The numerous accommodations and modifications that teachers make for students often amount to a lengthy list. These adjustments can involve altering not only instruction but also lesson materials, which tend to exhaust much of a teacher’s planning time. While circumstances, symptoms, and needs vary from student to student, there are some of the best “universal” practices that teachers can employ when a student is impacted by a medical condition, without causing a disproportional amount of stress to the teacher.
Symptom: Inattentiveness
| Strategies | Considerations |
- Verbal/non-verbal prompting or cueing
- Checklists or sticky notes for work completion; a checkmark or small sticky on the desk indicating strong/prolonged focus
- Offer preferential seating
- Proximity while giving instructions/directions
- Brain breaks for lengthy texts or multi-step tasks
- Brisk transitions between tasks/activities to build attentive momentum
| - Prompting and cueing could be as subtle as tapping on the desk to regain focus, and could be as direct as asking which number the student is on and encouraging further progress
- Checklists or sticky notes would typically be paired with a weekly/monthly incentive to track student’s attention goal (504/IEP)
- Preferential seating doesn’t necessarily mean in the front of the classroom; this could mean near the teacher’s desk, away from the window or hallway, or in the quieter back corner of the room
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Symptom: Vision issues
| Strategies | Considerations |
- Offer preferential seating
- Provide larger text/font size on handouts
- Limit screen time or allow frequent breaks during prolonged screen use
- Provide highlighted and/or condensed teacher notes
- Suggest colored overlays for students whose vision issues are exacerbated by bright white paper (often seen with PANDAS)
| - Highlighted/condensed teacher notes allow students to follow along with notes/outlines without straining their eyes to copy from the board
- Notes also ensure that only vital information is visually presented, avoiding extraneous details
- Colored overlays are inexpensive plastic sheets that students can lay over a textbook, worksheet, or even computer screen to dull the brightness of the white background
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Symptom: Working memory/memory processing difficulties
| Strategies | Considerations |
- Allow extended time for assessments and lengthier assignments, including a reduced workload when necessary
- Provide wordbanks, multiple-choice options, and true/false for exam questions that involve more memory recall or fact-based knowledge
- Allow use of a calculator for math assessments not hinging on mental math skills
- Provide sentence starters or transition wordbanks for essays or timed writing tasks
| - Extended time should account for the fact that the student likely required twice as much time to review and memorize info prior to the assessment
- When possible, reduce the exam questions to account for mastery of the skill, not the number of questions answered
- Quiz and test modifications, such as word banks, assist students with recall by providing examples
- True/false questions still assess the student’s knowledge of the concept but reduce unnecessary memorization
- If a math quiz is not based solely on the student’s knowledge of multiplication/division facts, the use of a calculator removes the mental math and memorization barrier
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Symptom: Executive functioning difficulties
| Strategies | Considerations |
- Give checklists for multi-step assignments or complex tasks, making sure to model how to order multiple tasks and check off to-dos as students finish sections
- Maintain consistent routines
- Provide approximate, suggested lengths of time for homework and/or classwork
- Provide brisk transitions between tasks/activities to build attentive momentum
- Model organizational strategies
- Check in frequently
- Simplify written instructions and verbally review instructions for clarity
- Review daily and/or weekly agenda; highlight due dates
- Allow students to write directly on assessments; avoid bubble sheets
| - Consistent routines ensure that students know the basic procedural expectations and can execute them independently
- Students may need to be explicitly shown how to place papers in organized sections of a binder
- Students may need extra time at the end of class to organize papers, materials, etc. in designated places to maintain organization
- Allowing students to respond directly on test booklets avoids the confusion of bubble sheets and/or the likelihood of them losing their place or skipping questions.
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Symptom: Fine motor issues
| Strategies | Considerations |
- Enable use of a word processor for written assignments
- Provide teacher notes; modified note-taking
- Utilize multiple-choice, true/false, matching, or short answer opportunities to allow students to demonstrate mastery
- Provide the student with a larger or slanted work surface
- Use larger lines, boxes, or spaces for written responses
- Allow the student to use bulleted responses when appropriate
- Encourage the use of a mouse instead of a touchpad
- Utilize speech to text technology if available, or a human scribe if not
- Offer pencil grips for writing and wrist supports for typing
- Allow verbal responses
| - If providing teacher notes, encourage students to participate by highlighting or starring essential material; have them include labels or symbols while following along.
- For lengthy assignments, consider other methods for demonstrating understanding:
- Put story events in order using event cards instead of writing a summary
- Match pictured steps/photo cards of a science lab to written steps, then put them in order
- Use Scrabble letters or alphabet cards to take a spelling quiz, instead of writing out the list
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Symptom: Behavioral issues
| Strategies | Considerations |
- Utilize verbal/non-verbal prompting or cueing
- Use positive reinforcement when procedures/behavioral expectations are followed
- Offer preferential seating
- Give instructions/directions in closer proximity to the student
- Allow frequent breaks for lengthy texts or multi-step tasks
- Utilize brisk transitions between tasks/activities to deter off-task behavior
- Use data tracking sheets and hold a weekly conference with the student, possibly providing incentives
- Utilize the 2 X 10 strategy to build positive relationships between adults and students. In this technique, teachers engage a student in a meaningful, genuine, 2-minute conversation, unrelated to academics, over a span of 10 days.
| - Prompting and cueing could be as subtle as tapping on the desk to deter off-task behavior.
- Prompting could also be as direct as reminding a student of behavioral expectations
- Checklists or sticky notes would typically be paired with a weekly/monthly incentive to track a student’s behavior goal (504/IEP)
- Preferential seating doesn’t necessarily mean in the front of the classroom; this could mean near the teacher’s desk, away from the window or hallway, or in the quieter back corner of the room.
- Moving closer (proximity) or sustaining eye contact can often deter misbehavior.
- The 2 X 10 strategy is proven to build rapport in difficult classrooms. It encourages a positive outlook regarding school and adults in schools.
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The classroom environment is filled with a countless array of personalities, abilities, and levels of motivation. Add to that the various medical considerations or chronic illnesses that students might experience and teachers no doubt feel stressed about making sure every learner receives what he or she needs in order to be academically successful. To ensure that students’ accommodations are met, every student must be provided with differentiated, personalized learning experiences to foster intrinsic motivation and appropriate levels of challenge.
