Autistic Life Skills: Toothbrushing

Full Disclosure: I don’t get any money for telling you what products I use, like, or don’t like. My opinions are just that, my opinions. There are no product links on this page. I assume you know how to use google.

My goal, in this “Autistic Life Skills” series is simple. To, hopefully, provide a more comprehensive understanding of the complexities of developing skills that incorporate sensory challenges, so that other teachers and parents (and other autistics who struggle with those same skills) might find some guidance to approach the teaching of these skills with less frustration on everyone’s part. Hopefully, a way to end the episodes of “wrestling a crocodile” (as the parent of one of my students describes their nightly toothbrushing routine.)

As a child, I was lucky that toothbrushing was never a battle my mother chose to pick. I thought I was very clever in the ways I hid the fact that I wouldn’t do it from her. I wasn’t; she just chose not to fight me about it. Through the luck of good genetics and floride in the water, I never got a cavity, but that luck certainly had nothing to do with my (lack of) toothbrushing.

I was in my 30s when I stopped getting nauseous and sometimes physically sick at the dentist, because I was able to advocate for myself to not get any flavored pastes (they make me sick) and to skip the floride treatment (the texture and taste - yes I can taste it!) makes me gag.

I was nearly 40 when I finally developed a tolerance for the electric toothbrushes that the dentist recommended. I still hate the Sonicare ones and won’t use them. But I worked my way up with the pulsar ones (the vibrating ones that look like manual toothbrushes) and now can use the Oral-B electric toothbrush (well, the CVS generic version!) They have a smaller brush head that means the vibrational input in my mouth is more localized, and the handle doesn’t vibrate as dramatically, so I get the input (and cleaning power) without my whole face, hand, and arm vibrating, which I never could stand. I’m still waiting for the dentist to tell me that my toothbrushing has gotten good enough that I can stop going every three months. Maybe next time?

Why do I tell that story? Because most of my students do not have the language to explain things as clearly as I just did. And yet, as verbal and generally self-aware as I am, look at how long it took for me to figure it out and find relief. I’m not saying that everyone with sensory challenges experiences dental hygiene the same way I did. I’m saying these are the places to start looking when a student struggles.

Especially when working with an older student, it’s important to recognize that there is likely a trauma component to the resistance to learning this skill. Do your research: what’s been tried in the past? How does the routine go at home? What are dental visits like? For many of our students, it’s a battle of wills with the parent at home, and either restraint or sedation at the dentist office. This is a breeding ground for trauma. You can’t start with sensory desensitization, or do sensory desensitization alone, and expect it to be effective. It might be effective in the classroom if they have a positive relationship with you, but it won’t transfer to the home environment. You have to work with the student and the parent to build trust around the routine and more positive associations.

What does that look like in practice?

We start by getting the student to hold the toothbrush.

Then we work on bringing to their face (any part accepted)

Slowly we work toward bringing to the lips.

Next is getting them to open their mouth.

Once they will hold it in their mouth for a count of 10 we can start putting it in each section of the mouth.

Then work toward top and bottom of each section.

Only after that do I introduce the “brushing” motion.

Some students can and will skip steps.

Some students do better starting with the vibration on.

The vibration scares some students away (like it did me.)

For some students we alternate: do each step without and then with vibration before moving on to the next step.

That’s going to depend on their sensory profile, and also where their sensory regulation is that day. (I know I’m more sensory defensive when I’m anxious or tired.)

Toothbrushing is a challenge, but it shouldn’t be a battle. Take on the challenge, work with your student, but know when to pick your battles and don’t make it a battle you choose to pick. 

When We Were Alone: Teaching our (Current) History with Residential Schools

The picture book study for this year’s Global Read Aloud was a pair of indigenous authors and illustrators. The use of language in the books was rich, and gave us ample opportunities to make connections to our own use of multiple communication strategies, as all of my students this year are multimodal AAC communicators. The themes fit beautifully into our social-emotional instruction, as we have been focusing on working together and what it means to be a community.

Then we reached the last book in the book study, “When We Were Alone” by Richard Anderson, illustrated by Julie Flett. The book makes great use of repetitive language that helps make the complex topic of indigenous residential schools more cognitively accessible. I have a student in my classroom who was previously placed at a residential school “far away from home” (as the story says) and who has a trauma history from that placement. I was initially a little apprehensive about reading this story with him. Would he understand it? Would he make the connection? From the first read-through, this student, who usually has difficulty sitting for lessons, sat with rapt attention for this story. His eyes were glued to every page as I read. It was clear the story had his interest. 

I did not draw, or ask him to draw, explicit connections to his own residential school experience. What we did was make explicit comparisons between the meaning behind the rules in the story “to make everyone the same” and the rules in our classroom “to be safe” “to get our work done” and “so everyone can participate.” My students’ active participation in these activities reinforced our classroom values more than any explicit teaching could have done.

I will say it explicitly here: My student’s former placement was a residential ABA program. While the stories are different, at far too many programs the strategies and intentions are the same as the story we read. ABA-based strategies, applied to appropriate skills, are not, by themselves, the problem. It’s the values and intentions that drive them that are deeply problematic and lead to student trauma. For teachers looking to broach this controversial topic with their class, this book may be a great place to start.

Hacking Classroom Culture: A Blueprint for My Implimentation

There’s a picture I took last spring of my students during their social skills group. They’re playing a matching game. The rules of the game are: chose a picture and ask your peer if he has it. Peer tells the first person he has the match and gives it to them. First person makes the match and puts it in the box. The students in the picture look absolutely pained, like this was the worst thing I could have possibly asked them to do.

It’s not the academic task. Matching was specifically chosen because it’s a mastered skill and the one they default to when they’re not sure what is being asked of them. No, what is paining my students, who are accustomed to doing their academic work 1:1 with a teacher, is that just answering the teacher they’re working with (who will provide prompting and reinforcement) isn’t enough to complete this activity. Interacting with a peer is a lot more work!

Enter Hacking Classroom Culture: Designing Compassionate Classrooms by Angela Stockman and Ellen Feig Gray. I was struck by how their ideas would fit so sensibly into the outlines I already had in place. I loved how easily and sensibly they dovetailed with best practices in severe disabilities and prevocational training. Finally, someone had given me some tools to build a classroom community, instead of a class of students who happen to share the same room and teacher.

So what are we going to do?

Morning Meeting:

First off, I moved the basic calendar and schedule work out of morning group. The students all need 1:1 support to complete this task and can do it at different speeds and independence levels, so it makes more sense to make it part of their arrival/unpacking routine.

(You can view my trello board to see a full implementation of our morning meeting here: https://trello.com/b/383gGHvw)

One of the best practices in severe disabilities for eliciting attention and language is a mystery box. The idea is that you put an object in a box and the students have to use their senses/language to figure out what it is. Here, I’ve put a social language spin on the idea:

Place object of high interest to a specific student (or highly correlated with a specific person in the classroom/school) in a box.

Students can take turns making guesses about what it will be like based on sound/touch or opening the box and describing/identifying it (scaffold for skill level)

Once object is identified, students complete the activity it is used for (e.g. fill out attendance for secretary) and then identify/bring it to correct person (vocational delivery skill and social interaction skill integration)

An old tired idea you see in most special education classrooms is practicing greetings and personal information during morning meeting. Or the age-old variant of identifying who is at home/work/school. I’ve brought in some math instructional targets to keep it fresh (and keep us moving!) and brought back some good old-fashioned “show-and-tell” (with a new more social spin!):

Organize students/have students organize themselves using personal information (e.g. height, birthday month, age, etc) - visual models of data.

Each student has an opportunity to share a skill they are working on in class or something that happened at home with the rest of the class.

-Encourage community, not just what I did but who I did it with/who helped me do it and where I did it (what tools helped me be successful)

(Teachers can model too, but careful not to turn it into sharing on behalf of students!)

*Both teachers and students (probably mostly teachers at first) have the opportunity to point out things they saw others do - that they thought was cool or they might want to try themselves.* 

Social Skills Group:

The first idea I fell in love with when I read Angela and Ellen’s book was the idea of Empathy Mapping. I tweeted at the time, and I still think, that teaching Empathy Mapping in conjunction with Story Grammar Marker would be a powerful way to give students a structure and language to understand the social world around them. So I want to do exactly that. My students have been working on body parts and what they do. Our next step is to develop visual empathy maps. I want to use folders, with one side being the self, what I am seeing, hearing, saying, feeling, etc. The other side will have a pocket that can be a generic person (background) or you can place a picture or a specific person, and have the same options (what are they seeing, hearing, saying, feeling, etc.) The folder format will allow me to keep the visual supports for both sides in the center.

Ideas I’m Still Pondering:

* I’ve usually used the standard Story Grammar Marker imagery/materials when I teach that unit/skill. I’m wondering if it would make more sense to use the same imagery as the Empathy Maps for students to more clearly see the connection. Haven’t made a decision yet.

* I’d love to invite some of our non-classroom school people to join us for morning meeting (I originally was calling it morning cafe for this reason) but I’m not sure if that will help or hinder the social connection of the objects that are related to them (if they are not in their expected context.) Maybe try and see what happens? Most won’t be able to come except once in a while anyway!

Next Steps:

My copy of Teach Like Finland is supposed to arrive later today. Can’t wait to see what other ideas I find!

The Gift of Flexibility

The rules that make up our social structure can seem arbitrary when participation is not intuitive: Go here now but not later. Touch this but not that. Put this here but not there. When you look for an underlying logic in order to understand them, as many autistic children and adults do, it appears they change on a whim. “Go with the flow” requires recognizing and understanding, or at least being able to follow, the “flow” of society, which is based on social norms - the very skill that eludes so many people on the spectrum. It’s really no wonder so many cling to routine, structure, and sameness and get upset when it is violated. From that perspective, it’s actually surprising more folks on the spectrum don’t spend more time in “fight or flight” mode. It is a constant battle to figure out how to live in a world that often doesn't make very much sense.

Engaging with the norms and expectations of the school and classroom environment is particularly challenging for several of my students. In particular, they do not recognize the logic behind sitting and completing an academic task, moving to another area, and repeating the demand. Both sitting and moving are non-intuitive demands. Both have, historically, had intensive intervention aimed at compliance with these demands. 

They often demonstrate their lack of understanding by removing themselves from the demand to engage in preferred activities which are both highly interesting to the student and engage the teacher in an interaction, thereby drawing both of them away from the interaction they do not understand the logic behind. What concerned me was students who were getting bigger and older (I teach middle school) and more aggressive. And we were the cause. (Of the aggression, teenage boys are going to grow like weeds whether we want them to or not.)

I met with the team and we got programs put in place to get everyone’s hands off the students unless there was a real immediate safety risk (e.g. about to be hit by a car!)

We got lots of alternative seating in place. More than enough for every student in the room. Ball chairs. Bouncy chairs. Rocking chairs. We stopped telling students to sit and started asking them where they wanted to sit.

We got some pretty ridiculous answers at first. On the table? On the heater? On the floor?

We said okay. We did our academic work there.

Sometimes students didn’t want to sit. They stood or leaned.

We said okay. We did our academic work there too.

It wasn’t perfect. Kids were still on the move a lot. Transitions were not flawless. But what changed almost immediately? The day we made this change, the aggression that was starting to become a problem disappeared overnight. We’re getting just as much work done as we did when we were following the compliance-based program with one difference: everyone, kids and staff, are happier. We’ve been at this for a couple of weeks now and an unexpected thing has happened: the kids are starting to sit. They are sitting in chairs and without being asked. The logic is simple really:

Stop fighting the kids and they’ll stop fighting you. It’s the gift of flexibility.

Finding Inclusion in a Separate Day School

This has been a hard post to write. But, as an inclusion-minded special educator, I wanted to tell the story of why I have decided to take a teaching position at a separate day school for students with disabilities. It’s not what I expected when I started looking, but I believe I have made the right decision for myself and for my students.

During my job search, I visited some schools that, though amazing educational institutions, would not be accessible to me given my own disabilities. These were places where I know I would not have been successful teaching because my access needs would have gotten in the way: classrooms that were too large, socially set up, or in an environment that I found far too distracting to focus. I also visited places that met my access needs but where I could not envision providing instruction that adequately met the needs of the enrolled students due to the space, the ratios, the technology access, or a combination of factors. I found both of these challenges to be present across settings: public, collaborative, and private. 

Going beyond physical access, I knew I needed an environment that backs up its statements about building independence and self-advocacy with real action. I needed stay away from environments that prioritize the ideal of “safe and happy” over meaningful instruction. I found each of these types of environments across settings as well, but I found the ones that most shared my teaching values in the separate day school setting.

Separate day schools don’t provide the access to rigorous grade-level instructional environment that can be found in a public school setting (if you have a teacher with the knowledge and mindset to provide access to that instruction.) However, just being in a public school doesn’t imply access, and all of the classrooms I visited operated on an “integration” not an “inclusion” model. 

Over the past two years, I have developed an instructional model that incorporates global learning opportunities to give students access to connection and collaboration with students beyond their local school community. Using this model, I am able to provide access to the grade-level classroom without sacrificing the intensive instructional supports of the self-contained environment. You can’t get that combination in a traditional public school’s grade-level classroom.

I worried about the social nature of these small close-nit institutions. Places with a strong focus on social norms can be inaccessible or even dangerous for me. But I learned this past year to value the sense of community that can be found in these environments when they are staffed by professionals who share the same commitment I do to high quality instructional access and building independence and self advocacy.

The school and classroom where I accepted a position are both small. Smaller than I found almost anywhere else. (One of many reasons why I will never name the school I work at on my blog or social media.) The reason that they had an opening at all was because they found that the students in this class were not being successful in a larger class, so they broke it up to give the students who needed it a more intensive instructional environment. We spoke about the idea of teaching vs. helping (a frequent problem in severe/multiple disabilities.) Instead of the “and how do you address that” question, I was told the story of how the school had made that mindset shift and hired staff who believe in teaching. The school values of building independence and self-advocacy really came through in both word and action.

I went into this job search looking for a placement in a public middle school. But I also went into it with a very clear understanding of what my teaching values are and where I was and was not willing to compromise. I know how to recognize an environment where it will be accessible for me to be the best teacher I can be for my students. I found those values and that environment in a separate day school. I didn’t find it at any of the other schools I visited. So, despite (or maybe because of) my belief in an inclusive environment for all learners, I have taken a position in a separate day school. Inclusion, after all, is a mindset not a placement.

Do You Have a Minute?

(Image courtesy of ASAN www.autisticadvocacy.org)

I've wished, pretty much since I learned about them, that the rest of the world would implement Color Communication Badges, especially for events like conferences where so much emphasis of the benefit is placed on the face-to-face connections: in other words, the socializing - that thing I can't do. My dear friend, Nightengale, made a wonderful argument in her most recent post about why we need to introduce the badges into schools. Because what we expect people to want isn't necessarily the same as what they do want, and the first step in advocacy is ask-vocacy: ask the person.


Then I spotted this on the Internet: https://twitter.com/weareteachers/status/771072597962272768

That got me thinking about the benefit of implementing Color Communication Badges in my classroom, not just for my students but for myself as well. There's pretty much nothing a student can do in my classroom that will bother me, or prevent learning from happening, but there are 4 little words that can throw off an entire lesson or even an entire day:

"Do you have a minute?"

The unwritten answer to this question, of course, is "yes." I work very hard to be flexible and accessible for collaboration. It's worked. It's worked a little too well, to the point where people think it's okay to interrupt me in the middle of lessons. But the fact remains that, a lot of the time, I don't have a minute. I'm with a student or group; I'm mentally (sometimes physically) organizing the next lesson; or I'm taking a much needed breather so I can be "on" again in a minute.

The problem is, once I've explained that, no, now is not a good time (because it would be rude to just ignore you) I've already lost that focus so I might as well recoup my losses and go down the rabbit hole on whatever you wanted "a minute" about. Maybe it will be useful. So I have acquired a reputation of being always accessible that is actually counterproductive to the way my brain works.

Therefore, when school starts again tomorrow, I'm going to be rolling out Color Communication Badges for everyone, students and teachers, in my classroom. The original descriptions (edited slightly for brevity) are:

Green: actively seeking communication. May have trouble initiating conversation, but want to be approached by people who are interested in talking

Yellow: only want to talk to people they recognize, not strangers/friends from the Internet.

Red: probably doesn't want to talk to anyone (or only a few people) unless it is an emergency.

(Source: http://autisticadvocacy.org/wp-content/uploads/2014/02/ColorCommunicationBadges.pdf)

I'm going to have to tweak the definitions for the classroom environment a little bit. (They stand fine as they are for leisure time.) My preliminary classroom definitions:

Green: available to talk on a new topic/with a new person. Ready to try something new.

Yellow: can talk, if it's on the topic at hand/current instructional topic, or getting information I'm waiting for. Probably don't want to try something new/work with a new person.

Red: not available, unless it is an emergency. 

I suspect my card will spend a fair amount of time on "yellow" during the school day. I'll check back in after a couple weeks, and let you know how it goes.

Autistic and Disability Culture - The Forgotten Cultural Competencies

This is the first post in a series of posts for Autism Acceptance Month unpacking the impact of being autistic in education and why we need more autistics in education at all levels.

I often get into conversations about cultural competency on Twitter and elsewhere and find that the voice of disability culture is un-heard and unrecognized in the conversation. Teachers who are otherwise very aware and active in trying to be culturally competent are completely unaware of the inherent biases of the educational system against Autistic and disability culture. So, piggy-backing on the excellent post by my friend Nightengale of Samarkand about practicing cultural competency in medicine, and in honor of April and Autism Acceptance, I want to see if I can unpack the concept for my fellow educators.

 First let's look at how educators encourage students to demonstrate and share their culture:
1. Sharing their food.
Many autistics have specific food preferences due to sensory sensitivities. These may have to do with texture, color, taste, or smell. Teachers at the elementary level could capitalize on this to re-frame the autistic students as experts to teach about the five senses. But that's not what happens. Seen as a medical deficit instead of cultural difference, students are given behavior plans to learn to eat what their typical peers eat in the way that their typical peers eat it. We would chastise a teacher for doing the same thing to a student from China who insisted on eating traditional noodles with chopsticks. We would encourage that student to share their tradition. But it is seen as perfectly acceptable to do to an Autistic student. Students with a variety of disabilities require specialized diets and food preparation for a variety of reasons in order to eat safely at school. Their peers are naturally curious about these differences, as much as they are curious about any other difference in food. While it may not be safe for these students to share food with peers, making it taboo to talk about leads to fear. Yet, many teachers are afraid, because they have limited understanding beyond the inservice they received about how the student could die if they let them near the wrong food (assuming they have any training at all.) This leads to unnecessary segregation: from separate tables to students who are required to be fed by nurses or even eat in the nurses office. This creates a clear and unnecessary "us" vs "them" distinction in the name of "safety."

2. Sharing their language.
Many people with disabilities are able to very articulately describe their experiences, but for many autistics and other people with disabilities, spoken language is not their primary means of communication. And most special educators will tell you "all behavior is communication." For many non-speaking autistics, physical and visual interaction with objects and people are meaningful forms of communication, so are scripting and echolalia. Yet, most speaking people are unwilling to listen to that communication unless it is translated for them into spoken language. Special education has only one translation manual, it's called the FBA, and it says that non-speaking students are only saying one of 4 things in every communication interaction: "I want this," "I want your attention," "stop this," or "this feels good." This problematic belief is what justifies providing limited vocabulary and not introducing robust AAC. When we ask a student from France to share something of their language, we are not surprised to hear greetings, stories, and poetry. When a student who uses AAC does the same, it makes the local and sometimes national news. The disability community refers to this as "Inspiration Porn."

But there is an even more insidious worm than the problems I have laid out above, although it is integral to all of the examples listed. The problem is not just that Autistic and disability culture and excluded from the conversation about cultural competence. The problem is not just that Autistic and disability cultural differences are treated as medical or educational deficits to be remedied or swept out of sight in the name of "safety." The real problem is that Autistic and disability culture is not on most educators' radar at all, even that of special educators (perhaps especially not that of special educators.)

Culturally inclusive educators do not teach about autistic and disability culture. Autism awareness in schools has everything to do with wearing blue on April 2 and nothing to do with learning about Autistic Culture. Even in special education classes specially designed for Autistic students, they do not learn any disability rights history. They might learn about the civil rights movement (if they get that much access to the general education curriculum, many don't.) But they won't learn about how their own history is intertwined with that history. They won't learn about the community that exists (mostly online) out there if they chose to get involved in advocacy.

Some of this is unintentional. Many teachers simply do not know about the history of the disability rights movement. Many, despite their best intentions, still think of their students as children. I have had conversations with many very well meaning teachers where I have to remind them repeatedly that I am talking about the student getting access to their community, not just the parent. But some of it is intentional. I have been blocked from providing inservice about disability history because it is "too political." Disability history is not pretty. What has been done to people with disabilities by well meaning professionals is not something to be proud of. But, as professionals, we have to own that history if we are going to change it. It is no different that any of the other hard parts of our history. Or am I the only one who reads Satayana any more?

Prove it: A Post for BADD 2015

This is my post for Blogging Against Disabilism Day 2015. Read more posts here.

A kindergarden student, learning to read, gets periodic assessment of their reading, and based on those assessments, moves up or down in their reading instructional level.

Yet, when my nonverbal 13-year-old student, who is also learning to read, takes the same assessment and I say I am going to move her up in reading instructional level as a result, I am met with the following response:

1. assumption that I read the passage to her.

and/or

2. push-back that I must do many more assessments before I can say for certain that she can read at that level.

When I use the formal assessment tools built into our phonics program for assessing symbol/sound awareness with one of my students and comment to one of my colleagues that my student (a non-speaking 14-year old who communicates with a low-tech eye gaze board) seems to know his consonants and be ready to move on to learning CVC words, I get the following response:

1. questioning whether I am going to assess all the letters or “just the ones on this page?"

2. commenting that “well those are the hard ones” despite the fact that I clearly stated that the section needed to be gone back to, not because the student had struggled but because the student had fatigued in using his eye gaze system and needed a break.

Why? Because they are non-speaking and the concept that a non-speaking person who is not yet using formal communication could read is completely alien, even to my fellow professionals working in the field of severe special education.

If they had been a verbal, typically developing, kindergarden students, no one would have questioned the validity of the assessment results. Yet this happens all the time when instructing students with limited formal communication skills in the general curriculum.

Yet there is a hypocrisy here. Because there is one assessment that they only had to take once. It’s the most flawed assessment they ever took, not least because it was a language based assessment given to someone with no formal language. I’m referring of course to the IQ test. The test that showed all the things they couldn’t do. The test that provided the justification for an assessment and therapeutic based education instead of a standards-based  education. No one seems to have any problem taking the results of that single assessment at face value.

That is the heart of ableism. We are only comfortable with accepting with assessments of individuals with disabilities that show us how they are disabled; the ones that show us what they can’t do. (If that reading assessment had shown she couldn’t read it, I doubt anyone would have asked me to do more assessments to make sure I wasn’t wrong.) Show an assessment that challenges those assumptions, an assessment that shows how they are skilled, and people will refuse to believe it without additional irrefutable proof.

Losing Control

Last week at #atchat, I was having a conversation with Ricky of www.atmac.org about the challenges of teachers who fear technology in the classroom, and who fear their students being more capable with the technology than they are. That got me thinking, and I said it at the time, the essence of that fear is teacher fear of losing control over the classroom dynamic.

It is common knowledge that every first year teacher struggles with classroom management. It's one of those rights of passage of first year teaching. There's a teaching urban legend that says "don't smile until October." Great emphasis is put on having an orderly, well controlled classroom.

In special education, this emphasis is paradoxically increased. Because our students struggle with the basic skills of self-regulation that come effortlessly (most of the time) to students in general education, most special education classrooms are filled with behavior charts and other paraphernalia of teacher-directed behavior support programs (incentive programs, reward/consequence programs, positive behavior supports..... the names and philosophies change - sometimes for the better sometimes for the worse, but all are predicated on the same concept: student must do what teacher says: top down.)

How many IEP goals have you seen that have goals for following (x step) directions? Or other goals of compliance. Participation in a structured activity goals? That's a compliance goal too. We spend a lot of time in special education teaching compliance.

And then, at some point, in "progressive" special education classrooms, somebody gets the idea of teaching self-regulation. It rarely goes well. The students are unprepared for there being no "right" answer. The teachers do not want to allow the behavior to become disregulated, so they control the choices, reinforcing the students' belief that there is a "right" answer and their own belief that their students are "too low" or "too routine oriented" to understand how to self-regulate. Because without the behavior plans and structure the class would get out of control.... right?

Wrong.

The problem is not that the students are "too low" (I don't believe such a thing exists) or "too routine oriented." The problem is trying to teach self-regulation in a context, and based on a foundation, that does not support it. The problem is that classroom culture of behavior charts.

I am not saying that we have to do away with extrinsic motivators (rewards) for all our students in every context. I'm not saying visual behavior supports aren't important - they are. But for most of the day, if students aren't motivated to learn the material, we need to find a way to make the material motivating. For example, I have a student who has been acting out during math: he struggles with numbers. We are learning about ratios as part of the 7th grade common core standards. He has been throwing every manipulative I try to use to teach this skill. But he loves time and clocks. So we started talking about the ratio of time to distance. He loves starting and stopping the stopwatch as we check the time to travel various distances. He still doesn't love telling the numbers, but he's more motivated to do so now that they are times.

More to the point, puts my timer to far better use than it was being put giving him check marks for staying in his seat and keeping his hands to himself to earn the swing when math was done. He still might ask for the swing after math, but it's not contingent any more. Sensory breaks are important, and now he's learning both math (which he wasn't before) and early self-regulation skills.

As my students build their skills in the areas of self-regulation, self-advocacy, and self-determination (all areas of the curriculum represented on every IEP in my classroom) I don't expect I will find anyone is "too low" to make progress and develop skills. And I'm not worried about losing control of my classroom to do it, because I won't be giving up any behavior control in order to for them to practice those skills. They are working on them every day in the classroom already. My students are the primary stakeholders in what goes on in my classroom: if they're not invested in learning, I don't waste my time teaching: the standards only tell us what to teach, not how.