Multiple Disabilities Brittinie & Tricia October 16, 2012 Encompasses a combination of conditions that may impact a student’s ability to learn and achieve success in an academic setting. o Students with severe disabilities are typically included under this terminology. o This disability category includes those students with the most severe physical, cognitive, and communicative impairments. “It should be noted o The common connection isn’t that they have two or more co-existing impairments, however, that these but that they generally need extensive support across any number of skill areas. students can alsohave average or even Characteristics - Six Categories that impact their learning: above-average intelligence” Intellectual functioning- Motor development- help develop appropriate Most have severe Significant delays in fine instructional programs. impairments and gross motor skills Physical Therapy w/ Health care needs- Adaptive skills- orthopedic supports to Medical procedures, Especially self-care and improve deficits in motor medical aids, medications social skills Resources: Programs should include Sensory impairments- Communication skills- United Cerebral Palsy self-care and self- Hearing and visual Challenges requiring Association – advocacy components impairments are common augmentative and www.ucp.org (essential for their Having a clear alternative communication Utah Center for inclusion in the understanding of their Assistive Technology – community) sensory impairments will www.ucat.usor.utah.gov Teaching Strategies: Assistiveware – www.assistiveware.com Planning process: a Peer tutoring – Must be GOAL: AAC devices multidisciplinary process reciprocal. Student with allow students with MD to Project Ideal - (parents, teachers, physical MD should be able to share countless emotional http://projectidealonline. org/multipleDisabilities. therapist, assistive provide something to the and social benefits that php technology teachers, and tutoring process, even if it can come from a any additional support is simply social behavior. reciprocal interaction with National Dissemination Center for Children staff). another person. with Disabilities Assistive technology – is http://nichcy.org/disabili Determining the students an effective tool for Tangible and tactile ty/specific/multiple strengths and desires students with MD in symbol systems: overcoming functional Choice boards Determine what Resources and communicative Object prompts & and support will be needed limitations. symbols Physical modeling & Develop an IEP Augmentative and prompting Alternative Computer or microswitch Integrate students with Communication –is any technology multiple disabilities with instructional device, other peers. Part of the technique, or system that learning process is social serves to support and development. bolster communication
Autism defined by IDEAAutism means a developmental disability significantly affecting verbal and nonverbalcommunication and social interaction, generally evident before age three, that adverselyaffects a childs educational performance. Other characteristics often associated withautism are engagement in repetitive activities and stereotyped movements, resistance toenvironmental change or change in daily routines, and unusual responses to sensoryexperiences.IDEA Regulations: Part 300 / A / 300.8 / c / 1 / iStatisticsCDC Report 2012 from www.austim-society.org1 in 88 are diagnosed1 in 54 boysAustim Spectrum includes: Autistic Disorder Rett syndrome Childhood disintegrative disorder Pervasive developmental disorder-not otherwise specified (PDD-NOS) Asperger syndromeCharacteristics Social Relationships: o Difficulty establishing relationships o Resist human contact o Issues with social interaction o Lack of eye contact o Uninterested in others Communication o Delayed language o Struggle to maintain communication (conversations) Poor communication leads to inappropriate behaviors (screaming, hitting, biting, running) o Echolalic speech – repeat what others say Repetitive Behaviors Interests o Narrow range of interests o Can spend hours alone exploring 1 thing obessesively Student Stress o Tend to get stressed easily o Difficultly dealing with stress o Get stressed or “set off” by little things o Often need rituals to complete tasks
Non Profit Organizationswww.autismspeaks.orgwww.autism-socitey.orgTeacher Tips Create structured/predictable environments Establish and display clear procedure for tasks Establish and display rules Establish consistent pattern for instruction Use visuals (pictures) for displaying rules and procedures Foster social interactions o Teach children with autism to take turns, wait, complete tasks, be flexible, be quiet… Communication o Variety of strategies depending on level of ASD Language Sign Language Communication boards Other tips: o Social Stories: Brief stories of when certain behaviors are acceptable and not acceptable o Picture Exchange Communication System: display picture of desired item or task…student responds…no words used o Visual Schedules: Pictures that depict daily routines displayed in classroom and in student notebook o Special Education Department: work with SPED to develop a plan that works with each individual student. http://www.autismspeaks.org/what- autism/symptomsResources fromhttp://www.autismspeaks.org/family-services/resource-library/tools-professionalsAutism Speaks School Community Tool KitThis tool kit is intended to be a support for the general education and administrative school staffwho interact with students with autism in various capacities.www.autismspeaks.org/schoolEden Autism Services Free Webinars: Teaching Students with AutismThis program provides free monthly webinars and "live chats," free lesson plans, and onlinediscussion forums to help teachers connect and collaborate on the best practices for supportingstudents with autism.Effective Strategies for Students in Grades PreK-5Effective Strategies for Students Grades 6-12
How to Set Up A Classroom for Students with AutismA Manual for Teachers, Para-Professionals and Administratorswww.autismclassroom.comSkills®: The Online Autism SolutionSkills® is an online tool for educators of children with autism that provides comprehensiveassessment and curriculum, positive behavior support planning for challenging behavior,progress tracking and treatment evaluation all in one place.www.skillsforautism.com
Intellectual DisabilityDefinition in IDEA: “…significantly subaverage general intellectual functioning, existingconcurrently with deficits in adaptive behavior and manifested during the developmental period, thatadversely affects a child’s educational performance.” [34 CFR §300.8(c)(6)]In 2010, President Obama signed Rosa’s Law, which replaced the stigmatizing label “MentalRetardation” with the more acceptable term “Intellectual Disability” IDs are the most common form of developmental disability 1-3% of America’s general population and 10% of students requiring SPED have an IDCauses: Genetic conditions (e.g. Down syndrome, Fragile X syndrome, Williams syndrome),problems during pregnancy (e.g. mother who used alcohol during pregnancy, improper cell division),problems at birth (e.g. lack of oxygen), and health problems (e.g. malnutrition, lack of appropriatemedical care, contact with poisons, and diseases like whooping cough, meningitis, or the measles)Characteristics: Variety of physical markers depending on cause of the disability Below average intelligence ranging in incidence rate and severity o For a mild diagnosis, students’ IQ scores will be between 70-75 or below o For a moderate to severe diagnosis, students’ IQ scores will be approximately 55 or below Slower learning rate and greater difficulty retaining information May reach a point where learning levels off Difficulty generalizing skills learned in one context to another Trouble solving problems/thinking logically Difficulty with social and daily living skills Developmental delays
Suggested Teaching Strategies: Treat students appropriately according to their chronological age Carefully follow the strategies outlined in the student’s IEP Break large concepts down into smaller steps and include breaks Teach one subject or idea at a time Supply manipulatives to concretely represent concepts Provide opportunities for continued practice in a variety of settings Teach social and daily living skills Match expectations to instruction (i.e. accommodations and modifications) Use peer-tutoring, inclusive methods, and family involvementAdditional Resources:The Archttp://www.thearc.org/page.aspx?pid+2335The Arc is a community-based organization that advocates and serves those with intellectual anddevelopmental disabilities and their families. The site includes various fact sheets on intellectualdisabilities detailing everything from the causes of these disabilities to criminal justice issuesregarding these disabilities.The Utah Association for Intellectual Disabilities (UIAD)http://www.uaidutah.org/homeThe UIAD is a relatively new non-profit organization that formed in 2008 after The Arc of Utahclosed due to financial reasons. UIAD took over some of the services the local Arc chapterprovided, including the “Holiday Gift Box Program, Bridge to the Future, Connections toComputers, and socialization projects.” The Bridge to the Future is a particularly beneficial resourcefor parents and educators alike, outlining the services a person with an intellectual disability mayrequire throughout stages of his or her life. People interested in supporting UIAD’s mission arewelcome to volunteer.Project Idealhttp://www.projectidealonline.org/index.phpProject Ideal is part of a teacher preparation program meant to prepare teachers to work withstudents with disabilities. It provides helpful resources such as tips for classroom management andmanaging student behavior along with descriptions of disability categories and disability law.The U.S. Equal Employment Opportunity Commissionhttp://www.eeoc.gov/facts/intellectual_disabilities.htmlThe EEOC provides information on employment opportunities and the rights of workers withintellectual disabilities. EEOC is an important resource for educators to gain knowledge on how toprepare students with disabilities for future jobs and opportunities. This resource would beespecially applicable for secondary teachers.American Association on Intellectual and Developmental Disabilities (AAIDD)http://www.aamr.org/index.cfmThe AAIDD offers links to national disability organizations focusing on specific disabilities.
Orthopedic ImpairmentDefinition: Orthopedic impairment is defined as a severe orthopedic impairment that adversely affects achilds educational performance. The term includes impairments caused by congenital anomaly (e.g., clubfoot,absence of some member, etc.), impairments caused by disease (e.g., poliomyelitis, bone tuberculosis, etc.),and impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that causecontractures).Characteristics of Students who have Orthopedic Impairment: Learning, perceptual, or sensory problems May impede speech production Impede expressive language of the childCharacteristics based on 3 Categories of Orthopedic Impairments:Neuromotor Impairments: an abnormality of, or damage to, the brain, spinal cord, or nervous system that sends impulses tothe muscles of the body. These impairments are acquired at or before birth, and often result in complex motor problems that can affectseveral body systems. Limited limb movement Loss of urinary control Loss of proper alignment of spineTwo most common are Spina Bifida and Cerebral Palsy 1. Spina Bifida: is a developmental defect of the spinal column. It may or may not affect intellectual functioning. Spina bifida occulta is a mild condition while spina bifida cystica is more serious. Involves some paralysis 2. Cerebral Palsy : refers to several nonprogressive disorders of voluntary movement or posture that are caused by malfunction of or damage to the developing brain that occurs before or during birth or within the first few years of life. Individuals with cerebral palsy have abnormal, involuntary, and/or uncoordinated motor movements. The four most common types of cerebral palsy include: Spastic (very tight muscles occurring in one or more muscle groups that result in stiff, uncoordinated movements) Athetoid (movements are contorted, abnormal, and purposeless) Ataxic (poor balance and equilibrium in addition to uncoordinated voluntary movement) Mixed (any combination of the types)Degenerative Diseases: are composed of various diseases that affect motor development. The most common is musculardystrophy. Muscular dystrophy: group of inherited diseases characterized by progressive muscle weaknessMusculoskeletal Disorders: are composed of various conditions that can result in various levels of physical limitations juvenile rheumatoid arthritis limb deficiencyTeaching Tips Special seating arrangements to develop useful posture and movements Instruction focused on development of gross and fine motor skills Securing suitable augmentative communication and other assistive devices Awareness of medical condition and its effect on the student (such as getting tired quickly) Educate everyone in the school community on a student’s disability Have parent/student/resource staff conferences to ensure classroom is accommodating for each child’s IEP
Due to the various levels of severity of orthopedic impairment, multiple types of assistive technology may be used speech recognition software screen reading software augmentative and alternative communication devices (such as communication boards) academic software packages for students with disabilitiesLearning Tools Physical Therapists who work on gross motor skills (focusing on the legs, back, neck and torso) Occupational Therapists who work on fine motor skills (focusing on the arms and hands as well as daily living activities such as dressing and bathing) Speech-Language Pathologists who work with the student on problems with speech and language Adapted Physical Education Teachers, who are specially trained PE teachers who work along with the OT and PT to develop an exercise program to help students with disabilities Other Therapists (Massage Therapists, Music Therapists, etc.)Additional Resources Project Ideal: http://www.projectidealonline.org/orthopedicImpairments.php Bright Hub Education: http://www.brighthubeducation.com National Center on Accessible Instructional Materials http://aim.cast.org/learn/disabilityspecific/physical United Cerebral Palsy: http://www.ucp.org/
DeafnessLegal Definition of Deafness:Deafness is defined as “a hearing impairment that is so severe that the child is impairedin processing linguistic information through hearing, with or without amplification.”*Important to understand the distinction between Deafness and Hearing Impaired.Hearing impairment is defined by IDEA as “an impairment in hearing, whetherpermanent or fluctuating, that adversely affects a child’s educational performance.”Characteristics of Students Who Are Deaf: 1. Typically no visible indicators, but students who are deaf often use hearing aides or cochlear implants to amplify sound. 2. Students have difficulty learning vocabulary, grammar, word order, and idiomatic expressions. 3. Frequent requests for repetition or clarification. 4. Tendency to bluff when not hearing someone due to the fear of asking them to repeat themselves. 5. Students can lack maturity for the following reasons: a. Rules of etiquette are acquired through listening and imitating, which is not possible for individuals who are deaf. b. Students fail to develop group social skills because interactions involving multiple conversations are confusing.Types of Hearing Loss:1. Conductive: Disease or obstruction in the outer or middle ear. Students can derive benefit from hearing aids and cochlear implants.2. Sensorineural: Occurs in the cranial nerve, inner ear, or central processing center of the brain. Sensorineural deafness is very difficult to treat.3. Mixed hearing loss: Occurs in the outer, middle, and inner ear. Hearing aides may help but have limited effect.4. Central hearing loss: Damage or impairment to the nerves or nuclei of the central nervous system, either in the pathways to the brain or the brain itself. Central hearing loss is very rare and very hard to treat.Suggested Learning Strategies:-Teacher Tips:
1. Reduce ambient noise in the classroom. 2. Face the class while presenting information. 3. Use appropriate body language, facial features, and signals while speaking. 4. Stand in one location, rather than moving around the room. Make sure the student is sitting near the teacher to facilitate lip-reading. 5. Use visual aids as often as possible. 6. Speak clearly, but do not exaggerate sounds while speaking. 7. Enroll in a sign language course, or at least learn some useful signs. 8. Create peer support 9. Help students learn to use their residual hearing to the maximum extent possible.-Learning Tools: 1. Assigned services- including interpreters, note takers, teachers’ aides or integration assistants. 2. Amplification devices for students with some residual hearing a. Hearing aids b. FM system (student has a small speaker, teacher uses a small microphone) c. Cochlear implants (sophisticated electronic hearing device that transmit electric signals to the brain). 3. American Sign Language (ASL) 4. Manually Coded English (MCE) such as: Signed Exact English (SEE) 5. C-Print (a typist is present in class using standard abbreviation to capture what is being said. Students read information on a computer screen). 6. Teachers should include closed captioning when showing videos.Additional Resources: • Hands and Voices (non-profit): http://www.handsandvoices.org/ • National Dissemination Center For Children with Disabilities: http://nichcy.org/tags/deafness-or-hearing-impairment • National Association of the Deaf: http://www.nad.org/ • Utah Deaf Services: http://deafservices.utah.gov/ • Council for Exceptional Children: http://www.cec.sped.org/ • Bright Hub Education- http://www.brighthubeducation.com/American Society for Deaf Children: http://www.deafchildren.org
What is Emotional Disturbance?A condition exhibiting one or more of the following characteristicsover a long period of time: An inability to learn that cannot be explained by intellectual, sensory, or health factors An inability to build or maintain satisfactory interpersonal relationships with peers and teachers Inappropriate types of behavior or feelings under normal circumstances A general pervasive mood of unhappiness or depression A tendency to develop physical symptoms or fears associated with personal or school problems Definition from IDEA Resources & Support Positive Behavioral Interventions & Supports (www.pbis.org) o Provides school assistance for identifying, adapting, and sustaining disciplinary practices Anxiety & Depression Association of America (www.adaa.org o Provides information and helpful services available. o Information separated into categories (military, women, college, teens, children) National Eating Disorders Association (www.nationaleastingdisorders.org) o Supports individuals and families affected by eating disorders o Serves for prevention, cures, and access to quality care National Alliance on Mental Illness (www.nami.org) o Information available, provides programs and services, online support groups, and advocacy
Emotional Disturbance By Mikayla and MichelleAnxiety Disorder Bipolar DisorderEating Disorder Examples of ED Psychotic Disorder
Obsessive- Conduct DisorderCompulsiveDisorder Characteristics When a person’s physical, social, or cognitive skills are affected Hyperactivity (short attention span, impulsiveness) Aggression/self-injury (acting out, fighting) Withdrawal (not socially interacting, excessive fear/anxiety) Immaturity (inappropriate crying, temper tantrums) Learning difficulties (academically below grade level) Learning Strategies: Family therapy Training strategies for parents Training in problem-solving for child Community-based services Psychotherapy or counseling Diet Medication Positive behavioral support in the school environment
IDEA Category of Disability (Developmental Delay)Description & Definition of developmental delay:(1) Who is experiencing developmental delays as defined by the State and as measured byappropriate diagnostic instruments and procedures in one or more of the following areas:Physical development, cognitive development, communication development, social or emotionaldevelopment, or adaptive development; and(2) Who, by reason thereof, needs special education and related services. [34 CFR §300.8(b)] Comment [c1]: 34 CFR §300.8(b)] is an Electronic Code of Federal a) Children aged three through nine experiencing developmental delays. Child with a Regulations. Current as of September 13, 2012. disability for children aged three through nine (or any subset of that age range, including Copy & paste code (CFR §300.8(b) into ages three through five), may, subject to the conditions described in §300.111(b). browser or click on the link below. http://ecfr.gpoaccess.gov/cgi/t/text/text-It’s a good idea to find out if your state has added details to this definition of developmental idx?c=ecfr&rgn=div8&view=text&node=34:22.214.171.124.1delay. States are allowed to do so, if they choose. They also decide on the age range of children .1.36.7&idno=34with whom the term may be used (3-5, 3-9, or any subset between 3-9). Comment [c2]: Utah’s Definition of Developmental DelayIt may be helpful to know that, under IDEA: Utah’s Baby Watch Early Intervention program serving children birth to three years of age defines a Your state may not require that your local school district also adopt and use the term developmental delay as: developmental delay in working with children. “Children birth to three years of age who meet or If your local school district decides to use the term, it must use the same definition and exceed the definition of developmental delays in one or more of the following areas: age range as the state does. Physical development Vision and hearingCharacteristics: Feeding and dressing skills Social and emotional development Skills such as taking a first step, smiling for the first time, and waving “bye bye” are called Communication and language Learning, problem solving and play skillsdevelopmental milestones. Children reach milestones in playing, learning, speaking, behaving,and moving (crawling, walking, etc.). A developmental delay is when your child does not reach The delay must adversely affect a student’s educational performance.these milestones at the same time as other children the same age.What are developmental milestones? Comment [c3]:Developmental milestones are a set of functional skills or age-specific tasks that most children Refer to additional group handout listingcan do at a certain age range. Your pediatrician uses milestones to help check how your child is characteristics and signs to watch for starting at an early age.developing. Although each milestone has an age level, the actual age when a normallydeveloping child reaches that milestone can very quite a bit. Every child is unique!Examples of Developmental Milestones: Gross motor: using large groups of muscles to sit, stand, walk, run, etc., keeping balance, and changing positions. Fine motor: using hands to be able to eat, draw, dress, play, write, and do many other things. Language: speaking, using body language and gestures, communicating, and understanding what others say.
Cognitive: Thinking skills: including learning, understanding, problem-solving, reasoning, and remembering. Social: Interacting with others, having relationships with family, friends, and teachers, cooperating, and responding to the feelings of others. Comment [CC4]: Teaching Strategies for students withIf a developmental delay is not recognized early, children must wait to get the help they need. developmental delayThis can make it hard for them to learn when they start school. In the United States, 17 percent Motor Skillsof children have a developmental or behavioral disability. But, less than half of children with Hands on activities such as rolling a ballproblems are identified before starting school. Sensory and Thinking SkillsAdditional Resources: Repetition such as playing "I Spy" multiple times using the same objectNICHCY Developmental Delay Resources: Language and Social SkillsThe National Dissemination Center for Children with Disabilities (NICHCY) offers brief, but Group activities such as playing rhyming gamesdetailed fact sheets on Developmental Delays. Each fact sheet defines the disability, describes itscharacteristics, offers tips for parents and teachers, and connects you with related information Comment [c5]:and organizations with special expertise. Also, lists early intervention services by state. References & additional resources: http://ecfr.gpoaccess.gov/cgi/t/text/text-Center for Disease Control and Provention (CDC), Local Health Department & Make-A- idx?c=ecfr&rgn=div8&view=text&node=34:126.96.36.199.Difference Information Network: An alternative to questions about children development is 188.8.131.52&idno=34the local health department or finding testing locations near your community contact the Make- http://www.med.umich.edu/yourchild/topics/devdel.A-Difference Information Network at 1-800-332-6262 htm http://www.zerotothree.org/Developmental Delay Resources (DDR): www.cdc.gov/actearlyA nonprofit organization dedicated to meeting the needs of those working with children whohave developmental delays in sensory motor, language, social, and emotional areas. DDR http://nichcy.org/state-organization-search-by-statepublicizes research into determining identifiable factors that would put a child at risk and http://www.utahparentcenter.org/disabilities/dd/maintains a registry, tracking possible trends. DDR also provides a network for parents and http://www.devdelay.org/professionals and current information after the diagnosis to support children with special need. http://www.utahbabywatch.orgWhat is Developmental Delay? http://www.ddivantage.comThis website answers many of the frequently asked questions about Developmental Delays, thecauses of them, what to do if you suspect DD, early intervention strategies and techniques,special education, and transition.