The document discusses low-incidence disabilities which affect less than 1% of students. It defines various low-incidence disabilities like deafness, blindness, deaf-blindness, traumatic brain injury, orthopedic impairments, and health impairments. For each disability, it describes characteristics, service delivery options, and teaching strategies. Common to all low-incidence disabilities is that they are difficult to serve due to lack of school knowledge and resources to support the students.

1. Based on: Special Education for Today’s Teachers: An Introduction,
by Rosenberg, Westling, and McLeskey (second edition)

2.  What are the definitions of various types of
low- incidence disabilities?
 What are some of the characteristics of children
with these kinds of disabilities?
 What service delivery options are typical for
children with low-incidence disabilities?
 What accommodations or teaching strategies
are helpful for students with various types of
low-incidence disabilities?

3. Less than 1% of the school-aged population:
 Deaf / Hearing Impaired
 Blind/Low Vision
 Deaf-Blind
 Complex Health Issues
 Severe Physical and Multiple Disabilities
All students with low-incidence disabilities experience one
commonality: they are difficult to serve because most
schools have little knowledge of how to best educate
them, of what technologies are available to assist them,
and of how to obtain appropriate support services from
outside agencies.

4.  Hearing impairment, whether
permanent or fluctuating,
adversely affects a child’s
educational performance, but is
not included under the definition
of deafness.
 Deafness is hearing impairment
so severe that the child is impaired
in processing linguistic
information through hearing, with
or without amplification, and that
adversely affects a child’s
educational performance.

5.  Hearing loss ranges from mild to severe can be
described by degree, type, and configuration.
 Rate of literacy development slowed (by 1/3) due
to delays in language development. Often
graduate with 4th grade reading level.
 Lack opportunity to develop social skills from
incidental learning. Need explicit teaching.
 Many deaf individuals choose membership in the
deaf community and culture.

6.  Early intervention
 School placement
 42% spend most of the day in
general ed. class
 31% educated in resource class
 15% educated in residential
school
 Regular ed. teacher collaborates
with teacher of students who are
deaf or hearing impaired.

7.  Oral/aural - Use residual hearing to learn and
communicate with people verbally.
 Speech reading - Perceive speech by watching mouth
movements, body language, and context cues.
 Cued speech - Use 8 hand shapes in 4 different
placements along with mouth movements to
differentiate sounds of spoken language.
 Manual - Use sign language (ASL). An interpreter
may assist in communicating with non-ASL speakers.
 Total communication - Use a combination of sign
language and verbal communication.

8.  Hearing aid
 Cochlear Implant
 FM system
 Sound field system
 Text telephones (TTY)
 Closed TV captioning
 Alerting devices
Cochlear Implant Listening Demos

9.  Face the student when speaking
 Get the student’s attention before speaking
 Assess student’s background knowledge
 Check for understanding
 Use visual aids and experiential learning
 Provide preferential seating
 Reduce background noise

10.  Vision impairment including
blindness means an impairment
in vision that, even with
correction, adversely affects a
child’s educational performance.
The term includes partial sight
and blindness.
 Legally blind: 20/200 with
correction in best eye or visual
field of 20 degrees or less.

14.  Things appear washed out,
like looking at a faded
photograph.
 Trouble differentiating
lightness and darkness or
things that are almost the
same color.

15.  Limited ability to access information
 Limited range of experiences
 Limited orientation and mobility
 Limited interactions with the
environment
 Delayed language development
 Slightly different motor development
sequence
 Social isolation and/or delayed
development of social skills

16.  Early intervention
 School placement
 87% spend at least part of the day in general ed.
 13% educated in separate facilities
 Resource classroom and residential setting not
common.
 Regular ed. teacher collaborates with teacher of
students who are blind or visually impaired.
Anna's World

17.  Tactile aids and manipulatives
 Enlarged print
 Low glare materials
 Back lighting
 Magnification devices
 Braille
 Optical character recognition
 Screen reading software
 Descriptive video service

18.  Provide opportunities for tactile
exploration
 Use concrete objects and
manipulatives
 Give verbal descriptions of visual
information
 Adjust lighting, colors, etc. as needed
to increase visibility of materials
 Provide preferred seating
 Adapt environment for mobility and
specialized equipment

19.  Concomitant hearing and visual impairments, the
combination of which causes such severe
communication and other developmental and
educational needs that they cannot be accommodated
in special education programs solely for children
with deafness or children with blindness.
 Many have some functional use of hearing and/or
vision. They may be able to:
 Move around independently
 Read enlarged print
 Recognize familiar faces/voices
 See sign language at close distances
 Understand and develop some speech

20.  About 63% have other disabilities
 Cognitive disabilities are common
 Slow pace of learning
 Enjoy movement
 Methodical
 Need for sameness
 Problems with:
 Isolation
 Communication
 Mobility

21.  Early intervention
 Services similar to those for students with severe
intellectual and multiple disabilities.
 15% educated in regular class or resources room
 39% educated in separate special ed. classroom
 46% educated in separate day or residential
school, hospital, home or other setting.
 In Texas, each service center has a deaf-blind
specialist.
 Multidisciplinary team approach

22.  Visual or tactile sign
language
 Voice and sign
 Voice only (with
amplification)
 Tactile symbols
 Communication
devices

23.  Multi-sensory teaching
 Link movement to language
 Coactive movement
 Physical guidance
 Brailling

24.  Injury to the brain caused by external physical force,
resulting in total or partial functional disability or
psychosocial impairment, or both, that adversely affects a
child’s educational performance.
 Open or closed head injuries resulting in impairments in
one or more areas: cognition, language, memory, attention,
reasoning, abstract thinking, judgment, problem-solving,
sensory, perceptual, and motor disabilities; psychosocial
behavior, physical functions, information processing and
speech.
 Does not apply to brain injuries that are congenital,
degenerative, or to brain injuries induced by birth trauma.

25. Characteristics depend upon the severity and
location of the injury, as well as the age and general
health of the individual. TBI can cause changes in:
 thinking and reasoning
 understanding words
 remembering things
 paying attention
 solving problems
 talking
 behaving
 physical activities
 seeing and/or hearing
 learning

26.  Multiple disabilities are concomitant impairments (e.g.,
mental retardation/blindness, mental retardation-
orthopedic impairment), the combination of which
causes such severe educational needs that they cannot be
accommodated in special education programs solely for
one of the impairments.
 Also defined by TASH in terms of necessary support:
“individuals who require extensive ongoing support in
more than one major life activity… such as mobility,
communication, self-care, and learning...”
 Usually have severe intellectual disability as well as at
least one other disability. Intellect may be higher than
estimated, as determining intelligence may be difficult.

27.  Require a long time to learn
 Have difficulty with:
 Learning complex skills
 Generalizing and discrimination
 Observational/incidental learning
 Attention
 Memory
 Skill synthesis
 Self-regulation
 Communication
 Inappropriate behaviors
 Medical problems

28.  Early intervention, with family support
 Served primarily in separate special ed. classes, either in
general ed. or separate schools.
 Emphasis on a functional curriculum, developing skills
for independence and community participation
 Only 12% spend most of their time in general ed.
 Inclusion requires collaboration between regular and
special ed teachers, and usually paraprofessional help.
 Reverse mainstreaming may be used to promote social
interaction with non-disabled peers.

29.  Adaptive behavior scales, ecological
inventories, and curriculum guides
used to determine what to teach.
 Teach skills as integrated clusters
within functional routines and
contexts.
 Partial participation when learning a
complete skill independently is not
possible.
 Systematic instruction (time delay,
system of least prompts) and data
collection.

30. A severe orthopedic impairment that
adversely affects educational
performance. Includes impairments
caused by congenital anomalies (e.g.,
club foot, absence of some member),
impairments caused by disease (e.g.,
polio, bone TB), and impairments
from other causes (cerebral palsy,
amputations, fractures or burns that
cause contractures).

31.  Neurological disorder caused by brain damage
before, during or after birth that affects movement
and posture.
 Non-progressive (brain damage does not worsen)
 May be hypertonic (tense), hypotonic (floppy),
athetoid (involuntary movement), ataxic (lack of
balance and coordination) or mixed.
 Affects different parts of the body (hemiplegic,
diplegic, quadriplegic)
 Can be mild, moderate, or severe
 May have other disabilities; 50-60% have intellectual
disabilities

32.  Inherited muscle disorder in which muscle tissue
degenerates over time.
 9 different types, vary by age of onset, muscles
affected, rate of degeneration, life expectancy, etc.
 Duchenne is most common type (and is the one
described in the textbook):
 Onset between 2-6 years
 Occurs only in boys
 Eventually affects all voluntary, heart, and breathing muscles
 Usually die by age 30
 Some types of MD have higher than average risk for
intellectual or learning disabilities
 Fatigue affects school performance

33.  An incomplete closure in the spinal column:
 Occulta: opening in one or more vertebrae without
damage to spinal cord (40% of population)
 Meningocele: protective covering of spinal cord pushed
out through opening in vertebrae
 Myelomeningocele: spinal cord protrudes through the
back
 May involve muscle weakness or paralysis, loss of
sensation, loss of bowel and bladder control below
place where incomplete closure occurs.
 Fluid my build up in brain (hydrocephalus), which
may be controlled through a shunt. If so, there
may be problems with attention, language, and
academics.
 May need multiple surgeries.

34.  Having limited strength, vitality, or
alertness, including a heightened
alertness to environmental stimuli, that
results in limited alertness with respect to
the educational environment.
 Due to chronic or acute health problems
such as asthma, ADHD, diabetes,
epilepsy, a heart condition, hemophilia,
lead poisoning, leukemia tuberculosis,
nephritis, rheumatic fever, and sickle cell
anemia.
 Adversely affects a child’s educational
performance.

35.  The most common OHI.
 Signs include difficult breathing,
wheezing, coughing, excess mucus,
sweating, and chest constriction.
 Can be triggered by allergies, cold,
dry air, or exercise.
 Loss of instructional time and fewer
opportunities for social and
recreational activities.
 Use inhaler to help with breathing
when an asthma attack occurs.

36.  Epilepsy is a neurological
condition that makes people
prone to seizures (abnormal
electrical discharges in the
brain). The two most common
types of seizure are:
 Tonic-clonic seizures
 Absence seizures
 Antiepileptic drugs can be use to
control seizures.

37.  Conditions diagnosed by physician
and educational impact determined
by educational personnel.
 Most children with OI and OHI are
served in general ed. classrooms.
 Students may receive related
services (e.g., PT, OT).
 School nurse develops “individual
health care plan” that includes
information about ongoing needs
and emergency medical treatment.

38.  Curriculum modifications such as changes in content,
outcomes, or levels of complexity
 Adaptations to the physical structure of the classroom
 Accommodations (e.g., sending work home, tutoring)
to help students make up missed work
 Pair students with limited stamina with another
student, give shorter assignments, more time to finish
 Special considerations for physical and health care
needs (e.g., asthma triggers, universal precautions)
 Facilitate acceptance to prevent teasing
 Assistive technology devices
 Collaboration with OT, PT, ST, nurse, parents, etc.