Human Exceptionality Chapter 12

SEVERE AND MULTIPLE DISABILITIES

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Chapter Twelve

CHAPTER FOCUS POINTS

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Focus 1What are the three components of the TASH definition of severe disabilities?Focus 2Define the terms multiple disabilities and deaf-blindness as described in IDEA.Focus 3Identify the estimated prevalence and causes of severe and multiple disabilities.Focus 4What are the characteristics of persons with severe and multiple disabilities?

CHAPTER FOCUS POINTS

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Focus 5Identify three types of educational assessments for students with severe and multiple disabilities.Focus 6Identify the features of effective services and supports for children with severe and multiple disabilities during the early childhood years.Focus 7Identify the features of effective services and supports for children with severe and multiple disabilities during the elementary school years.

CHAPTER FOCUS POINTSFocus 8Describe four outcomes that are important in planning for the transition from school to adult life for adolescents with severe and multiple disabilities.Focus 9Describe four features that characterize successful inclusive education for students with severe and multiple disabilities.Focus 10Describe four bioethical dilemmas that affect people with severe disabilities and their families.

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CASE STUDY: THE BEGINNING OF A NEW CIRCLE OF FRIENDS

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Joanne and JenniferInclusion in general education classroomPeer supportEstablishment and maintenance of

friendships between students with disabilities and peers without disabilities

Impact on students with and without disabilities

DEFINITIONS

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Historical Descriptions of Severe DisabilitiesHistorically, terminology has communicated

a sense of hopelessness and despair. Today terminology is changing again to

define severe disabilities based upon educational need with an emphasis on supporting the student in an inclusive setting.

DEFINITIONS

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The TASH definition focuses on three factors:The relationship of the individual with the

environment (adaptive fit), requiring the individual to cope with the demands of various environments as well as requiring these environments to accommodate the need of the individual.

The need to include people of all ages.Extensive “ongoing support” in life activities.

DEFINITIONS

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The IDEA Definitions of Severe and Multiple DisabilitiesIDEA does not include the term “severe disabilities” as

one of the 13 categorical definitions. Individuals with severe disabilities may be subsumed

under any one of IDEA’s categories, including the categories of multiple disabilities and deaf-blindness.

DEFINITIONSThe IDEA Definitions of Severe and Multiple

Disabilities (continued)Multiple disabilities are defined in IDEA as

concomitant impairments that may combine to cause such severe educational problems that they cannot be accommodated in special education programs solely for one of the impairments.

Deaf-Blindness is a dual sensory impairment resulting from concomitant vision and hearing difficulties that cannot be accommodated in a program for children with blindness or children with deafness.

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PREVALENCE

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Prevalence estimates generally range from no more that 0.1 to 1% of the general population.

The USDOE (2007) estimated that 131,682 students between the ages of 6 and 21 were served in public schools under the label multiple disabilities. This is 2% of the over 7 million students considered eligible for services under IDEA.

PREVALENCEThe USDOE also reported 1,600 students

between the ages of 6 and 21 were labeled deaf-blind. Overall, about 14,000 individuals in the United States are identified as deaf-blind.

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CAUSATION

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Disabilities may be the result of genetic or metabolic problems (e.g. Rh incompatibility). Most identifiable causes are genetic in origin.

Other causes involve prenatal conditions such as poor maternal health, drug abuse, infectious disease, advanced maternal age, radiation exposure, and venereal disease.

CAUSATIONPostnatal factors associated with poisoning,

accidents, malnutrition, physical and emotional neglect, and infectious diseases are known contributors.

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CHARACTERISTICS

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Intelligence and Academic Achievement

Adaptive SkillsSpeech and Language SkillsPhysical and HealthVision and Hearing

EDUCATIONAL SUPPORTS AND SERVICES

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AssessmentIdentifying the DisabilityAssessing for InstructionSchool Accountability

THE EARLY CHILDHOOD YEARS

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Services and Supports for Infants and ToddlersEffective programs are both child and family-centered.

Child-centered services begin with infant stimulation programs and continue as the child develops through health care, physical therapy, occupational therapy, and speech/language services.

Family-centered programs are holistic in their approach. Supports include parent training, counseling, and respite care.

THE EARLY CHILDHOOD YEARS

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Services and Supports for Preschool-Age ChildrenGoals for preschool programs serving children with

severe disabilities should blend the principles and elements of DAP, multicultural education, and special education and should include:Maximizing the child’s development in a variety of important

developmental areas.Developing the child’s social interaction and classroom

participation skills.Increasing community participation through support to family

members and other care-givers.Preparing the child for inclusive school placements and

providing support for transition into elementary school.

THE ELEMENTARY SCHOOL YEARS

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Self-determinationParental InvolvementTeaching Functional SkillsAssistive Technology and Augmentative

Communication

THE ADOLESCENT YEARS

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Outcomes important in the transition planning process for students with severe disabilities include:Establishing a network of friends and acquaintances.Developing the ability to regularly use community

resources.Securing a paid job.Establishing independence and autonomy in making

lifestyle choices.

INCLUSIVE EDUCATION

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Effective educational programs for students with severe and multiple disabilities include continual opportunities for interaction with their nondisabled peers. This requires:Placement of students in general education

schools and classrooms.Systematic organization of opportunities for

interaction between students.Specific instruction in valued post-school

outcomes.

SEVERE DISABILITIES AND BIOMEDICAL DILEMMAS

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Medical technology advances have resulted in an increasing number of infants with severe and multiple disabilities surviving and living into their adult years.

This has prompted ethical issues and an interest in bioethics.Genetic EngineeringGenetic Screening and CounselingSelective Abortion and Withholding Medical Treatment