A SUGGESTED CURRICULUM FOR THE PROFOUNDLY HANDICAPPED CHILD MIKE BAKER, Headteacher, Little Highwood Hospital School, Brentwood KEN JUPP, Headteacher, Golden Grove School, Turner Village Hospital,

EILEEN MYLAND, Headteacher, Grangewater School,

OWEN THURLOW, Headteacher, Bridge Hospital School, Witham

Colchester

South Ockendon Hospital, South Ockendon

The authors, all expesienced hospital school teachers in Essex, feel that it is both possible and necessary to educate the profoundly handicapped child, rather than merely mind him. They have devised a basic teaching programme which can be used with the most severely handicapped of the ESN(S) school population.

By profoundly handicapped children, we mean those who are severely physically and mentally handicapped, whose apparent response to the environment is negligible, who are non-ambulant, without speech, doubly incontinent and who may have sensory impair- ment. Children of this kind are usually found in the special care units of ESN(S) schools and, to a greater degree, in hospital schools. Many writers in special education do not have this type of child in mind when they are developing programmes for the handicapped, even though they may use the term “profoundly handi- capped”. We have suffered, probably in common with many readers, from going to conferences and lectures where the subject is “the care of the profoundly handi- capped”, only to find that the children being discussed are not profoundly handicapped at all.

We are mindful of the fact that children who are profoundly handicapped will have their lives restricted by the severity of their handicap. They will be unlikely to achieve total independence, and so our aim should be to encourage them to use all the senses available to them in order that they may communicate with and organise their environment.

These children require a curriculum which may be divided into the following areas: (1) communication; (2) cognitive skills; and (3) movement.

COMMUNICATION: The awareness and interaction of one human being with another. (This form, at its most basic level, is sensory input).

1. Non-verbal: Receptive - tactile reception visual/auditory reception visual/auditory memory

imitation facial expression body position.

2. Verbal: Receptive - listening attention auditory discrimination auditory memory

imitation verbalisation.

Expressive - gesture

Expressive - vocalisation

COGNITIVE SKILLS 1 . Association of experience 2. Concept formation - body awareness

self-identification spatial relationships.

3. Perceptual slcills - tactile perception visual perception auditory perception olfactory /gustatory perception.

MOVEMENT 1. a.

h.

d. C.

e.

f .

Head control Balance - in sitting, kneeling and standing. Reaching, grasping and releasing Feeding and drinking - lip closure

swallowing sucking chewing tongue control.

Positioning - lying prone lying sitting :

in chair - with support

on floor - with support without support;

without support kneeling standing - with support

without support. Mobility - rolling

creeping crawling walking wheelchair.

2. Toileting.

We have come to recognise that teaching targets of isolated components is not enough for any child. Child- ren learn by strategies which involve complete systems of learning and, whilst it is essential that objectives and tasks should be clearly and unambiguously defined, our method of teaching should take account of the fact that a combination of skills in co-operation and co- ordination with each other is necessary.

For example, the profoundly handicapped child may never achieve balance in sitting, kneeling and standing, or even in reaching, grasping and releasing. However, he may need to learn that communication may result from specific eye movements, finger movements, and so on. This underlines one essential weakness in any form of curriculum development which tries to isolate target skills and fails to recognise that the three core areas are closely and unequivocably linked.

The above is, of necessity, merely an outline of our present thoughts which we hope to develop in future Apex articles”. *The first of these articles is due to appear in the September issue of Apex.

132 Apex, J . Brit. Inst. Ment. Hand. Vol. 8 No. 4, 1981, 132