1. Inclusion of Children with Special Needs
Meeting the Needs of children with Special Needs Assignment
Case Study-Najia-Developmental Delay
Rubina Akbar
Student No: 300647837
Section 061
April 05, 2013
Professor: Lisa McCaie

2. Introduction of Najia & her family
According to the case study scenario, Najia is 11 months
old. She is not babbling or pointing to objects in the
room. Najia’s mother has three other children in the
centre and often appears very stressed .
Developmental Delay-Early Recognition

3. Najia’s development
 The development of Najia is atypical in the area of language and
communication developmental domains. As far as the behaviour is
concern, this child is not babbling at the age of 11 months and not pointing
to the objects in the environment. Every child develops at their own pace,
some children reached their milestone early in their life, but some children
develop their developmental milestone later period in their life.
 Najia’s development seems delayed. According to ages and stages, at the
age of 11 months, she should babble, point to objects, and respond to the
environment. As compare to other children, her development is behind or
she did not reach at her developmental milestone yet.

4. Language Developmental Milestone
By the age of 5 months
(cont.)
 baby should respond to loud noises
 turn toward sounds
 watch your face when you speak to him and try to "talk" back
By the age of 8 months
 babbles expressively as if talking
 respond to own name
 squeals, laughs, babbles, smiles in response
By 12 months
 the baby should try to imitate sounds that you make
 the child should use at least a few real words,
 recognize and react to the sound of his name,
 incorporate consonants into his babbling
 use sound to communicate with you.
 baby should begin repeating syllables, like "baba," "dada" or "mama" by about nine months of
age -- although probably he is not attaching meaning to the sounds yet
At 18 months
 the child should know the names of familiar objects and people
 An 18 month olds should use least 20 words, including different types of words, such as nouns
(“baby”, “cookie”), verbs (“eat”, “go”), prepositions (“up”, “down”), adjectives (“hot”,
“sleepy”), and social words (“hi”, “bye”).

5. Language Developmental Milestone
By 24 months
 The child should be able to say at least 8 to 10 words and combine them in two-word
phrases
 24 month olds should use at least 100 words and combine 2 words together. These word
combinations should be generated by the child, and not be combinations that are
“memorized chunks” of language, such as “thank you”, “bye bye”, “all gone”, or “What’s
that?”. Examples of true word combinations would be “doggie gone”, “eat cookie”, or
“dirty hands”.
For example:
Some children start talking or walking very early as compare to the other children, on the other
hand, some children talk very late. Some children don’t talk until they are three years of age.
Personal Experience with language concerns:
My sister in law has three daughters. Her all three daughters did not start talking until they were
three of their age. Our family was very concerned about this. Now, all girls are about 8, 7, and 5
years old, and they are very talkative and intelligent in their daily and school’s activities. There is no
concern at all.

6. Najia’s special needs
Najia requires some special needs:
 Language development
 Communication skills
 Cognitive Development
 Social and emotional
 Hearing and Vision testing
 Fast reflexes
Variation of Developmental Delay

7. Needs of Najia’s Family (cont.)
 The mother of Najia has three other children too.
The mother has a lot of responsibilities of four
children. She often seems much stressed in
everyday life. It is a challenging job for a mother
to take care of four children. Sometimes it
becomes very hard to deal with four children
especially when there is a child with special
needs.
 The mother has to take care of all four children
that is why sometimes the child who has special
needs is not getting enough attention and care
which is necessary or required for her
development and growth.
 The mother’s schedule and her struggling period
with four children can affect on Najia’s
development.
 The family needs social and emotional support
from peers, childcare, and from the community in
this case to develop Najia’s developmental
milestone.
 Child care center can meet the needs of parents
by providing suggestion and resources. Also,
caregivers can provide extra social and emotional
support to Najia and her family.

8. Risk Factors for Language Development
A list of risk factors has been identified, which suggest that a child is
more likely to have continuing language difficulties]. These include:
 quiet as an infant; little babbling
 a history of ear infections
 limited number of consonant sounds (eg. p, b, m, t, d, n, y, k, g, etc.)
 does not link pretend ideas and actions together while playing
 does not imitate (copy) words
 uses mostly nouns (names of people, places, things), and few verbs (action
words)
 difficulty playing with peers (social skills)
 a family history of communication delay, learning or academic difficulties
 a mild comprehension (understanding) delay for his or her age
 uses few gestures to communicate

9. Effects of children hearing on
language development
 Active involvement between adult and a child can be improved by
applying appropriate strategies based on needs and development of
the child. The number of total words and different words that the
parent uses with the child daily, the number of conversations, and
the positive affirmations from the parent are all related to infants’
and toddlers’ language development.
 Some infants and toddlers hear an average 600 words an hour
 Others hear as many as words an hour 2100 words an hour
 Some children hear 100 words hour
 while others hear 500 words an hour
“These differences in the amount of language that children
hear make a difference in their language development”

10. Suggestions for Promoting Language Skills
It’s never too early to seek help. We know that the
earlier we start to help children, the better their
outcomes.
 Consult a speech-language pathologist about your concerns.
 Have your child’s hearing evaluated – even if you think your child is
hearing just fine, it is important to make sure he is hearing sounds at
a variety of volumes and pitches. Even slight hearing impairments
can cause difficulties with speech and language development.
When to Seek Therapy

11. How parents can help in developing
children’s communication skills
Encouraging children to communicate
 There are many things parents can do at home on a
daily basis to develop children’s communication skills.
The key is to be consistent in expectations of children’s
response.

12. How parents can help in developing
children’s communication skills
Encouraging children to communicate (cont.)
 Looking at child’s face when parents speak to the child
 Emphasizing or stressing important words by saying them a bit louder
 Speaking slowly and clearly
 Using gestures, objects, or pictures to match your words
 Repeating parts of questions or instructions
 Giving him time to respond to you
 Providing him with visual aids such as objects and pictures
 Looking at an object, activity, or person
 Pulling another person towards an object or activity he wants
 Gesturing to show what the child wants or does not wants
 Encourage your child to ask for “more” of something he enjoys by using sounds,
words, gestures or pictures.
 Blow the bubbles and encourage your child to look at and touch the bubbles. When
bubbles have disappeared, put the cap back on the container and ask you child if he
would like more bubbles. Wait a few moments. If your child looks interested,
encourage him/her to ask for more by gesturing, pointing to the container, saying
“more”
 Pour a little bit of juice into a glass, play music and tickle, bounce or lift the child in the
air one time and then stop.

13. How parents can help in developing
children’s communication skills
Encouraging children to communicate (cont.)
 Show the child two objects, crackers or cookies and let the child make
choice. Wait a moment. Parent can point an object if child does not make
choice.
 Playtime is an excellent time to build your child’s communication skills, use
this time to have fun with the child.

Model by making sound like “ba”, “wa”, “ma”,”da”,”cah ”

14. Who can help?
 Resource Teacher or Consultant
 Pediatrician
 Audiologist
 Infant Development Program Consultant
 Speech and Language Therapist
 Special Education Teacher
 Vision or hearing impairment
 Agency support person

15. Who can help? (cont.)
 Resource Teacher or Consultant
 Gather information in relation to children with special needs
 Assist families and child care staff in identifying strengths, needs and
goals for the child with special needs
 Access and coordinate resources to support children, families and child
care staff
 Develop appropriate strategies and service plans to support inclusion of
the child with special needs
 Interact with related professionals in the community
 Pediatrician
 Specializes in child development and medical care for children
 Audiologist
 Provides hearing screening, assessments and intervention supports for
children with or at risk for hearing loss

16. Who can help? (cont.)
 Infant Development Program Consultant
 Works with families of children under the age of three with, or at risk of ,
developmental delay
 Can provide home visits, assessments, program planning, and liaison
with other families
 Speech and Language Therapist
 Works with children and their families to develop the child’s verbal and non-
verbal communication skills, their understanding of language and their
swallowing and feeding skills
 Special Education Teacher
 Specialty teacher who oversees and may also implement the education
and development of children with special needs

17. Strategies for developmental Needs
 To plan appropriate strategies to meet the child’s needs within
the child care setting, it is necessary to observe closely the
child’s behaviour and development.
 For example, I will start by taking a look at her existing skills
and abilities, or the things that she can do. This will give me a
clearer picture of the child’s developmental strengths and
needs. Secondly, before I implement a strategy, I would focus
on specific area of development, such as cognitive, language,
communication, social, and emotional development.

18. Strategies for Developmental Delay/
developmental Needs (cont.)
 Najia has special needs in language and communication
development. Based on those needs, I would plan to implement
some strategies for language development, for example:
 Spoken language
 Visual Language
 Repetition/Rhymes
 Signs/Gestures
 Use Self-Talk and Parallel Talk
 Offer Choices

19. Spoken language
 As an educator, to promote Najia’s
language and communication skills, I would
focus on using spoken language (words or
sounds).
 For example, I would talk to Najia more
often to promote her language skills and
will use the technique looking at her face
when I am speaking to her. I would
emphasize or stress important key words
by saying them a bit louder. Speaking
slowly, loudly, and clearly can be very
helpful in teaching language skills to Najia.
Also, it will enhance other infants’ language
skills too. Because in this room, I will have
a larger group of infants, and they are also
at the stage of learning new words, sounds,
and vocabulary. Therefore, it will be a
useful technique for all the other children
too. When I will talk to Najia, other children
will also listen and learn new words through
our conversation.

20. Visual Language
 A visual language is a
system of communication
using visual elements.
 For example,
 I would use visual language for
instance object, colour pictures,
black and white photographs,
colour line drawings, black and
white line drawings and symbols to
communicate with the child and
will teach the child language skills.
According to class notes, “Visuals
can help the child to communicate
with us. For example, the child can
point to make a choice”

21. Repetition/Rhymes
 Another strategy I can apply is by asking for objects and
repeating words, questions, instructions and rhymes. A little
louder, clear, and low speed sound can be effective technique
for children who have communication and language problem.
 For example, according to the reading package, it is
mentioned that “A child will be more likely to use signs if the
signs chosen are functional. For example, if singing “more”
gets the child more of something he likes, the child will be
motivated to learn. “My turn” and “help” are also useful as they
help the child access something desired.”
 For Najia, we can apply same strategy such as we can
practice babbling with her by saying “baba”, ma ma” etc.

22. Signs/Gestures
Examples
 Children who learn through
movement are good candidates
for using signs them selves. Some
basic signs can be introduced into
the classroom as a general
support . This strategy is equally
useful for the other group of
children

23. Signs/Gestures
Examples
 In addition, using signs and/or
gestures is an important
component of a total
communication approach.
 For example, I would model signs
or gestures while using spoken
language with Najia because it
can help to enhance her receptive
language (understanding).
Furthermore, I would provide
visual cues and cards to support
speech and I will assist adults by
slowing down their accompanying
speech and emphasizing the key
words. Some examples of using
gestures are “directions, greetings,
and concepts”.

24. Use Self-Talk and Parallel Talk
 Self-talk is talk that adults use to
describe what they are doing while
with the infant or toddler. For example,
if I am diapering a baby might say, “I’m Example
getting your diaper. Now I’m lifting your
feet. I’m putting the diaper on. All
done.” Parallel talk occurs when an
adult talks about what a child is doing.
 For example, while the child is playing
or eating I might say, “Mmm, you’re
eating your toast” while pointing to the
toast. These strategies tie language to Self-Talk and Parallel Talk
an act or object manipulation, making
words come alive and have meaning
for the child. This strategy will also be
helpful for other group of children,
because with the help of self talk and
parallel take, children will learn the
sequence, steps, or order. They will
also learn

25. Picture Exchange Communication
System (PECS)
 It was designed for children who are Example:
not yet initiating communication to
express their needs or interests. It
contains the six phases, but for Najia’s
case I can only use phase one
because it is designed for children who
are not verbal.
 For example, two adults are
required during the first teaching
session. One sits directly across from
the child to receive the picture. The
other is behind the child to prompt the
exchange. Place the desired items
and the picture of it in front of the child.
Do not ask the child what he wants.
Provide the child with the desired
object immediately and say, “Oh you
want this”. Children like to play with
other people. Other children PECS

26. Offer Choices (cont.)
Choice Boards Example:
For Najia, I would use individual choice
board, and for other children I would use
class wide choice board.
For example,
 This age group attract by colours, so I will
provide choice board of different colours.
She might attracts by any colour or make
some choice.
 In addition, Najia is learning to making a
choice. I can provide choices by showing
Najia two real objects, and wait for her reply
or pointing something to develop
communication skills. If she indicate her
choice by vocalizing, verbalizing, or
gesturing, I will immediately provide her
indicated choice to reinforce having made a
choice.

27. Offer Choices (cont.)
For older infants, I would provide
class wide choice board.
For example, I would provide a board
of activity pockets for where children
can make choice for toys, pictures, or
food etc. I will show the choice board
then older infant can choose may be
favourite toys to play or can choose
milk bottle if he/she is hungry etc.

28. Offer Choices (cont.)
 Song Boards Example:
 For Najia and other children I would
find props or pictures that correspond
to a few favourite songs.
 I will make a board with name of the
songs represented on the board then I
will ask “Do you want Twinkle Twinkle
Little Star or Eensy Weensy Spider.
 I will allow Najia to make a choice
through eye gaze, pointing or
gesturing.
 Other children can indicate song by
pointing or saying. When song is
finished I will put away the prop or
picture.

29. Some Other Examples of Strategies
Examples would include the following strategies:
 Use responsive talk.
 Use shorter sentences and decreased vocabulary.
 Exaggerate the pitch and intonation of your voice.
 Direct your communication at the infant or toddler.
 Use longer pauses between words and utterances.
 Frequently repeat words.
 Don’t be afraid to be redundant—for example, say, “A bird—a blue bird,” repeating
the word bird.
 Elongate the vowels in words (“Oooh, whaaaat is that?”).
 Use diminutive words (blanky, piggy, doggy).
 Use frequent paraphrasing or recasting of previous utterances (toddler says “We go”
and parent recasts by saying “Yes, we’re going”).
 Talk about what is immediately present.
 Use frequent phrases and parts of sentences in isolation (“in the car”).
 Use questions and attempts to elicit speech.
 Label words—nouns and actions—in context.

30. Changes in the physical environment
 For physical environment, I would develop curriculum based
on the needs of children and focusing as a larger group in
the room that meet the needs of all visual, auditory, and
kinaesthetic learner.
 For example, using visual pictures would be better choice
for developmental delay, speech delay, cognitive delay and
autism etc. To meet the auditory learner’s needs, I would
increase the use of audio and video material in the centre. I
would also provide real material for hands on experiences
and sensory experiences for kinaesthetic learners and other
special needs learners..

31. Changes in the teaching strategies
 For meeting the needs of special needs child, I would provide extra
time to respond. I would not be in a rush, I would wait and observe
the child’s behaviour and response.
 In addition, I would arrange practice sessions for speaking practice.
During these sessions, I would start sentence and encourage the
child to complete the sentence.

32. Recommended Resources
 Source # 1.
 Collage Pediatric Therapy
http://www.collagetherapies.ca/en/treatments
 Source # 2.
 Speechandhearing.ca
http://www.speechandhearing.ca/en/our-professions/speech-language
 Source # 3.
 Parentbooks
http://www.parentbooks.ca/

33. Resource No.1
Overview of Collage Therapies
“Collage Paediatric Therapy is a
team of
speech-language, pathologists,
psychologists,
occupational therapists,
physical therapists and
behaviour specialists who work
together in a practice and focused
exclusively on children.
Collage offers the convenience of
back-to-back therapy appointments
with different clinicians in the same
centre. In order to achieve the best
possible results, Collage centres also
provide parents and teachers with
the resources to help the child Find out more about Collage by
integrate their newly learned skills in visiting
the home and in school. They
provide full support to families, giving
them the time they need to discuss Collage Therapies Website
their child’s specific situation and
answering any questions they may
have”.

34. Collage’s Services
 They like to serve as many people as it possible. There is no limit of
population whom they serve.
 Assessments/Evaluation
 Treatments
 Tips for an Effective Treatment Program
 Offsite Services-In Home services, In school services
 Services for adults

35. Availability
 In home services are available for children to learn and engage in
their own environment.
 In school services, the therapists are available to do therapies in
school either for an individual child at the request of parents or for a
group of children if contracted by the school.

36. Therapists
 The following therapists provide services at collage’s
Mississauga centre:
 Speech-Language Therapy Jessica Mason, Aviva Bauer, Shani
Lantos, Katherine Kovler, Andrea Tsang
 Occupational Therapy Barri Trager
 Psychology Lena Solomon

37. Cost
 Families meeting household income requirements may qualify for
funding from certain charitable foundations.
 Alternatively, payment plans are available from their financing
partners where balances can be paid out over 6 months, 1, 2, 3, 4 or
5 years.

38. Location
The centre is located at:
1100 Central Parkway West,
Unit 4, Suite 100 Mississauga ,
ON L5C 4E5
Tel (905 ) 402-3122
Fax (905) 402-3124

39. Resouce No.2
Overview of CASLPA, Speechandhearing.ca
 About CASLPA
“With more than 6,000 members, the
Canadian Association of Speech-
Language Pathologists and
Audiologists (CASLPA) is the only
national body that supports and
represents the professional needs of
speech-language pathologists,
audiologists and supportive personnel
inclusively within one organization.
Through this support, CASLPA
champions the needs of people with
communications disorders.”
CASLPA is confident that their
program’s guidelines will shed light on
APD and help ensure that this
disorder is managed in a consistent Find out more by visiting
way across Canada. CASLPA's website.

40. Speech and hearing’s Services
Speech-language pathologists are involved in a number
of different activities to promote effective communication
and swallowing for the individuals they serve. These
activities may include:
 Assessment of communication and swallowing disorders
 Intervention for communication and swallowing disorders
 Education and supervision
 Consultation
 Research
Youtube video-APD

41. Availability
 Speech-language pathologists may work directly with clients, and/or with
their caregivers or other persons who regularly interact with them (e.g.
friends, relatives, professionals, colleagues, supportive personnel etc.), for
the purpose of creating environments that promote optimal communication
and swallowing.
 Branches for Speech-Language Pathologists and Audiologists are available
in all provinces and big cities of Canada.
Visit for more information about Availability

42. Therapists
Therapists
Cost:
Cost is not mentioned on the website. For further information
about APD, cost, or to schedule an appointment, contact an
audiologist.

43. Location
The centre is located at:
Ontario Association of Speech-Language Pathologists and
Audiologists (OSLA)
President: Shanda Hunter-Trottier
Executive Director: Mary Cook
410 Jarvis Street
Toronto, ON M4Y 2G6
Tel: (416) 920-3676 or 1-800-718-6752
Fax: (416) 920-6214
Email: mail@osla.on.ca
www.osla.on.ca
College of Audiologists and Speech-Lanaguage Pathologists of Ontario (CASLPO)
3080 Yonge Street, Suite 5060
Toronto ON M4N 3N1
Tel: (416) 975-5347 or 1-800-993-9459
Fax: (416) 975-8394
Email: caslpo@caslpo.com

44. Resouce No.3
Overview and Services of Parentbooks
Parentbooks serving families and
professional in Canada and around
the world since 1986.
 Parentbooks offers the most
comprehensive selection of resources
available anywhere — from planning a
family to everyday parenting issues to
special needs of all kinds. Knowledgeable
staff can help finding the books you need.
 Parentbooks' selection of resources for
caregivers, counsellors, therapists,
educators and clinicians serving the http://www.parentbooks.ca/
everyday and special needs of families is
unequalled.
 Customer can place order through web
Audio & Visual Resources
site, or shop in person, by phone, fax or
email; VISA, Mastercard and Interac.

45. Availability/Location
 Parentbooks are available online
 Parentbooks is open from 10:30 to 6:00 Mondays through Saturdays.
 Retail centre is located in downtown Toronto.
Location Map
 Address: 201 Harbord Street,
Toronto, Ontario, Canada M5S 1H6
Phone: 416-537-8334
Fax: 416-537-9499
Toll-free: 1-800-209-9182

46. Cost
 Please verify prices for books while the dollar remains
unstable.
 “All prices are in Canadian dollars and are subject to
change without notice”

47. Bibliography
 http://www.connectability.com/
 http://www.speechandhearing.ca/en/find-a-professional/find-a-professional-search-form/
 ww.hanen.org
 http://www.chs.ca/
 http://www.collagetherapies.ca/en/our-approach
 http://www.parentbooks.ca/
 http://autism.about.com/od/SymptomsofAutism/f/Early-Symptoms-Of-Autism-Include-No-
Babbling-Or-Pointing.htm
 http://www.webmd.com/brain/autism/autism-symptoms
 http://www.keepkidshealthy.com/growthcharts/
 http://family-alliance.com/
 http://www.abilityonline.org/
 http://cltoronto.ca/
 http://www.pwd-online.gc.ca/p.6dh.4m.2@.jsp?lang=eng
 http://www.youtube.com/watch?v=0gkGYP4fgMs
 http://www.youtube.com/watch?v=OFojO-ot5Ok
 http://www.youtube.com/watch?v=NbZhcyXfaNo
 Ages/stages Birth to 12 years
 (Connectability-Visual Communication Workshop, class notes, week 8).
 Assingment Package, (Unit four: Facilitating communication and social skills, pg 2of2)
 Class notes (using signs & gestures in the classroom, class notes, week 8).
 Using signs & gestures in the classroom, class notes, week 8
 Twenty Questions, class notes, week 8
 Inclusion of children with special needs, assignment package, class notes

48. Thank You