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The Educational Issues of Students with Bipolar Disorder

Symptoms and Accomodations

I. Symptoms of the Illness
II. Side Effects of the Medications
III. Attentional and Organizational Difficulties
IV. Specific Learning Disabilities

Boy at Desk

I. SYMPTOMS OF THE ILLNESS

Symptom: Children with bipolar disorder often have a reversal in their sleep/wake cycle and it is extremely difficult for them to get to sleep at night and to wake up early in the morning. He or she seems half comatose or extremely grumpy and sleeps through first and possibly second period, often missing important class material and doing poorly on tests in the first two periods.

Accommodations

  • Schedule academic classes later in the day when the student is more alert and emotionally available for learning.
  • Allow the student to take important tests later in the day when the student may be able to focus better.
  • Allow the student to begin the school day a little later.

Symptom: The student has daily and seasonal fluctuations in mood and energy and is therefore more attentive to classwork at certain times and less attentive at others.

Accommodations:

  • Create formal contingency plans when the student is unstable and is experiencing periods of withdrawal or fatigue (a symptom of the illness and often a side effect of the medications).

Symptom: The student can experience great irritability, building to a rage if not
recognized and dealt with in an appropriate and timely manner.

Accommodations:

  • Assign a staff/school person who the student can go see when he or she feels unable to cope. This can be a counselor, school therapist, teacher, or any other person (campus monitor, school nurse, etc.) with whom the student feels safe and whom the student trusts and chooses. Give the student a permanent pass and a private signal that only he and the teacher understands so that he can make a private exit in front of the rest of the class.
  • Offer the student a private place to go to calm down when feelings are overwhelming.
  • Schedule regular meetings with the school psychologist to teach the student self-calming and anger management techniques.
  • Assign an aide in the classroom to prevent situations that may cause the student to lose control.
  • Administer a Functional Behavior Assessment to identify triggers that cause the student to lose control. Then write a Behavior Intervention Plan to be added to the IEP which provides appropriate interventions for problematic behaviors. This can be as simple as identifying stressors which cause untoward behaviors.

Symptom: The student has periods of excessive anxiety and sadness.

Accommodations:

  • Assign a safe place and person where the student can regroup and calm down –preferably someone with whom the student can talk easily.
  • Have the student keep a journal in which he or she can address anxiety-producing thoughts and school experiences which can be shared with the school psychologist and the student’s personal therapist.
  • If the treating psychiatrist recommends the use of a light box, provide this daily during a study period in the resource room.

Symptom: The student is very perfectionistic and has difficulty making transitions.

Accommodations:

  • Reduce writing by allowing the student to use a computer so the page looks neat to him or her.
  • Allow student to finish tasks before moving on.
  • Have all teachers cue the student as to transitions and the time they will occur.
  • Provide an aide who will give support during non-supervised periods of the school day (lunch, recess, escort to and from the bus waiting area, etc)
  • Allow student to transition ahead of the rest of the class (going to lunch room, library, etc)

Symptom: The student has difficulty with peers. The student may have poor social skills, be bossy, misperceive the behaviors and intentions of others, and be socially inappropriate at times.

Accommodations:

  • Arrange for the student to learn social skills and group behavior by meeting with the school social worker, school psychologist, or the guidance counselor.
  • Develop a social skills class and have the student participate in it.
  • Place an aide in the classroom who can monitor social interactions and report incidents of social conflict. The aide can interpret and explain to the student how things occurred which may be outside the student’s perception. This aide can advocate for the child, act as a friend, make the child feel safe, and alert the school if there are any incidents of bullying going on.

Symptom: The student becomes overheated and overstimulated in gym classes and begins to suffer discomfort or to cut class.

Accommodations:

  • If the student participates, he or she must always have access to water and rest.
  • The student should have the option of less competitive physical activity such as Yoga. Tae Kwan Do, weight training, aerobics, etc.
  • The student should be graded based on attendance rather than participation.
  • If necessary for the student’s emotional well-being, have an Adaptive P.E. written into the IEP until such time as the student is ready for mainstream physical education.
  • If inclusion is an issue or a desire on the student’s part, the student could be appointed score keeper or equipment manager.

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II. SIDE EFFECTS OF THE MEDICATIONS

Symptom: The student is experiencing excessive thirst, a frequent need to urinate, or bouts of diarrhea as a result of some of the medications used to treat the illness (especially in the early stages of treatment).

Accommodations:

  • Allow the student to keep a water bottle at his or her side or to have unlimited access to (non-caffeinated) fluids.
  • Allow unlimited access to the bathroom (with a signal to each teacher as to where the student is going--without announcing it publicly)
  • Educate the staff (especially the school nurse) about medication side effects which may include drowsiness, diarrhea, stomach aches, and cognitive dulling and the need to accommodate for these.

Symptom: The student is sleeping in class because his or her body is not yet accustomed to a new medication.

Accommodation:

  • Provide a place for the student to take a brief nap so that he or she can continue with the school day. (Sleepiness usually subsides as the body adjusts to the medication).

Symptom: The student is experiencing cognitive dulling and a lack of endurance as a result of the medication(s).

Accommodations:

  • Schedule frequent breaks.
  • Provide extra time for work completion.
  • Decrease workload and homework.

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III. ATTENTIONAL AND ORGANIZATIONAL DIFFICULTIES

Symptom: Student has difficulty staying on task and paying attention for any length of time. Student is very fidgety in the classroom.

Accommodations:

  • Seat student close to teacher where the teacher can get student’s attention.
  • Schedule frequent breaks.
  • Offer choices such as going to a study carrel in the library or to a quiet area outside the classroom.
  • Assign a study buddy (use the phrase study-partner for an older student). The students can focus each other and acquire strategies for learning from each other.

Symptom: The student is disorganized and often misplaces needed books and materials. The student often forgets to bring home assignments and/or fails to turn in work.

Accommodations:

  • Use a “travel folder.” This is a pocket portfolio that has necessary papers to complete on the left-hand side (mark this “To Do”) and all completed homework is transferred to the right-hand side (mark this “Completed”).
  • Give student a planner book and have teacher check that daily assignments are recorded properly.
  • Email or fax parents list of assignments and news of upcoming projects or tests.
  • Have teacher or aide give the student a prompt before leaving school: “What do I need to do tonight and what materials would I need to accomplish it. “I need: my coat, my recorder, my math book, my study sheet for French, my planner, my lunch box, my travel folder (French sheet is there...) The teacher or aide could photocopy lists of materials and clothing and have student check items off as they are put in the bag. Student must be taught to pack backpack to return to school the same way: with a prompt such as “What do I need for school today?” (A parent has to help out here.)
  • Provide a second set of text books for the home work area.
  • Teach the student to number assignments in the order in which they should be done before beginning a homework session (thus they will focus and begin a mode of strategy). Have the student start with an assignment that is short and easy, but avoid saving the hardest or longest assignment for last. Have the student estimate how much time it will take to complete each assignment and measure the estimates against the actual time (these students have difficulty with time management). Have them use a stopwatch to assign chunks of time to each step of a study plan which will help move them on to the next step.
  • Teach the student to preview questions at the end of each chapter to focus him or her on important concepts. The student should also preview photos, captions and headings throughout the chapter before reading and when reviewing for a test.
  • Color-code subject folders and notebooks to match textbooks. For instance, if the math text is orange, place an orange strip of tape on the math folder and notebook so that student can quickly locate and assemble all materials needed for math. If school requires the books to be covered, color coordinate the books and folders.
  • If the student uses a locker, teach him or her to place all morning text books, notebooks and folders on top shelf of locker, and all afternoon materials on lower or bottom shelf. This will help organize the student and ensure that he or she goes to class with the correct materials. Have the student (with the help of an assistant if necessary) clean out locker at least once a week. Schedule that cleanup on Fridays to ensure that P.E. clothes and needed materials arrive home for weekend use.

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IV.SPECIFIC LEARNING DISABILITIES

Accommodations for Reading Disabilities or Dyslexia

Children with reading disabilities or dyslexia have problems decoding the phonetic structure of language, which negatively impacts comprehension. Absent previous remedial reading interventions (such as Orton-Gillingham), the student may need some or all of the following accommodations.

  • Provide student with larger print materials
  • Arrange for student to receive books on tape through the Recording for the Blind and Dyslexic in Princeton, NJ. Contact them at: http://www.rfbd.org/catalog.htm
  • Provide books that have information highlighted
  • Have student use tape recorders in the classroom.
  • Provide readers for tests.
  • Allow extra time for tests.
  • Provide materials that use lots of visuals.
  • Provide information in bullet format.
  • Teach the student to take notes and to study using visual techniques instead of words.
  • Provide hard copies of notes provided to the student.
  • Teach mapping techniques.
  • Allow extra time for assignments.
  • Do not penalize the student for spelling errors.
  • Provide computer-based reading software such as Kurzweil 2000 or Wordsmith which scans textbooks or other reading material into a computer and audibly reads the scanned text back to the student. (In Wordsmith, the student has a choice of a male or female voice or a British or American accent.) Look at http://www.dyslexic.com to learn more about these products.

Accommodations for Writing Disabilities or Dysgraphia

Children with writing disabilities or dysgraphia generally have problems with handwriting (the actual formation of the letters) as well as deficits in written expression. When writing, these children may omit words or reverse them, and syntax and grammar are often incorrect. These students may also have difficulty deciding on a topic for an essay or organizing it so that the ideas flow in a logical manner. These problems may not show up in expressive language assessments and may be exhibited only in the written language assessments. Students with writing disabilities or dysgraphia will need some or all of the following accommodations:

  • Teach and encourage the student to use a keyboard in class and to complete all assignments.
  • Assign a scribe to write longer or timed writing assignments.
  • Allow student to tape record classes. Do not penalize quality of note-taking or assume the student is not taking it all in aurally.
  • Provide paper copies of notes to the student.
  • Allow extra time for assignments.
  • Assign a scribe for important tests, or allow the student to give his answers orally.
  • Do not penalize the student for handwriting or spelling errors.
  • Have the parents investigate voice recognition software such as “Dragon Naturally Speaking ” (also available on http://www.dyslexic.com).

Accommodations for Math Disabilities or Discalculia

Children with math disabilities or dyscalculia generally have problems in math computation, function and application of math concepts. and in understanding the basic math functions. For example, they may reverse their numbers when they are writing. Students with math disabilities or dyscalculia may need some or all of the following accommodations:

  • Provide math books in larger print
  • Give the student graph paper to keep numbers in their correct columns
  • Provide manipulatives to help the student understand in a concrete way the abstract nature of numbers.
  • Provide a student with a calculator for more complicated math functions and teach the student to use it.
  • Do not penalize student’s grade for the reversing of numbers.
  • Allow extended time for assignments and tests.

Challenging Negative Remarks that Threaten to Derail the IEP Process >

This article was written by Janice Papolos (co-author of The Bipolar Child, Revised Edition), Mary Jane Hatton, and Sandi Norelli, (co-directors of the JBRF Educational Team), Christine E. Garcia, M.Ed., and Anne Marie Smith, M.Ed.
Copyright © 2002. All Rights Reserved.


 

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