INTRO: Intellectual disabilities are HIGH INCIDENCE. Wide range of abilities and characteristics within the label of ID. Many people with ID are educated in their home school and included for some or all of their school days. On the other end of the spectrum, people with more significant ID may be dependent on others for all parts of their day and may not even develop a way of communicating their basic needs. Intellectual and social functioning is significantly impacted in individuals with ID. While we can pinpoint and prevent some causes, there are still many unknown or uncontrollable causes.
Varying perspectives exist on the use of the term intellectual disabilities . Mental retardation has been widely used for more than five decades in this country, usage is changing. Intellectual disability is the acceptable term in other parts of the world. While the term “MR” is falling out favor, there is no agreement as to which term should be used.
Historically, definitions of ID were based only on measured intelligence and with a focus on routine care instead of treatment and education. Only in recent years has adaptive behavior played in increasingly important role in the definition and classification of intellectual disabilities. Intellectual disabilities are under the umbrella of “developmental disabilities”
Developmental disabilities are physical or cognitive impairments that are evident at birth or in early childhood and adolescent years. At least three areas of major life activity must be substantially impacted by the impairments for a diagnosis. Areas of major life activity: Self-care, learning, communication, mobility, etc There are 6 MAJOR DIMENSIONS of the ID definition
Intellectual Abilities: reasoning, planning, solving problems, abstract thinking, understanding of complex ideas, learning quickly, and learning from experience. Assessed with IQ test. Must score more than 2 standard deviations below the mean (100) to meet the AAIDD of subaverage intellectual functioning (IQ of 70-75)
Remember that measured IQ is only PART of the definition. You must consider the other dimensions of ID as well. Also remember that different disabilities can have an impact on IQ testing. It should never be the focal point of evidence to diagnose ID.
Learning & Memory: - Don’t generalize - apply what they have learned to new situations. Need explicit instruction to do that. Academic Achievement: significant delays in literacy and math. Generally commensurate with mental-age, but sometimes even lower than that. Motivation: - Learned helplessness - refusal to take on challenges due to experiencing repeated failure. “No matter how hard I try, I will not succeed” is the mantra behind learned helplessness. Also impacted by overuse of adult support. Speech and language - as minor as simple articulation problems (speech) to inability to produce oral language (language) in more severe disabilities. Physical development - generally as healthy as a typically developing child, but certain genetic syndromes affect heart formation as well as other major organ systems. And, depending on the severity of a brain trauma, things like fine motor skills and gait could also be affected.
Adaptive Behavior: conceptual, social, and practical skills learned by people in order to function in their everyday lives. Conceptual: Language (receptive and expressive) Reading and writing Money concepts Self-direction Social: interpesonal skills Naivetee Responsibility Following rules Self-esteem Obeys laws Avoids victimization Gullibility Practical: Activities of daily living (Eating, mobility, toileting, dressing) Occupational skills Safety Instrumental activities of daily living (meal prep, housekeeping, transportation, taking meds, money mgt, using the phone) Someone with limited adaptive skills would need assistance in functioning in everyday life. Possible to measure using adaptive behavior scales and compared to norms.
Think pair share What skills are important for scott to learn and apply now that he is fully included? scott will move to middle school next year. Identify some strategies teachers might use to help scott make a successful transition?
Sociocultural influences: mainly for people with mild intellectual disability. Cause is not apparent, but linked to low socioeconomic status and diverse cultural backgrounds - but the key is that their home life generally are void of learning experiences or opportunities from the very beginning. Poor nutrition and lack of medical care also contributes to this cause. Nature vs nurture controversy – still unresolved as to how much the environment impacts over genetics. Biomedical: Chromosomal - Down Syndrome/Trisomy 21 (1 in 800 live births), Fragile X, Williams Syndrome, Fragile x: Fragile X syndrome is the most common inherited cause of mental impairment. The syndrome occurs in approximately 1 in 3600 males and 1 in 4000 to 6000 females. The majority of males with fragile X syndrome will have a significant intellectual disability . The spectrum ranges from learning disabilities to severe mental retardation and autism. Also physical features Williams syndrome is a genetic condition that is present at birth and can affect anyone. It is characterized by medical problems, including cardiovascular disease, developmental delays, and learning disabilities. Metabolic and Nutritional- - generally based around inability to process lactose or phenylalanine, delayed diagnosis can lead to ID. Neonatal screenings in all hospitals for this inability Postnatal brain disease- tumors developing after birth, degenerative central nervous system diseases
Most young children with Williams syndrome are described as having similar facial features. These features include a small upturned nose, long philtrum (upper lip length), wide mouth, full lips, small chin, and puffiness around the eyes. Blue and green-eyed children with Williams syndrome can have a prominent "starburst" or white lacy pattern on their iris. Facial features become more apparent with age. Cardiovascular issues are common. Fragile X large ears, larger head circumference, longer face Down syndrome: Head and facial features often associated with Down Syndrome: Flattened back of head. Attractive Almond-shaped eyes, with one eye lid a little droopy. Slightly flattened bridge across nose. Smallish ears, positioned slightly lower on the head, with a small fold at the top of the ear. Smallish mouth. Slightly protruding tongue. Hand features often associated with Down Syndrome: Horizontal crease in palm of hand . Slightly shortened fingers. The little finger curves inward . Foot features often associated with Down Syndrome: Slightly enlarged gap between the big and second toes. Slightly shortened toes. Other Down Syndrome features often associated with Down Syndrome: Also, in the newborns that have to have open-heart surgery, a chest scar becomes a common Down Syndrome characteristic.
Fetal Alcohol Syndrome Low birthweight, prematurity Traumas - during delivery (anoxia), seizures shortly after birth Unknown - Hydrocephalus, too much cerebrospinal fluid in the skull and creates too much pressure on the brain. If caught early, shunts are placed and the child can survive and sometimes even avoid intellectual or physical disability - but usually there is a cognitive affect.
Assistive Technology - devices that help the person adapt to their environment Generally included for at least part of their day. Only students with the most significant cognitive impairments would be considered for special schools. Academic skills: focus on functional application of curriculum (sight words, money mangement, community living, etc).
Sheltered workshops - separate vocational training and work setting. Only with other people with disabilities. Minimum wage not usually paid. Supported employment - inclusive setting for employment, but with support. Community-based employment: competitive, “regular” jobs. May have a job coach to check in on them and communicate with the employer. Earns regular wages.
Sheltered workshops - separate vocational training and work setting. Only with other people with disabilities. Minimum wage not usually paid. Supported employment - inclusive setting for employment, but with support. Community-based employment: competitive, “regular” jobs. May have a job coach to check in on them and communicate with the employer. Earns regular wages.