How to Prevent Falls at Home

A person with a developmental disability under the age of 65 years, may be eligible for assistance through government programs to help cover the cost of specialized footwear, walking aids and other safety devices. For example, in Ontario apply for funding via Ontario Disability Support Program (ODSP). ODSP will coordinate with the Adapted Devices Program (ADP) through the Ministry of Health to provide funding. Once over the age of 65 years, applications go to the ADP program directly. Assistance is provided by the therapist/supplier or alternatively a Physiotherapist or Occupational Therapist from a local hospital or clinic. In Ontario a Doctor’s referral to the local Community Care Access Center would connect you with the local community supports.

Here are some helpful tips that could help prevent falls in the home:

Install proper lighting throughout the home. Pay close attention to stairs and bathrooms. Use night lights in the hallways, particularly between bedroom and the bathroom.
Keep floors and stairs free of clutter.
Wear proper foot wear. Shoes, boots and slippers should provide good support and have good soles. Avoid loose slippers or stocking feet.
Use walking aids and other safety devices for extra safety. If using a cane or walker, make sure that it is the right height and that the rubber tips are not worn.
Have at least one handrail on all stairways and steps in the house. Ensure that the handrails are securely attached and in good repair.

How to Prevent Falls on the stairs

A person with a developmental disability may have additional perceptual issues that can increase the likelihood of falls. A clear diagnosis with specific guidelines and recommendations will ensure the proper adaptations unique to the particular individual. Support and supervision may be required to ensure safety.

Make sure there is proper lighting (there should be a light switch at the top and bottom of the stairs.
Ensure that you are not wearing your reading glasses. If using bifocals, adjust them so that you can see the stairs clearly,
Wear proper foot wear. Avoid using loose slippers or stocking feet.
Check that the steps are in good repair and are slip-resistant. Fix promptly if there are broken or uneven stairs.
Paint or use a contrasting coloured tape on the edge of stairs to enhance the visibility of each step.
Ensure that handrails are securely attached and in good repair.
Remove any loose stair or floor coverings. If you must have a rug make sure it has a non-slip/rubber backing.
Remove any clutter from the stairs or landing. Avoid storing items temporarily on the stairs.
If carrying something, make sure it’s not too large to hide the view of the stairs and that one hand is free to use the handrail.
Take the stairs slowly one step at a time. Do not rush; it is one of the major causes of falls.

www.phac-aspc.gc.ca/seniors-aines— 12 steps to stair safety at home

How to Prevent Falls in the Shower or Bathtub

There is often funding available for assistive devices, home modifications/renovations and vehicle modifications if the eligibility criteria is reached. In Ontario, the local Community Care Access Center can provide assistance in assessing and recommending the appropriate aids and renovations and in funding applications. Please refer to the links section of the document for further information.

Install safety devices
1. grab bars (in shower/ bath tub and toilet area)
2. shower chairs
3. hand held shower head
4. raised toilet seat
5. toilet seat rail
Ensure that the bathtub plug is easy to reach and to use.
Use a full-length rubber bathtub mat for every bath or shower.
Ensure the rug outside of the tub or shower has a rubber backing.
Use portable grab bars or install wall mount grab bars to help with getting in and out of the tub/shower.
Use a bath seat with rubber tips on the legs.
Use a hand held shower head and a long hand brush.
Ask for help if you have difficulty getting into and out of the bathtub or shower.
Use a raised toilet seat with hand rails if you have problems sitting or getting up from the toilet.

*Some aids or devices are designed specifically for an individual and should be recommended by the consulting specialist.

http://www.marchofdimes.ca/dimes/people_with_disabilities_caregivers/programs_and_services/hvmp/The+Home+and+Vehicle+Modification+Program.htm March of Dimes Home and Vehicle modification Programme and funding

Local Health Integrated Network (LHIN) provides a wide-range of health-care services and resources to support you at home, at school or in the community. http://healthcareathome.ca/central/en

http://www.cmhc-schl.gc.ca/en/co/prfinas/index.cfm Canadian Mortgage and Housing Programme Home Renovation funding for Seniors and People with Disabilities.

Sources:

Active Independent Aging – A community guide for falls prevention and Active living –
Activity tool 1. Use your sea legs in the bathroom!
Public Health Agency of Canada handout – If you fall or witness a fall, do you know what to do?
Active Independent Aging – A community guide for falls prevention and Active living – Handout 1. A guide to preventing Falls

Falling is a very serious health problem for seniors

Facts

One third of seniors over the age of 65 have a fall every year and half of them have more than one fall.
Falls are the most common cause of injury.
Seniors are nine times more likely to have an injury than someone under 65.
Approximately one third of injury related hospitalizations for seniors are the result of falls.
Half of all falls happen at home.

Precautions to Take to Reduce the Risk of Falling

A person with a developmental disability may require the support of a family member, friend and/or a staff person to assist in communicating with and coordinating supports with their Doctor and other specialists. It is helpful to keep a daily or weekly log of observations of any health issues to review with your Doctor, other supports and specialists. This will be most beneficial when an individual can not express themselves without support. In your log, write down any questions you may have as they come up. Take this with you to all appointments or consultations. This will ensure that all concerns have been addressed and lead to an accurate assessment.

Speak to your doctor about fall prevention.
Have regular vision and hearing tests.
Take prescription and over the counter medications correctly.
Keep a medication record and review it regularly with the doctor and pharmacy.
Tell your doctor if your medication makes you dizzy or lightheaded.
Get help and advice from a qualified Occupational and Physical Therapist.
Eat a healthy diet.
Develop a good and safe program for staying active.

Sources:

Active Living Coalition for Older Adults (ALCOA) issue number 3, November 2002—Preventing Falls in Older Adults by MARK Speechley, PhD, University of Western Ontario
Active Independent Aging — A community guide for falls prevention and Active living – Handout 1. A guide to preventing Falls
Public Health Agency of Canada handout — If you fall or witness a fall, do you know what to do?

Aging Issues

Getting older is part of life and not well understood by those not yet in the midst of it. Gerontologists, retirement planners and healthcare professionals tell us that it is important to plan ahead to age well. One step in the right direction is to understand more about the aging process and its possible impacts on us.

The current generation of older adults with a developmental disability is the first to look forward to living into old age. This has important learning implications for caregivers and for people with a developmental disability. Some aspects of aging and developmental disabilities are summarized below.

Longer Life Expectancy

In the past, the life expectancy of people with a developmental disability was shorter than the general population. Today, with improvements in quality of life, more community resources and advances in medical knowledge, people with a developmental disability can also look forward to older adulthood.

The Aging Boom

Longer life expectancy for people with developmental disabilities comes at a time when the Baby Boom Generation is entering the senior years. The earliest baby boomers, born in 1945 following WW II, are now in their 60’s. There will be increasing pressure on our social and health programs to adjust to the phenomenon of the Aging Boom.

Services for People with a Developmental Disability

Developmental service providers are witnessing the effects of aging on many of the people they serve and on aging family caregivers. Developmental service workers have not traditionally been trained in the aging process and do not have a lot of experience supporting older adults with a developmental disability. The system of services for people with a developmental disability faces significant new pressure as a result of the longer life expectancy of people being supported, the aging of family caregivers and the Aging Boom.

The Long Term Care System – Services for Older Adults

The system of services for older adults includes a range of health, social, recreation, home support and residential services. The people working in this system are educated in their respective disciplines and are generally knowledgeable about aging. However, they do not usually have any training in developmental disabilities. As older adults with developmental disabilities access these services, providers are being pressed to become knowledgeable about their needs.

Legislation and Regulation

Long term care and developmental service providers in some jurisdictions are sharing their respective knowledge and collaborating on innovative projects to support older adults with developmental disabilities. They are however, often constrained in their innovation due to the legislative and regulatory frameworks under which they must operate. Government ministries are beginning to examine existing regulations and develop protocols to enable greater flexibility so the two sectors can respond with efficient and effective strategies and programs.

Learning How to Age Well

Aging is a normal part of the life process but it does not happen automatically. It requires knowledge about the aging process and commitment to maintaining one’s quality of life. People with developmental disabilities will need guidance to acquire the knowledge and skills they need to age well. Caregivers need to learn about aging so they are able to provide informed support. Aging brings changes in the body, social roles, income, emotions and interests. These changes require that each person make adjustments to maintain the quality of his life as he grows older. There are four very important things to keep in mind as one ages.

As We Grow Older We Become More Uniquely Ourselves
Aging does not change who we are. If we are physically active when we are young we will be physically active when we are old. If we enjoy making friends now we will still enjoy making friends as an older adult. Aging ripens who we are.
Use It or Lose It
If we stop lifting weights we will experience a loss of muscle tone and strength, regardless of age. If we stop exercising our minds we will lose some of our capacity to remember and to learn, regardless of how old we are. If we continue to use and develop our mental and physical abilities as we age we will remain mentally agile and physically fit.
Plan for the Transition
We hope we will get older. It will bring change beyond our control and offer opportunity to make changes within our control. If we learn about the aging process and plan ahead for how we will enjoy getting older, we can make the transition with much more ease. If we are involved in supporting a person with a developmental disability who is approaching older adulthood, then we owe it to him/her and to the support circle to learn about aging.
Maintain Social Relationships
The most common factor that leads to a person requiring placement in a long term care home is a lack of social relationships and the isolation that comes with it. People who remain involved with other people maintain their independence in older adulthood.

Ageism

We learn early in life to make distinctions based on age. Age is a useful variable. It provides us with a tool to organize society and to govern access to certain privileges. Age defines when we may drive a car, vote and attend movies on our own. Age is used to group young people into categories to ensure fairness of competition in baseball, soccer and hockey. Civil society uses age as a means to structure rites of passage such as beginning school, retiring from employment and joining seniors’ organizations. Birthdays are a means to celebrate another year in a person’s life. Age is used to group people into generations with certain common characteristics such as the depression generation (those who were children during the Great Depression of the 1930’s) and the baby boomers (those born between the end of WW II and 1965).

Age can also be misunderstood and misused. Sometimes these misunderstandings are funny, such as when a 5 year old calls his 29 year old father an old man. There are other misunderstandings of aging that can be damaging to individual older adults and to society generally. When age is used to limit rights, to insult or to group people based on myths rather than reality, ageism is at work.

Examples of ageism based on myth are illustrated in these statements: “You can’t teach an old dog new tricks.” “Older workers are slow and less productive.” “Old people are a drain in society.” The truth is different than these commonly used statements lead us to believe.

Older Adults and Learning

The fact is that older adults are pursuing education in growing numbers. Many colleges, universities and elderly person’s centres have educational programs geared to the learning needs of older adults. Online educational opportunities for seniors are also becoming more popular. Older adults can learn and want to learn.

Older Workers and Productivity

The age of an employee has no effect on the person’s performance. Studies conducted to assess the performance of older workers found that older employees demonstrate acceptable productivity and have attendance records equal to or better than other age groups. Employers themselves, also report that older workers are dependable and meet productivity requirements. Generally, older employees perform as well as or better than younger employees. Qualifications, experience, work attitudes and interests are more useful criteria in hiring decisions than age.

Old People are a Drain on Society

The facts show that:

69% of seniors provide some form of help to the people in their lives—their spouse, children, grandchildren, friends and/or neighbours.
19% of seniors participate in formal volunteer work. Informally, about the same number also look after children at least once a week.
23% of seniors provide unpaid care to other seniors, thereby helping to reduce our health care costs.
The economic value of seniors’ volunteer services is estimated at between $764 million and $2.3 billion annually.
Seniors are the largest per capita donors to charity in the Canadian population.
Collectively, seniors are a powerful consumer force. Their participation in the marketplace helps contribute to the stability of many Canadian businesses, especially in the service sector.
Seniors make major contributions to our economy through the income, property and sales taxes they pay.

For more information on ageism:

The Vanier Institute of the Family, TRANSITION MAGAZINE, Autumn 2000, VOL. 30 NO. 3,
A Society for All Ages http://www.vifamily.ca/library/transition/284/284.html#3
Sourced from The Ontario Partnership on Aging and Developmental Disabilities http://www.opadd.on.ca

Bath/Shower Sequence

Good personal hygiene is a necessary life skill that can help one have positive self-esteem, and provide more opportunities in adulthood to get and maintain a job, and to lead a healthy life style. As children get older, and reach puberty, it is a good time to teach how to bathe/shower independently, with minimal prompting while keeping privacy and personal space in mind.

When teaching a new skill to increase independence, you may want to use a visual sequence. A visual sequence uses pictures (real photos, picture symbols, line drawings) to break down a task into smaller steps. By breaking down a skill into smaller steps, it can help teach the skill one step at a time.

Before making a visual sequence for bathing/showering, you would want to discuss the importance of having good hygiene, when to shower or bathe, and what areas are most important to clean (hair, under arms, private areas)

When making a visual sequence of an area where it will get wet, it is a good idea to have it laminated, and put in the shower stall/bath tub at eye level for the individual to follow. You may also want to make a copy of the visual sequence to review before having a bath/shower. An idea would be to create a book about bathing/showering with the same visuals used in the sequence.

Here is an example of a showering and bathing visual sequence.

Bathing/Showering Sequence

Showering Sequence

Social Skills Program

About the Program:

This kit is designed to provide classroom teachers with all the activities and material ideas required to implement the sessions in the classroom.

There are six sessions, usually implemented on a weekly basis with the entire group of children. The sessions are structured so that they provide information on a specific topic through a variety of methods.

Each session begins with an icebreaker to get children warmed up. This is followed by a visual schedule of the activities that will occur and a set of rules.

Puppet scenarios are carried out demonstrating the concept or skill that is being discussed for that week. The scenarios promote discussion regarding the topic and there are visuals to support each main point.

A story describing the topic and desired responses is included. This is followed by a few cooperative games each week. The circle closes with an art activity that can be carried out immediately or left with the group to be carried out during the week.

Informing Parents

As a school-age teacher, you may wish to share with the parents the fact that you are implementing a social skills program in your classroom.

As a program consultant implementing this program in partnership with a classroom teacher, you will require parental consent.

Session Topics

1 – Listening 2 – When Someone Says My Name 3 – Getting Someones Attention 4 – Asking A Friend to Play 5 – Taking Turns 6 – Anger Management

The Importance of Role Play

Activities that develop and build on children’s self-esteem are important in helping children learn who they are. Role play, including acting out scenarios to problem solve, story making through dramatic play and practice in coping with real life situations will support children’s social-emotional growth and development. Role play will give children the skills to handle problematic social interactions, such as bullying, which may happen as they progress through life.

When children engage in role playing it helps to develop their way of thinking and helps them to develop feelings of empathy. When children are given the opportunity to role play skits/scenarios they will be able to experience the role of bully, victim, and bystander. They will also learn how to help others who are being bullied and how to avoid bullying.

A way for you to introduce the concept of role playing using the topic of bullying would be to develop several scenarios for the children to follow. Select situations that you have observed occurring. You can write the scenarios or use the social scripts available in the Bullying Workshop until the children develop a general comfort level and can write their own. Have the children develop scenarios from their own experiences. The children can write a skit or scenario about a distressing situation having to do with bullying whether the focus is on the bullies, victims or bystanders. Every one of the skits/scenarios should be recorded and presented in a way where the individuals who wrote them are anonymous. For example, have the children jot the ideas down on a piece of paper, hand them in, rearrange them and hand them out again. When these ideas are shared anonymously the children will begin to learn that others have shared the same experiences.

When encouraging opportunities for children to role play regarding bullying:

Prepare and introduce the subject. Educate children on bullying by talking about bullies, victims, and bystanders before introducing the activity. You can refer to the document titled Educating Children about Bullying for ideas about introducing the topic of bullying to children in your group.

Arrange the room in a way where all children can be effective contributors to the role play activity. This may involve moving tables and chairs to create a more open space for greater participation.

Model the first scenario by taking part yourself with two other children who would be most comfortable with performing in front of the group. This will give the children an idea of how to start off. Use specific scripts at first and practice at least once in the beginning.

Define roles (bully, victim, bystander) and situations (see scenario examples below). Once the group is ready to ad-lib the skits and practice problem solving you no longer need to provide them with prewritten scripts.

Make it realistic and fun by using phrases such as “Action!” to begin the role play, “Freeze!” to have the children stop to discuss the situation as a group, and “Cut!” to end the dialogue.

Small groups allow all the children to have a turn in role playing. It will give all children a chance to act out their feelings and ideas. Smaller groups are also great for children who may be more reluctant to share their ideas in a larger group setting.

Keep it short for the first few times the children participate in the activity. This will provide an opportunity to discuss the main points.

Reverse roles played by the children to allow the children to experience and therefore identify with the roles played (bully, victim and bystander). Ensure that children who tend to bully have a chance to experience the role of the victim.

Change groups to allow the children to discuss different points of view and build on ideas.

Expect noise. Children will become excited, laugh and possibly raise their voices. Provided this excitement is because of the task at hand, allow this to take place. It will create genuine feelings and ideas if the children are given the opportunity to establish realistic scenarios.

Praise all efforts. Provide specific positive feedback such as, “I like the way you stood up to the bully and told her to leave you alone”.

Coach the children through skits, if necessary. Coaching the children may involve asking questions about feelings, problems, solutions, obstacles (e.g., “Why do you think he was not comfortable enough to deal with the bully himself?”), body language (e.g., “Johnny had his arms crossed when you were talking to him. What do you think that means?”) and more.

Construct questions for the children to think about as the role plays are happening. Some questions may include: How do you feel when this happens to you? How do you think your friends feel when they are bullied? What kind of things do you think will help to stop bullying? The children think about these questions both generally and as they relate to the scenarios that are being role played.

Scenario Examples:

Janet is making fun of your name.
Tony wrote all over your paper with a red pen.
Rahman says that no girls can play in the block centre.
Asia is trying to take your snack again.

Information adapted from

Creating A Positive Environment

We are all affected by our environment. Our physical surroundings affect how we feel, how comfortable we are, how we relate to others, and how successfully we accomplish our goals.

For a young child, the environment is particularly important. For example, the size of the classroom and outdoor play areas, the colours of the walls, the type of furniture and flooring, the amount of light, and the number of windows all influence how children learn. Although these are factors teachers have limited control over, there are many things, that can be done to create a supportive and interesting environment for young children. Thoughtful arrangement of the indoor and outdoor environments can support and include all children.

Physical Space

Every child in a program needs to be able to move freely throughout the play areas. The classroom should have clearly defined activity areas that have been arranged to promote independence, foster decision-making, and encourage involvement.

Define activity areas by using shelves, area rugs, tables, or low dividers. The physical layout of the playroom will identify the purpose of each space and provide children with easily-marked boundaries.
Try to group quiet activities together in one area of the room (e.g., reading centre and circle area) while leaving the more active centres (like blocks and sensory) in another area.
Each play space should allow for two to three children to move about freely without bumping into each other or play materials.
More room may be required in the individual play areas to accommodate children who use wheelchairs or walkers.

Accessibility

The location of materials in the classroom can encourage a child to independently select toys they may want for play. Simply put, accessibility means that the children are able to play with all the toys that are available in the classroom.

Here are some tips on how to arrange materials:

Store materials and toys on low shelves, thus encouraging children to select and use them on their own.
Categorize toys or materials and place them in bins. This can help children learn to sort similar items (e.g., blocks, farms animals, crayons) and help make clean up time easier.
Keep materials in areas where they are to be used (e.g., glue sticks, crayons, and markers in the craft area).
Limit the number of toys in each bin to make it easier and lighter for a child to carry. Place heavier toys on the bottom shelves.
Consider the height of tables and chairs. Children need to be comfortably seated on chairs that allow their feet to touch the ground. If the chair is too big, they will be unable to reach for items.
Use stepping stools or blocks for children to step or stand on. These items are portable and can be used at the washroom sink, water table, cubby area, or while sitting on a chair to support their feet.

TIP: Walk around the classroom on your knees, look around, and reach. Is everything accessible?

Visibility

Young children respond to the use of pictures and/or drawings in the classroom. These types of visual supports can be used to teach children a variety of skills such as developing independence. The use of pictures and/or drawings in the classroom allows you to define play spaces and label materials.

Place a photo or tape a piece of the toy on the front of the bin. This will identify the contents of the bin.
Label your shelves with pictures or a toy piece. This will show children where toys are to be returned.
Define play areas with signs or photos. Attach a photo or sign that represents the play area at the entrance where the children can see it.
Set up some play spaces to allow two or three children to play at a time. You can indicate this by using a photo or card system of your choice. Some examples are: cut-outs of a child’s silhouette to correspond to the number of children who can play at one time, printed number of children with corresponding number of dots underneath (e.g., number 3 with three dots underneath), or space for a specific number of children to place their name/picture card.

Sensory Factors

A sensory-rich classroom provides children with an opportunity to explore their environment through touch, sight, sound, smell, and taste. Although it is important to provide sensory experiences in your daily routine, remember that some factors in the environment may have the opposite effect on children.

Adding Sensory Stimulation:

Add texture to toys, tabletops, shelving, and cubby areas. Children with visual impairments relate best to auditory and tactile stimulation. Materials should be brightly coloured, and whenever possible, have large, distinct features. Some examples are bubble wrap and corrugated cardboard.
Attach items that create an auditory effect. Things such as bells on the side of toys, shaker water bottles in the drama centre, and squeaky toys in the water table can help some children better attend to activities.
The room should be well lit preferably with the use of natural light from windows.

Reducing Sensory Stimulation:

Reduce the noise level in your classroom. Use large area rugs, acoustic tiles on the floors and ceilings, and fabric or art work on the walls.
Place tennis balls on the legs of chairs to reduce noise. Simply cut a hole that is slightly larger than the diameter of the chair leg and insert it into the ball.
Create a quiet area. Some children with special needs have a low threshold for noise and may benefit from having a quiet area to relax and get away from the loud and busy classroom.

Selection of Play Materials

The types of materials in a classroom and the way in which they are organized convey important messages to children. When the room is attractive, cheerful, orderly, and filled with interesting objects, you are providing an environment that children will naturally want to explore. The selection of play materials within the classroom and play areas will determine how children use and manipulate these items.

Select materials that address the differences in children’s skill levels. For example, some children may be able to complete a ten-piece puzzle, while others can complete a three-piece puzzle.
Provide materials that encourage children to think and problem solve. Some play activities such as magnets and weights teach children to explore how the materials interact with each other.
Offer unusual play materials that are not provided on a daily basis (e.g., natural materials such as a bird’s nest, leaves, pinecones, rocks, shells, or decorating supplies such as wallpaper sample books and fabric swatch books) and allow children to use them in a creative manner.
Materials should be related to the achievement of curriculum goals. Are the materials lending themselves to the development of social, cognitive, fine motor, and communication skills?
Use the “TRUE” approach in your classroom:
T– Twin play materials for certain activities. While you are always striving to promote interactions between children, there are times when it is necessary to give each child the same toy or play item. For example, provide duplicates of pouring and scooping toys at the sand or water table.

R– Replace or rotate play materials as necessary. Sometimes a simple re-arrangement of how play materials are displayed will re-stimulate interest in a play centre.

U– Uncluttered toy shelves and floor space create harmony in the classroom. You want children to have access to play items. However, not all toys need to be available to them all the time.

E– Eliminate extra pieces of toys in bins. Bins should hold toys and not be used solely for storage. Lego pieces can be limited to a reasonable amount, which will allow children to use them in a creative manner. Too many pieces of toys at tidy-up time can be an overwhelming task for children.

Remember that room arrangement, individual play areas, and materials are key components in establishing a positive learning environment for young children.

Classroom Layout Tips

Cubby

Place coat hooks at the child’s level.
Add a photo of the child and a name card to personalize the space.
Add a shelf or bin for personal belongings (the message to the child is “This is your space.”)

Arts and Crafts

Place smocks on hooks that can be easily reached by the children.
Make an attractive display of the materials to encourage children to use them. Materials should include a wide variety of items such as a selection of paper, a choice of glueable objects (pompoms, fabric scraps, recyclables), and several types of writing instruments.
Locate the arts and crafts area near a water source. Many art projects need water for use and clean up purposes.
All appropriate materials should be stored near the main art table.
Provide a variety of types of scissors to promote independence (loop, ring, double ring, and left-handed).
Keep the arts and crafts area out of the line of traffic as art supplies can be messy and/or dangerous if they fall to the floor.
Freestanding easels should be set up in pairs to promote socialization. If floor space is unavailable for freestanding easels, then mount easels permanently to the wall.
Allow children to independently access all creative materials and experiment. For example, if that day’s creative activity is finger painting, a child may also use available sponges, add stickers, glue yarn scraps, or colour with crayons.

Sand and Water

Locate the sand and water play tables near the block and craft centre. These areas, are noisy and can be distracting for some children.
Keep the sand and water play out of the line of traffic, as floors tend to get wet and slippery.
Have both tables available each day unless other sensory activities are offered.
Keep smocks near the area and easy to reach. It is important to encourage all children to wear a smock or protective cover as it gives the message that it is okay to be messy when playing in this area.

Table/Floor Toys

The table toy area should be enclosed on three sides using an L-shaped shelf to create boundaries.
Select a quiet area in the room where children can concentrate on the toys with few distractions.
Toys are best stored on shelves near the table for easy access.
For floor toys, provide ample, unobstructed floor space where children can play.
Group toys by type: table toys, puzzles, beading, stacking, floor toys, interlocking, vehicles, floor puzzles, construction.
Label bins with pictures or an actual representation of the contents of the bin.

Block Centre

Locate the block centre in a corner of the room. Furniture or shelving can be moved to create boundaries as well.
Choose an area that is adjacent to another active and noisy area so that the children performing quiet activities will not be disturbed.
An enclosed block area gives children a sense of security and provides a definition and purpose of the play area.
Blocks should be stored at the children’s eye level. This allows the children to see what shapes are available for their use.
The block centre should be large enough for children to be able to spread out their blocks. Insufficient floor space prevents creativity.
Some children like individual play spaces in the block centre. Use masking tape or large poster board to define these areas.

Dramatic Play

Enclose the dramatic play centre on three sides. If necessary, use the actual furniture in the centre to create an enclosed area.
This centre should be located near another noisy and busy area. The recommended placement for the dramatic play centre is beside the block area. Both centres lend themselves to the development of imaginative play skills.
Provide hooks and mini-hat racks for children to easily access dress up clothes.
Install a mirror on the wall so that children can look at themselves..
Combine the use of real and realistic-looking props to facilitate dramatic play.

Book Centre

Locate the book centre in an area of the room that is secluded and quiet.
Display books attractively. Young children usually cannot read titles so they need to see the cover of each book.
Light the area with natural light if possible. If this is unavailable, a standing lamp or overhead fixture can provide additional lighting.
Make the area comfortable and relaxing by providing beanbag chairs or large floor cushions.
Include a small table and chairs in the book centre as some children prefer to look at books, while sitting at a table.

Outdoors

The space needs to be large enough to accommodate all the children in the group.
The outdoor play area should provide active and quiet spaces as well as places for children to play together or alone.
Ample space between equipment is necessary so that children are not running into one another.
A smaller-sized sand box with a ledge allows children to sit comfortably. The sand box should be located away from the climber or bicycle area for safety reasons.
Use chalk, tape, or small pylons to define high traffic areas where children ride bicycles or wagons. Use large traffic signs to indicate the flow of pathways.
Incorporate indoor activities outside as well (e.g., water play).

Washroom

Sinks and toilets should be mounted low enough for children to use independently. Children should be able to feel the floor underneath their feet when sitting on a toilet.
Each sink should have a mirror directly above it for children to look at themselves.
The washroom area should be brightly lit with overhead lighting.
Soap and paper towels need to be located at a child’s level so that they are easy to reach.
For washrooms within a classroom, do not locate any other activity centres near the door. This will ensure safety and privacy.
Change tables should be located in the washroom area rather than the classroom space.

Quiet Centre

Locate a special quiet area beside the book centre using shelving to section off the space.
The quiet area requires very little space. Remove the individual shelves of a shelving unit and staple a sheer curtain to the top of the shelf.
Add pillows to create comfortable seating.
Lighting should be the natural light that passes through the curtain.

Identifying Classroom Stressors Checklist

For anxiety to be prevented or reduced, children must feel safe, cared for and be able to understand what is expected of them. Their environment must be welcoming, inclusive and predictable.

The classroom environment can unwittingly add to stress and anxiety in children. This can be prevented or reduced by making some simple modifications. Adjusting your expectations of the children or rearranging your room can make a big difference in reducing and preventing anxiety.

Use the checklist below to evaluate your classroom environment, then follow the suggestions. This will start you on your way to ensuring your classroom is well organized and contributes to reducing anxiety in children.

Is there time for each child to receive some individual attention on a daily basis?
__ Always __ Sometimes __ Never

Does each child receive the amount of attention they require?
__ Always __ Sometimes __ Never

Does the program ensure all children are included?
__ Always __ Sometimes __ Never

Do my classroom goals support the individual learning styles and interests of all children?
__ Always __ Sometimes __ Never

Is there a consistent routine to the day?
__ Always __ Sometimes __ Never

Is a visual schedule used so that all children can understand and anticipate the daily routine?
__ Always __ Sometimes __ Never

Does the daily routine include time and space for movement and gross motor activities?
__ Always __ Sometimes __ Never

Does the daily routine include time and space for quiet activities and “down time”?
__ Always __ Sometimes __ Never

Is the room arranged to have louder play areas close to each other and away from quieter areas?
__ Always __ Sometimes __ Never

Are the classroom materials age and developmentally appropriate for all children?
__ Always __ Sometimes __ Never

Are the toys and materials organized and kept in their correct containers?
__ Always __ Sometimes __ Never

Are the containers labeled with pictures to ensure that all children know where materials belong?
__ Always __ Sometimes __ Never

Is natural light utilized when possible?
__ Always __ Sometimes __ Never

Are overly bright or harsh lights avoided?
__ Always __ Sometimes __ Never

Are there times in the day when lighting is dimmed?
__ Always __ Sometimes __ Never

Are noise levels at a tolerable level?
__ Always __ Sometimes __ Never

Is excess noise limited? (e.g., loud clocks or constant background music)
__ Always __ Sometimes __ Never

Are there times of the day when noise levels are reduced?
__ Always __ Sometimes __ Never

Do all caregivers maintain regular speaking levels and tones when addressing the children?
__ Always __ Sometimes __ Never

Are there quiet, private areas in the room for “down time”? (e.g., book area with pillows or tent)
__ Always __ Sometimes __ Never

Are strong smelling disinfectants, deodorizers and perfumes avoided?
__ Always __ Sometimes __ Never

If you answer “sometimes” or “never” to questions 1-4: Refer to Caregiver Behaviour and Expectations, for tips and ideas to reduce stressors in your classroom.

If you answered “sometimes” or” never” to questions 5-12: Refer to Organizing the Environment for tips and ideas to reduce stressors in your classroom.

If you answered “sometimes” or “never” to questions 13-21: Refer to Keep Sensory Stimulation at Moderate Levels for tips and ideas to reduce stressors in your classroom.

Preventing and Reducing Classroom Stressors

Caregiver Behaviour and Expectations

As caregivers, the things we say and do, our behaviour and our expectations can sometimes contribute to a child’s anxiety. Working to build and maintain safe, comfortable, predictable, positive relationships with each child can prevent and reduce anxiety.

Here are some things to consider in your daily interactions:

Have appropriate expectations for each individual child – When setting your expectations take into consideration each child’s age, developmental level and learning style. It is a good idea to keep at least one goal in mind for each individual child to focus on during curriculum planning and throughout the day. For example, Jimmy is learning to cut with scissors. He is easily frustrated trying to hold the paper and cut at the same time. You decide to give him narrow strips of heavier paper for cutting practice. He very quickly has success in cutting through the strips with one snip!
Follow the child’s lead – Plan activities that capture the child‘s interests and abilities. For example, plan activity circles about bugs after noticing the children showing an interest in bugs outside. For a child with a more narrow selection of interests, such as trains, try using that interest to build a program theme that will encourage greater participation in a variety of activities (e.g., “Let’s join the train for circle!”)
Provide opportunities for children to have individual attention from a responsive adult – Even a few minutes of individual attention each day will show a child that they are listened to, are special and that you are happy that they are there. Try to make use of times when the numbers are lower, such as early morning or late afternoon, or ask a child to help you with classroom tasks, such as setting the table or cleaning paintbrushes. This will give you an opportunity to talk and spend individual time with a child.
Create a welcoming environment – Greet and welcome each child as they enter the room. This will help to strengthen your relationship with each child and their family in a positive way. This will also help you to understand and respond to how the child may be feeling that day. For example, Megan is usually very happy to come to child care. This morning she clings to her father and cries. Her father tells you that Megan had a hard time waking up this morning. You get down at her level and say, “It seems like you’re feeling sad. Come sit with me in the book corner and we’ll read your favourite book.”
Keep consistent routines – The more consistent your daily routine, the easier it is for children to anticipate what will happen next and make sense of the day. This predictability may help children cope with stressors. One method of creating consistency is to follow a schedule where the daily events occur in the same order but the types of activities can change. Posting your schedule visually, at the children’s level, may help each child know what to expect and prepare for changes.
Give warnings for transitions – Inform the child when there will be transitions or changes in the daily schedule. For example, provide a visual cue like turning the lights off to indicate that a change is coming and say, “Two more minutes, then circle time”.

Organizing the Environment

How a room is organized can either increase or reduce a child’s anxiety. Planning the room set up, selection and organization of materials can work to reduce overall classroom anxiety.

The following are some suggestions to make the best use of space in your classroom.

Create well defined play areas – Classrooms that have all the shelves and tables against the walls and large open spaces may encourage an increase in activity level, such as running. This may lead to anxiety in other children who are engaged in more purposeful play. For example, Jimmy is building a large block tower and becomes anxious and upset every time Suzy runs past. Try to break up the room into designated play areas using shelves, tables and other furniture.
Consider the size and function of each play area – Make sure each area is large enough for children to play comfortably. Areas such as dramatic play or the block centre require more space than areas designed for quiet activities. Remember to provide quiet spaces for children who need a space to relax, rest, or think.
Consider the location of each play area – Put areas that compliment one another closer together. Try to keep quiet areas and louder, busier areas apart, giving children the opportunity to choose a calmer, quieter area when needed.
Use visuals to reinforce play area expectations – Post visual pictures in each area to help remind children what the area is used for and how many children can be in that area at once. For example, if the book centre is also used for calming and relaxation, post a picture that indicates that this is a quiet area, such as person with their finger to their lips.
Reduce clutter – Keeping the room tidy and clearing away unnecessary clutter may reduce visual stimulation and help children find what they need more easily. Using picture labels on bins and shelves can also help to organize the materials, thus providing more structure and consistency.

Keep Sensory Stimulation at Moderate Levels

Children who have sensory processing difficulties may experience anxiety when their environment is providing too much or too little sensory information. Keep in mind that what is tolerable to us may not be for a child with sensory processing difficulties. The following are some suggestions to ensure sensory stimulation is kept at moderate levels:

When possible, utilize natural lighting and avoid overly bright lights.
Keep noise levels to a moderate level, including background sounds such as a constantly playing radio or loud, ticking clock.
Maintain a regular speaking voice in both volume and tone.
Use unscented cleaning products.
Provide opportunities and space for both movement and stillness throughout out the day.
Reduce active play or anything that is too stimulating during times of high anxiety or when the children are overly boisterous and need help to calm down, such as at nap time.
Lower the lights and play quiet soothing music.
Create “escape” tasks for children who need to leave the room. Use them before the child experiences difficulties.

If you notice that a child seems to be trying to block out sensory stimulation or seeking sensory stimulation, consult a professional such as an Occupational Therapist for suggestions.

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