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Multiple disabilities


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Published in: Education, Health & Medicine

Multiple disabilities

  1. 1. Multiple Disabilities Vanessa G. Cabag
  2. 2. Multiple Disabilities Definition Persons with multiple disabilities have a combination of two or more serious disabilities (e.g., cognitive, movement, sensory), such as mental retardation with cerebral palsy. Vanessa G. Cabag
  3. 3. Multiple Disabilities The U.S. federal government definition includes those who have more than one 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“ Dual sensory impairment, or deaf-blindness, is defined as a separate disability group. Multiple disabilities have interactional, rather than additive, effects, making instruction and learning complex. Vanessa G. Cabag
  4. 4. Multiple Disabilities In 1996 Fred Orelove and Dick Sobsey defined this group as individuals with mental retardation who require extensive or pervasive supports and who also possess one or more significant motor or sensory impairments and/or special health care needs. These physical and medical problems result in the presence of two or more of the following characteristics: restriction of movement skeletal deformities sensory disorders seizure disorders lung and breathing control; or other medical problems related to these characteristics, such as skin breakdown or bladder infections. Vanessa G. Cabag
  5. 5. Multiple Disabilities Causes In nearly half of the children born with multiple disabilities there is no identifiable cause. In the rest of the known causes there are: Chromosomal abnormalities, Developmental disorders of the brain, Metabolic disorders; and Negative prenatal environmental influences. Vanessa G. Cabag
  6. 6. Multiple Disabilities Primary Measures Used to Diagnose Individual intelligence tests & Tests of adaptive behavior Early assessment of: movement limitations muscle tone and flexibility seizure activity breathing control sucking and swallowing vision and hearing; and Vanessa G. Cabag
  7. 7. Multiple Disabilities genetic makeup are also, and prenatal assessment of genetic material or physical identification of deformities via sonograms may be conducted. Vanessa G. Cabag
  8. 8. Multiple Disabilities Accurate psychological testing of these individuals is challenging due to their frequent limitations in controlled movement, vision, hearing, communication, or cooperative behavior. Thus, interviews with family members and educators regarding the person's adaptive behavior skills (i.e., communication, self-care, home living, social skills, community use, self-direction, health and safely, functional academics, leisure, and work) may be more informative and reliable than a norm-based IQ or achievement score. Vanessa G. Cabag
  9. 9. Multiple Disabilities Characteristics People with multiple disabilities have a combination of various disabilities that may include: speech physical mobility learning mental retardation visual hearing brain injury; and possibly others. They may also have sensory losses and behavior and /or social problems. Vanessa G. Cabag
  10. 10. Multiple Disabilities Perhaps the most significant characteristic of many people with multiple disabilities is deficits in the area of communication, making it difficult for them to communicate their wants, needs, and pains to those around them. Vanessa G. Cabag
  11. 11. Multiple Disabilities This limitation can be devastating to the emotional and intellectual development of the child, but can be addressed through the use of assistive technology and augmentative communication systems. Vanessa G. Cabag
  12. 12. Multiple Disabilities Children ages 3 to 5 are considered to have multiple disabilities when they demonstrate concomitant cognitive, physical, and/or sensory impairments which result in severe delays in development. Children with multiple disabilities will typically share deficits in five distinct areas of development: intellectual functioning adaptive skills motor skills sensory functioning communication skills Vanessa G. Cabag
  13. 13. Multiple Disabilities This disability category includes those students with the most severe physical, cognitive, and communicative impairments. Most of the students served under the multiple disability category do have some level of cognitive impairment, but the specific diagnosis of this impairment can often be ambiguous or undetermined. It should be noted however, that these students can also have average or even above-average intelligence. The common connection between students in this category is not just that they have two or more coexisting impairments, but that they generally need extensive support across many skill areas. Vanessa G. Cabag
  14. 14. Multiple Disabilities Prevalence Definitions of this highly variable group with both severe and multiple disabilities are less precise than some other disability groups, making an estimate of their prevalence difficult. Prevalence ranges from less than .25 percent to .50 percent of the population; and is considered relatively uniform across socioeconomic classes. Vanessa G. Cabag
  15. 15. Multiple Disabilities Variety of Diagnostic Labels (1)severe or profound levels of mental retardation (IQ scores below 40) (2)mental retardation that requires extensive or pervasive supports for an extended time (3)autism, childhood disintegrative disorder, or Rett syndrome (several types of autism spectrum disorders) (4)various genetic disorders accompanied by extensive mental retardation (e.g., Tay-Sachs disease, untreated phenylketonuria, tuberous sclerosis, LeschNyhan syndrome) Vanessa G. Cabag
  16. 16. Multiple Disabilities Individuals with several autism spectrum disorders, by definition, have significant developmental delays in communication and social interaction, and may exhibit extensive limitations in many adaptive skills. Thus, their disability may be extensive enough to fit the definition for mental retardation and severe disabilities, though this is not true for all persons identified with autism (e.g., Asperger's syndrome). Vanessa G. Cabag
  17. 17. Multiple Disabilities Implications of Educational Legislation Legislation in the early 1970s addressed the right to education and other rehabilitation services for all individuals with disabilities. In 1975 the Education for All Handicapped Children Act (known since 1990 as the Individuals with Disabilities Education Act, or IDEA) formed the legal basis for public education for all children, including those with severe and multiple disabilities. Vanessa G. Cabag
  18. 18. Multiple Disabilities IDEA added requirements that are especially valuable for these individuals, including: (1) early intervention starting at birth or whenever a disability is suspected; (2) related services such as physical, occupation, and speech and language therapy, including augmentative and alternative communication (AAC) methods; Vanessa G. Cabag
  19. 19. Multiple Disabilities (3) the requirement for a plan and services to facilitate transition to work and adulthood; and (4) a value placed on inclusion in general education with nondisabled peers. Most states provide services to these students until age twenty-two or beyond, focusing upon functional skill development. Vanessa G. Cabag
  20. 20. Multiple Disabilities Prior to the 1975 law mandating public education for all children, students with severe and multiple disabilities, if educated, received services in institutions or settings operated by parent groups or state mental health departments. When laws enacted in the mid1970s required publicly funded special education, most schools established programs for these students but continued to isolate them from their nondisabled peers in separate buildings or selfcontained classrooms in elementary schools. Vanessa G. Cabag
  21. 21. Multiple Disabilities Currently in many states, the "least restrictive environment" for most of these students is the age-appropriate school setting alongside nondisabled peers, though not necessarily in the general education classroom. Currently, a majority of these students are served in separate classrooms for most of the school day. Vanessa G. Cabag
  22. 22. Multiple Disabilities Since 1975 U.S. courts have defined specific portions of special education law. For those with severe and multiple disabilities, several legal battles have resulted in: (1) summer educational programs being required in many states to lessen or prevent skill regression; (2) interventions that enable students to stay at school (e.g., providing catheterization for those unable to urinate voluntarily); Vanessa G. Cabag
  23. 23. Multiple Disabilities (3) related services and technology to assist with movement, positioning, speech, and alternate forms of communication; (4) the mandate to educate all students with disabilities, and not limit services based on an assessment of educational potential; and (5) the provision of regular opportunities for interaction with nondisabled peers and inclusion in general education classrooms– or justification for not providing these opportunities. Vanessa G. Cabag
  24. 24. Multiple Disabilities While all states are required to provide a free and appropriate education for these students, there are many differences in how localities implement the law and thus in the actual quality of educational services for these students. Vanessa G. Cabag
  25. 25. Multiple Disabilities Educating Students with Severe and Multiple Disabilities When compared to their peers, most students with severe and multiple disabilities learn more slowly, forget more readily, and experience problems generalizing skills from situation to situation. Vanessa G. Cabag
  26. 26. Multiple Disabilities These characteristics are best addressed when educators follow accepted practices. First, the public education of these students must start early and continue at some level throughout life. Second, all students typically need speech and language intervention, while many others will need physical and occupational therapy. Students with sensory impairments may need interpreters and mobility trainers, while some with medical needs may require nursing services or supervision. Vanessa G. Cabag
  27. 27. Multiple Disabilities Third, because the educational teams of students are often large, close collaboration between members is essential if their expertise is to result in improved student functioning. The benefits of integrating therapy into natural activities is widely accepted over the traditional practice of isolated, or pull-out, therapy. Vanessa G. Cabag
  28. 28. Multiple Disabilities Fourth, curriculum for these students tends to be; functional in nature reflecting skills needed in everyday life across domestic leisure school community vocational domains Vanessa G. Cabag
  29. 29. Multiple Disabilities Students are taught to; make choices communicate in functional ways (which may include AAC methods such as signing, use of pictures, etc.) develop useful skills that reduce their dependence on others learn social skills suited to their chronological age Vanessa G. Cabag
  30. 30. Multiple Disabilities Fifth, when skills are taught in multiple, normalized settings, generalization problems are lessened. Thus, communication and social skills are most effectively taught in the context of interactions with typical classmates, while job and community skills are best taught during community-based instruction. Vanessa G. Cabag
  31. 31. Multiple Disabilities Trends and Controversies Several important trends, some considered controversial because they advocate the inclusion of these students in general education with the necessary supports, reflect improvements in the lives of these students. First, through advancements in medicine and technology these individuals not only experience longer lives, but also have better options in mobility, communication, sensory augmentation, and other areas. Vanessa G. Cabag
  32. 32. Multiple Disabilities Second, starting in the 1960s, there has been gradual improvement in societal attitudes toward people with significant disabilities. This has led to legal protections, special education, community living alternatives, supported employment, and an increase in relevant supports. Vanessa G. Cabag
  33. 33. Multiple Disabilities Third, with the Timothy W. decision (Timothy W. v. Rochester, New Hampshire, School District, 1989), "free and appropriate education for all" was reaffirmed, schools were required to keep current with best practices for educating those with significant disabilities, and the procedure of selecting who can and cannot learn was declared illegal. Vanessa G. Cabag
  34. 34. Multiple Disabilities The current trend to include individuals with severe or multiple disabilities in classrooms and community activities with their nondisabled peers has been particularly controversial. Special education placement data show gradual growth of students with disabilities who are placed in a general education setting, but much slower growth for students with severe and multiple disabilities. Schools have complained that they are not able to include these students or provide the necessary supports and services to achieve a meaningful education for all involved. Vanessa G. Cabag
  35. 35. Multiple Disabilities Some general education teachers have communicated an unwillingness to have these students in their classrooms, even with support, and they also may lack the required skills necessary to teach these children in a general education classroom. However, there are numerous examples of schools meaningfully including these students in ways that promote social and educational participation, as well as evidence to support the benefits of inclusion for both students with severe disabilities and typical classmates. More research, the dissemination of information on inclusion, and improvements in teacher training are needed. Vanessa G. Cabag
  36. 36. Multiple Disabilities Vanessa G. Cabag
  37. 37. Multiple Disabilities THANK YOU And GOD BLESS  Prepared by: Miss Vanessa G. Cabag Vanessa G. Cabag