In Paul's class, 'a friend is a friend, regardless of... abilities'

By Louise Kinross

Paul Alcamo is a veteran at Holland Bloorview. He joined the hospital in 1987 as a recreation therapist and later became a teacher in our school. Almost 20 years ago he helped found our reverse-integration kindergarten, which invites able-bodied children to attend our school for children with disabilities.

The two-year program is a partnership between Holland Bloorview and the Dr. Eric Jackman Institute of Child Study at the University of Toronto. It promotes inclusion by educating kids about disability and adapting all activities. Typical children are immersed in the disability world, enabling them to gain a deep understanding of diversity, while the children with disabilities develop confidence in voicing their needs. In recent years the school has struggled to attract children who don’t have disabilities. BLOOM talked to Paul about his life's passion.

BLOOM: Why did you choose the field of children’s rehab?

Paul Alcamo: I worked in a program at North York Parks and Rec with kids with a range of abilities, and that spawned my thought of this as a career. I liked these kids and thought it was a natural bond and connection that I wanted to continue. I’ve always enjoyed the interaction and meeting the challenge, together with the children, to help them learn and grow.

BLOOM: What is the integrated kindergarten?

Paul Alcamo: It’s a classroom first and foremost that tries to give children as rich and joyful a learning experience as we can. The overriding philosophy is that a friend can be a friend, regardless of their abilities. We embrace all of the important things that are wonderful about Ontario’s curriculum—enquiry and discovery and taking joy in learning and sharing that with your friends. We have to make sure we differentiate it so we can accommodate the different abilities in our class. We have a healthy combination of direct teaching and situations where children are encouraged to pursue their questions or ideas about big issues.

BLOOM: I know you have amazing themes where you transform the classroom?

Paul Alcamo: I’ve always felt that in order to develop your understanding of a topic you have to practise it in an active way. With our pretend centre we’ve created a whole dig site where the kids become paleontologists extracting dinosaur bones. Then they go to the museum to clean the bones and put them into the shape of the dinosaur, and then describe the dinosaur. We’ve turned the pretend centre into a coral reef, a rainforest and a den where bears can hibernate.

Last year on a walk outside the kids saw these bugs crawling under a rotting log, and they asked: ‘What’s going on there?’ So we created the framework of the rotting log in the pretend centre and the kids dressed up as wood lice and bess beetles. They re-enacted how a bess beetle chews up wood that is partially broken down by fungus, and poops it out and feeds it to its larvae. The information that they develop and practise through play really stays with them, and they go home and tell their families about it.

BLOOM: You do a lot of teaching about friendship.

Paul Alcamo: We talk a lot about abilities and who’s the same and who’s different. We embrace the idea that caring, sharing, including and encouraging are four things that are really important to friendship. The kids come in and report if they saw someone doing any of these four things, which keeps them mindful of how others behave. They have a language. For example, you’ll hear: ‘That’s not a very encouraging thing to say.’ Or ‘You’re not including him properly.’ This is a philosophy that you have to imbue and work at.

BLOOM: What kind of changes do you see in the kids?

Paul Alcamo: The kids who come in and are getting therapy? I see them realize that they have to be outgoing in order to make friends. And that if you stay quiet and still, and don’t advocate for yourself, you run the risk of being left alone because you’re giving that signal that you want to be by yourself. ‘Do you want to be by yourself? If not, go ask someone to play with you.’

With both groups we make them understand there are ways to figure out how to play together. Sometimes that means changing the equipment or the jobs you do in the game, or where the game is played, or your boundaries or your timing.

We have to be very explicit with the kids about what they’ll do if they use a walker or a power wheelchair or run on their legs. We don’t just tell them it would be ‘nice’ to consider their friends’ needs.

With tag, we change the roles so everyone is working hard, but at their level of ability. So if you’re using a walker or wheelchair you can hold on to a long Styrofoam pool noodle and go forward. Even though you can’t move as fast, the longer noodles give you extra reach to tag kids. But if you run on your legs, you have to run backwards to tag people. So you’re still working hard, but we’re slowing you down.

For kids who are reticent about being ‘it,’ we came up with the idea of Captain Invincible. This is the person who’s allowed to unfreeze people when they’re frozen. It’s a powerful role, but you can go at your own speed.

BLOOM : What changes do you see in the other kids?

Paul Alcamo: Sometimes at the beginning of the year, they’ll refer to another child by their equipment name. So they may refer to ‘the wheelchairs.’ By the end of the year, they’re just using their friends’ names. They have an understanding of what their friend needs to do this or that, and they’re not upset about adaptations. It’s a matter of ‘these are my friends, we play together, this is how my world works, and this is natural.’

BLOOM: What’s the greatest challenge?

Paul Alcamo: Just making sure you stay on top—that your accommodations are in place, you have differentiation in your lessons so everyone has what they need to learn, and you’re conscientious about reinforcing that we’re all friends and we all have to find a way to play.

BLOOM: In the past you had more kids without disabilities, but you mentioned enrollment has declined in recent years.

Paul Alcamo: It’s a sad occurrence. I think there may be a number of factors. These days most families send both parents to work, whereas when we began the program there were a lot of stay-at-home moms. Also, we used to be the only full-day kindergarten, but we don’t have that niche anymore.

The families who do come are very committed to the idea of learning about the world of their classmates with disabilities and how to include and adapt and see their friend as a friend. We have families who come back to meet every year on the last day of Centreville for a reunion. We’re still accepting families through the Institute of Child Study until January of next year if anyone is interested.

BLOOM: Have your thoughts about disability changed?

Paul Alcamo: I’ve always had the belief that first and foremost these are children. Honestly, as I’ve gotten older and become a parent, you reflect on these things and it hits you a bit more. If anything, it’s made me someone who is even more emotionally committed to these kids. My attachment to these kids goes even deeper.