Whether you have decided to home school your child for a year or for an extended period, developing a curriculum can be a challenge. Start by setting goals for your child, research and experiment with ways your child learns, review various curriculums, and put together a program for your child. Here are websites to get you started:

• About Homeschool
• Free Homeschooling Resources
• Home School Advisor
• Homeschool Central (Additional resources for special needs)
• Homeschool.com
• Home School Legal Defense Association
• Homeschooling Today
• Homeschool World
• The Home School Mom
• Time4Learning

A Practical Approach for the Classroom

Lesson Planning Guide for Students with FXS

This guide is intended for classroom teachers who may have little or no exposure to Fragile X syndrome (FXS). Our goal is to help make the teaching and learning environment from preschool through high school more effective, more efficient, and more rewarding for teachers and the student(s) with FXS who come under their care.

This guide provides practical information that includes:

• A background on Fragile X syndrome.
• Descriptions of behavior and learning styles.
• A discussion of educational and community resources.
• Sample lesson plans for children with FXS at a variety of developmental levels.
• Strategies to facilitate the inclusion of children with FXS.

Note: Special thanks to NFXF members Randy & Diane Dobslaw, and in honor of their son Brett, whose generosity enabled this publication. This guide also owes a profound debt of gratitude to Dr. Marcia Braden, whose original work, Curriculum Guide for Individuals with Fragile X Syndrome, is incorporated extensively throughout the guide.

Read: Lesson Planning Guide for Students with Fragile X Syndrome: A Practical Approach for the Classroom

Additional Resources

General Links for Teachers

• Developmental FX – Tracy Murnan Stackhouse, MA, OTR
• Marcia Braden Resources
• Teachers.Net

• IDEA 2004 mandates educational alternatives for eligible children and adolescents with developmental disabilities through age 21, though there are some states who offer services beyond that age.
• It is important to note that once the young adult leaves the school system, it is the parents’ responsibility to set up all aspects of their child’s day.
• Once the young adult leave the school system, each state provides an array of support for the adult person with a developmental disability, based on eligibility, need, and the wait list for services (and many states have a wait list for adult services).
• The programs and services offered vary not only by state but also by localities within each state, and the adult services are offered by various agencies and these services often vary from agency to agency.
• There is always the option to “private pay” for services if the wait list is too long or you wish to create programming that is not offered by any agency.
• For more information about the adult services in your area, contact your local disability organization. If you do not know that organization, contact your local/nearest Arc.

Overview

• Each state provides an array of residential programs. These vary not only by state but by localities within each state. The range of residential services also varies among provider agencies.
• Residential services may range from independent apartments with minimal supervision to supervised apartments, group homes, and host homes (where a child lives with another family).
• Some agencies provide both residential and vocational/day programming services, while others provide only one of these services—meaning the person and family must deal with two sets of providers.
• There are also residential settings for families in a position to pay privately. See the “Living Settings By State” section of the NFXF Adolescent & Adult Project (link below).
• Because there tend to be extensive waiting lists for residential services in many states, parents often look for other options. One trend is parents getting together in a community to set up independently operated programs for their children. When parents do this, the options are almost endless. Some of them are listed below.
  • Note that not every program founded by parents will have a name—many will just get together and do what it takes to meet their children’s needs.
  • A group of parents may coordinate their efforts to buy a house and pay for a care provider to be responsible for their children.
• Transition to a residential program should ideally be gradual. One method of transition that parents may find helpful is to seek respite services at a residential agency before their child moves in. This affords their child the opportunity to both test the environment and meet other residents and caregiving staff.

Success in living away from home can be maximized by:

• Teaching your child independent living skills while he or she is still living at home.
• Investing time to find the best living situation for your child, as there is no one best way to approach this aspect of his or her life.
• Cultivating friendships for your child.
• Finding dedicated and caring people willing to work with your child and family.
• Making sure your child is active and engaged in the community during the day.
• Ongoing family involvement and advocacy.

Contact your local disability organization to find out about the services in your area and to get your child on the appropriate waiting lists.

 Additional Resources

• Private Programs Started By Parents – This is a new approach to independent living, and as the NFXF learns more, we will convey information to you.
  • F.R.I.E.N.D.S. On My Own, Apartment Living Program – Colorado
  • The POINT Program – New York
• Administration on Developmental Disabilities
  Developmental Disabilities Program
  Area of Emphasis – Housing
• The Arc – Housing Issues for People with Disabilities
• To find information in your state, conduct an Internet search for:[Your State] Housing for People with DD (or developmental disabilities)

• There is a range of employment and day services you can consider for your young adult – everything from a job (full or part time, and with/without a job coach), to volunteer work, to a supervised work crew, to a sheltered workshop employment, to adult day programming. A combination of activities is also often used. There are agencies within each state that provide services in these areas.
• The programs and services offered vary not only by state but also by localities within each state, and the services offered also often vary from agency to agency.
• Some agencies provide both employment/day programming and residential services, while others provide only one – meaning the person and family may have to deal with two sets of providers.
• One other aspect of your child’s day to consider is to find physical activity (exercise) for your child to do each day. Many local recreation centers offer programs for people with varying abilities or they will include your child into their regular programming.
  • Recreation center activities may include sports or craft activities or even dances.
  • An added benefit to utilizing the recreation center is the social component that is present at the center, which is so important for your child!
  • Call your local recreation center to see what activities your child can participate in.
  • If you do not have access to a recreation center, maybe you can form a neighborhood walking group. Maybe a local church or school will let you bring in a group for craft projects or dances.
  • With a little work you can keep your child active and healthy.
• Successful jobs/days can be maximized by:
  • Spending the time to find the right job/activity for the day, including the length of time and time of day
  • Finding the right mix of jobs/activities for the week
  • Finding “natural supports” at a job
  • Finding dedicated and caring people willing to work with your child and learn about Fragile X
  • Ongoing family involvement and advocacy
  • Keeping your child active and engaged in the world around him or her
• Contact your local disability organization to find out about the services in your area and to get your child on the appropriate wait lists.

Resources

• Administration on Developmental Disabilities – Developmental Disabilities Program
  Area of Emphasis – Employment
• The Arc – Employment Issues for People with Disabilities
• Centers for Disease Control & Prevention – Developmental Disabilities
• Therapeutic Recreation Directory & Activity and Treatment Ideas for Recreation Therapy
• U.S. Department of Health & Human Services
• U.S. Equal Employment Opportunity Commission – Questions & Answers About Persons with Intellectual Disabilities in the Workplace and the Americans with Disabilities Act

• The Arc: Aging
• The AAMR: Fact Sheet: Aging: Older Adults and Their Aging Caregivers
• Developmental Disabilities Program: Areas of Emphasis – Employment
  U.S. Department of Health and Human Services
  Administration for Children and Families
• International Center for Autism Research and Education
  Autism and Aging: What Happens when Children with Autism Grow Up
• Social Security Administration: Benefits For People With Disabilities
• To find information about adult resources in your state, try searching for:[Your State] Adult DD Services
• To find information about transition services (from high school to adulthood) in your state, try searching for:[Your State] Transition Services

Ten Rules of Time-Out

Make time-out a process, not a place. If a time-out is linked only to a specific place in the home or classroom, you are limited in both how and where you can use it. If you place your child on a kitchen chair or in his room as a consequence of hitting, what are you going to do if he hits in the grocery store? My recommendation is to sit the child down right where the infraction takes place, or if they are already sitting, simply turn them around so that they are either not facing you or the group. If you are in the grocery store.

My recommendation is to sit the child down right where the infraction takes place. You can sit them down right in the aisle. Make sure that you position yourself so that they cannot leave and or pull down stuff from the shelves. They are now in time-out. This differs from the information that is available in many parenting books and on the web. It is an important modification for children with FXS for many reasons, several of which will be addressed in the following recommendations. The biggest and most common obstacle that parents have cited to me about using time-out is getting the child to the designated chair, corner or step. This can be eliminated without rendering the process ineffective.

It is a slight but crucial change in thinking: It’s not the location that matters- it’s the time away from your attention. The act of removing the child from your attention is, in the clinical sense, a punishment, and a deterrent for the behavior. Most children want attention. (Note: Although children with FXS may exhibit social anxiety, they are social beings. For children with autism, time-out presents an additional challenge, and it often is not effective for them. Consultation with a psychologist or behavioral interventionist is recommended.)It is important to note that although you can and should use time-out in a variety of places, you want to establish your processes at home and practice in a controlled setting before you take your show on the road. You would not initiate this process in a grocery store, but after you have used it successfully at home and then perhaps at Grandma’s house, you would be ready for public places.

Make sure time-out means time away from your attention. This is the most fundamental part of time-out and one that appears to be the most difficult to implement. If you place children in time-out and talk to them about what they have done and why they are there, they are not in time-out; they are simply on the kitchen chair getting a lecture or engaging in an argument. Neither one of these strategies is effective in changing behavior. Yes, you will need to communicate with your child in time-out, but in a very structured and routine way.

Decide on a simple and consistent phrase before you start. The use of a consistent phrase serves several purposes in the time-out process, and it should contain two basic components. The first part lets the child know what he did and that it is wrong. The second part lets the child know what is happening; it labels the process. So for a child who hits, an appropriate phrase would be, “No hitting, time-out.” This is very short for several reasons. Children with FXS typically have language delays, so more language will actually lead to less understanding. Most parents feel it is necessary to explain and rationalize the situation with their children. However, when you engage in discussion, you delay the time-out, which makes it more difficult for the child to link time-out with undesirable behavior. By the time the child is actually in time-out, she may have forgotten what she did to get there.

Consistency of language also allows you to change location without disrupting the routine. Consistency of language also allows you to change location without disrupting the routine. You cannot take the kitchen chair with you to Grandma’s house, but you can take your time-out routine and your phrase, “No hitting, time-out.” It is important to choose the phrase that you want to use ahead of time so that you do not have to think about what you are going to say in the heat of the moment. In addition, everyone who is involved in changing the child’s behavior should use the same phrase. Consistency, consistency, consistency! Using a consistent phrase also keeps you from engaging in discussions and arguments.You have a set, minimalist response to any comment: “No hitting, time-out.” Changing behavior is tough, particularly when you are initiating something new. Using this same phrase can be calming for you. Ultimately, “No hitting, time-out” reminds both you and your child what she did and why she is in time-out.

Link time-out to a specific act or behavior. Time-out is not for generalized naughty behavior. We have all said, “That’s it! You have been whining and grumpy all day. You can go to your room for a time-out until you can come down and be nice.” Or: “You sit on this chair until you can calm down.” In order for the child to understand why she is in time-out, it must be clearly linked to behavior. Behaviors are things like hitting, kicking or biting. Time-out should not be confused with a time to organize oneself. It is not the same as going to the quiet corner for children who have sensory integration issues. It is not part of a sensory diet; it is part of a behavior plan. Implementing time-out effectively can be challenging, and it should be reserved for major offenses.

Impose time-out immediately following the behavior. For time-out to be effective, you must establish a clear relationship between it and the undesirable act. This is particularly important for children with FXS, who have short attention spans and difficulties with sequencing and cause and effect. The shorter the time between the behavior and the time-out, the more easily the child is able to understand the relationship between the two-and the more effective time-out will be in decreasing the unwanted behavior.

Do not engage in dialogue. On the way to time-out, or during the time-out itself, many children will attempt to get your attention by arguing. They may deny their involvement (“I didn’t do it”), blame another child (“Liam hit me first”), or comment on their feelings about you and/or your parenting skills (“I hate you, bad mommy”). If you address any of these comments prior to or during a time-out, the child has your attention, and she is not actually in time-out. It is very difficult not to comment on these statements, and that is why it is important to use the previously determined phrase. “No hitting, time-out.” This is your mantra. It helps keep you from engaging with your child during the time-out process.

Do not address behaviors that occur on the way. As stated in No. 6, children will attempt to get your attention in any way they can. They will also attempt to delay time-out whenever possible. Hitting you, trying to bite you, and knocking down the planter next to the couch are all attempts to engage you and consequently delay or avoid time-out. If you address these behaviors, the child will learn quickly that kicking or spitting will work in delaying the punishment, and he will continue to use them. By implementing time-out in the manner outlined in No. 1, you decrease the likelihood of additional provocative behaviors. You are not dragging the child to his room or lifting him onto the second step, so he has less of an opportunity to employ negative behaviors.

The focus thus remains on the original behavior hitting. It is important to note here that all children at some time or other will attempt to use these strategies. Nobody wants time-out it is not fun. That is what makes it an effective tool. Nobody wants time-out-it is not fun. That is what makes it an effective tool. It is also important to note that children are not “bad” just because you’re having to employ time-out. It doesn’t mean your children are unusually manipulative or strategic. Our brains are simply designed to work this way. We all avoid things that we do not like and/or are unpleasant, and we repeat things that work for us.

Adjust the duration of time-out for the child. Two commonly asked questions are 1) “How long should the child stay in time-out?”, and 2) “How many times should I put her back?” These questions are related, since keeping a child in time-out beyond his ability to handle it often leads to him getting up repeatedly. Again, we need to think about how the brain works, and more specifically, how a brain with FXS works. The rule of thumb for time spent in time-out is one minute for every year, so a three-year-old child would spend three minutes in time-out. This works fine for typically developing children, but for children with FXS, I recommend cutting the time in half. Such children typically have attention issues that need to be considered. It would be unreasonable for them to be able to stay in one place for as long as a child their age without FXS. We also want the time-out process to be successful for all involved. Keeping children in time-out for too long will result in frustration for parents, teachers, and children.

The second question is answered quite easily but again can be quite difficult to put into practice. If the child leaves time-out, you need to put him back as many times as it takes until he stays for the predetermined amount of time. Remember, this is a punishment for specific behavior. You put him in time-out and you need to tell him when it has ended. When the child attempts to leave the situation, remember to use your phrase rather than commenting on his leaving. If he gets up or attempts to leave and you say, “Now Justin, you need to get back in time-out,” or “I told you that you have two more minutes,” the child has your attention and is no longer “in” time-out. If the child attempts to get up or to leave, sit him back down and say “No hitting, time-out.” You have thus kept engagement with him at an absolute minimum, and the focus is redirected back to the original offense.

Make time-out one component of a comprehensive behavior plan. Time-out is not a comprehensive behavior plan in and of itself. It is an effective consequence for many behaviors, but to change behavior one must institute a complete plan that addresses all the factors that may be influencing it, including medications the child may be taking, therapeutic and remedial interventions such as speech and occupational therapy, and environmental factors. Comprehensive plans by definition require the coordination and collaboration of parents and professionals.

Use time-out in a consistent manner. Consistency is the key to success in any behavior plan and the most difficult to employ. If you decide that a child should go to time-out every time she hits, then you need to follow through, even when you are out in public or even when the child is tired. If you start making exceptions, what you have actually taught the child is that sometimes you can hit, and sometimes you cannot. This has the effect of strengthening the behavior. Still, consistency is difficult to maintain, so do not be too hard on yourself.

As I have advised many parents, do not try to implement any behavior plan when you are tired or on a trip. Set aside a weekend when this is your priority. I know in our busy schedules this is easier said than done. But if you need to address a behavior effectively, a comprehensive plan requires an initial time investment. It will pay off in the end. It is also important to note that time-out expectations for a typically developing child may look very different than those for a child with FXS. Remember the ultimate goal of the procedure. In other words, do not get hung up on whether or not the child is sitting or lying down. That is not the behavior you are trying to change; you are trying to decrease hitting. I have found the modifications and guidelines discussed above to be very effective for children with FXS. I have successfully guided parents and other caregivers through this process and have implemented it during home consultations. However, as is the case with any comprehensive behavior plan, it is always important to consult with a professional for support and guidance in dealing with difficult and challenging behaviors.

• Children with Fragile X syndrome often have delays in toilet training. Read up on strategies for teaching this skill and then choose one or a variation of one to try with your child to see the response.
• If your child shows some success, then continue the training. If your child is resistant or it appears your child is not ready, stop the process. Take a break – look at what worked, what did not work, and figure out how you want to approach it next time.
• Your child will have success.

Additional information

The following information have been collected for easy reference.

• Podcast: Let’s Get Going: Toileting Ideas
  with Karen Riley, PhD, Cindi Rogers, parent, and Jayne Dixon Weber, Coordinator of Support Services, NFXF & parent. A 65 minute recorded interview about toileting ideas. April 2009
• Please Don’t Poo-Poo This Article
  By Jayne Dixon Weber, March 2009
• A Holistic Approach to Toilet Training
  By Karen Riley, July 2008
• Toilet Training the Child with Fragile X Syndrome

Books

• Elmo’s Potty Time
  By Caleb Burroughs
• Even Firefighters Go to the Potty: A Potty Training Lift-the-Flap Story
  By Wendy Wax and Naomi Wax
• Everyday Solutions: A Practical Guide for Families of Children with Autism Spectrum Disorders
  By Mindy Small, Lisa Kontente
• It’s Potty Time for Girls: Potty Training Made Easy!
  By Chris Sharp (Illustrator), Gary Currant (Illustrator)
• The No-Cry Potty Training Solution: Gentle Ways to Help Your Child Say Good-Bye to Diapers
  By Elizabeth Pantley
• Once Upon a Potty – Boy
  By Alona Frankel
• Once Upon a Potty – Girl
  By Alona Frankel
• Potty (Leslie Patricelli board books)
  By Leslie Patricelli
• THE POTTY BOOT CAMP: Basic Training For Toddlers
  By Suzanne Riffel
• The Potty Journey: Guide to Toilet Training Children with Special Needs, Including Autism and Related Disorders
  By Judith A. Coucouvanis
• Potty Time with Elmo: 7 Button Little Sound Book (Play-a-Song Series)
  By Staff of Publications International
• Potty Training Boys the Easy Way: Helping Your Son Learn Quickly–Even If He’s a Late Starter
  By Caroline Fertleman and Simone Cave
• Road to Independence: Independence Skills Training for Special Needs Children
  By Brenda M. Batts
• Small Steps Forward: Using Games and Activities to Help Your Pre-School Child with Special Needs
  By Sarah Newman
• Stress-Free Potty Training: A Commonsense Guide to Finding the Right Approach for Your Child
  By Sara Au and Peter L. Stavinoha PhD
• Teach Toileting: A Revolutionary Approach for Children with Autism Spectrum Disorders and Other Special Needs
  By Deborah Bialer
• Toilet Training for Individuals with Autism or Other Developmental Issues
  By Maria Wheeler
• Toilet Training in Less Than a Day
  By Nathan H. Azrin and Richard M. Foxx
• Toilet Training Without Tantrums: from parent or child
  By John K Rosemond
• The Ultimate Guide to Potty Training for Boys & Girls [Kindle Edition]
  By Johanne Cezar
• Understanding Your Young Child with Special Needs
  By Pamela Bartram