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Ginny

Ginny is a new 9th grade student at Midland High, a school that has received special recognition as completely accessible to students with physical impairments. Ginny, born with Spina Bifida, is grossly overweight and confined to a wheelchair. Diane Lane, the Exceptional Student Education coordinator, is struggling to help Ginny and her family control her weight and hygiene so that she can participate in a school-to-work program.

 

Ginny could hear them giggling and talking about her as she made her way to Diane Lane’s office at the end of the hall. Sometimes she just didn’t have time to take care of her personal needs before the bell rang for 5th period. Luckily there was no one in Mrs. Lane’s office when she got to the door.

"Come in, Ginny," responded Mrs. Lane as she held the door open for the girl. Tears were streaming down Ginny’s face as she directed her wheelchair into Diane’s office. Ginny could hardly catch her breath to explain what was wrong, but no explanation was necessary. Mrs. Lane knew exactly what had happened and tried to console Ginny by leaning over to look her straight in the eyes.

"We have talked about this before, Ginny, and you know your first priority must be to take care of your personal needs before going to 5th period," explained Mrs. Lane, trying to be sensitive yet firm. "Did your step-mom give you more medicine last night?"

Ginny nodded, trying hard to hold back the tears.

"I can’t go by myself and when I have to go all the way to the clinic so they can help me I’m late for class," Ginny paused briefly to compose herself.

"You know I will write you a pass to get into class late." assured Mrs. Lane.

"I know, Mrs. Lane, but everyone laughs at me when I come into class late. I hate it when they laugh at me!" Ginny continued.

"Come on Ginny, let’s get you cleaned up so you can get back to class. I’ll get your change of clothes and meet you in the girl’s bathroom," responded Mrs. Lane with an empathetic ear.

Ginny Williams, a student with physical disabilities, was a new 9th grader at Midland High School. Diane Lane, the coordinator for Exceptional Student Education, was doing her best to ease Ginny’s transition into her new environment. Ginny’s records from her previous school in another city indicated that she had completely rejected any attempts at learning personal hygiene and self-toileting skills and preferred to have someone else deal with the consequences when she had accidents.

Ginny was born with spina bifida, which left her paralyzed from the waist down. Also, due to complications resulting from a surgical procedure to repair the opening in her spine, Ginny had spent much of her infancy in the hospital recovering from a dangerous infection. As a result, she was developmentally delayed and classified cognitively as well as physically handicapped in school.

Up until the time of her parent’s divorce at age 12, Ginny’s records indicated normal weight gain and better than average mobility skills. Now, at age 15 and living with her father, his new wife, and several young step-siblings, Ginny was grossly overweight and unable to lift herself out of her wheelchair. Mrs. Lane was very concerned about the problems Ginny would encounter if she did not lose some weight. In addition, she would not be eligible for the school-work program if she could not tend to her own personal-needs.

Diane Lane was a seasoned professional with 24 years in Exceptional Education, the last five as coordinator of the ESE services at Midland. Her main responsibilities centered on the school-to-work program, but she also was in charge of discipline, IEP’s, and staffing. As the only school in the county that was completely accessible to students with physical impairments, Midland had received special recognition for it’s accomplished school-to-work programming for students with special needs. Mrs. Lane was determined to see that each and every one of her students succeeded, and Ginny was no exception. As Diane Lane would soon learn, however, the odds were stacked against her.

Mrs. Lane’s first goal was to help Ginny with her weight problem so that she would have an easier time transferring out of her wheel chair. Diane had noticed that Ginny’s lunch usually consisted of junk food and candy. She decided to call Mrs. Williams, Ginny’s stepmother, to discuss diet options.

"Good morning, Mrs. Williams. This is Diane Lane from Midland High School."

"What has she done now?" responded the voice at the other end. Mrs. Lane could tell from the tone of her voice that Mrs. Williams was having a bad day.

"Ginny is not in trouble, Mrs. Williams, but I do have some concerns about her weight that I’d like to discuss with you," answered Diane.

"Yes, she is very heavy," came the reply, in a more concerned tone.

"Students in our vocational training program must be able to handle all their personal needs by themselves. Ginny is not eligible until she can develop more independence with toileting. Part of her problem seems to be that she is overweight and has trouble lifting herself out of her chair. I think it might help if you could encourage Ginny to bring healthier lunches to school and get more exercise."

"I don’t have time to make her lunch every morning. I have three other children to get off to school. Ginny’s old enough to look out for herself. I have told her over and over to pack herself a good lunch but all she wants is candy and chips. I can’t watch her all the time!" Mrs. Williams firmly replied, trying to defend herself to Mrs. Lane.

"I understand Mrs. Williams, but just for a couple of weeks, couldn’t you please help Ginny put together a healthier lunch? We’ll do our part to reinforce her choices here at school. We will also work on Ginny’s upper-body strength in adaptive PE so that she can transfer herself out of her chair for toileting. If we work together, Ginny can become more self sufficient and that will really be a help to you at home as well." Diane added.

"I’m doing the best I can," came the reply. Mrs. Williams hung up the phone.

In a conversation with Ginny the following day, Mrs. Lane learned that Ginny was afraid of her stepmother and tried to avoid interactions with her whenever possible. Her father worked long hours and was rarely home except on weekends. Ginny was his only child from a previous marriage. She seemed unclear about the whereabouts of her mother.

For the next two weeks it seemed that Diane had gotten through to Mrs. Williams. Ginny was bringing a regular sandwich with a small bag of chips and perhaps an apple or carrot sticks for lunch. Then, all of a sudden she began bringing a big bowl of plain lettuce with no dressing or frills. Her stepmother called the school and made it very clear to the secretary that Ginny was to receive no additional food. After about three days, Mrs. Lane noticed that Ginny was stealing food from other students and begging for money to buy snacks and candy from the school store. Diane was very concerned because Ginny had never before exhibited any of these behaviors.

Also of great concern was that Ginny was still having bathroom accidents at school. The accidents were even more frequent than before. Mrs. Lane and her staff had been working very hard with Ginny and could not figure out what was causing these setbacks. Finally, after a bit of prodding, Mrs. Lane learned the reason. In a misguided effort to help Ginny lose weight, Mrs. Williams was giving her a laxative every evening. At first Diane decided to give Mrs. Williams the benefit of the doubt. Even though this was an unacceptable way for Ginny to lose weight, perhaps Mrs. Williams meant no harm. Hopefully all that was needed was some gentle coaching on better weight management techniques for Ginny.

When Diane called Ginny’s home to express her concerns, Mrs. Williams made it very clear to that she knew what she was doing. She intended to manage her step-daughter’s diet her way and forbade anyone to interfere. Mrs. Lane decided that Mrs. Williams needed some additional coaxing by someone else. She asked the principal, Mr. Driggers, to intervene. After a lengthy discussion with Mr. Driggers, Mrs. Williams agreed to meet with a dietician to discuss Ginny’s needs. For the next few months, things seemed to improve.

Mrs. Lane asked Mrs. Parnell, one of her more experienced paraprofessionals, to accompany Ginny to the restroom after lunch every day so that she would not be late for her 5th period class. In addition, by the end of the second grading period, Ginny had lost ten pounds. She was also working with the Adapted Physical Education teacher to improve her upper-body strength. By the end of her 9th grade year, Ginny had continued to lose weight, was able to transfer in and out of her chair, and was having no more accidents at school. Mrs. Lane and Mrs. Parnell both felt she was ready to start the school-to-work program. Ginny was very excited and seemed to be ready to accept the responsibility.

Ginny’s IEP for her 10th grade year included learning vocational skills such as filing and answering the phone. Her long-range goals included participation in the job program by her junior year. Her stepmother seemed to accept the plan.

Ginny’s junior year passed without a glitch, aside from the occasional phone call from Mrs. Williams to question Mrs. Lane’s and Mrs. Parnell’s intentions. Mrs. Lane arranged a job placement for Ginny at a local hospital doing basic office work. She was assigned a job coach and they worked together every day for the first few weeks until Ginny felt comfortable with her new surroundings and responsibilities. Mrs. Parnell volunteered to check in on Ginny periodically and help her maintain the work necessary to earn a special diploma.

Several weeks passed before Mrs. Lane began receiving distressing news from Ginny’s employer. Mr. Jones, the hospital supervisor, reported that although Ginny was a very good worker, lately she was coming to work dirty and disheveled. She had also, had several bathroom accidents at work. Mr. Jones was very empathetic and not discouraged by an occasional accident, but Ginny’s personal hygiene would have to improve. A call to Ginny’s job coach confirmed Mr. Jones’s concerns. The job coach explained that Ginny was reminded every day to bathe and put on clean clothes before coming to the hospital but there had been no change. Diane Lane dreaded the call she was getting ready to make next.

"Hello, Mrs. Williams. This is Diane Lane from Midland," Mrs. Lane began.

"I received a call from Mr. Jones, Ginny’s supervisor at the hospital today. He expressed some concerns regarding Ginny’s personal hygiene. He made it clear that if she did not improve, he would be forced to let her go. Ginny seems to really enjoy her job, and I would hate to see her lose it." Mrs. Lane continued, trying to be very diplomatic and avoid a confrontation on the phone.

Mrs. Williams seemed calm and collected as she began her response. "Mrs. Lane," she began, "Ginny and I now have an understanding that she is responsible for her own laundry and personal hygiene. She is old enough to handle those needs on her own. Therefore, if Ginny loses this job, it is her responsibility and not mine. Do I make myself clear enough for you?" she finished.

"I agree that…" Click. Mrs. Lane could not believe that she was just cut off.

The next day, Mrs. Lane and Mrs. Parnell went to visit Ginny at her job and found a disheveled young lady who reeked of a distressing odor.

After a gentle hug by both teachers, Mrs. Lane began a line of questioning that confirmed her suspicions.

"Ginny, your stepmother tells me that you are responsible for your own laundry and personal upkeep now. Is that true?" Mrs. Lane questioned.

"Yes, but she says I can’t use her washing machine and I have to find someone else to help me," Ginny confessed. "She doesn’t want me to take a bath at night because I take too long. In the mornings, there isn’t enough time either. My daddy says she’s right and I have to do what she says," Ginny added tearfully.

Diane had fought the urge to call social services before, but this time she felt she had no choice.

 

Discussion Questions

  1. List what you have learned about each of the characters in the case.
  2. What do you think is motivating the thoughts/actions of each of the characters?
  3. What are the issues/problems in the case?

 

Additional Questions

  1. What events have transpired in Ginny’s life between the time she was 12 until now which might have contributed to her condition in the ninth grade?
  2. Do you think that Ginny’s step-mother understands Ginny’s condition or is realistic about her ability to function on her own?
  3. Why is it important for Ginny to be able to assist with toileting?
  4. Can Ginny’s non-compliance in her toileting routine be used as a basis for excluding her from her proposed secondary program?
  5. How did communication breakdown after Ginny’s job placement? How could this situation have been avoided?
  6. Should there have been a more coordinated effort among social service agencies to address the challenges presented by Ginny and her family.
  7. What role did Ginny’s father play in her situation?
  8. What would you say to Ginny’s step-mother if you were given an opportunity to talk with her. What about her father?

 

CEC Competencies/Knowledge Areas Addressed in the Case

 

Major Areas:

Typical concerns of parents of individuals with exceptional learning needs and appropriate strategies to help parents deal with these concerns.

Rights and responsibilities of parents, students, teachers, and schools as they relate to individuals with exceptional learning needs.

Life skills instruction relevant to independent, community, and personal living and employment.

Effects an exceptional condition may have on an individual’s life.

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