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Chapter Five: Learners with Intellectual and Developmental Disabilities

PSY 423: Education of the Exceptional Child October 11th, 2012
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Brandon Bell

on 11 October 2012

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Transcript of Chapter Five: Learners with Intellectual and Developmental Disabilities

Chapter Overview Mentally Retarded vs. Intellectually Disabled Brandon Bell
PSY 423--Education of the Exceptional Child
October 9, 2012 Chapter Nine: Learners with Intellectual and Developmental Disabilities Definition Prevalence Professional Assessment of Progress Issues for Educators and Professionals Causes Educational Considerations Psychological and Behavioral Characteristics Identification and Assessment Misconceptions About Learners with Intellectual and Developmental Disabilities Myth: Professionals agree about the definition of intellectual disabilities. Fact: Considerable disagreement exists among professionals about definition, classification, and terminology. Myth: Once diagnosed as intellectually disabled, a person retains this classification for life. Fact: A person's level of intellectual functioning doesn't necessarily remain stable; this is particularly true for those individuals who are mildly intellectually disabled. With intensive educational programming, some persons can improve to the point that they are no longer intellectually disabled. Myth: Intellectual disability is defined by how a person scores on an IQ test. Fact: The most commonly used definition specifies that an individual must meet two criteria in order to be considered intellectually disabled:
1. Low intellectual functioning and
2. Low adaptive skills Myth: In most cases, it's easy to identify the cause of intellectual disability. Fact: Although the mapping of the human genome has increased our knowledge about causes of intellectual disabilities, it's still difficult to pinpoint the cause of intellectual disabilities in many people, especially those with mild intellectual disabilities. Myth: Psychosocial factors are the cause of of the vast majority of cases of mild intellectual disabilities. Fact: Exact percentages aren't available, but researchers are finsing more and more genetic syndromes that result in mild intellectual disabilities; hereditary factors are also involved in some cases. Myth: The teaching of vocational skills to students with intellectual disabilities is best reserved for secondary school and beyond. Fact: Many authorities now believe it appropriate to introduce vocational content in elementary school to students with intellectual disabilities. Considerations for Transition to Adulthood Myth: People with intellectual disabilities should not be expected to work in the competitive job market. Fact: More and more people who are intellectually disabled hold jobs in competitive employment. many are helped through supportive employment situations, in which a job coach helps them and their employer adapt to the workplace. In philosophy Consumer rights and decision-making Natural supports + Years of intensive instruction from general and special educators, other professionals Natural difficulties Full potential January 2007:
American Association on Mental Retardation (AAMR) changes to
American Association on Intellectual and Developmental Disabilities (AAIDD) Pejoration of professionally-used terms idiot imbecile moron Disagreement within and without AAIDD
Trying to find a "slur-proof" term is fruitless
Unlike "idiot," the term mentally retarded has not become a slur except in its shortened form "retard" Pejoration of the term "retard" + acceptance of "disability" = institution's name change Our text follows the prevailing view: intellectual disability, short for intellectual and developmental disability
The term "mental" connotes "emotions"
"Mentally retarded" is still used in many public schools (Polloway, Patton, & Nelson, 2011) Delicate and contentious—seven definitions since 1950s
Reasons for caution:
Concern for misdiagnosis of ethnic minorities—chronically poor performance of African American, Hispanic, and Native American students
Stigmatic diagnosis of intellectual disability
Intellectual disability may be more of a social construction
Counterargument: Don't ignore what's really going on in the intellectually disabled—a push too far by the AAIDD The AAIDD's Definition "[Intellectual disability] is a disability characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills. This disability originates before age 18." (AAMR Ad Hoc Committee on Terminology and Classification, 2010, p.1) Adaptive Behavior Yesterday: IQ tests
faulty
only one indication of an individual's ability to function Today: Adaptive behavior + IQ tests
Social intelligence: Involves understanding and interpreting people and social interactions, such as being able to "read" when someone is angry and not being gullible
Practical intelligence: The ability to solve everyday problems... mental retardation intellectual disability Improvement Is Possible Yesterday: Little hope for improvement
ID thought to be incurable Today: Improvement is possible
Virtually all with ID can improve
Those with even mild ID can improve to point at which they are no longer considered intellectually disabled How well an intellectually disabled person functions is directly related to the amount of support received from the environment. "Strategies and resources that 'a person requires to participate in activities associated with normative human functioning'". (Thompson et al., 2009, p. 135, qtd. in Hallahan et al., 2012 p.105) Classification of Intellectual Disabilities Most school systems classify students with intellectual disabilities according to the severity of their condition using the APA's classifications. Mild Moderate Severe Profound IQ 70 50 35 20 Degree of intellectual disability What's Changed....What Hasn't Statistically, 2.2% of the school-age population is identified as intellectually disabled. In actuality, 1% of the school-age population is identified as intellectually disabled. Why are the actual figures lower? Schools using low adaptive behavior as well as low IQ as criteria In a toss up, some prefer the less stigmatizing term of learning disabled over intellectually disabled Mild Moderate Severe Profound IQ 70 55 35 20 85 100 115 130 145 0 50 Prenatal Perinatal Postnatal chromosomal inborn errors of metabolism developmental disorders affecting brain formation environmental influences Down syndrome Fragile X syndrome Prader-Willi syndrome Williams syndrome Usually not inherited
Trisomy 21-- 21st set of chromosomes is a triplet rather than a pair
Most common form of intellectual disability that is present at birth (Beirne-Smith, Patton, & Kim, 2006) Distinctive physical characteristics
Thick, epicanthal folds in the corners of the eyes
Small stature
Decreased muscle tone (hypertonia)
Hyperflexibility of the joints
Small oral cavity
Short, broad hands
Heart defects
Susceptibility to upper respiratory infections (R.L. Taylor, Richards, & Brady, 2005) Intellectual disability: Most individuals Mild fall in the moderate range Severe Profound IQ 70 50 50 35 35 20 Degree of intellectual disability Possible link to Alzheimer's moderate Likelihood of having a child with Down syndrome increases with the age of the mother (Beirne-Smith et al., 2006)
Other possible causes: Age of the father, exposure to radiation, and exposure to some viruses Methods for screening for Down syndrome: Maternal serum screening (MSS) Amniocentesis Chorionic villus sampling (CVS) Nuchal translucency sonogram Down syndrome spina bifida (To screen or not to screen...) Most common known hereditary cause of intellectual disabilities, second most common syndrome that causes intellectual disabilities. (Polloway et al., 2011) Occurs in 1 in 4,000 males and 1 in 6,000 females. (Meyer & Batshaw , 2002) In association with milder cognitive deficits, such as learning disabilities, the prevalence may be as high as 1 in 2,000. (Hagerman , 2001) Associated with the X chromosome in the 23rd pair "Fragile" because the bottom of the X chromosome is pinched off in some of the blood cells. Not as common in females because of their extra X chromosome
Various physical features (Dykens, Hodapp, & Finucane, 2000) Most with the syndrome inherit a chromosomal abnormality from their father; some inherit from their mothers. (Percy, Lewkis, & Brown, 2007) Two phases:
Infancy: Lethargy and eating difficulties
After age 1: Obsession with food
Prader-Willis is the leading genetic cause of obesity Syndrome causes various other health problems, among them are sleep apnea and scoliosis Varying intellectual ability--most are mildly intellectually disabled, some have a normal IQ. (R.L. Taylor et al., 2005) Mild Severe Profound IQ 70 50 35 20 Degree of intellectual disability Moderate Mild 70 50 Caused by absence of material on the seventh pair of chromosomes (Mervis & Becerra, 2007) Other traits: Heart defects, sensitivity to sounds, elfin facial features Typically occurs without prior family history, but can still be inherited (Haldeman-Englert, 2008) Mild Severe Profound IQ 70 50 35 20 Degree of intellectual disability Moderate Mild 70 50 Moderate 35 Result from inherited deficiencies in enzymes used to metabolize basic substances in the body, such as amino acids, carbohydrates, vitamins, or trace elements. (Medline Plus, 2007) Most common error: Phenylketonuria PKU)
Body cannot convert phenylalanine to tyrosine--buildup of phenylalanine causes abnormal brain development States screen babies for PKU; special diet implemented if detected Diet now continued indefinitely Those who stop are at risk for developing learning disabilities Women with PKU who abandon the diet are at high risk of having children with PKU Microcephalus Head is abnormally small and conical Intellectual disability ranges from severe to profound Mild Severe Profound IQ 70 50 35 20 Degree of intellectual disability Moderate Severe Profound 35 20 No specific treatment available, short life expectancy (National Institute of Neurological Disorders and Stroke, 2008) Hydrocephalus Cause: Buildup of cerebrospinal fluid inside or outside the brain Blocks circulation, creates pressure on brain, enlarges skull
Degree of intellectual disability depends on timing of diagnosis and treatment Two types of treatment:
Shunt for draining and redirecting fluid to abdomen
Fluid bypass device Malnutrition Radiation Fetal alcohol spectrum disorders (FASD) Rubella Fetal alcohol syndrome (FAS)
Causes abnormal facial features, growth retardation, and intellectual disabilities Can adversely affect unborn fetuses
X-rays, pregnant women
The public and nuclear power plants If the mother-to-be has it, the child may end up blind and/or develop intellectual disabilities
Most dangerous during first trimester Positioning Low birthweight (LBW) Anoxia Infection LBW and premature--synonymous terms
LBW=5.5 lbs or lower
Factors: Poor nutrition, teen pregnancy, drug abuse, excessive cigarette smoking
Statistics Syphilis and herpes simplex--can transfer from mother to child
These can cause intellectual disabilities Biological Psychosocial Infections Malnutrition Toxins Meningitis
Infection of the covering of the brain, caused by a variety of bacterial or viral agents Encephalitis
An inflammation of the brain, results more often in intellectual disabilities, usually affects intelligence more severely Lead poisoning Extreme cases of abuse, neglect, or understimulation can result in intellectual disabilities Less severe factors can also cause intellectual disabilities Heredity Then: Psychosocial factors most mild intellectual disabilities Now: Specific genetic syndromes Fragile X syndrome Prader-Willi syndrome Williams syndrome Intelligence Adaptive Behavior Individual IQ tests(e.g. WISC-IV) mental age chronological age ( ) X 100 Four cautions
An individual's IQ can change
All IQ tests are culturally biased to some extent
The younger the child, the less valid are the results
The ability to live a successful and fulfilling life does not depend solely on IQ IQ = Usually involves a parent, teacher, or other professional answering questions related to the person's independence and daily living skills and maladaptive behavior. Remember: Not all of the intellectually disabled exhibit all of these deficiencies. Affected areas:
memory
language
self-regulation
motivation
social development Attention for learning Working memory Limitations in language comprehension and production (Abbeduto, Keller-Bell, Richmond, & Murphy, 2006) (of behavior) Metacognition A person's awareness of strategies needed to perform a task Understanding (sources of) motivation helps in understanding behavior (Switsky, 2006) Gullibility Linking Genetic Syndromes to Particular Behavioral Phenotypes Researchers have recently noticed behavioral patterns, or phenotypes, associated with some of the genetic syndromes Down syndrome Fragile X syndrome Prader-Willi syndrome Williams syndrome Visual spatial skills
Visual short-term memory Educators: Build upon these strengths! Problems interpreting facial emotions
Cognitive skills tend to worsen over time Receptive and expressive vocabulary
Long-term memory
Adaptive behavior Sequential processing
Repetitive speech patterns
Social anxiety and withdrawal Relatively high IQ (average about 70)
Visual processing
Facility with jigsaw puzzles Auditory processing
Feeding problems in infancy
Sleep disturbances
Obsessive-compulsive behaviors
Obesity Imitation of emotional responses
Facial recognition and memory
Musical interests and skills Fine-motor control
Overly friendly
Anxieties, fears, phobias The lesser the degree of intellectual disability, the more the teacher emphasizes academic skills The greater the degree of intellectual disability, the more stress there is on self-help, community living, and vocational skills Functional and academic standards should be merged
(functional academics) Systematic Instruction Instruction in Real-Life Settings with Real Materials the use of instructional prompts, consequences for performance, and strategies for the transfer of stimulus control (Davis & Cuvo, 1997) Positive reinforcement = faster learning Constant and progressive time delay Instruction of daily living skills is more effective in actual settings where students will use those skills. (McDonnell, 2011) Service Delivery Models Placement of students ranges from general education classes to residential facilities
Focus on increased integration--degree of integration determined by severity of intellectual disability Assessment of Quality of Life Testing Accommodations and Alternative Assessment Assessment of Adaptive Behavior Interviews, observations, and self-reports, some of which are standardized, can be helpful in assessing adaptive behavior. Standardized questionnaires are available to assess quality of life. Accommodations include modifications in
Scheduling (e.g. extended time)
Presentation format (e.g. reading directions to the student)
Response format (e.g., allowing the student to dictate responses)
For those who can't be tested using traditional methods:
Direct observation of specific behaviors
Checklists
Curriculum-based measures of functional literacy
Leisure-recreation, domestic, and vocational skills Early Childhood Programs Designed for Prevention Preschool programs differ in their goals according to whether they are aimed at preventing intellectual disabilities or furthering the development of children who have already been identified as intellectually disabled. Suited for children who are at risk of developing mild intellectual disabilities Early Childhood Programs Designed to Further Development Created for students who have already been identified with intellectual disabilities, especially severe ones Intense Focus on Self-Determination Promoting self determination has become a major guiding principle in educating persons with intellectual disabilities. Community Adjustment Employment Community survival skills:
Managing money
Using public transportation
Maintaining living environments Smaller living communities are replacing large residential institutions Some people favor supported living Two employment models Structured training requiring relatively low skills Involves receiving at least minimum wage in settings where most of the workers are not disabled, accompanied by ongoing assistance from a job coach Two other models: Customized employment and self-employment Supported competitive environment Looking to the Future Sheltered workshop Optimism in the face of a bleak outlook Employment and living arrangements: Outcomes for ID adults are slowly improving With the development of innovative transition programs, many people with intellectual disabilities are achieving levels of independence never thought possible Contributors to success: Parents, students and many professionals, all working together` Thanks for your attention! © 2012 Brandon Bell Hallahan, D. P., Kauffman, J.M, & Pullen, P. C. (2012). Exceptional learners: An introduction to special education. Boston: Pearson Education, Inc.
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