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Intellectual Disabilities

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Idiot Imbecile Moron Feebleminded Mentally deficient Mentally Retarded/retard

Tradition?

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DEFINITION OF INTELLECTUAL DISABILITY

DEFINITION OF INTELLECTUAL DISABILITY

IDEA: “Significantly subaverage general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period that adversely affects a child’s educational performance.”

Atkins v. Virginia

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IDEA Definition 3 key criteria: – First: “significant subaverage intellectual

functioning” must exist. Significant= IQ score is 2 or more standard deviations below the mean on standardized intelligence test. More later…

– Second: intellectual functioning is not sole criteria, must also have deficits in adaptive behavior—life skills

– Third: deficits must have appeared during developmental period of child’s life—not a result of traumatic brain injury, head injury as an adult.

Classification by IQ Score

Level IQ Score Mild 50-55 to

approximately 70 Moderate 35-40 to 50-55

Severe 20-25 to 35-40

Profound Below 20-25 7

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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 the age of 18.”

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Changes in Perspectives about ID

Changes in expectations for people with disabilities Functional descriptions of disabilities Chronologically age appropriate activities Consumer-driven services and supports Support networks that provide individualized supports

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Assumptions in Defining and Identifying ID (AAIDD)

Limitations in present functioning are considered within the context of the individual's age, peers,

and culture; Valid assessment considers cultural and linguistic

differences as well as communication, sensory, motor, and behavioral factors;

Limitations often coexist with strengths within an individual;

Describe limitations so that an individualized plan of needed supports can be developed; and With appropriate, personalized supports, the life

functioning of a person with intellectual disability will improve

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Levels of Support: from Supports Intensity Scale

(AAIDD, 2002) Intermittent: as needed; episodic—for a period of transition (job loss, medical crisis) Limited: time limited, but not intermittent— transition to living in group home Extensive: usually ongoing, daily involvement, long term support and long term home living support Pervasive: possibly lifelong, high intensity, across environments, may be life-sustaining

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Identification and Assessment: IQ Testing

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Limitations of IQ Scores

Concept of intelligence is hypothetical construct. IQ tests measure only performance on items on test, at one point in time. IQ scores can change significantly. IQ testing is not an exact science. IQ can be culturally biased.

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Limitations of IQ Scores

IQ scores can never be used a sole basis for providing or not providing special education services. Results of IQ tests should never be used for identifying objectives or designing instruction.

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Assessing Adaptive Behavior

Adaptive behavior: “the collection of conceptual, social and practical skills that have been learned by people in order to function in their everyday lives” (AAIDD, 2015). Critical in determining level of support Completed by someone familiar with the individual

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Characteristics

Mild ID Difficulty with academics Social and communication skills close to age-appropriate. Likely to become independent or semi- independent adults.

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Characteristics Moderate ID – Likely to show significant delays in

preschool years. – More likely than those with mild ID to

have health and behavior problems.

Severe ID – Identified at birth – Additional disabilities and/or health

problems.

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Characteristics Cognitive functioning:

Learning rate: slower Memory: difficulty with short-term and working memory Once skills are committed to long- term memory, retention as good as others without ID

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Characteristics

Attention: may have attentional problems related to relevant features of learning task Generalization and maintenance of learning: trouble using skills in different situations Motivation: Outer-directed, learned helplessness

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Characteristics

Adaptive behavior: Self-care and daily living: dressing, eating and hygiene; self-management Social relationships: appropriate social and interpersonal skills Behavioral excesses and challenging behavior Positive attributes Meet Mary Warm

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PrevalencePrevalence

About 0.78 - 1.27% of the general population 6.7% of students (ages 3 – 21) receiving special education (USDOE, 2014)

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Causes Biomedical Causes

2/3rd of severe forms have specific biological etiology. Most common biomedical causes of ID are Down syndrome and fragile X syndrome. See Table 4.2 for full descriptions.

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Causes Environmental Causes

Psychosocial disadvantage Intellectual disability of cultural/familial origin

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Etiological Risk FactorsEtiological Risk Factors Prenatal (before birth) Biomedical Social Behavioral Educational Chromosomal

disorders Poverty Parental drug

use Parental ID

w/o supports Single gene disorders

Maternal malnutrition

Parental alcohol use

Lack of preparation for

parenthood

Syndromes Domestic violence

Parental smoking

Metabolic disorders...

No prenatal care

Parental immaturity

View all of Figure 4.3 on p. 122

Focus on: Prader-Willi Syndrome

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• Weight gain between 1 - 6 years of age

• Distinctive facial features • Global developmental

delay before age 6; mild to moderate intellectual disability or learning problems in older children

• Hyperphagia/food foraging/obsession with food

Focus on: Fragile X Syndrome

• Males and females can be carriers or have the full mutation

• Full mutation = distinct facial characteristics

• Educational problems range from ADHD, LD, anxiety to ID

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Focus on: Fetal Alcohol Spectrum Disorder

Ranges from: • Fetal alcohol

effect (FAE) • Fetal alcohol

syndrome (FAS)

• Alcohol-related Neurodevelop mental Disorder (ARND)

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Etiological Risk FactorsEtiological Risk Factors Perinatal (during birth)

Biomedical Social Behavioral Educational Prematurity Lack of

access to birth care

Lack of parental

caretaking

Lack of referral for intervention

services Birth injury Parental

abandonment Neonatal disorders

View all of Figure 4.3 on p. 122

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Etiological Risk FactorsEtiological Risk Factors Postnatal (after birth) Biomedical Social Behavioral Educational Traumatic

brain injury Impaired

child caregiver

Child abuse and neglect

Impaired parenting

Malnutrition Lack of adequate

stimulation

Domestic violence

Delayed diagnosis

Meningoence- phalitis…

Family poverty…

Inadequate safety

measures…

Inadequate early

intervention… View all of Figure 4.3 on p. 122

Juniper Gardens Children’s Project

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Prevention

Rubella vaccine Parental screening/diagnostic tests for genetic influences Newborn screening Education and training Early intervention

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Educational Approaches: Curriculum Goals

Educational Approaches: Curriculum Goals

Academic Curriculum: Meaningful academics High expectations in general education curriculum for students with mild intellectual disabilities Use actual materials to teach Use lots of drill and practice

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Curriculum Goals

Functional curriculum: •Teaches skills that lead to independence, self-direction and enhancement of daily life. •Life skills: Teach personal independence •Self-determination: (set goals, implement course of action, evaluate performance, and make necessary adjustments to meet goal)

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Instructional Methods

Task analysis--breaking tasks into simpler sub-tasks Active student response--observable response to instructional antecedent Systematic feedback--Change focus and timing as learning progresses (see Figure 4.6)

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Instructional Methodology

Transfer of stimulus control Generalization and maintenance – Naturally occurring contingencies – Program common stimuli – Community based instruction

Direct and frequent measurement Spotlight on assistive technology

People with intellectual disabilities and/or developmental disabilities, like all people, have inherent sexual rights. These rights and needs must be affirmed, defended, and respected.

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Last Word: Statement on Sexuality

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Educational Placement Alternatives:

Educational Placement Alternatives:

General education class 17% Resource room 27% Separate class 49% Separate schools or residential facilities, including institutions 7%

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Acceptance and MembershipAcceptance and Membership

Meet Jill Egle Can We Talk, Ben Stiller?

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Misconceptions Misconceptions

MYTH: Once diagnosed, a person remains within this classification for the rest of his/her life.

FACT: Level of mental functioning does not necessarily remain stable, particularly for mild.

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MisconceptionsMisconceptions

MYTH: If an individual achieves a low score on an IQ test, this means that his or her adaptive skills are also subnormal.

FACT: Possible for an individual to have a low tested IQ and still have adequate adaptive skills; depends on training.

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MisconceptionsMisconceptions

MYTH: Children with Down syndrome are always happy and pleasant to have around.

FACT: The idea that they are significantly more so than other children is exaggerated.

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MisconceptionsMisconceptions

MYTH: Most children with intellectual disabilities look different from other children.

FACT: The vast majority of children who have intellectual disabilities look like children without disabilities.