
• Be supportive and positive at all times.
• Push your ASD student to their limits, but stress the importance of proper basics. Find new ways to teach
the same skills!
• The goal is “To be a Black Belt. Utilize key words and concepts (ie. focus, discipline honor, integrity, etc.)”
• Most Asperger students are able to learn martial arts and are typically EXTREMELY interested in Martial
Arts due to things such as Anime, Yu-Gi-Oh, etc.
• Gross motor and fine motor issues can result in slow growth but by allowing for slow growth, you can hold
most students to traditional standards.
Final thoughts on ASD
• Routine is paramount for students on the Spectrum. It provides structure they can understand, and stability
they crave. Routine builds students for LIFE.
• Positive reinforcement and praise always – NEVER punitive or negative reinforcement.
• When ever you get stuck with a negative behavior, remember to stop and explain the WHY behind your
requests. Do not take for granted that they understand why you are telling them to do something.
• Build behavior modification plans based upon rewards. Keep consequences for negative actions consistent
and clearly explained.
• Remember – the WORST thing your ASD student should be able to imagine is not being allowed to
participate – that is the ultimate consequence of negative behaviors.
• You could fill your ENTIRE school with students on the spectrum if you wished. There are approximately
430 Nampa children under 18 years old on the spectrum, desperately looking for a social, physical outlet that
can help them learn how to live and thrive in this world.
Emotional Disturbance
A condition exhibiting one or more of the following characteristics over a long
period of time and to a marked degree that adversely affects a child's educational
performance: An inability to learn that cannot be explained by intellectual,
sensory or health factors; An inability to build or maintain satisfactory
interpersonal relationships with peers and teachers; Inappropriate types of
behavior or feelings under normal circumstances; A general pervasive mood of
unhappiness repression; or A tendency to develop physical symptoms or fears
associated with personal or school problems.
Definition
• In the special education realm, conditions which generate behavioral issues fall
under the category emotional disturbance. Several disorders receive this
classification, as the previous pages definition suggests.
• The term includes schizophrenia. The term does not apply to children who are
socially maladjusted, unless it is determined that they have an emotional disturbance.
• Overwhelmed? A simpler way to understand emotional disturbances is to remember
that, when it comes to special education, the term “emotional disturbance” is
associated with mental health or severe behavior issues.
Common Traits
• The National Dissemination Center for Children with Disabilities (often
referred to as NICHCY) lists six types of emotional disturbances: anxiety
disorders, bipolar disorder, conduct disorders, eating disorders, obsessivecompulsive disorder (OCD) and psychotic disorders; however, they note that
this list isn’t all-inclusive.
Educational Challenges
Given the behavioral issues related to the disability category at hand,
educating students diagnosed with emotional disturbances can
prove challenging. The challenge often stems from potential
classroom disruptions; for instance, imagine the trouble created
when a student begins crying uncontrollably or starts throwing a
wild temper tantrum.
Educational Challenges
• Avoiding disruptive behavior may entail behavior modification. Behavior
modification can involve strategies such as positive reinforcement and incentives to
help students learn behaviors that are less disruptive and more socially acceptable.
• Martial Arts classes should focus on mutual respect – earned not given - and clear,
concise choices and simple, fair, and consistently enforced consequences for actions.
• Collaborate with other professionals who work with your student (psychotherapist,
behavioral therapist, etc.) to determine specific ways to effectively educate the
individual.
Biggest Hurdle to teaching students with
Emotional disturbance?
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Parents…
Parents fear of violence inherent in Martial Arts.
Parents fear of abusive teachers
Parents fear of uncontrollable children with fighting skills.
Parent misunderstanding of what we REALLY DO in the Martial Arts.
You must communicate with the parents!
You CAN Help Eliminate ED!
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You will not “Cure” your student. You can help them to gain COMPLETE control over their issues.
Your goal is to create a lifetime of mental health for the student, and achieve Martial Arts Success.
Be supportive and positive at all times. Build them up!
Push your student to their limits, but stress the importance of never giving up. Stress the inevitability of
success if they just keep trying!
• The goal is “To be a Black Belt. Utilize key words and concepts (ie. respect, confidence, success, dignity.)”
• Medicine is often essential to controlling ED. Regardless of your personal beliefs, never encourage your
student to “try alternative ways”, or tell them Martial Arts will be all they need.
• NEVER, EVER BE ALONE WITH A SEVERE ED STUDENT! NEVER!
Attention Deficit Hyperactive Disorder
Any of a range of behavioral disorders occurring primarily in
children, including such symptoms as poor concentration,
hyperactivity, and impulsivity.
ADHD
• ADHD is one of the most common neurodevelopmental disorders of
childhood. It is usually first diagnosed in childhood and often lasts into
adulthood. Children with ADHD may have trouble paying attention,
controlling impulsive behaviors (may act without thinking about what the
result will be), or be overly active.
Symptoms of ADHD
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daydream a lot
forget or lose things a lot
squirm or fidget
talk too much
have trouble taking turns
• make careless mistakes or take
unnecessary risks
• have a hard time resisting
temptation
• have difficulty getting along with
others
• talk all the time
Three types of ADHD
• Predominantly Inattentive Presentation: It is hard for the individual to organize or finish
a task, to pay attention to details, or to follow instructions or conversations. The person is
easily distracted or forgets details of daily routines.
• Predominantly Hyperactive-Impulsive Presentation: The person fidgets and talks a lot.
It is hard to sit still for long (e.g., for a meal or while doing homework). Smaller children
may run, jump or climb constantly. The individual feels restless and has trouble with
impulsivity. Someone who is impulsive may interrupt others a lot, grab things from people,
or speak at inappropriate times. It is hard for the person to wait their turn or listen to
directions. A person with impulsiveness may have more accidents and injuries than others.
• Combined Presentation: Symptoms of the above two types are equally present in the
person.
Behavioral Therapy
Research shows that behavioral therapy is an important part of
treatment for children with ADHD. ADHD affects not only a
child’s ability to pay attention or sit still at school, it also affects
relationships with family and how well they do in their classes.
Behavioral therapy is a treatment option that can help reduce these
problems for children and should be started as soon as a diagnosis
is made.
Tips for Martial Arts success:
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Use a folder for parent-school communications.
Make activities clear
Give positive reinforcement
Be sensitive to self-esteem issues
Involve the school and parent in a comprehensive, consistent plan.
Avoid punishing for being ADHD – it’s not lack of focus or discipline.