INTERVENTIONS

AUTISM, ADHD,
DYSLEXIA
Dr Tina Gupta MD
Director ICCAYA
WHAT EVERY TEACHER WANTS TO
KNOW
 AUTISM
IN THE CLASSROOM
 1 in 68 children may have an ASD

4 times more common in boys than

in girls: 1 in 37 boys while 1 in 151
girls

Cause: Mostly genetic

Fact check Vaccinations do not cause Autism

Still most children are diagnosed

after 4 years while Autism can be
reliably diagnosed as early as 2.

44% of these children have an IQ in

average or above average range.
 Intensive therapy started before the
EARLY age of 2 years has excellent results
INTERVENTION with upto 10% of children losing their
diagnosis.

ABA Applied Behavior Analysis and

therapies based on its principles are
the most researched and practiced
interventions

Supported by Speech therapy,

Occupational therapy, hearing
impairment support & nutrition
AUTISM INTERVENTIONS AT ICCAYA
STARTING AGE 12 MONTHS
EARLY INTERVENTION: The Critical “year 2”
Goals of Early Intervention
The Early Start Denver Model, Dynamic period of brain growth,
which combines applied behavioral during which increases in brain
analysis (ABA) teaching methods volume and atypical connectivity
with developmental 'relationship- associated with ASD first emerge.
● Physical Skills based' approaches. This approach Many children show regression of
● Thinking Skills was novel because it blended the skills in year 2.
● Communication Skills rigor of ABA with play-based routines
● Social Skills that focused on building a A time of substantial neural
● Emotional Skills relationship with the child. plasticity providing greater
potential to alter developmental
20 HOURS A WEEK OF INTERVENTION course
AND 5 HOURS A WEEK OF PARENT
DELIVERED THERAPY
Autism in the
Classroom
5 CORE DIFFICULTIES

ATTENTION & HYPERACTIVITY

REPETITIVENESS

PROCESSING INFORMATION

SOCIALIZATION &
COMMUNICATION

SENSORY SENSITIVITY TO
SOUNDS/ LIGHTS ETC
Do not imitate the actions of others during
songs/games.
Show reduced or lack of imitation of other’s
language.
Overly repeat what others’ say, (parroting or
echoing).
Not attend to peers’ actions in play.
Have reduced or limited referencing of the
adult when engaged in an activity.
Play alone which limits opportunities to
imitate what other children are doing.
Respond inconsistently to their surroundings
(e.g., calling of name, ringing of a bell,
following directions, etc.).
Have limited use of words, gestures, or facial
expression to get needs met (e.g., does not
ask for help, does not point to request, etc.).
Have repetitive, overlearned or “scripted”
language.
Have limited back and forth conversational
skills.
Use eye contact inconsistently when speaking
to another person
Does not ask for help, does not point to
request, etc.
Struggle to play appropriately with toys, including
repetitive or restricted actions on toys (e.g., repeating
roll a train/car back and forth, opening and closing
the door on the toy barn).
Have difficulty engaging in imaginative play
Play exclusively with or show intense interests in
certain toys (trains, animals) or insist on keeping a
certain object with them.
Show little interest in object play and prefer more
active games.
Overly conform to the rules of the game or how the
child expects the game to be played.
Avoid play with sensory materials given possible
sensory aversions or become overly focused or
involved with the sensory aspects of toys
Desire friendships but make inappropriate attempts to
initiate (e.g., hit a peer, give a bear hug, or take their
toys in an attempt to initiate play).
Avoid opportunities to socialize (e.g., prefer to play in
an empty sandbox or on a solitary swing).
Struggle with social awareness and reading social
cues.
Prefer to play with children younger or older than
them.Show limited awareness of other children or
become overly focused on objects in play.
Have difficulty sustaining engagement with other
children (e.g., only a few seconds engaged in peek-a-
boo, etc.),
Not actively participate in classroom routines, such as
circle, snack, centers, etc.Attempt to initiate but
primarily object focused, meaning they want the other
child’s toy.
Goal 1: Communication
“They don’t pay attention to what I’m
Gain attention, eye contact, body response saying”

Always use their name

Use their special interest or activity they are SELF ABSORBED

engaged in to communicate

Provide more opportunities for the child with LACKS JOINT ATTENTION
ASD to communicate.
NON VERBAL
Offer the student choices and require the
student to respond.
ECHOLALIA OR SCRIPTED
Use expansions - adding one more piece of LANGUAGE
information to what they say

VISUAL SUPPORTS
DOING REPETITIVE BEHAVIORS
Goal 1: Communication
“They struggle with open ended
questions. They don’t ask for help.”
Keep questions short

Ask only the most necessary questions.

SELF ABSORBED
Structure your questions, eg you could offer
options or choices.
LACKS JOINT ATTENTION
For example, ask “Did you enjoy your lunch?”
and “Did you enjoy maths?” rather than “How NON VERBAL
was your day?”.

Give them visual cards to seek help ECHOLALIA OR SCRIPTED

LANGUAGE
Give them a 'HIGH-INTEREST' object

Encourage requests DOING REPETITIVE BEHAVIORS

Goal 1: Communication “They react badly when I say no. They
hit me if they don’t want to do
Offer other ways of expressing ‘no’ or ‘stop’ something I ask.”
Set clear boundaries and explain why and where
”
it is acceptable and not acceptable to behave in
certain ways. SELF ABSORBED

LACKS JOINT ATTENTION

NON VERBAL

ECHOLALIA OR SCRIPTED
LANGUAGE

DOING REPETITIVE BEHAVIORS

Goal 2: Information Processing
“They find it hard to process what I
say”

Say less and say it slowly.

SELF ABSORBED
Use specific key words, repeating and stressing ”
them. LACKS JOINT ATTENTION
Pause between words and phrases to give the
person time to process what you’ve said, and to NON VERBAL
give them chance to think of a response.
ECHOLALIA OR SCRIPTED
Don’t use too many questions.
LANGUAGE
Sensory inputs may be affecting how much they
can process. DOING REPETITIVE BEHAVIORS

FILTERING UNNECESSARY INFO

Goal 3: Socializing with Peers
“They find it hard to play games, take
turns, share a toy or an experience”
Create Personalized Teaching Stories like :
Going to a Picnic, having Lunch together,
Playground Day- Use visual cards.
POOR EYE CONTACT
Reinforce what the student does well socially ”
POOR JOINT ATTENTION
Model social interaction, turn taking and
reciprocity
LACK OF POINTING
Teach imitation, motor as well as verbal.
POOR IMITATION
Use strengths to give a student a chance to
shine and be viewed as competent and
UNDERSTANDING NON VERBAL CUES
interesting

Create small lunch groups, perhaps with INITIATING CONVERSATION

structured activities or topic boxes.
TURN TAKING
Goal 3: Repetitive Behaviors“They get disturbed by change,
sometimes engage in hand flapping, finger
Modify the environment, reduce classroom flipping or have intense interests”
noise

Make daily class routine more predictable IMBALANCE IN CORTICOSTRIATAL

CONNECTIVITY
Create visual supports

Identify rumbling and create alternative relaxing SIGNS OF HYPER AROUSAL OR HYPO
activities AROUSAL
Create a SENSORY ROOM in school
SIGN OF STRESS AND ANXIETY

ADAPTATION TO LACK OF SOCIAL OR

FUNCTIONAL SKILLS
Goal 3: Socializing with Peers
“They find it hard to play games, take
turns, share a toy or an experience”
Create Personalized Teaching Stories like :
Going to a Picnic, having Lunch together,
Playground Day- Use visual cards.
POOR EYE CONTACT
Reinforce what the student does well socially ”
POOR JOINT ATTENTION
Model social interaction, turn taking and
reciprocity
LACK OF POINTING
Teach imitation, motor as well as verbal.
POOR IMITATION
Use strengths to give a student a chance to
shine and be viewed as competent and
UNDERSTANDING NON VERBAL CUES
interesting

Create small lunch groups, perhaps with INITIATING CONVERSATION

structured activities or topic boxes.
TURN TAKING
 ADHD/ADD
IN THE CLASSROOM
 UNDERSTANDING ADHD
BEHAVIORS IN CHILDHOOD

CLASSROOM STRUCTURE AND

AGENDA TEACHING PRACTICES THAT

SUPPORT ADHD BEHAVIORS

EFFECTIVE APPROACHES TO
INCENTIVES & DISCIPLINE

TEACHING SELF REGULATION

Executive functions deficits in ADHD Child

BEHAVIORAL INHIBITION SUSTAIN FOCUS ALERTNESS EFFORT

WORKING MEMORY GOAL DIRECTED PERSISTENCE

ORGANIZING PLANNING PRIORITIZING SELF REGULATION OF EMOTIONS AND

PERSISTENCE
TIME AWARENESS AND MANAGEMENT
SHIFTING AND FLEXIBILITY
AROUSAL AND INITIATION
SELF MONITORING AND
METACOGNITION
 BE AWARE
NEARLY 30%

DELAY IN EXECUTIVE
SKILLS
DEVELOPMENT THAN
 QUICK FACTS

On average, every classroom of 30 students has 50% of children who have ADHD also
1 to 3 children with ADHD
have sleep problems
Three boys are diagnosed with ADD for every
one girl 1 in 4 students with ADHD has other
serious learning disabilities
The rate of emotional development for children
with ADHD is as much as 30% slower than it is
ADHD behaviors are not intentional
for their children without the condition. For
example, a 10 year old with ADHD operates at or wilful
the maturity level of about a 7 year old
Self regulation is delayed
65% of children with ADHD have problems with
defiance, non-compliance and other problems
COMMON
CLASSROOM DIFFICULTY SITTING STILL, UNABLE TO ORGANIZE
CONCERNS ALWAYS ON THE GO
HOMEWORKS NOT DONE
NOISE MAKING, BLURTING
OUT, EXCESSIVE TALKING IMMATURE SILLY BEHAVIORS

UNABLE TO WAIT TURNS IMPULSIVE BEHAVIOR

WHICH CAN LOOK LIKE
EASILY FRUSTRATED AGGRESSION

FORGETTING RULES BOSSY OR INTRUSIVE WITH

OTHER CHILDREN
UNABLE TO KEEP HANDS TO
SELF QUALITY OF WORK BELOW
THEIR ABILITY
UNABLE TO STICK TO TASKS
OR ACTIVITIES
Symptoms worsen 1:1 ATTENTION
when NOVEL
STRUCTURED
CHILD IS TIRED, HUNGRY OR
HIGHLY ENGAGING
SLEEPY LOTS OF REINFORCEMENT

TASK ARE COMPLEX AND VERY

DEMANDING

TASKS ARE REPETITIVE AND

BORING

SELF CONTROL IS NEEDED

PERSISTENCE IS NEEDED
KEY FACTORS
FOR CLASSROOM
SUCCESS
PROACTIVE CLASSROOM MANAGEMENT

VERY HIGH RATE AND FREQUENCY OF REINFORCEMENT

ENGAGING INSTRUCTION AND MOTIVATING LESSONS

EXPLICIT TEACHING OF EF SKILL

HIGHLY ENGAGING HANDS ON

TEACHER FLEXIBILITY AND WILLINGNESS TO PUT FORTH

EXTRA TIME

COMMUNICATION, COLLABORATION AND TEAM WORK

 ADHD FRIENDLY CLASSROOM STRUCTURE

IS THIS IN MY
CLASSROOM

CLEARLY DEFINED SEATING SPACE & CENTER

CHALLENGING STUDENTS NEAR TEACHER

CALM DOWN AREAS

ROUTINES ESTABLISHED FOR DAILY

ACTIVITIES

DOWNTIME LIMITED, TRANSITION WARNINGS

GIVEN

RULES INSTRUCTIONS ARE CLEAR REPEATED

ATTENTION ENHANCING
STRATEGIES
S
L
A
N
T
E KEEP INSTRUCTIONS SHORT AND
SIMPLE

N ESTABLISH EYE CONTACT AND

ATTENTION BEFORE COMMAND
G INCREASE ACTIVE CLASS ENGAGEMENT

A “HELPER”

ACTIVE LISTENING “1 2 3 ALL EYES ON

G ME” “SHOW ME THE LISTENING EARS “

PRAISE FOR EYES ON TEACHER

E CATCH DOING GOOD WORK

DIRECTIONS SHOULD BE BRIEF WRITTEN
IF POSSIBLE AND STUDENT REPEATS
BEFORE STARTING
FREQUENT CHECK INS AND FEEDBACK
INSTRUCTIONS IN SHORT SEGMENTS
( TEACH - THEY TEACH -TEACH)
COLOR HIGHLIGHTING KEY PARTS OF
TASK
ASSIGN WELL FOCUSED BUDDIES OR
PARTNERS
INITIATE THE HOME WORK AT SCHOOL
JUST 5 MINS OF START TIME
KEEPING A DESK CHECKLIST OR A TASK
CARD
BEAT THE CLOCK CHALLENGES AND
INCENTIVES
GET THEN STARTED OR REWARD
STARTING RIGHT AWAY
BREAK THE TASK INTO SMALLER
SEGMENTS
VISUAL SUPPORTS AT THE STUDENTS
DESK LIKE A DIGITAL TIMER,
COUNTDOWN TIMER , A REMINDER
CARD JUST TAP AS THE TEACHER MOVES
AROUND
INHIBITION AND SELF REGULATION
STRATEGIES
IMMEDIATE FEEDBACK & REINFORCEMENT CLASS INCENTIVE SYSTEMS

EXERCISE AND MOVEMENT BREAKS EARNING MINUTES OR TIME FOR MY

DESIRED ACTIVITY
CUE CARDS ON DESK FOR STOP, THINK,
MAKE A GOOD CHOICE EARNING TOKENS FOR CLASS REWARDS

DESIGNATED CALMING SPOT CHART MOVES

KEEP A BAG OF SENSORY TOYS MY POINT/ YOUR POINT

BEHAVIOR CHARTS; SIMPLE, FEW TARGETS,

REWARDS CLEAR, EXPECT SOME PUSH
BACK, BE CONSISTENT, AGE APPROPRIATE
 PERIOD 1 PERIOD 2 PERIOD 3 PERIOD 4

REMAINED
SEATED WITH
ONLY 2
WARNINGS

COMPLETED
80% OF HIS
WORK

PLACED THINGS
BACK IN RIGHT
PLACES

DAILY BEHAVIOR REPORT CARD

MAXIMIZE POSITIVE FEEDBACK
CATCH THE STUDENT BEING GOOD IN CLASS

USE DESCRIPTIVE COMMENTING SO

LET THE STUDENT KNOW WHEN “ON
TRACK “AND WHAT SPECIFICALLY
THEY ARE DOING RIGHT

PRASE IMMEDIATELY WITH EYE

CONTACT

PRAISE EFFORTS AND

IMPROVEMENT
EFFECTIVE USE OF INCENTIVES IN CLASS

SELECT 1-2 SPECIFIC ACHIEVABLE

BEHAVIORS TO INCENTIVISE IN
CLASS

ALWAYS COMBINE WITH PRAISE!

CREATE MEANINGFUL INCENTIVES

FOR THE CHILD

TANGIBLE REWARDS AND ACTIVITY

BASED REWARDS
ACADEMIC SUPPORTS AND
STRATEGIES
 READING ACTIVE READING TECHNIQUES
AND SELF MONITORING OF
COMPREHENSION, STOP AND PROCESS,
FOCUS AIDS

WRITING ORGANIZERS, GUIDED

1. BREAKING LONG ASSIGNMENTS INSTRUCTIONS
INTO SHORT MANAGEABLE PARTS
2. SELF MONITORING
3. ORGANIZATION ASSISTANCE AND MATHS MEMORY AIDS , MANIPULATIVES
HOMEWORK SUPPORT/ASSISTANCE
GOOD WEBSITES FOR ACADEMIC
STRATEGIES

http://iris.peabody.vanderbilt.edu www.readwritethink.org

http://coe.jmu.edu/learning www.readingrockets.org
toolbox/strategies.html
www.newmanagement.com
http://sandrarief.com
www.pbis.org
www.interventioncentral.org

www.fcrr.org

www.whatworks.ed.gov
TEACHER SPECIFIC STRATEGIES
TEACHER RELATIONSHIP AND POSITIVE
PROACTIVE STRATEGIES ARE FOUNDATION
FOR SUCCESS

EXPECTATIONS & INSTRUCTIONS

CLEAR & SPECIFIC

FREQUENT SPECIFIC POSITIVE

FEEDBACK AND DIRECTION

MORE PRAISE THAN CORRECTION

OR REDIRECTION

POWERFUL, VARIABLE, MEANINGFUL

INCENTIVES ARE USED
MANAGING MISBEHAVIORS IN
CLASSROOM
MANAGING MISBEHAVIORS IN CLASSROOM

IMMEDIATE

SMALL FREQUENT CONSEQUENCES

DO NOT LOSE COOL

CONSISTENT FOLLOW THROUGH

LIMIT MAXIMUM THAT CAN BE TAKEN

AWAY

DO NOT START A POWER STRUGGLE

REDIRECT THE CHILD POSITIVELY

PRAISE THE STUDENT NEXT TO THE

CHILD FOR EXACTLY WHAT YOU WANT
THE CHILD TO DO PROXIMITY
PRAISE

TELL THE CHILD WHAT YOU WANT

INSTEAD OF WHAT TO STOP DOING

BE BRIEF AND MATTER OF FACT

MINIMIZE ATTENTION TO NEGATIVE

BEHAVIOR
REMOVING PRIVILEGES
MAKE SURE THE STUDENT IS
CAPABLE OF FOLLOWING THE RULE
TELL AHEAD OF TIME WHAT WILL
HAPPEN IF THEY FORGET THE “RULE”
GIVE A “REMINDER”SO THAT THEY
CAN CHOOSE TO DO THE RIGHT
THING
SHOULD BE LOGICALLY CONNECTED
TO THE BEHAVIOR
FOR EXAMPLE:
Dont use materials appropriately take them
away
Dont line up properly go to the end of line
Unsafe recess behavior miss 5 minutes next
day
Make disruptive noise move to another
area
Cant cooperate in a group, work be self
TIME OUT TO CALM DOWN

TIME OUT IS NOT A PUNISHMENT

SPARINGLY USED

TEACH OTHER STUDENTS TO GIVE PRIVACY

USE FOR AGGRESSIVE OR UNSAFE BEHAVIOR

ONLY

EXPLAIN TO STUDENT HOW TO USE A TIME OUT

WELCOME BACK AND PRAISE NEXT POSITIVE

BEHAVIOR
 GIVING LOTS OF POINTING OUT
NEGATIVE ATTENTION WHAT THE
TO PROBLEM STUDENT IS DOING
BEHAVIORS IS WRONG

ASKING
GETTING INTO
STUDENT
POWER
WHY THEY
STRUGGLES
WHAT DOES NOT HELP ARE
MISBEHAVIN
G

TAKING AWAY ALL SENDING STUDENTS

OF THE RECESS TO THE OFFICE
ADHD STUDENTS WORK
HARDER WHEN THEY HAVE A
POSITIVE RELATIONSHIP WITH
THEIR TEACHER

PROACTIVE STRATEGIES ARE

MORE EFFECTIVE THAN
REACTIVE

ADHD IS CHRONIC SO
SUPPORTS ARE NEEDED LONG
TERM

KEY POINTS TO REMEMBER ABOUT ADHD IN

CLASSROOM
DYSLEXIA
Deficits in sld: dyslexia/ dysgraphia/
dyscalculia
1. Difficulty reading (e.g., inaccurate, slow and only with much effort)
2. Difficulty understanding the meaning of what is read
3. Difficulty with spelling
4. Difficulty with written expression (e.g., problems with grammar,
punctuation or organization)
5. Difficulty understanding number concepts, number facts or
calculation
6. Difficulty with mathematical reasoning (e.g., applying math concepts
or solving math problems)

Reading deficits
Basic deficits:
Phonological Awareness recognizing sound
segments in spoken words
Reading Comprehension
Learning to read is a sequential process:
Sounds-words-sentences-paragraphs
Decoding-comprehension -retention
● Slow to learn the connection between
letters and sounds
● Difficulty "sounding out" unknown words
● Repeatedly misidentifying known words
● Makes consistent reading and spelling
errors including letter reversals (b/d),
inversions (m/w), transpositions (felt/left,
was/saw), and substitutions (house/home)
● Transposes number sequences and
confuses arithmetic signs (+, -, x, /, =)
● Slow reading rate read word by word
● Read without expression
● Read without punctuation
Learning to Read : Decoding Bag: “buh”
“aah’ “guh”
● Slow to learn the connection between letters and sounds
● Difficulty "sounding out" unknown words
● Repeatedly misidentifying known words
● Makes consistent reading and spelling errors including letter reversals (b/d),
inversions (m/w), transpositions (felt/left, was/saw), and substitutions
(house/home)
● Transposes number sequences and confuses arithmetic signs (+, -, x, /, =)
● Slow reading rate read word by word
● Read without expression
● Read without punctuation

Difficulty understanding or remembering what is read because

so much time and effort is spent figuring each word
Learning to Read: Comprehension
Understanding written language develops with mastery in decoding and sight
words. Can relate what they read with what they know.
Difficulties:
● lnability to connect ideas in a passage
● Gross omissions/ overlooking details
● Difficulty distinguishing minor details/ significant facts
● Lack of concentration
Learning to Read: Retention
● Trouble remembering and summing up what is read
● Difficulty connecting what is read to prior knowledge
● Difficulty applying content of text to personal experience
READING SIMULATION
EXERCISE
We begin our trip at a familiar place, our body like yours
We pegin our qribeq a faziliar blace,
and mine. It contains a hundred trillion cells that work
together by design. And within each one of these many
cells, each one that has DNA, the DNA code is exactly a poqy like yours enq zine. Iq
the same. So, the code in each cells is identical
conqains a hunqraq qrillion calls
When you see………………Pronounce as qheq work qogaqhar py qasign. Enq
q d or t
z m
wiqhin each one of qhese zany calls
p b each one qheq hes QNA dhe QNA
b p
coqe is axesqly qhe saze So qhe coqe
ys er
a e in each call is iqanqical
e a
dysgraphia
● Tight, awkward pencil grip and body position
● Illegible handwriting, Inconsistencies : mixtures of print and cursive, upper and
lower case, or irregular sizes, shapes, or slant of letters. Inconsistent position
on page with respect to lines and margins and inconsistent spaces between
words and letters. Slow or labored copying or writing - even if it is neat and
legible
● Avoiding writing or drawing tasks
● Tiring quickly while writing
● Saying words out loud while writing or carefully watching hand while writing
● Unfinished or omitted words in sentences
● Difficulty organizing thoughts on paper
● Difficulty with syntax structure and grammar
● Large gap between written ideas and understanding demonstrated through
speech.
WRITING AND SPELLING
● Random (or non-existent) punctuation.
● Spelling errors (sometimes same word
spelled differently); reversals; phonic
approximations; syllable omissions; errors
in common suffixes.
● Clumsiness and disordering of syntax; an
impression of illiteracy.
● Misinterpretation of questions and
questionnaire items.
● Disordered numbering and written number
reversals
 Mathematics Basic skills

● Memory to recall rules and formulas and recognize patterns

Language to understand vocabulary, instructions, and explain their
thinking
Sequential ordering to solve multi-step problems and use procedures.
Spatial ordering to recognize symbols and deal with geometric forms.
Higher-order cognition helps children to review alternative strategies
while solving problems, to monitor their thinking, to assess the
reasonableness of their answers, and to transfer and apply learned skills to
new problems.
Often, several of these brain functions need to operate simultaneously
“ If only you
try harder
you can
succeed”
 “ If only you try harder
you can succeed”
Learning to speak is a natural process learning to read is not so min 2 yrs
socialization & education is recommended”

Early identification, neither overdiagnosis nor

underdiagnsosis will help the child with dyslexia
WHAT WE DO FOR DYSLEXIA

INTERVENTIONS FOR
PSYCHO EDUCATIONAL READING, WRITING,
ASSESSMENTS AS PER MATHS,
CBSE GUIDELINES COMPREHENSION AND
BEHAVIOR PROBLEMS IN
DYSLEXIA
DYSLEXIA DIAGNOSIS IN THE CLASSROOM

An outline of what is going to be taught in the Stress free high interest reading
lesson, ending the lesson with a resume of what
has been taught. Never read aloud

Homework is correctly copied Do not read beyond their current level

Share tel nos of few peer buddies Spelling drills and techniques for improvement

Make a daily checklist to review each evening Use pocket speller

Encourage good organization skills Encourage proof reading

Blackboard copying- leave long enough Simplify written material

DYSLEXIA DIAGNOSIS IN THE CLASSROOM

Encourage handwriting practice]

Give credit for effort

Avoid using red pens while checking

Spelling should be level appropriate

Discourage rewriting whole pages

Give less demanding homework

Use tape recorders, computers or scribe

assistance for writing
OPEN FOR
DISCUSSION
 A FREE
OFFER
CONSULTATION TO TEACHERS
AT RED ROSES PUBLIC SCHOOL FOR
ANY IN HOUSE SERVICES AT ICCAYA