Intellectual Disabilities

Title, EditionISBN

© 2009 Pearson Education, Inc.All rights reserved.

Exceptional Children: An Introduction to Special Education, 9th EditionISBN 013514454X

© 2009 Pearson Education, Inc.All rights reserved.

Chapter 4Intellectual Disabilities

© 2009 Pearson Education, Inc.All Rights Reserved.2

Exceptional Children: An Introduction to Special Education, 9th EditionHewardISBN 013514454X


Focus QuestionsWhat implications for special education does viewing intellectual disabilities as an inherent trait within the individual or as a state of functioning that reflects the fit between a person’s capacities and the contexts in which the person is to function?What should teachers know about IQ tests and the assessment of intellectual functioning?Which is more important in determining a person’s level of adaptive functioning: intellectual capability or a supportive environment?How are the characteristics of students with intellectual disabilities relevant to planning and delivering instruction?




Focus Questions continuedWhat factors might account for the wide differences in the prevalence of intellectual disabilities within the school-age population across states and school districts?Why has the prevention of intellectual disabilities proven so difficult?What should curriculum goals for students with intellectual disabilities emphasize? What are the most important features of effective instruction for students with intellectual disabilities?What is needed to make education for a student with intellectual disabilities appropriate in a general education classroom?

Key Terms and Concepts Levels of Intellectual Disabilities (Intellectual Disabilities): IQ

Scores, Information provided by IQ Scores, Corresponding levels of classification for Intellectual Disabilities, Rosa’s Law

Intellectual disability: Minimum IQ Score Levels of Classification and learning/functional characteristics

of each When intellectual disabilities are identified Components under IDEA Independent living “issues”

Learning issues – children with disabilities (Learned helplessness, outer- directedness, memory issues, etc.) Teaching paces. Academic and Functional Curriculum

Rubella vaccine Self-monitoring, Video Modeling Self-determination, Social Role Valorization




INTELLECTUAL DISABILITIES HAS LEGALLY REPLACED THE TERM

Mental Retardation

WHY????? Rosa’s Law: Federal law changing the term “mental retardation” to “intellectual disability”. Law signed by President Barack Obama in October 2010.http://www.whitehouse.gov/the-press-office/2010/10/08/remarks-president-signing-21st-century-communications-and-video-accessib




Definitions of Intellectual Disability (ID)IDEA definition

Significantly sub-average intellectual functioning Significant sub-average intellectual functioning - a

score of two or more standard deviations below the mean on standardized intelligence tests

Deficits in adaptive behavior Collection of conceptual, social and practical skills that

have been learned by people in order to function in their everyday lives

Measured by an adaptive rating scale/observation/functional assessment

Manifested during the developmental period Does not include sensory disabilties




Definitions of Intellectual Disability (cont.)

AAIDD 2002 definition Intellectual disability is characterized by

significant limitations in both intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills. This disability originates before age 18.




Definitions of Intellectual Disabilities (cont.)

Five assumptions essential to understanding and appropriately applying the definition

Limitations in present functioning must be considered within the context of community environments typical of the individual’s age peers and culture.

Valid assessment considers cultural and linguistic diversity as well as differences in communication, sensory, motor, and behavioral factors.

Within the individual, limitations often coexist with strengths. The purpose of describing limitations is to develop a profile

of needed supports. With appropriate personalized supports over a sustained period, the

life functioning of the person with intellectual disability generally will improve.




Definitions of Intellectual Disability (cont.)

NJAC 6A:14 Definition A disability that is characterized by significantly below

average functioning existing concurrently with deficits and adaptive behavior; manifested during the developmental period that adversely affects a student’s educational performance and is characterized by one of the following:

Mild Cognitive Impairment Moderate Cognitive Impairment Severe Cognitive Impairment




Identification and Assessment

Students are typically identified early in life (before age 3)

Evaluations Consist Of: Intelligence Testing (IQ) to measure

intellectual functioning Test of Adaptive Functioning to measure

skills acquired to function in everyday life




Identification and Assessment Assessing Intellectual Functioning

Part of a multifactor evaluation Administered by a school psychologist, or

other trained professional Standardized Test- administered in the same

way to each individual Norm Referenced Test- results are compared

to a large group of people representative of the population




Identification and Assessment Norm curve-IQ Scores are distributed

throughout the population according to the bell-shaped curve

Standard deviation- explain how far a score is from the mean (average or middle)




Identification and AssessmentAssessing Intellectual Functioning Standardized tests are used to assess intelligence

A diagnosis of ID requires an IQ score at least 2 standard deviations below the mean (70 or less)

2%=20,000 people per million




Classification of Intellectual Disabilities by IQ Score

Classification by the degree or level of intellectual impairment as measure by IQ test:

Level Intelligence Quotient

Mild 50-55 to 70

Moderate 35-40 to 50-55

Severe 20-25 to 35-40

Profound (not in NJAC)

Below 20-25




Identification and Assessment Important considerations of IQ tests:

IQ is a hypothetical construct Not precise, assumption that it takes more intelligence to perform certain tasks

at certain ages IQ tests measure how a child performs at one point in time

Snapshot of child’s ability, used to infer/predict how student may perform in other situations

IQ tests can be culturally biased Tend to compare with white, middle class children

IQ scores can change significantly Typically in the 70-85 (borderline) range; intense intervention helps increase IQ

IQ testing is not an exact science Other things impact IQ- motivation, time, location, norming population, which

test is used, testing bias Results are not useful for targeting educational objectives –

should not be used to determine IEP Objectives Educational or functional assessments are more useful for planning goals and

objectives




Identification and Assessment Results should never be used as the

sole basis for making decisions regarding special education services

You always need 2 evaluations by two different evaluators in the state of New Jersey to determine eligibility for special education and related services




Identification and Assessment Typically Used Intelligence Tests

Stanford Binet Wechsler Intelligence Scale for

Children (WISC-IV) Wechsler Adult Intelligence Scale

(WAIS) Woodcock Johnson Test of Cognitive

Abilities (WJ3-COG)




Identification and Assessment Demonstration

WJ3 Test of Cognitive Abilities Decision Speed Pair Cancellation Visual Matching

Review of Reports




WISCTest Results and ImpressionsThe WISC-IV is an age-normed test of cognitive abilities which yields a full scale IQ score and four index scores. Each score has a mean of 100 and a standard deviation of 15. He achieved the following scores on the WISC-IV: Full Scale IQ 63 Index scoresVerbal Comprehension 59 Perceptual Reasoning77

Similarities 3 Block Design 5Vocabulary 2 Picture Concepts 9Comprehension 4 Matrix Reasoning 5

Working Memory 68 Processing Speed 78Digit Span 4 Coding 5Letter-Number Sequencing 5 Symbol Search 7




Assessing Adaptive Behavior• Adaptive behavior is the collection of conceptual,

social, and practical skills that have been learned by people in order to function in their everyday lives.

• The adaptive skills exhibited by a person with ID are critical factors in determining the supports a student requires for success in school, work, community, and home environments.

• Measurement of adaptive behavior has proven difficult because of the relative nature of social adjustment and competence.

• Most instruments consist of a series of questions that a person familiar with the individual answers




Assessing Adaptive Behavior Typical Assessments Used

Battell Developmental Inventory (BDI-2) Used to identify preschool disabled students

AAMR Adaptive Behavior Scale Daily living skills Maladaptive behaviors

Vineland Adaptive Behavior Scales Completed by someone familiar with the

child Scales of Independent Behavior- Revised

Structured interview, checklist




Characteristics Lasts throughout one’s lifetime Children make tremendous

advancements in adaptive skills Some get declassified or eligibility

category changes




Characteristics Mild Intellectual Disabilities

Identified until enter school Some identified in 2nd or 3rd grade Master academic skills to 6th grade

level Learn job skills, function semi-

independently. May be able to support themselves.




Characteristics Moderate Intellectual Abilities (35-40 to

50-55) Show significant delays in development

during preschool years As get older, discrepancies in intellectual

functioning and adaptive behavior grow wider between disabled and non-disabled peers

More likely to have health and behavior problems than Mild




Characteristics Severe (20-25 to 35-40) and Profound

Usually identified at birth or shortly thereafter Have significant central nervous system

damage Have additional disabilities and/or health

conditions IQ’s can be used as basis for this

differentiation, but functional ability is usually the determining factor




Characteristics Cognitive Functioning

Deficits in cognitive functioning and learning characteristics of individuals with Intellectual Disabilities include:

Poor memory (weak short-term, better long-term)

Slow learning rate, however, they don’t always need slow pace, often benefit from going “fast”

Attention problems Difficulty generalizing what they have learned Lack of motivation




Poor Memory Difficulty remembering information The more severe the cognitive impairment, the

worse the memory Short Term/Working Memory-ability to recall and

use information from a few seconds ago (ex. Sequence of job tasks, directions, mental math)

Long Term Memory-information recalled after a period of days or weeks (relative strength for people with ID)

Teaching strategies Rehearsing Organizing information into sets Discrete Trials




Slow Learning Rate The rate at which a child acquires knowledge and skills Well below that of typically developing children Trials to criterion- number of practice or instructional

trials needed before a student can respond correctly without prompts or assistance (used to measure learning rate)

Example: 2 or 3 trials needed to teach a typically developing child to know the difference between a circle and a square, a student with slow learning rate may take 20 or 30 trials

Strategies Slow down instruction, allow more time to learn

skills Fluency strategies (repeated reading, timed trials,

flash cards)




Attention Problems Ability to attend to a task Often slower to attend to relevant features of a

learning task than same aged peers w/o disabilities

Many focus on distracting irrelevant stimuli Trouble with sustained attention to learning

tasks Interferes with ability to acquire, remember and

generalize knowledge and skills Instructional Strategies:

Distracted limited environments Reinforcing correct responses Gradually increase complexity and difficulty of a task




Generalization and Maintenance of Learned Skills Have trouble using their knowledge and skills

in settings and situations that differ from the context in which they first learned those skills

Example: learn that a circle is round, but do not generalize that skills to other objects in the environment; learn to say hello to the teacher, but will not say hello others

Strategies: Community visits/Field Trips Allow opportunities to generalize skills Have other teachers/school personnel work

with your students




Lack of Motivation Lack of interest in learning or in problem solving tasks Learned helplessness- individual’s expectation of failure,

regardless of his efforts, base on experiences of repeated failure If task is too easy, don’t try hard enough If task is too hard, individual may shut down Outer-Directedness- an individual’s distrust of own

response to situation and reliance on others for assistance an solutions

Not born with these characteristics, but MAY develop over time

Teaching Strategies Immediate reinforcement for correct responses Allow opportunities to experience success Explicitly teach self-determination, self-care, and problem-

solving .




Adaptive Behavior Characteristics By definition, children with Intellectual

Disabilities have substantial deficits in adaptive behavior

Can take many forms and can occur across many domains of functioning

Limitations may be in Self Care Skills Social Relationships Behavioral Excesses and challenging

behavior




Self Care and Daily Living Individuals with ID require extensive supports and must be

taught basic self-care skills Self Care Skills/Daily Living Skills

Dressing Eating Hygiene

Goals is for independent living and successful employment Teaching Strategies/Supports

Direct instruction Prompting Simplifying directions/routings Community Visits Instructional Aide EI (Early Intervention) DDD (Division of Developmental Disabilities) DVRS (Division of Vocational Rehabilitation Services)




Social Development Children with ID have trouble making and sustaining

friendships and personal relationships Poor communication skills

Interrupts Stands to close Does not maintain eye contact Strays off topic

Inability to recognize emotional states in others Unusual or inappropriate behaviors when interacting Teaching Strategies/Supports

Community Visits Model/Reinforce appropriate behavior (model can be teacher or

another student) Speech/Language Therapy Social Skills Groups




Behavioral Excesses and Challenging Behavior

Children with ID are more likely to exhibit behavior problems (the more severe the ID the more severe the behavior problems)

Higher incidences of mental illness and behavior disorders Difficulty accepting criticism Limited self control Aggression Self-injury Teaching Strategies/Supports

Behavior Plan Medical treatment Instructional Aide Consultation from a Board Certified Behavioral Analyst (BCBA)




Positive Attributes Highly individualized personalities Tenacity Curiosity in learning Get along well with others Positive influences on those

around them




Prevalence and Causes•During the 2009–2010 school year, 460, 964 students ages 6 through 21 received special education under the category of ID.

• These students represented 7.8% of all school-age children in special education.

•ID is the fourth-largest disability category.•Prevalence rates vary greatly from state to state.

Causes• More than 350 risk factors associated with ID have been

identified.• 35% of cases have a genetic cause• Another third of cases involve external trauma or toxin• Etiology remains unknown for another third of cases




Prenatal Causes (Before Birth) Biomedical

Chromosomal Disorders Single-gene disorders Syndromes Metabolic Disorders Cerebral dysgenesis Maternal Illnesses Paternal Age

Social Poverty Maternal malnutrition Domestic Violence Lack of access to care




Prenatal Causes Continued Behavioral

Parental drug use Parental alcohol use Parental smoking Parental immaturity

Educational Parental cognitive disability without supports Lack of preparation for parenthood




Perinatal (during/shortly after birth) Biomedical

Prematurity Birth injury Neonatal disorders

Social Lack of access to birth care

Behavioral Parental rejection of caretaking Parental abandonment of child

Educational Lack of medical referral for intervention services at

discharge




Postnatal (After birth) Biomedical

Traumatic brain injury Malnutrition Meningeoncephalitis Seizure disorder Degenerative disorders

Social Impaired child caregiver Lack of adequate stimulation Family poverty Chronic illness in the family Institutionalization




Postnatal Continued Behavioral

Child abuse and neglect Domestic violence Inadequate safety measures Social deprivation Difficult child behaviors

Educational Impaired parenting Delayed diagnosis Inadequate EI services Inadequate special education services Inadequate family support




Biological Causes Prenatal causes include:

Down syndrome* Fetal alcohol spectrum disorders Fragile X syndrome * Klinefelter syndrome Phenylketonuria Prader-Willi syndrome Williams syndrome

*Most common causes of ID




Biological Causes Perinatal causes include:

Intrauterine disorders Neonatal disorders




Biological Causes Postnatal causes include:

Head injuries Infections Degenerative disorders Malnutrition




Environmental CausesPsychosocial disadvantage occurs when no biological risk factor is evident as a cause of ID.Environmental influences include

• Poverty and malnutrition• Minimal opportunities to develop early

language• Child abuse and neglect• Chronic social or sensory deprivation• Lack of access to prenatal or birth care• Parental drug use or smoking• Parental immaturity or cognitive disability• Parental lack of preparation for parenting




Prevention The biggest single preventive strike against ID was the

development of the rubella vaccine in 1962

Toxic exposure through maternal substance abuse and environmental pollutants are two major causes of preventable ID that can be combated with education and training

Advances in medical science have enabled doctors to identify certain genetic influences

Although early identification and intensive educational services to high-risk infants show promise, there is still no widely used technique to decrease the incidence of ID caused by psychosocial disadvantage




Educational Approaches Academic Curriculum

Basic reading, writing and math skills Skills must reflect functional performance

Reading signs/bus schedule Writing grocery lists/job applications Working with money

Must carefully assess to see what skills student could use most often

Must also predict what prerequisite skills the student may need next

Can be restrictive and ineffective- participation in the academic parts of the general education curriculum should not limit opportunities to learn independent functioning

Challenge is to balance the general education curriculum with functional goals




Educational Approaches Functional curriculum

A functional curriculum will maximize a student’s independence, self-direction, and enjoyment in school, home, community, and work environments

Skills include: purchasing, shopping, ordering in a restaurant, cooking, telling time, nutrition and fitness.

Content should be related to skills that will allow the student to function independently in the home, school, or community (Will I need it when I am 21? Most useful to the student.)

Transition planning becomes very important when in high school




Educational Approaches Self-determination

Self-determined learners set goals, plan and implement a course of action, evaluate their performance, and make adjustments in what they are doing to reach their goals

Self-determination combination of skills, knowledge and beliefs that enable a

person to engage in goal directed, self-regulated, autonomous behavior

An understanding of one’s strengths and limitations together with a belief in oneself as capable and effective

When acting on the basis of these skills and knowledge, the individual has a greater ability to take control of their lives and assume the role of successful adults




Self-determination cont’d Teaching Revolves Around:

Choices/decision making Goal setting Problem solving Self evaluation Self management Self advocacy Self awareness Responsibility for learning Generalization of skills

Can be a goal in itself, or a means in achieving other goals




Self-determination (cont) Students take responsibility for their

learning For example:

They learn to get teacher attention in a general education classroom

They learn to show their work to the teacher and ask how they are doing or say that they are finished.

Michael Wehmeyer is the “guru” of self-determination (great journal articles)




Instructional Methods Learn best when instructional methods are explicit, systematic and derived from

research Assess each student’s present levels of performance to help identify and

prioritize the most important instructional targets (this may already be in the student’s IEP)

Define and task analyze the new knowledge or skills to be learned Design instructional materials and activities so that the student has frequent

opportunities for active student response in the form of guided and independent practice

Use mediated scaffolding (provide and then fade prompts and cues so students can respond to naturally occurring stimuli)

Provide systematic consequences for student performance in the form of contingent reinforcement, instructional feedback and error correction

Incorporate fluency building activities into lessons Incorporate strategies for promoting the generalization and maintenance of

newly learned skills Conduct direct and frequent measurements of student performance, and

use those data to inform instructional decisions




Instructional Methods Task Analysis

Breaking down complex or multistep skills into smaller, easier-to-learn subtasks

Sub-skills and subtasks are then sequenced either in the natural order in which they are performed, or from easiest to most difficult

Assessment helps pinpoint where instruction should begin Important to consider to what extent the natural

environment requires the performance of the target skill for a given duration or at a minimum rate

Example: making tea of tea




Instructional Methods Active student response (ASR)

Providing instruction with high level of student participation Words read, problems answered, boards cut, test tubes measured, comments

spoken, praise and supportive comments, etc. Measure how many responses are emitted in a given period of time. A lesson rich in ASR will generally result in more learning

Systematic feedback provided by the teacher Positive reinforcement- praise and/or other forms of confirmation for correct

responses Error correction- used when a responses is incorrect Increases the efficiency of instruction for students with disabilities Best when given during the acquisition state of learning or practice stage of

learning “Very good! Two quarters equals 50 cents” “You answered 28 problems in one minute! Great job!”




Instructional Methods Transfer of stimulus control from prompts to task

Avoid trial and error learning Provide a prompt (physical, verbal, picture, auditory) that make a correct response probable Ex: provide a picture chart for a student to follow a series of tasks

Generalization and maintenance Extent to which students can use what they have learned across settings and

over time Aim for naturally occurring reinforcement contingencies

Teach skills student need, and will be valued by the community

Program common stimuli- increase chance that student will perform new behavior

Incorporate into the teaching situation as many features as possible from the natural setting, teach skills that will student generalize new skill (ex. folding and making the bed)

Community based instruction Setting where student can use their skills




Video Modeling and PromptingUse of iPODs and iPADsLearner watches a brief person performing the target skill and then imitates the model’s behavior. In video self-monitoring, learner watches of video of him/herself Video prompting – learner watches a series of videos with each one depicting a single step. Step is performed before next step is shown.

AdvantagesCan take video models with them. Commonly used technology.“Cool”, flexible, can be adjusted to the settingCost effectiveBuilds independence




Instructional Methods Direct and frequent measurement of student

performance Verify effectiveness of instruction Direct- objectively records the learner’s

performance of the behavior of interest in the natural environment for that skill

Frequent- occurs on a regular basis Measurement should take place as often as

instruction occurs




Acceptance and MembershipNormalization – Nirje“Eight Planks” including normal rhythm of the day, normal routine, normal developmental experiences“to establish and/or maintain personal behaviors which are as culturally normal as possible” Wolfensberger

Social Role Valorization – WolfensbergerPeople’s welfare depends on the roles they occupyRoles that are positively values will get better treatment than those who occupy roles that are devalued by others

Acceptance and membership in society for those with ID will be better if they perceived in a positive way, making self-determination and social role valorization critical.




Educational Placement AlternativesDuring the 2008–2009 school year, 17% of students with ID were educated in the general education classroom27% were served in resource room programs 48% were served in separate classes7% of students with intellectual disabilities are educated in separate schools, residential facilities, or home/hospital environments




Resources

Teaching Accommodations http://teacherweb.com/ON/JohnMcGregorSecondarySchool/LearningandEnrichmentCentre/ModificationsforMID.pdf

NJ Department of Human Services - Division of Developmental Disabilitieshttp://www.state.nj.us/humanservices/ddd/resources/