PAPER B8 : Introduction to Neuro Developmental Disabilities

(LD, MR (ID), ASD)

Learning Disabilities :Nature, Needs and

Unit
Intervention
Ms. Apoorva Panshikar 1
Index
1.1 Introduction
1.2 Learning Objectives
1.3 Definition, Types and Characteristics
1.4 Tools and areas of assessment
1.5 Strategies for reading, writing and maths
1.6 Curricular adaptation, IEP, Further Education
1.7 Transition Education, lifelong education
1.8 Summary
1.9 Activities
1.10 Study questions
1.11 References
1.12 Suggested Readings

1.1 Introduction
There are many who have seen the film “Taare Zameen Par”. This is a movie acclaimed for
the acting prowess of actor-director Aamir Khan. Apart from the fact that Aamir Khan has
acted well, the film was also talked about because it dealt with a very different topic. The
film “Taare Zameen Par” is about a 7-8 year old school-going boy Ishaan Awasthi. Ishaan is
a loving child. He however has problems in his schoolwork. He cannot read, cannot write
well, and has difficulty in math. His teachers scold him. His parents think that he is naughty,
lazy, avoids studying. In spite of this, he is very creative. He can draw and paint beautifully.
Neither his teachers nor parents consider the talent that the child has as important. His
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classmates and peers make fun of him too. The child becomes a loner. The boy’s parents
send him to a boarding school where he meets a teacher. This teacher recognises that Ishaan
is different from the rest of the students. Ishaan has Learning Disability. The teacher,
Nikumbh Sir, then teaches Ishaan the way he can learn. The boy then gains confidence and
improves not only in academics but overall as well.

As we have seen in this film, many children show problems in learning even the very simple
academic tasks. They appear to be intelligent but because they cannot read and spell and do
maths, they have confused their teachers. They cannot learn, remember and perform well in
their school exams. The parents and teachers of these children tend to criticise them. They
think that s/he is stupid. They may think that the child is lazy and does not want to study.
What they may not know, as we saw in “Taare Zameen Par” is that the child might have a
learning disability (LD). The teachers and parents hope that the child will start studying and
will start learning like other children, but this is rather difficult.

1.2 Learning Objectives: At the end of this unit, the students will be able to:
1. Define learning disabilities

2. Explain the types of learning disabilities

3. Describe the characteristic of learning disability

4. Explain the areas and tools of assessment

5. Describe the various strategies for reading, writing and maths

6. Explain the meaning of curricular adaptation, IEP and further education

7. Describe transition education and lifelong education for students with LD

In this lesson, we are going to try to understand this intriguing condition- learning disability.

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Did you know?

Albert Einstein could not read until he was nine.

Walt Disney and Vice President Nelson Rockefeller had trouble reading all their lives.

1.3 Concept and Definition of Learning Disability:

Learning Disability (LD) is a general term that is used to describe learning problems of a
specific kind. What is interesting is that there is no one clearly and widely accepted definition
of LD. There are 12 definitions available in literature on LD. We will study a definition that
is most widely accepted. It is given by National Joint Committee on Learning Disabilities
(NJCLD) in 1994. NJCLD is a coalition of parent and professional organisations in USA
Learning disabilities is a general term that refers to a heterogeneous group
of disorders manifested by significant difficulties in the acquisition and
use of listening, speaking, reading, writing, reasoning, or mathematical
abilities. These disorders are intrinsic to the individual, presumed to be
due to central nervous system dysfunction, and may occur across the life
span. Problems of self-regulatory behaviours, social perception, and social
interaction may exist with learning disabilities but do not by themselves
constitute a learning disability. Although learning disabilities may occur
concomitantly with other handicapping conditions (for example, sensory
impairment, mental retardation, serious emotional disturbance) or with
extrinsic influences (such as cultural differences, insufficient or
inappropriate instruction), they are not the result of those conditions or
influences.
The definition given is important as it helps us understand the actual concept. Based on the
definition we know that:
i. Learning Disabilities (not Learning Disability) is a group of disorders. You will not
find only one problem in a child with LD. We will see a combination of two or more
problems. For example, a child will not show only reading problems. We will find that the
child cannot understand oral language also. There are problems in doing math word problems
as well. If a child cannot read only, it may be because the child requires to use corrective
lenses.
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ii. Different children with LD have different combinations of problems. The severity of
the problems also differs. To illustrate, one child with LD has problems in reading and maths.
Another child with LD does not have problems in reading and maths , but problems are
found in writing and spelling. A third child has difficulties in understanding and using oral
language. Similarly, two children with reading difficulties manifest the problems differently.
One student can read fluently but cannot understand what is read; whereas another child
cannot read at all.
iii. We see the problems in a wide range of skills that children acquire and use. These
include listening, speaking, reading, writing, reasoning, and mathematical abilities.
iv. The above listed problems are not just difficulties but are ‘significant’ difficulties. We
have seen many children and people who find it difficult to learn math, or write
compositions/ essays, learn science experiments or understand the reasons for natural
phenomena. We cannot call these people as having LD just yet. What does the term
‘significant’ difficulty mean then? It means that when standardised tests (educational or tests
of psychological processing) are administered to the person, s/he shows a lag of at least one
and half to two years on the tests. This is in spite of the fact that the person does not have
Intellectual Disability (the IQ is average or above average)
v. We can observe the manifestations of the disability only. There is no external and
observable physical problem. We cannot identify that a child has LD by merely observing
his/her physical looks. The disorder is in the central nervous system and so other people can
only see the manifestations and conclude that the person may have LD.
vi. Along with the problems mentioned above (point iii ), the child may show problems
in social skills, self-regulation etc. If a child is showing only social skill deficits and
problems in self-regulation, then the child does not have LD.
vii. A person with other disabilities as Mental Retardation, Visual Impairment, Hearing
Impairment, and Emotional Disturbance may have an LD also e.g. a child may have visual
impairment and LD or Mental retardation along with LD. Therefore, there can be co-
existence of LD with the conditions mentioned above. However, because a child has Mental
Retardation, it cannot lead to a LD. These conditions do not cause an LD; they can co-exist.
The cause of LD is Central Nervous System dysfunction.
viii. A person from different cultural background, social strata, economic strata,
impoverished background may also have LD, but these conditions do not lead to LD.
Children in schools where poor teaching practices are found may also have LD, as would

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children who go to schools where the teaching practices are ideal. We cannot say that
because the child comes from a poor family, s/he has LD. Belonging to “religion A” does not
make a person LD. Again, like we saw in point viii, there can be a co-existence of some
specific backgrounds with LD, but these conditions do not lead to / cause LD.

Learning disabilities should not be confused with learning problems that are primarily
the result of visual, hearing, or motor handicaps; of mental retardation; of emotional
disturbance; or of environmental, cultural or economic disadvantages.

SNDT Women’s University (1997) propounds another definition of Learning

Disability. It states ,

“Children with Learning Disability have a normal intelligence and

are in the regular schools. They manifest the following characteristics: (i)
Cognitive characteristics- On psychological testing, these children may
have an IQ of above 85-90. They are not mentally retarded and are neither
hearing-impaired nor visually impaired. (ii) Academic characteristics – In
classroom performance, children with Learning Disability show a much
poorer achievement in reading and writing and doing maths compared to
the class average. These children would manifest a difficulty in one or
more of the following areas – only reading, reading and writing, doing
arithmetic, language, thinking tasks and comprehension tasks.
(iii)Behavioural characteristics – Children with Learning Disability will
also manifest behaviours like hyperactivity, difficulty in being attentive
and learning when the teacher is teaching, clumsy and motor in-co-
ordination. (iv)Socio-emotional characteristics – children with Learning
Disability will have difficulty in initiating and maintaining relationships
with peers, establishing relations with teachers and other adults, mood
swings and occasional emotional imbalance like excessive anger,
depression, frustration and low self-esteem.

This definition is extremely explicit in describing the characteristics of children

with Learning disability and thus making is rather convenient for teachers to
recognise a child who may have Learning Disability.b

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Interesting to Know...
Myths Facts
People with LD cannot learn at all. People with LD are intelligent and can learn
with different teaching methods.
People with LD are just lazy and so cannot People with LD work as hard as others or
perform. even harder, but may not succeed. Due to
repeated failure, they may later give up and
so appear lazy.
LD disappears with age. LD neither can disappear nor be cured. As
one becomes older, the person learns ways to
deal with the condition and so it may seem
that LD has been cured or has disappeared.

Types of LD
The definition of LD itself indicated to us that LD is a heterogeneous condition. Based on the
kind of difficulties the students experience, the specific types of LD have been given. We
thus study four major types of LD:
1. Dyslexia – Specific LD in reading
2. Dyscalculia – Specific LD in Math
3. Dysgraphia _ Specific LD in writing
4. Non-verbal LD

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Dyslexia

Dyslexia is a specific learning disability in reading. Dyslexia means poor/ disordered reading.
The skill of reading requires that the student learn the connection/ association / link between
the letters of the alphabet and the sounds that each letter and letter combinations make. Once
the child knows that specific letters make specific sounds ( e.g. c says /k/) then this helps in
decoding the word for reading. However, the skill of reading words is not reading alone.
Reading has another component. This is the skill of comprehending what we have read. Thus,
reading is both, decoding and comprehension.

Reading = decoding the word + comprehending the word

The students with dyslexia cannot read accurately and fluently. The student makes many
errors while reading. The student reads slowly and hesitantly. Along with this, there may be
difficulty in comprehending/ understanding what they have read. Though children with
dyslexia may have a history of late talking, we can diagnose them as having dyslexia only
once they enter school. This is because generally children learn to read after formal education
starts in school.

The characteristics of children with dyslexia are stated below.

 May be slow to learn the connection between letters and sounds

 The child often has difficulty separating sounds in words ( e.g. knowing that the word
cat has three sounds /k/ /a/ /t/ )
 Blending sounds to make words is difficult ( e.g. putting together the three sounds /k/
/a/ /t/ to read the word cat)
 Has difficulty decoding single words (reading single words in isolation)
 May have difficulty reading small words like at, to, said, and, does etc.
 Makes errors in reading. e.g.
a. Letter reversals - d for b as in, dog for bog and vice versa
b. Word reversals - tip for pit
c. Inversions - m and w, u and n
d. Transpositions - felt and left
e. Substitutions - house and home

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What could be the reasons for dyslexia? We already know that LD has a neurological basis.
Thus, dyslexia also has a neurological basis. The neurological dysfunction causes perceptual
problems. The perceptual problem may be in the visual perceptual area or auditory perceptual
area. Because of this, the child may have difficulty perceiving the visual stimuli correctly. It
is precisely because of this that the b / d reversals occur. In the same manner, those having
auditory perceptual problems may find it difficult to discriminate between the sounds. This
then contributes to LD. Dyslexia may be visual or auditory in nature. It can also be caused
because the child cannot integrate auditory stimuli with visual stimuli. Due to this, the child
cannot understand and learn the link between the letters and the sounds they make (e.g., b
says b as in ball).

Dyscalculia

Dyscalculia is a broad term for severe difficulties in math. Herein, again, dys means
disorder/ difficulty etc. in ‘calculia’ (Math). Thus, it includes all types of math problems. It
ranges from inability to understand the meaning of numbers to inability to apply math
principles to solve problems. The nature of problems the children show can be listed below:

 Difficulty learning the meaning of numbers

 Trouble with tasks like sorting objects by shape, size or color
 Difficulty recognizing groups and patterns
 Trouble comparing and contrasting objects using concepts like smaller/bigger
or taller/shorter
 Difficulty in learning to count
 Difficulty recognizing numbers
 Matching numbers with amounts
 Poor understanding of the signs +, -, ÷ and x
 Difficulty knowing the use of these mathematical symbols
 Difficulty with doing addition, subtraction, multiplication and division
 May find it difficult to understand the words "plus," "add," "add-together”
 Difficulty with times tables
 Poor mental maths skills
 May reverse or transpose numbers for example 63 for 36, or 785 for 875

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  May have a poor sense of direction (i.e., north, south, east, and west)

Apart from these basic arithmetic and Math skills, they also show difficulty in functional
math (understanding time, money transactions, measurement etc.). Solving problems
based on quantitative thinking is also difficult. Thus, time management, money
management, understanding whether to halve, multiply, add or subtract is a problem.
Many children who have dyscalculia may also have dyslexia. Alternatively, at times, a
person with dyslexia may show symptoms of dyscalculia. This is because the person
cannot understand the language of math and so may appear to have dyscalculia.

Dysgraphia
Many students who have LD demonstrate problems in some areas of writing. When there
are significant difficulties in acquiring and using writing skills it is called as dysgraphia
(dys meaning disordered and graphia meaning writing). The skill of writing includes three
major components - handwriting, spelling and written expression. Students who show
major problems in any or all areas listed above are said to have dysgraphia. In dysgraphia,
the child’s motor skills are affected and so it affects the person’s ability to write. The list
of the manifestations in three broad areas- handwriting/ penmanship, spellings and written
expression - is given below.
Handwriting/ penmanship-
 Poor colouring skills

 Incorrect grasp of the writing instrument

 Has difficulty copying letter from the board

 Cannot write letters from the memory

 Incorrect alignment of letters , the letters slant too much

 Inconsistent spacing between two words and between letters within a word

 Writes letters in reverse or mirror image

 Mixes capital and lowercase letters

 Distorts shapes of letters and numbers

 Puts too much or too little pressure while writing

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 Spelling -
 Performs poorly on spelling tests

 Exhibits weak word recognition skills

 Reverses and transposes letters

 Additions and Omissions seen in spelt words

 Repeatedly misspells the same words

Written expression –
 Difficulty forming sentences to communicate an idea

 Difficulty thinking of ideas while writing a composition

 Difficulty organising the thoughts logically in a composition or essay type answer

 The sentence structure may be wrong

 The choice of words to communicate the ideas is rather limited

 Written compositions are rather short

Non-verbal Learning disability

The fourth type of LD is Non- Verbal Learning Disability. This disability is commonly
known as NVLD. A nonverbal learning disability is different from the three previously
mentioned conditions – dyslexia, dyscalculia, and dysgraphia. The three skills (reading,
writing, and mathematics) require the acquisition and use of language skills. Therefore, when
there is a deficit in the language component of learning, dyslexia, dyscalculia and dysgraphia
can result. LD can also manifest when the learning of non-language based aspects is affected.
NVLD is a condition in which an individual does not accurately process information that is
not verbal or linguistic in nature. Hence, the person cannot process visual-spatial information,
facial expressions, or social cues causing LD, which is NVLD.
We can understand this condition better when we look at the sign and symptoms of NVLD.
The child with NVLD

 Has trouble recognizing nonverbal cues such as facial expression or body language
 Shows poor psycho-motor coordination; clumsy; seems to be constantly “getting in
the way,” bumping into people and objects

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  Has problem using fine motor skills e.g. tying shoes, writing, using scissors
 Needs to verbally label everything that happens to comprehend circumstances, spatial
orientation, directional concepts and coordination
 Has difficulty coping with changes in routing and transitions
 Has difficulty generalizing previously learned information
 Has difficulty following multi-step instructions
 Makes very literal translations
 Asks too many questions, may be repetitive and inappropriately interrupt the flow of a
lesson
 Imparts the “illusion of competence” because of the student’s strong verbal skills

Characteristics of LD:
In the following section, we will look at the characteristics of LD. An understanding of these
will help you as a teacher to identify children who may have an LD. Remember that the signs
and symptoms do not help diagnose LD. Nonetheless, if you see these signs and symptoms,
you should refer the child to the concerned specialists for further assessment. Teachers are
often the first to notice, "Something doesn't seem right about this child”. If you thus find at
least some of the given signs and symptoms of LD, you will be able to recognize the potential
problems early.

We can list and describe the characteristics of LD under seven different heads. Following are
the characteristics of individuals with learning disabilities.

1. Motor skill deficits

2. Attention deficits
3. Oral language deficits
4. Written language deficits
5. Math skills deficits
6. Cognitive skills deficits
7. Social skill deficits

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 Characteristics of Learning Disability

We have listed the seven broad characteristics of children with LD. Now we will try to
understand what the characteristics and the manifestations of each of them in a child with LD
are.

1. Motor deficits are the first listed characteristic. Motor skill development in any
person is understood can comprising of fine motor development and gross motor
development. Gross motor development is the development of the bigger muscles in
our body. The muscles of the torso, hands, and legs can be considered gross muscles.
What we see in children with LD is that there is no problem in the development of the
muscles per se. There is no lag in the gross motor development. Therefore, we see that
they start holding their neck, sitting, standing, walking etc. age-appropriately. Due to
minimal brain dysfunction, however, they may show an awkward gait or clumsy
behaviour.

The problems and deficits that we find are in their fine-motor development. This is
characterised by difficulty in doing activities that require the use of fine motor skills
like colouring with crayons, writing with a pencil, tying shoe laces, picking up and
using a spoon to eat etc.

The activities that require coordination of various muscles may also be difficult for
children with LD. They may show problems in throwing a ball for example.

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2. Another deficit that we come across in children with LD is attention deficit. Many
children who have LD have difficulty in paying attention to tasks they are required to
attend to and complete them. They have low span of concentration and are
distractible. Thus, if 10-year-old children can on an average focus attention and
concentrate for around 10-12 minutes at a stretch, a 10-year-old child with LD may be
able to attend to the task for only 2-3 minutes. Along with showing problems in
paying attention for appropriate periods, some children may also have hyperactivity.

In a child with LD, hyperactivity and impulsivity are related characteristics. Children with
hyperactivity – impulsivity have problems in controlling excessive activity and they
behave without thinking. Being over active does not mean being hyperactive. When
the excessive activity creates problems, it may be called hyperactivity.

In both the cases – attention deficit and hyperactivity, the child is bound to show deficits
in learning, but in a child with LD, it is a manifestation of LD and not a cause.

3. We have seen earlier that delay in the development and use of oral language skills is
a feature of LD at different stages in school life. Oral language includes the skills in
listening and speaking. Listening here is not the physical act of hearing, but
understanding the language that people around us use while communicating with us.
Children having LD generally have delay in understanding age-appropriate
vocabulary and language. Many a time, difficulties in understanding oral language
may cause difficulties in speaking (using oral language to communicate). The child
with LD may have a limited word bank, thus uses the same set of words to
communicate a variety of ideas. Similarly, the sentences that the child constructs to
communicate his/her thoughts may be age-inappropriate. They may be immature and
resembling the language of a child much younger in age. In children with LD,
speaking difficulties can be present independent of listening problems. Speaking does
not refer to articulation problems, but using language to communicate the ideas.

4. Written language deficits are characterised by difficulties in reading and writing.

Reading means the skills of decoding the written form and understanding what is
being read. Writing, along with referring to the act of writing (handwriting/
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 penmanship) also includes the grammar, spellings and skills in creative expression.
These reading and writing difficulties, are evident right from the time the child goes
to school and is exposed to reading and writing skills. A teacher is rather quick to
notice these problems in a child in his/her class. It is when a teacher notices these
signs that a child generally gets a referral for further assessment.

5. Math skill deficits are also a characteristic feature of children with LD. The difficulty
in understanding and using Math skills is seen right from the pre-primary grades
through adulthood. We find the deficits in understanding Math concepts (e.g. addition
as a concept, percentage, area, shapes etc.), the steps involved in doing Math sums
(computation), understanding what Math operation to use where ( reasoning) and
solving word problems (problem solving).

6. We find cognitive skill deficits in children with LD as well. Cognitive skills are the
skills that help us understand the environment around us. Cognitive skills include
skills like perception, memory, reasoning and thinking.

Perceptual problems in the visual and the auditory area are of most concern to us in
the field of LD. Perception has to do with attaching a meaning to the stimuli around
us at once. Only if we recognise the stimulus, we can understand it further.
Significant difficulties in reading, writing and doing math are many a time attributed
to perceptual deficits.

Children with LD may show problems in memory also. They show difficulty in
remembering and recalling information that they have heard, seen, or read.

Problems in reasoning and thinking i.e. thinking logically, understanding cause –

effect relationships, drawing conclusions etc. are noted. The child/ adolescent may not
know how to organise and manage ones time, use study skills effectively and manage
one-self.

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 7. Apart from the characteristics mentioned above, in children with LD, we can also
find problems in making friends and interactions with people around them. These are
called social skill deficits.

1.4 Tools and areas of assessment

Students with LD show many different characteristics. Similarly, there are different
types of LD. It is important to know whether a child actually has LD, or just a learning
problem, and what is the nature of the difficulty. To enable a teacher to do that, we have to
learn about the different ways of conducting assessment and also the various areas that are
assessed.

Tools of assessment
When we conduct assessment, we use different types of tools to gather data. The use of
varied tools helps in getting data about the child’s performance in the many areas. We have to
then analyse the data to know the nature or difficulties the child is facing in learning. We
need some tools to gather information about the numerous skills. Broadly, we can list four
tools that are used.
i. Tests

ii. Observation schedules

iii. Checklists

iv. Rating scales

The tools can be described in some detail to know their use better.
i) Tests: tests of many kinds are used to collect assessment data. The tests used may be
standardized or non-standardized/ teacher-made in nature. Both the kinds of tests
are however equally useful. The standardized tests are used for testing the child’s
IQ, cognitive abilities and academic achievement levels. The most widely used IQ
test is WISC-IV. Apart from this, Binet-Kamat, Malin’s Intelligence Scale for
Indian Children and Standard / Coloured Progressive Matrices may be used. To
assess cognitive abilities, the Woodcock -Johnson –Cognitive is used and the
Woodcock-Johnson- Achievement is used for determining the achievement levels.
These are only some examples of the standardized tests that are used. The use of
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 standardized tests alone does not always give complete data. Thus, the assessor
may develop specifically tailored teacher-made tests to get information of a
specific nature. Generally, curriculum-based tests are developed for the purpose.

ii) Observation schedule: another important tool that is used is observation schedule.
An observation schedule may be used to screen children who are at-risk for LD.
Similarly, it may be used to note the presence or absence of certain specific
behaviours. For example, to list the reading behaviours in a child, the observation
schedule may be used. Thus, what words were read, what words were difficult for
the child, did the child require additional time to complete the task etc. are some
of the behaviours that a teacher can note using an observation schedule.
Attentional behaviour and social skills can also easily be observed using an
observation schedule.

iii) Checklists and iv) rating scales are used in addition to observation schedules. The
purpose of these two tools is similar to the observation schedule. The observed
academic, or non-academic behaviours can be noted with the help of a checklist
(to know the presence or absence of the behaviours) and with the help of a rating
scale (to know the extent / frequency/ severity of the behaviour).

When we use these tools to collect the information about the child with LD, his/her learning
levels and thus, the learning needs, we do it for helping him/her to overcome the difficulties.
In the next section, we will learn about the strategies to be used for helping students with LD
to read, write and do maths better.

Areas of assessment:
The assessment of LD requires that we assess the student/ child in five areas. These are
cognitive skills, motor skills, perceptual skills, adaptive skills, and language skills.

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The description of each area is given below:
The very first area that has to be assessed is the cognitive skills. Cognition is the ability to
think. Therefore, the child’s ability to think, reason and engage in problem solving is
assessed. It also includes the assessment of the child’s intellectual level. Therefore, the
child’s IQ (Intelligence Quotient) is determined. Determination of IQ is extremely important
because it helps us rule out the possibility of Intellectual Disability leading to learning
problems.
The second area assessed is the motor area. The gross and fine motor skills are of focus here.
The experts study whether the child has age appropriate motor skills e.g. the gross motor
behaviour like walking, running, control of movements of the upper limbs etc. The fine motor
skills like eye-hand co-ordination, buttoning, tying shoelaces, opening and closing of the
bottle cork, beading, colouring, writing etc. are checked.
The assessment of perceptual skills involves the assessment of visual perception and auditory
perception areas. In LD, we know that the child does not have any sensory problem. The
child may however have perceptual problems. The child may not be able to make sense of the
sensory stimuli adequately well. Thus, the child is given tasks to assess visual perception and
auditory perception and integration of auditory and visual stimuli. Activities like finding the
differences, sequencing, matching, focusing on target stimuli and identifying them are done,
to list a few.
Language assessment involves assessment of oral language as well as written language
skills.

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.

In oral language, the skills pertaining to oral receptive language are assessed. Thus, checking
for the student’s understanding (comprehension) of instructions that are provided orally is
done. Whether the student can follow one-step instructions, two step instructions and multi-
step instructions is noted. Similarly, what is the nature of language used (speaking) by the
child to communicate orally is observed. The written language is also affected in students
with LD. Keeping this in mind; we assess their reading skills and writing skills as well.
Assessment of reading skills involves assessing the word reading ability, and comprehension
of the text that is being read by the child. The accuracy of word reading and the fluency of
reading texts is checked. The writing skills include the handwriting, spellings and written
expression and we record the student’s skills in each of these.

Another important area that has to be assessed is adaptive behaviours. Adaptation refers to
how and how well the person is changing and adjusting to the changing demands of people or
situations. This reflects in the person’s social behaviour (social skills). Thus, the adaptive
behaviours are assessed. A person with LD may have social and emotional issues. To
understand the presence and the extent of these problems, the assessment in this area is
important.

1.5 Strategies for reading, writing and maths

To be able to teach a child with LD, the teachers have to change the teaching methods so that
their specific learning needs are met. The interventions that we plan can be at a general level.
These general modifications will help facilitate the child’s inclusion in the regular class. Of

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course, along with these general changes, we will also have to teach the child in specific ways
that will aid in acquiring the specific academic skills the child lags in.

Activity:
You know the characteristics of children with LD. Keeping in mind their characteristics list at
least five changes you can bring about in a classroom to include the child with LD.

___________________________________________________________________________

___________________________________________________________________________

_________________________________________________________________________

General Guidelines
Since you have already listed ways of reaching out to the children with LD, let us now view
the general guidelines:

General Guidelines / Tips for Teachers

a. Keep instructions brief and as uncomplicated as possible

b. Allow the student to tape-record lectures

c. Clearly define course requirements, the dates of exams, and when assignments

are due

d. Provide advance notice of any changes

e. Provide handouts and visual aids

f. Use buddy system to help a non-reader student during in-class assignments

g. Use more than one way to demonstrate or explain information.

h. When possible, break information into small steps when teaching many new

tasks in one lesson

i. Allow time for clarification of directions and essential information.

j. Provide study guides or review sheets for exams.

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 k. Provide alternative ways for the students to do tasks, such as dictations or oral

presentations.

l. Provide assistance with proofreading written work.

m. Stress organization and ideas rather than mechanics when grading in-class

writing assignments.

n. Allow the use of spell-check and grammar-assisted devices.

o. When in doubt about how to assist the student, ask him or her.

Since you now know what to keep in mind while teaching children with LD, you can try to
complete the following activity.

Activity: Create a brochure on “tips for teachers of children with LD” to help teachers
in general classrooms.

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Specific Interventions
We have taken into consideration the general guidelines for teaching children with LD. Let us
now think about some specific ways that we can take to help the children deal with the
particular problems they face in learning.

Reading :
i. Direct, systematic, explicit teaching of phonics helps children with LD learn to read.
Phonic training involves learning the sound of each letter. Once the child learns the
basic phonics, the skills can be generalised to read bigger words as well.

ii. Apart from teaching phonics, the child can be taught to read sight words. Sight words
are high frequency words that make reading smoother. Since these words occur very
frequently in the text, it is important that the child be able to read them without effort.
In English language, there are many words that we cannot read using phonics, such
words are taught as sight words. When sight word reading is taught, the words are
taught as whole words (like recognising pictures/ patterns) than reading them
phonetically. What are the steps in teaching sight words then?
a. Write the word ( target word) on a flash card
b. Show the word to the student and say the word aloud
c. Make a sentence using the word, as the word is shown
d. Say the word again, pointing out to the word
e. Place word cards with the target word and other words in front of the student.
Ask him/her to pick the card that reads the target word.
f. If the student picks the word correctly, expose the child to the next word. If
the child cannot select the target word, point it out to the student and say the
word.
g. Repeat the step until the child can select and read the sight words correctly.

iii. A method called Neurological Impress Method works well with children who find it
difficult to read fluently. In this method, the teacher and the student sit side-by-side
and read the same reading matter nearly simultaneously. The teacher reads a little
faster than the student does and the student quickly follows with reading. The
teachers’ reading impresses upon the student the correct reading and the student thus

21
 learns to read with greater fluency. As the child spends more and more time in this
kind of paired-reading, the teacher reduces the volume of her voice and gradually the
student reads by him/herself.

iv. Many children with LD lose their place in the text while reading. Using the finger or
ruler to track the words being read helps to stay on the text correctly. This also
improves the reading performance.

v. Since reading errors occur due to visual perceptual deficits, training in visual
perceptual exercises will benefit the child. Training in finding the word/s in a maze or
grid is one such exercise. Finding the hidden objects/ patterns / pictures is another
such activity. Matching the figure / word with a figure / word given also helps learn
read by developing the skill of visual discrimination.

vi. We know that reading involves understanding the text. We can do the following to
help the child comprehend the read text better.
a. To teach reading comprehension, it is important to teach the child the key
words in the text in the beginning. When the child is able to read the words
accurately, then understanding what s/he is reading becomes easier.

b. We can also provide a summary of the text to be read to the child. When the
child knows what the text is about, the child understands the specific details in
the text given to him/her.

c. The first two ways that we have suggested yet needs the teacher to help the
student in the process of understanding the information/ text. Since we want
the student to be able to read and understand as much as possible
independently, we can teach the child “how to comprehend” than “the text to
be comprehended”. When we teach the child “how to comprehend”, we are
teaching the child metacognitive strategies.

Metacognition means knowing how I think. Therefore, when we teach

metacognitive strategies to the child, the child learns to follow steps to

22
 comprehend. A strategy called SQ3R can be taught for comprehension. SQ3R
is an abbreviation of
S Survey the text
Q ask Questions about the text that you want to understand (e.g.
what is the chapter about? ) or read the Questions given at the end of the text
to understand.
R Read the text actively to find the answers to the questions
R Recite answers that are found to oneself
R Review the whole chapter to check what you have understood

There are many other strategies that the teacher can develop and teach the chld to use them to
facilitate learning of different skills.
Writing:
Handwriting difficulties:
i. Providing exercises and activities to develop and strengthen fine motor control will
help in improving the handwrititng.. For example, the child can be encouraged to do
paper tearing, paper rolling, colouring within boundaries, stacking blocks using pincer
grasp, threading, beading, clay modelling, using manipulative aids, etc.

ii. Teaching the child what the correct pulled toward the desk/ table. (
body position to write refer to the diagram below)
appropriately is. This will require
the child to sit with feet firmly on
the ground and lean forward
around 30 degrees while writing,
and placing the paper at an angle of
45 degrees to the bottom edge of
the table. The chair has to be fully

iii. The pencil/ pen / writing instrument have to be held firmly in the thumb, index finger
and middle finger.

23
 iv. Teachers should give multisensory input to learn letter formation. Thus, along with
providing the visual input of the shape of the letter, the child should trace it on sand
paper/ raised boundaries, write in sky/ air / in sand, say the word aloud and hear the
sound the letter makes.
v. Providing a ruled / square line paper to learn letter and word spacing helps as well.
Spellings:
i. To help in learning spellings, we can teach the child phonics. Teaching phonics
involves teaching the child the connection between the letters and the sounds they
make. Though most children learn the sound-symbol association automatically, a
child with LD needs to be taught that explicitly.
ii. The way the child learns phonic skills, the child can also learn to spell by learning
spelling patterns , e.g. word families – it family ( bit, fit, hit, kit, lit etc.)
iii. The child can also be taught to spell the words as a whole rather than breaking them
into letter sounds. So the whole word approach can be used. The child, here in, sees
the word as a whole, tries to visualise the word as a whole, write it as a whole while
saying it aloud. The child repeats this procedure until the word is spelt correctly.
Written Expression:
Many students with LD can write short sentences, but struggle when they have to write
paragraphs. We need to teach the students techniques that will help them break down the task
of writing paragraphs into smaller parts and attempt to complete each one before putting the
parts together. For this, we can teach them the strategy called POWER.
P plan what to write
O organize your thoughts and ideas
W writes the draft
E edits your work
R revises your work and writes the final draft

This strategy POWER is a very comprehensive strategy. It covers all the steps involved in
writing (an answer, paragraph, or composition). We will elaborate the strategy in little more
for better understanding.
The P in POWER needs the student to think about their ideas and elaborate on each
idea. For doing this, we can ask the student to answer ‘wh’ (who, what, when, where, why)
questions about the topic and write these responses. E.g., the student has to write a

24
composition on “A visit to a museum”. To write on this topic, the student will be asked to
answer the ‘wh’ questions like
Who – who went to the museum? Who accompanied you to the museum? Who (m)
did you meet at the museum? Etc.
What – what did to take with you to the museum? What did you do at the museum?
What did you see there? What did you like / not like at the museum? What mode of
transport did you take to reach there?
When – when did you decide to go to the museum? When did you go (day, time)?
When did you return from there?
Where – where is the museum located?
Why – why did you go there?
For the O in POWER, we teach the student to organize the ideas. The ideas have to
be organized in the logically sequence so that they do not seem disconnected. The student can
number the ideas and later can write the draft accordingly. At this step, you can also teach the
student to look up the spellings of words s/he wants to use in the composition but cannot spell
those words.

To be able to plan and organize better, we can teach the student to use a mind map. A
mind map is a graphic organizer (a diagrammatic representation). A simple mind map like the
one given below will help the students a lot. The mind map for the topic “A visit to the
museum” is drawn for you. Study it carefully.

After organizing oneself, the student can now write the first draft (W in POWER)
of the paragraph/ composition. The student will now elaborate on the ideas that s/he has
generated.
Once the draft is ready, we can teach the student to edit the written work (E in
POWER). While editing, teach the student to check for spelling errors, punctuation, correct
the flow of ideas, change the words using better vocabulary etc.

Lastly, revise (R in POWER) the edited draft and write the final copy of the composition.

The use of this strategy takes a long time in the beginning. However, with practice the
student will be able to use it well, even during the exams.

25
 WHO – My friend and I,
My parents
Classmates and my cousin

WHAT – went by bus, WHEN

Saw artefacts, coins, in the summer
Statues, old documents holidays, morning

Liked – the natural to evening

history section

A VISIT TO A MUSEUM

WHERE – at Chhatrapati Shivaji WHY – read about the

Vastu Sangrahalaya, close to home museum in our library,
Teacher told us

Mind Map for the composition topic “a visit to a museum”

Activity: Choose a topic to write a composition on. Draw a mind map for that topic.

26
 Maths:
i. The teaching of maths concepts very explicitly becomes very important for children
with LD. We cannot expect them to learn the concepts by themselves without effort.

ii. Since children with LD have difficulties with directional concepts like left –right,
east- west, north-south etc. and this affects their Math learning, these spatial concepts
have to be taught to them. The learning of these concepts then helps in learning the
placement of numbers and digits in alignment for computation.

iii. Training in understanding patterns in sequences is another crucial learning. This helps
develop quantitative reasoning (inductive reasoning – drawing general conclusions
based on specific instances).
E.g. - 5, 10, 15, 20, 25
In this number sequence, the child should know what is the relationship of the
first number with the second and the second with the third and all the numbers
with each other. Only if the child can understand that the numbers are
arranged by skip counting by 5, the child can later learn the 5 times table.
The child can also learn and engage in using deductive reasoning. In the same example given
above, if the child can predict what number comes after 25, the child has arrived at specific
answer based on the rule that the numbers skip by five.

iv. Use square-line paper even for children in beyond grade 3 and 4. Using square line
paper helps the child to organise the space on the paper to solve sums.

v. Use colour coding to highlight important concepts while solving sums. For example,
use different colour pens to emphasize the units/ ones place, draw a box to write the
27
 carry over number, use highlighter pens to identify numbers that need to be regrouped
to subtract ( bigger number from smaller number).

vi. Metacognitive strategies can be taught to the children to do word problems. This is
similar to the use of metacognitive strategies for teaching reading comprehension. We
will try to learn one specific strategy – SQRQCQ

S urvey – Read the entire word problem carefully to learn what it is about.

Q uestion - Ask, "What question needs to be answered in the problem?" Think about
what the problem is asking.

R ead - Read to find all the facts you need to answer the question. Look for key words
and terms like how much more, how many were left, all together, total, difference that
can help you to decide which facts are needed to answer the question. Ignore any
information that is not needed to answer the question. Cross out any information not
needed.

Q uestion - Ask, "What computations must I so to answer the question?" Decide if

you need to add, subtract, multiply, divide, or do these operations in some
combination.

C ompute - Write the problem on paper and do the computations. Check to make sure
your computations are accurate. Double-check your work. Circle your answer.

Q uestion - Ask, "Does my answer make sense?" You can tell if it does by going back
and looking at the question you tried to answer.

Sometimes you will find that your answer could not be correct because it does not fit
the facts in the problem. When this happens, go back through the steps of SQCQRQ
until you arrive at an answer that does make sense.

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1.6 Curriculum adaptation, IEP, further education

The strategies that we have listed in the previous section are focusing on the basic
curricular skills viz. reading, writing and maths. Children with LD require training not
only in these basic curricular skills but also in the way the school curriculum is
transacted to them. Thus, the curriculum that is designed for them has to be changed to
suit their learning needs. Curriculum adaptation helps a teacher to make the needed
changes. In an inclusive classroom, teachers can use curriculum adaptation in the class
and also provide individualised remedial instruction by developing an Individualised
Education Programme (IEP).

Curriculum Adaptation:

Curriculum adaptation is a process of making necessary changes in the learning

content such as modification, substitution/ replacement, omission etc. without
changing the learning purpose. Bearing this in mind, for a child with LD, the
adaptation in the curriculum can happen in seven different ways.

 Quantity – this refers to the amount / number of activities that the child has to
learn so that we can consider that the child has mastered the content. Thus, if
the children without LD are completing 10 sums in maths, the child with LD
may be required to complete seven sums. We have therefore reduced the
number / quantity.

 Time – as a teacher, we can bring about a change in the time given to the
CWLD to complete the task or time allotted to write a test. The adaptation here
involves permitting additional time for task and test completion.
 Input method – when a teacher teaches a CWLD, s/he can alter the method of
teaching. If a chalk and talk method is used for the class, this CWLD may be
taught using pictures, showing videos, using activities etc.
 Output method – the way a teacher changes the manner in which s/he teaches,
similarly, the way a CWLD responds to the teaching can also be changed. To
give an example, if all the children in the class are responding in writing to the
given task, this CWLD can be expected to orally respond to the same task.

29
  Difficulty – the content that is taught varies in the level of difficulty. Thus, the
CWLD can be expected to learn content that is of different difficulty level than
the peers. The CWLD may be learning simpler concepts as compared to the
classmates.
 Level of support – this aspect of adaptation is required when the student can
be expected to perform like the classmates but with some human or material
support. Thus, a CWLD may require a reader, a scribe or to use a calculator
while completing the tasks. These supports when provided, we have adapted
the support.
 Level of participation – though this is considered to be one of the ways of
adapting the curriculum, we generally find that children with LD can
participate in most classroom activities. They do not require any specific
adaptation with regard to this. However, if the need be, the teacher can alter
the extent to which the child can actively participate in the classroom activities
and tasks.

Activity:

Identify a CWLD in the classroom and write in two sentences each how you will
make curriculum adaptation for him/her in each of the seven aspects.

Quantity:_____________________________________________________________
____________________________________________________________________

Time:________________________________________________________________
_____________________________________________________________________

Input:________________________________________________________________
_____________________________________________________________________

Output:_______________________________________________________________
_____________________________________________________________________
30
Difficulty:____________________________________________________________
_____________________________________________________________________

Level of support:
_____________________________________________________________________
_____________________________________________________________________

Level of participation:
_____________________________________________________________________
_____________________________________________________________________

Individualised Education Programme:

An Individualised Education Programme / plan is a written plan that outlines the steps
to be taken to enable a child with special needs to achieve specified targets. So, an
IEP mentions a description of the special student's current skill levels based on
assessment . It includes the measurable and observable goals and the specific skills for
improvement in each area of educational need that has been identified from
assessment. The method of instruction that will be provided and when, where, and for
how long that specially designed instruction will be provided is described. In addition
any related services (like occupational therapy, speech therapy, counselling etc.) the
student will need to support specially designed instruction are also mentioned. The
IEP is prepared for a period of one academic year for each child. The format of the
IEP is given below:

31
In column 1, the content to be taught is listed. For a child with LD, generally the
content to be taught is the skill (reading, writing, math, thinking etc.) that is deficit
and so has to be improved. The steps in learning the content is written in the second
column, task analysis. The time frame for completing the content is the duration. The
specific methods that will be used and the material that will be used to teach the
content is decsribed. How the evaluation will be done, what criteria will be used is
written in the column titled évaluation’. The last column, ‘remarks’ is reserved for
making any extra and special notes about the child and the teaching - learning.

Further Education:

Further education refers to the education that will take place beyond the free and
compulsory education for a child with disability. For a CWLD, further education may
comprise of vocational education or higher education depending upon the readiness,
and interest of the student.

1.7 Transition education and lifelong education

When the children with LD progress toward completing their school education and
make a decision to acquire either higher education, or vocational education, they
require some support to make this transition. Transition education refers to the
education that is provided so that the students can move from one set up to another. In
this case, of children with LD, most may enter higher education after high school.
And for the purpose to facilitating this transition, a Transition Plan is prepared. It is a
document that outlines what you want to achieve in the next few years and what
support you will need to live as independently as possible. It covers every aspect of a
person’s life, including education, employment, housing, health, transport and leisure
activities. Therefore, the essential components of all transition plans for students with
learning disabilities will cover the following areas:

a) Academic preparation (including literacy),

b) Preparation for metacognitive training to enhance problem solving, communication
and future goal specific skills,
c) Personal skills development, including future independence, life planning, social
skills and self-advocacy skills development, and importantly
32
 d) Specific preparation for the student’s chosen field of study or career.

The schools have to plan and execute this transition plan for three to four years so
that the student becomes ready and equipped to take on new learning challenges.

It is important that students with learning disability receive transition education

because the skills that they acquire as part of transition education will help them
become lifelong learners. Since people with LD have issues in learning, they may not
voluntarily choose to study (and educate themselves) beyond what seems to be
mandatory for them. Thus, transition planning is the key to lifelong education for
students with LD.

1.8 Summary

In this section we will quickly review the content that we studied in the unit on
Learning Disability.

We started the lesson by understanding that meaning of Learning Disability. Learning

Disability means significant learning problems. These problems are not because of
other disabilities (like mental retardation, visual impairment etc.) . We then tried to
understand the characteristics of children with LD. Since LD is a heterogeneous
condition, we understood the classification / types of LD. Dyslexia, dysgraphia,
dyscalculia and non-verbal LD are the four major types of LD we will find in school
students. We then read about the general guidelines for teaching children with LD and
understood the specific interventions for specific learning problems viz. reading,
spelling, written expression and math. Since children with LD are in school, they
require to learn the content (and subjects) like their classmates, but may need it to be
modified. This is done by adapting the curriculum. Their individual deficit skills are
trained through the planning and implementation of the IEP and the students are
prepared for further and lifelong education by means of the transition plans.

1.9 Activities

33
 You can do the following suggested activities to develop better appreciation of the
condition called Learning Disability.

 Visit a school for children with LD

 Prepare a checklist to screen children with LD in a general class
 Observe children in a regular class and try to identify children who may have
LD
 Observe and record the teaching strategies the teachers for children with LD
use in their classrooms

1.10 Study questions

1. Define Learning Disability (LD). Explain the characteristics of Learning Disability in

detail.
2. What is learning disability? Describe the various types of LD.
3. Describe the various tools used for assessment of LD.
4. What areas are assessed for knowing the learning needs of children with LD?
5. Explain the strategies employed to teach reading skills to children with LD.
6. Describe the teaching methods to develop writing skills in children with LD.
7. How do we teach math to children with LD?
8. What principles will you keep in mind to adapt the curriculum for children with LD?
9. Short notes:
a. Further Education
b. Transition education
c. Lifelong education

1.11 References
1. Bender, William N., Learning disabilities, Characteristics, Identification and Teaching
Strategies, 1995

2. Chaote Joyce. Successful Mainstreaming Allyn & Bacon, 1991

3. Hetcher Jack M., Reid Lyon, Fuchs Lynn S. and Barnes Marica A. Learning
Disabilities: From Identification to Intervention, The Guilford Press, 1st edition, 2006.

34
 4. Lerner Janet W. and Kliner Frank, Learning Disabilities and related Disorder
Characteristics and Teaching Strategies, Houghton Mifflin Company, 10th Edition,
2005.

5. Nakra Onita, Children and Learning Difficulties, Allied Publishers, 1996.

6. Rawal Swaroop, Learning Disabilities in a Nutshell: A Parent-teacher Manual for

Understanding and the Management of Dyslexia, Dysgraphia, Dyscalculia and
Dyspraxia, B. Jain Publishers Pvt. Ltd , 2010.

7. Thapa K., Aalsvoort G.M., Pandey J. (Eds.), Perspectives on Learning Disabilities in

India: Current Practices and Prospects, SAGE Publications Ltd, 2008

1.12 Suggested Readings

1. Das, J.P., Reading difficulties and dyslexia, New Delhi , 2001.

2. Raj, F., Breaking Through- A handbook for parents and teachers of children with
Specific Learning Disabilities, Secunderabad, Vifa Publication, 2010

3. Reddy, L.G. , Rama, R. and Kusuma, A. , Learning Disabilities: A practical Guide to

Practitioners, New Delhi: Discovery Publishers, 2000

PAPER B8 : Introduction to Neuro Developmental Disabilities

(LD, MR(ID), ASD)

35
 Intellectual Disability :Nature, Needs and
Intervention
Unit
Dr Preeti Verma
2
INDEX

2.1 Introduction
2.2 Learning Objectives
2.3 Definition, Types and Characteristics
2.4 Tools and Areas of Assessment
2.5 Strategies for Functional Academics and Social Skills
2.6 Assistive Devices, Adaptations, Individualized Education Plan, Person Centered Plan,
Life Skill Education
2.7 Vocational Training and Independent Living
2.8 Study Questions
2.9 References
2.10 Suggested Readings

2.1 Introduction

If you look around your surrounding, you will realize that not all people function the same
way as you do. Some may be quick, some may be slow, and some may not be able to see or
hear or may not be able to move around like you. You may have heard them as being called
blind, deaf or physically challenged. You may have heard them being labeled as ‘disabled’.
You may also have seen people who can't mentally function at normal level like most of us.
They may not be able to control their body movement, their intelligence, social interaction as
well as language since the birth or early childhood. In this case, we are referring them as
mental retardation or intellectual disability. A disability is any continuing condition that
restricts everyday activities. It is an impairment that limits functioning.

An intellectual disability (ID, formerly mental retardation) is a type of disability that results
from limited mental capacity. The cause of Intellectual disability are many. These include
genetics, brain injury, and certain medical conditions. There is no treatment for intellectual
36
disability as it is not a disorder. Instead, individuals with ID are provided additional supports
which help people to enjoy a satisfying life despite their disability.

People with limited mental abilities struggle to develop the skills needed for independent
living. Without these skills, it is hard to live in a safe and socially responsible manner.
Children with ID’s usually develop more slowly than their peers. They usually sit, walk, and
talk much later than other children. This delayed development means they do not act their age.
Limited mental capacity makes learning very difficult. Therefore, learning new information
and skills is challenging. It is also difficult to apply information in a practical and functional
manner. People with ID have trouble grasping complex and abstract concepts. This affects
their ability to develop important social skills. This is because social skills are complex and
abstract.

IDs can coexist with psychiatric disorders. Therefore, no single set of symptoms can
completely describe an ID. Nonetheless, you will find it useful to discuss some common
characteristics. The management of ID requires early diagnosis and intervention, along with
health care and appropriate supports lessens disability and optimizes progress in functioning.

Providing services to help individuals with intellectual disabilities has led to a new
understanding of how we define the term. After the initial diagnosis is made, we look at a
person’s strengths and weaknesses. We also look at how much support or help the person
needs to get along at home, in school, and in the community. This approach gives a realistic
picture of each individual. It also recognizes that the “picture” can change. As the person
grows and learns, his or her ability to get along in the world grows as well.

2.2 Learning Objectives

 Explain the characteristics and types of Intellectual disability.

 Describe the tools, areas of assessment
 Prepare and apply intervention strategies functional academics and social skills.
 Describe assistive devices and adaptations,
 Explain individualized education plan, person centered plan and life skill education

 Explain the characteristics and types of Autism Spectrum Disorder.
 Describe the tools, areas of assessment and apply intervention strategies.
 Discuss the importance of vocational training and independent living

2.3 Definition, Types and Characteristics
Let us first learn what Intellectual Disability is. The term “Intellectual Disability” (ID) has
widely replaced the term Mental Retardation (MR) for policy, administrative and legislative
37
purposes in most countries. Mental retardation is a developmental disorder characterized by
significant, concurrent deficits in general intelligence and adaptive behaviours. This is
included under the category of psychiatric disorders in the international classification. It is a
lifelong condition, associated with a wide range of sensori-motor problems, psychiatric and
behavioural disorders (Salvador-Carulla & Bertelli, 2008).

Henceforth we would be using the term ID instead of MR. However in some definitions and
references you will still read the term MR. The question as to whether IDD are a disability or a
health condition remains a hotly debated one, with two co-existing approaches used as a basis
for new conceptualizations of this entity. Based on a health condition perspective, MR is
currently coded as a disorder in ICD (category F.70). At the same time, impairments in
intellectual functions that are central components of IDD can be classified within WHO’s
International Classification of Functioning, Disability and Health (ICF) and therefore seen as a
part of disability.

Intellectual disability (ID) is a neurodevelopmental disorder with multiple etiologies that is

characterized by deficits in intellectual and adaptive functioning presenting before 18 years of
age.The adaptive deficits are due to intellectual impairment and affect social, conceptual or
practical functioning, or a combination of these, in one or more settings (eg, school, home). ID
is highly heterogeneous and encompasses a broad spectrum of functioning, disability, and
strengths.

ID exists within a spectrum of severity that ranges from mild to profound. Standardized
intelligence quotient (IQ) testing is no longer used to classify the severity of impairment in ID.
The severity of ID is defined according to the level of support needed to address impaired
adaptive functioning. The cause of ID, the presence of comorbidities, and the severity of
impairment, affect when and how a child presents with ID. Children with mild ID present later
and have better clinical functioning than those with more severe ID.

Let us study few definitions of ID. Intellectual disability is a disability that occurs before age 18.
People with this disability experience significant limitations in two main areas: 1) intellectual
functioning and 2) adaptive behavior (the use of everyday social and practical skills) (AAIDD,
2010).
The ICF is a classification of health and health-related conditions for children and adults that
was developed by World Health Organization (WHO) and published in 2001. The WHO would
like the ICF classification system to be considered a partner to the ICD (International
Classification of Diseases and Related Health Problems) system used in the U.S. and abroad.
38
Whereas the ICD classifies disease, the ICF looks at functioning. Therefore, the use of the two
together would provide a more comprehensive picture of the health of persons and populations.
The diagnostic and statistical manual of mental disorders (DSM-IV-TR), published by
American Psychiatric Association, mentions that three essential components of feature of
mental retardation to diagnose a person with mental retardation (American Psychiatric
Association [DSM-IV-TR], 2000). The three diagnostic criteria for Mental Retardation are as
below:
 Criterion A. Significantly sub-average intellectual functioning: an IQ of approximately 70
or below on an individually administered IQ test (for infants, a clinical judgment of
significantly sub-average intellectual functioning).
 Criterion B. Concurrent deficits or impairments in present adaptive functioning (i.e. .e.,
the person's effectiveness in meeting the standards expected for his or her age by his or her
cultural group) in at least two of the following areas: communication, self-care, home
living, social / interpersonal skills, use of community resources, self-direction, functional
academic skills, work, leisure, health, and safety.
 Criterion C. The onset is before age 18 years.
Types of Intellectual Disability
Intellectual disabilities are categorized by their severity. Experts divide the types of cognitive
impairment into four categories: mild intellectual disability, moderate intellectual disability,
severe intellectual disability, and profound intellectual disability. The degree of impairment
from an intellectual disability varies widely. While IQ scores are still relevant, DSM V does not
place so much emphasis on degree of impairment but on the type of intervention.
The category details are as follows:

Mild Intellectual Disability:

Approximately 85% of individuals with an intellectual disability fit into this category and many
even achieve academic success, are often able to acquire sixth-grade level academic skills. A
person who can read, but has difficulty comprehending what he or she reads, they attain reading
and math skills up to grade levels 3 to 6. They also often have the skills necessary to live
independently and hold a job, but may need assistance if under unusual stress.Their IQ is
between 50 to 70 and are slower than typical in all developmental areas. There are no unusual
physical characteristics. They are able to learn practical life skills, blend socially and function
in daily life

Moderate Intellectual Disability:

About 10% of people with intellectual disabilities fit into this category. The IQ scores lies
between 35 to 49. Noticeable developmental delays (i.e. speech, motor skills) and physical signs
39
of impairment (i.e. thick tongue) may be observed.These individuals benefit from social skills
and vocational training. They are able to learn basic health and safety skills and can complete
self-care activities. They can often learn to travel from place to place independently and hold an
unskilled job with supervision.People with moderate intellectual disability have fair
communication skills, but cannot typically communicate on complex levels. They may have
difficulty in social situations and problems with social cues and judgment. These people can
care for themselves, but might need more instruction and support than the typical person.

Severe intellectual disability:

Their IQ score falls between 20 to 34.Considerable delays in development are observed. They
understand speech, but little ability to communicate, are able to learn daily routines. They may
learn very simple self-care and need direct supervision in social situations. Only about 3 or 4
percent of those diagnosed with intellectual disability fall into the severe category. These people
can only communicate on the most basic levels. They cannot perform all self-care activities
independently and need daily supervision and support. Most people in this category cannot
successfully live an independent life and will need to live in home setting.

Profound Intellectual Disability:

About 1 to 2 percent of people with intellectual disabilities fall into this category.Their IQ is less
than 20. There are significant developmental delays in all areas,with obvious physical and
congenital abnormalities. They are not capable of independent living, require close supervision
and sometimes attendant to help in self-care activities. They depend on others for all aspects of
day-to-day life and have extremely limited communication ability. May respond to physical and
social activities. Frequently, people in this category have other physical limitations as well.

40
 Remember
Intellectual disability is a disability characterized by significant limitations
both in intellectual functioning (reasoning, learning, problem solving) and in
adaptive behavior, which covers a range of everyday social and practical skills.
This disability originates before the age of 18.

Characteristics:
Now let us learn about the characteristics of Intellectual disability. Intellectual disability refers
to significantly sub average general intellectual functioning resulting in or associated with
concurrent impairments in adaptive behavior and manifested during the developmental period.
Characterized by two dimensions: limited intellectual ability and difficulty in coping with the
social demands of the environment.
As we have read earlier that ID means substantial limitations in age-appropriate intellectual and
adaptive behavior. Although many individuals with Intellectual disability make tremendous
advancements in adaptive skills, most are affected throughout their life span (Hawkins, Eklund,
James & Foose, 2003). Many children with Intellectual disability are not identified until they
enter school and sometimes not until the second or third grade, when more difficult academic
work is required. Most students with mild ID are able to cope with academics almost up to the
sixth-grade level and are able to learn vocational skills well enough to support themselves
independently or semi-independently.

41
Children with moderate retardation show significant delays in development during their
preschool years. As they grow older, discrepancies in overall intellectual development and
adaptive functioning generally grow wider between these children and same age peers.
Individuals with severe and profound mental retardation are almost always identified at birth or
shortly afterward. Most of these infants have significant central nervous system damage, and
many have additional disabilities and/or health conditions.
Let us study the areas of deficits:
Cognitive Functioning
Deficits in cognitive functioning and learning styles are characteristic of individuals with mental
retardation include poor memory, slow learning rates, attention problems, difficulty generalizing
what they have learned, and lack of motivation. Students with mental retardation have difficulty
remembering and retaining information in short-term memory (Bray, Fletcher, & Turner, 1997).
These children are unable to retain the information absorbed. The extent of inability to
remember things will depend on the severity of the condition. People with mild ID can retain
quite a bit of information. It's not that children with ID cannot learn it's just that they take longer
to do so. Individuals with mental retardation acquire new knowledge and skills at a much slower
rate as compared to typically developing children.
Students with ID also have low attention spans and find it difficult to concentrate on a particular
task and complete it.They often have trouble attending to relevant features of a learning task and
instead may focus on distracting irrelevant stimuli. In addition, individuals with mental
retardation often have difficulty sustaining attention to learning tasks (Zeaman & House, 1979).
These attention problems compound and contribute to a student’s difficulties in acquiring,
remembering, and generalizing new knowledge and skills.They are unable to generalize and
think abstractly. In other words have trouble using their new knowledge and skills in settings or
situations that differ from the context in which they first learned those skills.
Adaptive Behavior
In the definition given above, we have read that children with intellectual disability have
substantial deficits in adaptive behavior. Adaptive functioning refers to the application of skills
learned so as to live life independently. Limitations in self-care skills and social relationships as
well as behavioral excesses are common characteristics of individuals with intellectual
disability. The extent of dependence will again depend on the severity of the condition. People
with profound characteristics may generally depend on others throughout their lives. These
limitations can take many forms and tend to occur across domains of functioning.
Such children have poor communication skills. They find it very difficult to listen, understand,
and respond in conversations. Their social skills are also on the lower side. Although they are

42
affectionate and endearing people, they find it difficult to make new friends and sustain
friendships. They lose focus during conversations, do not maintain eye contact, and interrupt
frequently. Building relationships is not easy for most of them. Limited cognitive processing
skills, poor language development, and unusual or inappropriate behaviors can seriously impede
interacting with others.
Students with intellectual disability are more likely to exhibit behavior problems than are
children without disabilities. Difficulties accepting criticism, limited self-control, and bizarre
and inappropriate behaviors such as aggression or self-injury are often observed in children with
intellectual disability. Thus, limited intellectual ability impairs ability to adjust to new
circumstances, solve problems and make decision.

Motivation:
Students with intellectual disability often exhibit a lack of interest in learning or problem-
solving tasks. Some also develop learned helplessness, a condition in which a person who has
experienced repeated failure comes to expect failure regardless of his or her efforts. When faced
with a difficult task or problem, some individuals with intellectual disability may quickly give
up and turn to others or wait for others to help them.

Speech and Language:

Due to diminished intellectual functioning and associated neurological conditions, many

children with intellectual disability have delayed language and speech problems.

Now … all the characteristics have been discussed. Revise them using the points given
below.

Points to Remember

Characteristics of Intellectual Disability

 2-4 years behind in all areas of cognitive development (e.g. reasoning, problem-
solving, working memory)
 Low achievement in most or all academic areas (e.g. reading comprehension,
mathematics, written expression)
 Short attention span and easily distractible

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  Delays in speech development
 Difficulties with learning concepts
 Academic difficulties last across the school years
 May seem to learn more slowly than do other students
 Difficulty with memory
 Difficulty using academic strategies (e.g. note taking, memorizing definitions)
 Difficulty with generalization of information to other material
 Difficulty generalizing material learned in one setting to another (e.g., from school to
the community)
 Difficulties with more advanced academic skills related to content (e.g. math word
problems, identifying themes and symbols in literature)
 Delays in language may affect reading
 May have difficulty comprehending and summarizing what has been read
 Weak vocabulary (knowledge of words)
 May operate at a concrete rather than abstract level of thinking
 Difficult in remembering things
 Unable understand how things work
 Trouble in understanding social rules
 Trouble seeing the consequences of their actions

ACTIVITY:

Write in the space given below, atleast ten characteristics of intelectual disability the way
you have understood. Support it with examples.

Characteristics Examples

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Now compare your list of characteristics to those given above, highlight any differences,
mark with any color pen and relearn.
2.4 Tools and Areas of Assessment:
DSM-5 emphasizes the need to use both clinical assessment and standardized testing of
intelligence when diagnosing intellectual disability, with the severity of impairment based on
adaptive functioning rather than IQ test scores alone. In DSM-5, intellectual disability is
considered to be approximately two standard deviations or more below the population, which
equals an IQ score of about 70 or below. The assessment of intelligence across three domains
(conceptual, social, and practical) will ensure that clinicians base their diagnosis on the impact
of the deficit in general mental abilities on functioning needed for everyday life.
Assessment tools are instruments for obtaining information that can be used to make judgments
about children's disability, learning behavior and characteristics or programs using means other
than standardized instruments.
Different tools are
 Observations
 Interviews
 Questionnaires
 Rating Scales
 Checklists

Observations:
Observation may be defined as a systematic viewing of a specific phenomenon in its proper
setting or the specific purpose of gathering data for a particular study. Observation includes
seeing, hearing, perceiving. It is concerned with planned watching, recording, and analysis of
observed behaviour as it occurs in a natural setting. Observation may be defined as a systematic
viewing of a specific phenomenon in its proper setting or the specific purpose of gathering data
for a particular study. When the observer employs explicitly formulated rules for the observation
and recording of behaviour, it becomes a systematic observation. These rules are called

45
observation schedules. This approach works well for areas that are difficult to assess with pencil
and paper tests or when multiple opportunities are provided for students to demonstrate
acquisition of skills and knowledge over time. Often, observations are some of the most
important information you can gather.

Behavioral observations may be used clinically (such as to add to interview information or to

assess results of treatment) or in research settings (to see which treatment is more efficient or as
a Dependent Variable)

Types of observation
 Participant and non participant observation
 Controlled and uncontrolled observation

Participant and Non participant:

Both Participant and Non participant are based on the role of the observer. In participant
observation, observer participates actively, for an extended period of time. Assumes that
observer will become accepted member of the group or community. It is possible that there may
be lack of objectivity on the part of the observer.

In non-participant observation, the observer attempts to observe people without interacting with
them. They may be told that they are being observed or they may not be informed of being
observed. Observer is detached from situation so relies on their perception that may be
inaccurate.

Controlled and Uncontrolled observation:

Both controlled and uncontrolled observation are based on the rigor of the system adopted. In
controlled observation greater control of sampling and extraneous variables is possible. It
permits stronger generalizations and checks on reliability and validity. Particular types of
behavior are looked for and counted and the implementation of controls may have an effect on
behaviour

How to prepare for Observation

 What to look at
 Pre specify/decide the objectives
 Select on the event / person to watch (Initially may be unfocused)
 How to observe
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 Observation by broad sweep
 Observation of nothing in particular
 Searching by paradoxes
 Searching for problems
 Where and when to look
 Systematic and principled approach
 Reflexive decision making
 What to record
 Verbatim, key phrases, key elements, narratives
 Formatted recordings – tally counts, audio, video recordings
 Time Sampling and Situation sampling

Interview

We need to gather information from parents, caregivers, teachers and other professionals. This
can be done through interviewing people. Let us see what is an interview and what are the
different types of interviews. Interviews may be defined as two-way systematic conversation
between an investigator and an informant, initiated for obtaining information relevant to as a
specific study. It involves not only conversation, but also learning from the respondents’
gestures, facial expressions and pauses, and his environment. Interviewing requires face-to-
face contact or contact over telephone and calls for interviewing skills. It is carried out by
using a structured schedule or an unstructured guide. Interview is the only suitable method for
gathering information from illiterate or less educated respondents. It is useful for collecting a
wide range of data from factual demographic data to highly personal and intimate information
relating to a person's opinions, attitudes, values, and beliefs, past experience and future
intentions. Interview is required when qualitative information is required or probing is
necessary to gather more data. It is easier also for people to talk than to write. Once rapport is
established, even confidential information may be obtained. Interview enables the investigator
to grasp the behavioural context of the data furnished by the respondents. It permits the
investigator to seek clarifications and brings to the forefront those questions, that, for one
reason or another, respondents do not want to answer. Thus, interview is the method of
collecting data involves presentation or oral-verbal stimuli and reply in terms of oral-verbal
responses.

An interview can be conducted in many ways and for a variety of purposes. There are two
kinds of Interviews: structured or unstructured.

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Structured interview as the name implies, designed to provide a diagnosis for an interviewee
by detailed questioning in a "yes/no" or "definitely/somewhat/not at all" forced choice format.
It is broken up into different sections reflecting the diagnosis in question. Often Structured
interviews use closed questions, which require a simple pre-determined answer. Examples of
closed questions are "When did this problem begin? Was there any particular stressor going on
at that time? Can you tell me about how this problem started?" Closed interviews are better
suited for specific information gathering. Pre decided questions or interview schedule are
prepared. Questions are arranged in order; clarification can be sought on vague answers.
Analysis can be quantitative and qualitative.

Unstructured interviews can be less structured and allow the interviewee more control over the
topic and direction of the interview. Unstructured interviews are better suited for general
information gathering, and structured interviews for specific information gathering.
Unstructured interviews often use open questions, which ask for more explanation and
elaboration on the part of the interviewee. Examples of open questions are "What was
happening in your life when this problem started? How did you feel then? How did this all
start?" Open interviews are better suited for gathering general information. There are no pre-
determined questions, the process lacks direction and control.

The Interview Process

 Before the interview
 Prepare the questionnaire / interview schedule
 Get to know your interviewee
 During the interview
 Make a connection / establish rapport
 Learn to listen
 While asking questions – decide types of questions depending on the responses that are
required
 Carry the interview forward
 Record the interview
 After the interview
 Thank
 Organize information

Questionnaires:

Questionaires are one of the most common instrument to collect information. It contains a set
of questions logically related to a problem under study. It aims at eliciting responses from the
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respondents.The content, response structure, the wordings of questions, question sequence, etc.
are the same for all respondents. The questions in the questionnaire have to be read, understood
and filled in by the respondents . There is no need for face to face question answer
session.Questionnaires can be described as ‘schedules’ when used for directly for interviewing
and can make use of checklists and rating scales
Factors to consider while constructing questionnaires
 Determine the type of data required and its logical sequence
 Check level of respondents’ knowledge
 Decide data gathering method – interview or mailing?
 Draft the Instrument – decide the broad categories, sequencing, specific questions under
the categories
 Evaluate the draft – take expert guidance
 Pre test
 Specify procedures and instructions
 Design the format

Rating Scales:
Rating is a term applied to expression of opinion or judgment regarding some situation, object
or character. Rating Scale is a technique used in measuring responses such as feelings,
perception, likes, dislikes, interests, and preferences. It is an instrument that requires the rater
to assign the rated objects that have numerals assigned to them. Rating scales present users
with an item and ask them to select from a number of choices. The rating scale is similar in
some respects to a multiple-choice test, but its options represent degrees of a particular
characteristic. A rating scale is a set of categories designed to elicit information about a
quantitative or a qualitative attribute. This is a recording form used for measuring individual's
attitudes, aspirations and other psychological and behavioural aspects, and group behaviour.
The rating scale involves qualitative description of a limited number of aspects of a thing or of
traits of a person.
When we use rating scales, we judge properties of objects without reference to other similar to
other similar objects. Rating scale refers to a scale with a set of points, which describe varying
degrees of the dimension of an attribute being observed. Opinions are usually expressed on a
scale of values. The type of information collected can influence scale construction.
Types of rating scale:

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Graphic rating scale: is defined as any rating scale consisting of points on a continuum, and is
a generic label given to a broad category of rating formats: Never, seldom, sometimes, usually,
always
Numerical rating scale: In a typical numerical scale, a sequence of defined numbers is supplied
to the rater. The rater assigns to each stimulus to be rated an approximate number in line with
these definitions or descriptions.
Descriptive rating scale: Each rating level is defined, often in detail and is not necessarily
assigned a point value. Having good descriptions for rating levels lessens some of the problems
identified for graphic scales and does not force a teacher to quantify performance, if that is not
appropriate
Checklists:
It consists of a prepared list of items pertinent to an object or a particular task. The presence or
absence of each item may be indicated by checking 'yes' or 'no' or multipoint scale. The use of
a checklist ensures a more complete consideration of all aspects of the object, act or task.
Checklists contain terms, which the respondent understands, and which more briefly express
his views than answers to open-ended question. It is at best when used to test specific
hypothesis. It may be used as an independent tool or as a part of an schedule/questionnaire.

Activity for YOU

1) Investigate each tool given above and prepare a guide for a child whom you need to assess.
Choose specific instrumentation in your study. Be sure to specify if you will use it
qualitatively or quantitatively. That will help you to understand how you will actually use the
tool in your information gathering process.

2) Prepare an assessment tool for a child of your choice or the one who has been assigned to
you. Use the tools that you have learnt above and prepare a test.

Areas of Assessment

Assessment is a process of collecting data for the purpose of making decisions about
individuals or groups and this decision-making role is the reason that assessment touches so
many people’s lives” (Salvia, Ysseldyke and Bolt 2007). Going by the definitions of AAMR,
Intellectual Disability is “the degree with which individuals meet the standards of personal
independence and social responsibility expected for age and cultural group” (1983) and “the
collection of conceptual, social, and practical skills that have been learned by people in order

50
to function in their everyday lives” (2002). The diagnostic criteria in DSM-5 mentions,
intellectual disabilities as having two key diagnostic criteria, namely.

 Cognitive/intellectual functioning
 Adaptive functioning

Assessment is a dynamic, ever-changing construct, which is influenced by factors such as

cultural norms, age-related expectations, and a combination of anticipated and idiosyncratic
behaviors. It assesses what a person does in typical situations rather than what a person can do
or might do under the best of circumstances.
Let us now learn what assessment of cognitive functioning will includes. It comprises of
various mental abilities like:

 Reasoning
 Problem solving
 Planning
 Abstract thinking
 Judgment
 Academic learning (ability to learn in school via traditional teaching methods)
 Experiential learning (the ability to learn through experience, trial and error, and
observation).

Various types of standardized psychological tests are used during the assessment of
intellectual disabilities. These tests assess intelligence (IQ), learning abilities, and behavioral
skills. A standardized test is uniformly designed and consistently administered. This permits
comparisons of individual scores against average scores for the same group. This comparison
provides vital information about a person's skills and abilities relative to their peers.
Comparisons between group and individual scores should be matched by age, culture,
education, and other factors know to affect IQ scores.

Previously an IQ score of 70 or below was the recommended cutoff score, which are two
standards deviation below the mean. However, in some cases, although the individual's IQ
score is below 70, he or she should not be diagnosed as mental retardation if there is no
obvious disturbance in adaptive functioning. Some others factor that may result an individual
score poorly should be taken into consideration. For example, some of the factors include the
socio-cultural background of an individual; the problem with native language; as well as

51
related communicative, motor and sensory handicaps (American Psychiatric Association
[DSM-IV-TR], 2000). Thus the DSM-5 (APA, 2013) has de-emphasized specific IQ scores.
Nonetheless, an assessment of intellectual functioning remains central to diagnosis. Thus, IQ
scores are still very important considerations. IQ tests have two parts. One part measures
verbal abilities. The other part measures spatial abilities. Spatial is sometimes called
performance skills. It refers to movement and the manipulation of three-dimensional space.
Verbal and spatial scores vary widely. One person might have low scores across the board.
Another person might do well in verbal areas but poorly on performance or spatial tests.
Therefore, even though two people have the same total IQ scores, their abilities may be very
different.

Adaptive skills comprise everyday competence. Adaptive skills are defined as practical,
everyday skills needed to function and meet the demands of one's environment, including the
skills necessary to effectively and independently take care of oneself and to interact with
other people. Limitations in present functioning must be considered within the context of
community environments, including schools and homes, typical of the individual’s age peers
and culture. Within an individual, limitations often coexist with strengths.

Adaptive skills include skills needed to live in an independent and responsible manner.
Limited abilities in these life skills make it difficult to achieve age appropriate standards of
behavior. Without these skills, a person needs additional supports to succeed at school, work,
or independent life. Deficits in adaptive functioning are measured using standardized,
culturally appropriate tests.

Assessment of Adaptive skills includes: Conceptual skills (Receptive language, Expressive

language, Reading, Writing, Money concepts, self Direction), Social skills (Interpersonal
responsibility, Self esteem, gullibility, following rules/laws) and Practical skills (daily living
skills, instrumental activities, occupational skills and safety).
Adaptive Skill Assessment
Adaptive skill measures should assess a comprehensive range of skills. AAMR identifies 10
adaptive skill areas.
 Communication: Speech, language, and listening skills needed for communication with
other people, including vocabulary, responding to questions, conversation skills, etc.
 Community Use: Skills needed for functioning in the community, including use of
community resources, shopping skills, getting around in the community, etc.
 Functional Academics: Basic reading, writing, mathematics, and other academic skills
needed for daily, independent functioning, including telling time, measurement, writing
notes and letters, etc.

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 Home Living: Skills needed for basic care of a home or living setting, including cleaning,
straightening, property maintenance and repairs, food preparation, performing chores, etc.
 Health and Safety: Skills needed for protection of health and to respond to illness and
injury, including following safety rules, using medicines, showing caution, etc.
 Leisure: Skills needed for engaging in and planning leisure and recreational activities,
including playing with others, engaging in recreation at home, following rules in games,
etc.
 Self-Care: Skills needed for personal care including eating, dressing, bathing, toileting,
grooming, hygiene, etc.
 Self-Direction: Skills needed for independence, responsibility, and self-control, including
starting and completing tasks, keeping a schedule, following time limits, following
directions, making choices, etc.
 Social:Skills needed to interact socially and get along with other people, including having
friends, showing and recognizing emotions, assisting others, and using manners.
 Work: Skills needed for successful functioning and holding a part-time or full-time job in
a work setting, including completing work tasks, working with supervisors, and following
a work schedule.
 Motor Skills: Fine and Gross Motor Development is generaly used for children.
Thus, one can utilize data from each of the 10 adaptive skill areas, three adaptive skill
domains (i.e., Conceptual, Social, and Practical skills )
The Conceptual skill domain includes:
Communication
Functional Academics
Self-Direction

The Social skill domain includes:

Social Skills
Leisure

The Practical skill domain includes:

Self-care
Home/School Living
Community Use
Health and Safety
Work

Besides Coginitive functioning and adaptive skill assessment, educational assessment is

equally important for

• Progress Monitoring: Frequent, data-based measures of IEP goal attainment

• Transition Planning: Assessment of occupational interests and aptitudes that begins by
age 14

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Tests of IQ and adaptive functioning form the basis for making a diagnosis of intellectual
disability. Other tests (e.g., neuropsychological tests) may provide further detail. However,
test scores are not the sole basis for diagnosis. All relevant information is obtained before a
diagnosis is made. This includes interviews from parents, teachers, observations, and medical
history. For instance, some children appear to be smarter or higher functioning than the
testing indicates. These observations are also taken into account along with all the other data.
The diagnostician then compares all the data to the diagnostic criteria for intellectual
disabilities.

Previously, we reviewed that intellectual disabilities are defined by two major symptoms. We
had stated that there are limitations in intellectual functioning (mental abilities) and there are
limitations in adaptive functioning or life skills. These life skills include conceptual, social,
and practical skills.

A medical evaluation, therefore, is just the beginning of the assessment process. A thorough
assessment usually includes the following:

 comprehensive medical exam

 possible genetic and neurological testing
 social and familial history
 educational history
 psychological testing to assess intellectual functioning
 testing of adaptive functioning
 interviews with primary caregivers
 interviews with teachers
 social and behavioral observations of the child in natural environments

As mentioned, intellectual functioning and adaptive functioning are the primary diagnostic
criteria. In the next section, we will discuss the strategies used for functional academics and
social skills.

2.5 Strategies for Functional Academics and Social Skills

A child with a significant intellectual deficit may not be able to cognitively “catch up” to his
peers in terms of intelligence and academic performance. As the child gets older, he further
54
lags behind, particularly if no appropriate academic supports are implemented. The child with
the intellectual deficit will continue to learn and understand some aspects of the world at a
slower pace, but this cognitive growth is less complete and there will remain significant gaps
in the student’s knowledge base, unless some form of functional academic program is
implemented.
Functional academics helps to teach skills that allow students to succeed in school and
beyond, it is designed to teach functional skills which allow each student to succeed in real-
life situations at home, school, work and in the community. It helps to develop critical
academic and life skills. The functional academics curriculum includes a range of areas
namely: Pre-requisite concepts, maths, activities of daily living, reading, writing,
communication, social & emotional skills, community orientation, skill oriented activities, art
and craft etc. The teachers tailor the academic programs in above areas to the age, gender,
needs and functioning of the student. Each of the subcomponent is divided into skill level and
task analyzed to sequential steps which ranges from early childhood to transitional skills.
Such skills are not taught in isolation but as part of multi-sensorial approach. Key outcome of
functional skills is for the students to exercise maximum sense of control, engage in self-
directed behavior and autonomy over his/her environment.

Functional Academics are a set of specific skills designed to assist students socially,
academically, and behaviorally. These skills cover a wide variety of processes and are
individualized for each student. It prepares students to become participating members of
their communities.

In order to develop the child’s potential to the fullest, special education and training should
begin as early as infancy. With the appropriate supports, students with intellectual disability
can achieve a high quality of life in many different aspects. While students with intellectual
disability may have limitations in adaptive behaviors, these limitations may co-exist
alongside strengths in other areas within the individual. Independence and self-reliance
should always be primary goals of all instructional strategies employed with students with
intellectual disability.Thus, teachers need to provide direct instruction in a number of skill
areas outside of the general curriculum in order to address the limitations in intellectual
functioning and adaptive behavior experienced by those with intellectual disability. Though

55
these skills are more functional in nature but are essential for the future independence of the
student.

Strategies to teach functional skills

 Use short and simple sentences to ensure understanding.

 Use alternative instructional strategies and alternative assessment methods.
 Teach organizational skills.
 Teach student decision-making rules for discriminating important from unimportant
details.
 Use strategies for remembering such as elaborative rehearsal and clustering information
together.
 Use strategies such as chunking, backward shaping (teach the last part of a skill first),
forward shaping, and role modeling.
 Use mnemonics (words, sentences, pictures, devices, or techniques for improving or
strengthening memory).
 Use concrete items and examples to explain new concepts.
 Proceed in small ordered steps and review each frequently.
 Provide direct instruction in reading skills.
 Offer "standard" print and electronic texts.
 Provide specific and immediate corrective feedback.
 Use visual supports when relating new information verbally.
 Provide the student with hands-on materials and experiences.
 Break longer, new tasks into small steps.
 Demonstrate the steps in a task, and have student perform the steps, one at a time.
 Address the student and use a tone of voice consistent with their age.
 Avoid long, complex words, technical words, or jargon.
 Ask one question at a time and provide adequate time for student to reply.
 Use heavy visual cues (e.g. objects, pictures, models, or diagrams) to promote
understanding.
 Target functional academics that will best prepare student for independent living and
vocational contexts.
 Use physical and verbal prompting to guide correct responses, and provide specific
verbal praise to reinforce these responses
 Use of assistive technology. For example, softwares are available that combines reading
for meaning with direct instruction for decoding and understanding, which can be adjusted
by the teacher to meet the specific academic capacities of the student.
 Take advantage of Student strengths and interests in the classroom. e.g., if a student
demonstrates an interest in cars, have opportunities to read about cars, write about cars, do
math problems about cars, etc.

An “ecology based curriculum approach” will help to focus on skills that need to be learnt for
functional independence. This is an activity-based approach that helps the teacher to plan
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instructional programmes, and emphasizes on utility of learnt skill that requires to be age-
appropriate. Instructional plans are not restricted to classroom learning but directly transfer or
generalize to various daily living situations at Home, Neighborhood, Community from school
level. This approach takes into consideration environmental and age related needs to integrate
into communities and enables the teachers to prepare students to smoothly integrate into their
communities. The education of students with intellectual disability should focus on preparing
them for independent living in their own environments in which they live. Transferring learnt
skills to integrate into easily applicable situations is an important pre-requisite for selecting
activities in functional academics. Hence use of functional literacy skills such as reading or
writing name and address, filling bank forms, reading significant billboards and product
names of consumer goods. This applies similarly to selecting numeracy skills such as
concepts of time, money, calendar reading, measurements of various items with
corresponding measurement units for mass, weight, distance, volume and quantity of items
(Narayan & Myreddy, 2006).

Social skills are defined as “a set of competencies that a) allow an individual to initiate and
maintain positive social relationships, b) contribute to peer acceptance and to a satisfactory
school adjustment, and c) allow an individual to cope effectively with the larger social
environment”. Social skills can also be defined within the context of social and emotional
learning — recognizing and managing our emotions, developing caring and concern for
others, establishing positive relationships, making responsible decisions, and handling
challenging situations constructively and ethically (Zins, Weissbert, Wang, & Walberg,
2004). This understanding of what social skills are, you will be able to evaluate and build
students’ social skills within a variety of social contexts.

Very often, they behave inappropriately in social situations, and are rejected and isolated by
their peers. They are socially incompetent and unable to deal with life’s challenges or to
respond effectively to society (Deshler & Schumaker, 1983). Inappropriate social behaviour
of persons with intellectual disability may result from incorrect perceptions of social
situations. They also have problems in detecting and understanding contextual clues and
situations are unable to identify emotional and social relationships, and do not understand
others’ feelings and perceptions. They may lack an understanding of cause-effect
relationships in social situations. Quite often they do not know the appropriate way to behave
in specific situations, and how to converse in a different manner with adults and peers. They
may not notice how people respond to their behaviour and may misconstrue social details and
inflections (Kronick, 1983).
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Social and emotional learning strategies:
 Encourage children to consider how individual actions and words have consequences.
 Develop children’s ability to take different perspectives and viewpoints.
 Teach students to think through situations and/or challenges by rehearsing possible
outcomes.
 Create opportunities to practice effective social skills both individually and in groups.
 Model effective social skills in the classroom and at home through praise, positive
reinforcement, and correction and redirection of inappropriate behaviors.
 Discuss effective interactions with specific attention to the steps involved. For
example, discuss the process of a conversation, showing how effective listening
makes such interaction possible.
 Role-play scenarios that build social skills.
 Adjust instructional strategies to address social skills deficits.
 Clearly state instructional objectives and behavioral expectations throughout each
lesson.
 Simulate “real life” challenges students may encounter at school, home, and in the
community to place social skills in their practical contexts.
 Provide daily social skills instruction.
 Directly teach social skills, such as turn-taking, social distance, reciprocal
conversations, etc.
 Break down social skills into non-verbal and verbal components.
 Explains rules / rationales behind social exchanges.
 Provide opportunities to practice skills in many different environments.
 Work to expand the young child’s repertoire of socially mediated reinforcers (e.g.
tickling, peek-a-boo, chase, etc.).
 Model tolerance and acceptance.
 Provide opportunities for students to assume responsibilities.
 Teach other students to ignore inappropriate attention-seeking behaviors.
 Have other students (who demonstrate appropriate behavior) serve as peer tutors.
 Use social stories.
ACTIVITY:

A child with intellectual disability has been admitted in your class. You have to prepare
instructional
strategies in functional academics for this child. Hypothesize a case or use the same
data on whom you have done your case study and prepare your instructional strategies.

2.4 Assistive Devices, Adaptations, Individualized Education Plan, Person Centere

Plan,
58
Life Skill Education
Individuals with intellectual disability require supports in domains like home
living, community living, lifelong learning, employment, health and safety,
social activities, and protection and advocacy. Use of technology assists them to
become more independent in their lives.
Assistive technology (AT) is a generic term that includes assistive, adaptive, and
rehabilitative devices for people with disabilities. People with intellectual disabilities use
assistive technology to compensate for functional limitations and increase learning,
independence, mobility, communication, environmental control and choice.
Communication: Technology can help individuals to communicate when they are unable
to do so with their voices to communicate. Communication devices are means for
communication for a person who cannot communicate with his or her voice, due to
physical and/or cognitive reasons. Augmentative and alternative communication (ACC)
includes all forms of communication (other than oral speech) that are used to express
thoughts, needs, wants, and ideas. Communication boards are also used for people for
whom non-verbal communication is a large part of their communication. Communication
boards are boards or pages in a book that have pictures and words that a person can point
to in order to express themselves. Computers are used as Communicators, that allow a
person to communicate audibly by pointing to particular images, or typing in a message.
The computer then “speaks” the word, phrase, or sentence aloud. Communicators are often
used by someone who has difficulty with verbal expression. Some people with a
communication disability may use a “speech to speech” to facilitate communication.
Let us see how and when technology is used
Environmental Controls: Devices to control the environment are important to people
with severe or multiple physical disabilities and/or cognitive disabilities, who have limited
ability to move about in their environment or control electrical appliances. Technology
allows a person to control electrical appliances, audio/video equipment such as home
entertainment systems or to do something as basic as lock and unlock doors.
Mobility: Simple manual to sophisticated computer-controlled wheelchairs and mobility
aids such as walkers and canes are available for a person who cannot walk. Technology is
often used to aid finding direction, guiding users to destinations. Computer cueing systems
and robots are also used to guide users with intellectual disabilities.
Education: Technology is used in education to aid communication, support activities of
daily living and to enhance learning. Computer-assisted instruction can help in many
areas, including word recognition, math, spelling and even social skills. Computers are
used as a tool to improve literacy, language, mathematical, organizational, and social skill

59
development. People who cannot operate the keyboard, there are alternative ways to
access computers.
Activities of Daily Living: Technology assists people with disabilities in their day to day
tasks. Support is given through automated and computerized devices to assist in eating
and self care. Audio prompting devices and video based instructional materials are used to
assist a person with memory difficulties to complete a task, following a sequence of steps
for example making a bed or taking medicines or learning functional life skills such as
shopping for grocery, check a bill etc.
Employment: Technology, such as video-assisted training, is being used for job training
and job skill development and to teach complex skills for appropriate job behavior and
social interaction. Computerized prompting systems which use audio cassette recorders
help workers manage their time in scheduling job activities and stay on task.

Sports and Recreation: Adaptations are made in computer games that slows the game
for a user who cannot react as quickly to game moves and decision-making. They provide
opportunities for opportunities for developing cognitive, social and eye-hand coordination
skills. Sports equipment and toys are adapted to compensate for functional limitations.

Thus, we may say that Assistive technology can help people with intellectual disabilities
overcome barriers towards independence and inclusion. Technology can compensate for a
person’s functional limitations. Assistive device should available in all settings like home,
school, work and recreation. There should be consistency in the kind of technology
available, how it is used, and methods for instructing the user on operating the device.
Transitions from one device to another should be made as smooth as possible by building
on and integrating previously learned skills. Technology should be flexible and
customized to accommodate the unique abilities of each person with intellectual
disabilities.

Adaptations
Children with intellectual disability have the capability to learn, however they often learn
at a slower rate than their peers. These students generally do not fit into a specific mold,
rather they have varying strengths and weaknesses throughout all subject areas. As
teachers, we know the best ways students with special needs learn is by having adaptations
and accommodations that can be used for that specific child, to meet their needs, so they
can be successful in the classroom.
Some adaptations are as simple as moving a distractible student to the front of the class or
away from the window or object that distracts. Other modifications may involve changing
the way that material is presented or the way that students respond to show their learning.
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 These Adaptations, accommodations, and modifications are based upon the individual
needs and the personal learning styles and interests of children. Modifications are learning
outcomes, which are substantially different from the prescribed curriculum, and
specifically selected to meet the student’s special needs. These learning outcomes are
detailed on the student’s IEP. Modifications can be made to:

 What a child is taught, and/or

 How a child works at school.

Modifications or accommodations are most often made in the following areas:

Scheduling: giving the student extra time to complete assignments or tests, breaking up
evaluation over several days
Setting: working in a small group, working one-on-one with the teacher
Materials. providing audiotaped lectures or books, giving copies of notes, books on CD
(digital text)
Instruction: reducing the difficulty of assignments, reducing the reading level, using a
student/peer tutor
Student Response: allowing answers to be given orally or dictated, using a word processor
for written work

Adaptation: Adaptations retain the learning outcomes of a prescribed curriculum, and are
provided so the student can challenge the regular learning outcomes. A child on an adapted
program may be well below the standard of the class, but still may be able to minimally meet
the grade level expectations. Class or grade level comparisons in establishing if a student
meets expectations should be avoided. These adaptations can include alternate formats,
instructional strategies and assessment procedures. Adapting the content, methodology,
and/or delivery of instruction are essential elements in special education.
Adaptations include, advanced organizers to assist with following classroom lectures,
extended time for assignments or tests, audio tapes or peer helper to assist with assigned
readings, computers to facilitate completion of written assignments, alternative written
assignments, separate settings for tests and exams, and supervised breaks for tests and exams.

Individualized Educational Plan

An IEP Individualized Education Program is a written document that spells out the child’s
learning needs, the services the school will provide and how progress will be measured. The
61
IEP also helps teachers monitor the student's progress and provides a framework for
communicating information about the student's progress to parents and to the student. The
IEP is updated periodically to record any changes in the student's special education program
and services that are found to be necessary as a result of continuous assessment and
evaluation of the student's achievement of annual goals and learning expectations. Several
people, including parents, are involved in creating the document. The entire process can be a
great way to sort out your child’s strengths and weaknesses. Working on the IEP can help
you figure out ways to help him succeed in school.

Contents of the IEP

The IEP must include certain information about the child and the educational program
designed to meet his or her unique needs. In a nutshell, this information consists of:

Current performance: The IEP must state how the child is currently doing in school (known
as present levels of educational performance). This information usually comes from the
evaluation results such as classroom tests and assignments, individual tests and observations
made by parents, teachers, related service providers, and other school staff. The statement
about "current performance" includes how the child's disability affects his or her involvement
and progress in the general curriculum.

Annual goals: These are goals that the child can accomplish in a year. The goals are broken
down into short-term objectives. Goals may address academic, social or behavioral, physical
and other educational needs. The goals must be measurable, i.e., it must be possible to
measure whether the student has achieved the goals.

Special education and related services: The IEP must list the special education and related
services to be provided to the child. This may include supplementary aids, services,
modifications and supports.

Dates and places: The IEP must state when services will begin, how often they will be
provided, where they will be provided, and how long they will last.

Transition service needs: Begins when the child is age 14 (or younger, if appropriate), the
IEP must address the courses your child needs to take to reach his or her post school goals. A
statement of transition services needs must also be included in each of the child's subsequent
IEPs.

62
Besides the above, the IEP must mention the content that needs to be taught whether
academic or non academic, task analysis of the content to be taught step by step, the method
of teaching through which the content would be taught and the teaching learning aid or
material that would be used in the teaching learning process.

Measuring progress: The IEP must state how the child's progress will be measured and how
parents will be informed of that progress. An IEP should be Specific, Measureable,
Achievable, Relevant and Timebound.

FIVE PHASES OF IEP PROCESS

Gather Information

Set The Direction

Develop IEP

Implement The IEP

Review and update the IEP

An IEP format

Student information
School
Student Name

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Age
Disability
Gender
Class
Mother tongue
Medium of Instruction

Short Time Content Task Method Materials Method of Remarks

Term Period Analysis of
Goal Date teaching evaluation

ACTIVITY:

Prepare an IEP for a child whom you have assessed. List out the strengths and deficit
areas first.

Person Centered

Person-centered planning (PCP) is a set of approaches designed to assist someone to plan

their life and supports. It is used most often as a life planning model to enable individuals
with disabilities or otherwise requiring support to increase their personal self-determination
and improve their own independence. Person Centered Planning is an ongoing problem-
solving process used to help people with disabilities plan for their future.
Person Centered Planning focuses on what is important to a person, capacities and strengths.
It is a process for continual listening and learning, focusing on what are important to someone
now and in the future, and acting on this in alliance with their family and their friends. The
overall aim of person centred planning is “good planning leading to positive changes in
people’s lives and services” (Ritchie et al, 2003). It is flexible and enables to find new
possibilities that are unique to each person.

Person centred planning is based on the social model of disability because it places the
emphasis on transforming the options available to the person, rather than on 'fixing' or

64
changing the person. O’Brien (1989) listed five key areas important in shaping people's
quality of life, and asserting that services should be judged by the extent to which they enable
people to:

 Share ordinary places

 Make choices
 Develop abilities
 Be treated with respect and have a valued social role
 Grow in relationships

The process focuses on discovering the person's gifts, skills and capacities, and on listening
for what is really important to the person ( Snow, O'Brien & Mount). It is based on the values
of human rights, interdependence, choice and social inclusion, and can be designed to enable
people to direct their own services and supports, in a personalized way.

Life Skill Education

Life skills are abilities for adaptive and positive behaviour that enable individuals to deal
effectively with the demands and challenges of everyday life (WHO). It transforms
knowledge into positive behavior. Life skills enable individuals to convert knowledge,
attitudes and values into actual abilities - i.e. "What to do and how to do it".
Life skills include psychosocial competencies and interpersonal skills that help people make
informed decisions, solve problems, think critically and creatively, communicate effectively,
build healthy relationships, empathize with others, and cope with managing their lives in a
healthy and productive manner. Essentially, there are two kinds of skills -those related to
thinking termed as "thinking skills" and skills related to dealing with others termed as "social
skills". What is important is self management ie., managing/coping with feelings, emotions,
stress and resisting peer and family pressure. Life skills education is a structured programme
which initiates participatory learning that aims to enhance positive and adaptive behaviour by
facilitating individuals to develop and practise psycho-social skills and function effectively in
social environment.

For children with intellectual disability, life skills based education is essential to enable them
to cope with difficulties in day-to-day life. Life skills include a wide range of knowledge and
skill interactions believed to be essential for independent living (Brolin, 1989). The three

65
major skill areas that need to be addressed are daily living, personal/social, and occupational
skills.

Skills that are essential for independent adult living include managing personal finances,
managing a house, caring for personal needs, being aware of safety, preparing own
meal/food, personal grooming and caring for clothing, showing sense of responsibility and
engaging in leisure activities.
Personal and Social skills are critical in maintaining friendships and in any kind of vocation.
Lack of appropriate personal and social skills is often the cause of poor employability and
terminations. Individuals with intellectual disability find it challenging to get along with
others and often do not learn by observing. Thus, skill instruction in these areas should
include being aware of self, acquiring self-confidence, learning socially responsible
behavior, maintaining good interpersonal skills, achieving independence, achieving problem
solving skills and communicating with others.

Occupational skills are equally important, without which sustenance in a job becomes
difficult. Between 70% and 80% of students with disabilities are unemployed or
underemployed. Early educational efforts need to be directed towards skill areas
like knowing different vocational options, selecting and training for specific vocation,
exhibiting appropriate work habits and behavior, maintaining employment and exhibiting
sufficient physical energy and skills.

2.7 Vocational Training and Independent Living

Vocational training is used to prepare for a certain vocation or craft. Vocational training is
education only in the type of job or vocation a person wants to pursue, forgoing traditional
academics. Vocational training, is all the training needed for a certain job. The training
generally focuses on providing students with hands-on instruction in a specific vocation, and
generally allows them to forgo the general education courses associated with formal
education.
The Vocational Training aims at imparting training for work readiness, economical self-
sufficiency and independent living in the community. The training provides the students with
an employment experience to improve their work capacity, quality and speed.

Important vocational skills:

66
Vocational training should provide students with a curriculum that prepares them for the
job/vocation that they intend to enter. Broad-based knowledge and skills are good, but for
students with disabilities, specific skills are necessary for survival in the workplace, in the
community and need to be explicitly taught. Some of the skills that is essential for
independent living and vocational skills are as follows:
Academic Skills
 Reading and writing (e.g., sight-word vocabulary, spelling, handwriting, typing, etc.)
 Math (e.g., basic computation, money, measurement)
 Problem solving
 Listening comprehension
 Speaking
 Computer
 Art or music
Communication Skills
 Following and giving directions accurately
 Communicating information
 Understanding and processing information
 Requesting or offering assistance
Social and Interpersonal Skills
 Answering the phone and taking a message
 Making necessary phone calls to employers and other professionals as part of a job
requirement
 Displaying appropriate workplace behavior and etiquette
 Knowing appropriate topics for discussion in the workplace
 Knowing when and when not to socialize on the job
 Learning how to protect themselves from abuse / victimization
 Learning social problem-solving techniques
Occupational and Vocational Skills
There are a number of skills and behaviors that most jobs require. It is important to help
students to acquire skills that will make them productive members in society. Some of these
activities include the following:
 Using a punch or signing the register to clock in time
 Arriving to work on time
 Informing when sick
 Requesting for leave
 Using the appropriate voice tone and volume
 Accepting instructions and corrections

67
  Knowing appropriate interaction with coworkers (i.e., getting along; social problem
solving; making friends; and recognizing personal, professional boundaries)
Some students with mild intellectual disability may be taught to search for appropriate jobs in
order to be independent. These skills include the following:
 Looking for jobs (advertisements in the newspaper and online, Signs of ‘Vacancy’ or
wanted)
 Filling out job applications
 Writing resume and cover letter or seeking help from others to write a letter or resume
 Keeping necessary identification documents (photo ID, birth certificate etc.)
 Learning interviewing skills ( answering questions, body posture and language etc.)

Independent living skills instructions, which are designed to meet the unique needs of
children with intellectual disability, includes:
 Activities that are appropriate to his/her life style so what he/she learns applies to their real
life
 Teaching methods that fit their learning style
 Individualized teaching based on the existing skills
 Opportunities to learn new skills and further develop existing skills

Independent living skills are abilities that are necessary to live safely on one’s own, without
help from caregivers. Independent Living Skills increases self-reliance and self-confidence.
The skills needed for independent living includes activity of daily living skills ( ADL). ADL
skills are the things we normally do on a daily basis, including any daily activity we perform
for self-care. These are tasks that are absolutely necessary for someone to live independently.
Some of the examples of ADL skills are self help eating, grooming,locomotion skills etc.
Some activities are not absolutely necessary for fundamental functioning but are instumental
in enabling an individual to live independently within a community. The skills which aid in
daily living in society are doing housework, maintaining personal hygeine, preparing own
meal, taking medicines, shopping for self which may include groceries, clothes, being able to
contact utility services, such as electrician, plumber, booking gas and cable suppliers. Get
help for basic household emergencies, calling a chemist, taking part in activities for personal
fitness, understanding the dangers of smoking, drugs, alcohol and abusive behaviors seeking
help when required,communicating with others, managing money matters etc.
ACTIVITY

List the skills required under each area for vocational and independent living
68
Academic Skills Communication Social and Interpersonal Occupational and
Skills Skills Vocational Skills

1.
2
3
4
5
6
7
8
9
10

2.8 Study Questions

 Define Intellectual disability. Discuss the different types of intellectual disabilities. Explain w
examples.
 List the characteristics of Intellectual disability. Give examples.
 Discuss the tools of assessment.
 Describe the areas of assessment, Discuss the identification criteria of intellectual disability.
 Define the term adaptive behaviour and explain how it may be assessed and what strategies should
used to improve these skills.
 Discuss how you would develop social skills in a child with intellectual disability.
 Discuss the importance of vocational training and independent living.
2.9 References

 American Psychiatric Association. (2000). Diagnostic and statistical manual of

mental disorders (4th ed., Text rev.). Washington, DC: Author.

 Bray, N. W., Fletcher, K. L., & Turner, L.A. (1997). Cognitive competencies and
strategy use in individuals with mental retardation. In W. E. Maclean, Jr. (Ed.), Ellis’
handbook of mental deficiency, psychological theory and research (pp. 197–217).
Mahwah, NJ: Erlbaum.

 Brolin, D. E. (1989). Life Centered Career Education: A Competency Based

Approach (3rd ed.). Reston, VA: The Council for Exceptional Children.

 Deshler DD, Schumaker JB (1983). Social Skills of Learning Disabled Adolescents:

69
 Characteristics and Intervention. Topics in Learning and Learning Disabilities; 3: 15-
23

 Hawkins BA, Eklund SJ, James DR, Foose AK. Adaptive behavior and cognitive
function of adults with Down syndrome: Modeling change with age. Mental
Retardation. 2003;41:7–28.

 Kronick D (1981). Social Development of Learning Disabled Persons: Examining the

Effects and Treatments of Inadequate Interpersonal Skills. San Francisco: Jossey-Bass
Publishers.
 Mount, B (1992) Person Centred Planning; A Sourcebook of Values, Ideas and
Methods to Encourage Person-Centered Development. New York, Graphic Futures

 Narayan J & Myreddy V (2006) Training module on Mental Retardation,

Secunderabad, NIMH.

 O'Brien J. (1989) What's worth working for? Leadership for Better Quality Human
Services. Syracuse NY. The Center on Human Policy, Syracuse University for the
Research and Training Center on Community Living of University of Minnesota.

 Ritchie, J., Spenser, L. and O‘Connor, W. (2003). Carrying out qualitative analysis. In
Qualitative research practice – a guide for social science students and researchers (ed.
J. Ritchie and J. Lewis), pp. 219-262. Sage Publications, London

 Salvador-Carulla L, Bertelli M.(2008), 'Mental retardation' or 'intellectual disability':

time for a conceptual change. Psychopathology;41(1):10-6. Epub 2007 Oct 18.
Review.

 Salvia, J., Ysseldyke, J.E. & Bolt, S. (2007).Assessment in special and inclusive
education. (10th edition). Boston: Houghton Mifflin Company.

 World Health Organization. ICF: International Classification of Functioning,

Disability and Health.Geneva: World Health Organization; 2001.

 Zins, J. E., Weissberg, R. P., Wang, M. C., & Walberg, H. J. (Eds.). (2004). Building
academic success on social and emotional learning: What does the research say? New
York, NY: Teachers College Press.

 Families Leading Planning 'What is Person

CentredPlanning? http://www.familiesleadingplanning.co.uk/Documents/WHAT%20I
S%20PERSON%20CENTRED%20PLANNING.pdf

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  http://www.ukessays.com/essays/psychology/case-study-mental-
retardation-psychology-essay.php

2.10 Suggested Readings

 Browning , R, E: Teaching Students with Behaviour and Serve Emotional Problems

 Folk, M. C., & Campbell, J. (1978). Teaching functional reading to the TMR.
Education and Training in Mental Retardation, 13, 322326.
 Jampala, M, B: Methods of Teaching Exceptional Children, 2004
 Kumta, N.B.: Mental Retardation: A Multidisciplinary Approach, K.E.M. Hospital,
Bombay
 Lewis J., Ed. D.Reading Instruction and Related Areas with Students Who Have
Mental
Retardation, Multiple Disabilities, or Both University of Northern Colorado,
National Center on Low Incidence Disabilities, and the School of Special Education.
 Moyes, R.A Building Sensory Friendly Classrooms to Support Children with
Challenging Behaviors: Implementing Data Driven Strategies, 2010
 Pidikiti, S: A study on “The Families Having Children with Mental Retardation ”,
1998
 Pierangelo, R. & Giuliani G.A.Transition services in Special Education, Allyn&
Bacon, 2003
 Reddy G.L. & Rama, R: Education of children with special needs, New Delhi -
Discovery Pub.
2000

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 PAPER B8 : Introduction to Neuro Developmental Disabilities

(LD, MR(ID), ASD)

Autism Spectrum Disorder: Nature, Needs and Unit

Intervention
Dr Shyamala Dalvi 3

INDEX
3.1 Introduction
3.2 Learning Objectives
3.3 Definition, Types and Characteristics
3.4 Tools and Areas of Assessment
3.5 Instructional Approaches
3.6 Teaching Methods
3.7 Vocational Training and Career Opportunities
3.8 Study Questions
3.9 References
3.10 Suggested Readings

72
3.1 INTRODUCTION

The paper or course deals with Neuro developmental disabilities. Neurodevelopmental

disorders are impairments of the growth and development of the brain or central nervous
system or Neurodevelopmental disorder is known as disruption in growth and development of
the brain or central nervous system .
This Unit deals with autism spectrum disorder. Let’s look at the following case study and
answer a few questions.
Sagar is in Sr.Kg class. He has difficulty communicating with his peers and doesn’t know
how to respond when teacher or his peers speak to him. Though he is unable to initiate
conversation he is fascinated with cars and is able to tell all the models of cars. During the
day Sagar becomes upset and loses his temper when there is a change in the routine or the
teacher wants him to participate in the class activities. He also keeps running back and forth
with his hands covering his ears anytime he feels like in the classroom.

So teachers what do you think !!! Answer these questions

o What difficulties does Sagar have?
o Does he have speech?
o What upsets him ? Why do you think so?
o Why does he keep running ?

3.2 Objectives
After completing the unit the student-teachers will be able to
• Explain the definition and characteristics of Autism spectrum disorder
• Describe the tools and areas of assessment to identify students with autism spectrum
disorder
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 Discuss and apply appropriate intervention strategies to enhance learning.
• Discuss and elaborate on relevant career opportunities and vocational training

Very different thoughts right!! Lets read on to understand this disability ..

3.3 DEFINITION, TYPES AND CHARACTERISTICS
Autism Spectrum Disorder (ASD) or autism, as is commonly known, is a general term for a
group of complex disorders of brain development like difficulties in social interaction, verbal
and nonverbal communication and repetitive behaviours. Autism is a spectrum disorder
because the symptom ranges from mild learning and social disability to a more complex
condition with multiple difficulties along with various behavioural issues. Children with
autism do not lack skills but their skills do not develop age appropriately and are also uneven.
For example, a 4 year child with autism may have his/her speech development like that of a
2-year old child, gross motor skills development may resemble like an 4 year, fine motor
skills of a 3-year and self-help skills of a 3-year old child.
The word "autism," which has been in use for about 100 years, comes from the Greek word
"autos," meaning "self." The term describes conditions in which a person is removed from
social interaction -- hence, an isolated self.
Eugen Bleuler, a Swiss psychiatrist, was the first person to use the term. He started using it
around 1911 to refer to one group of symptoms of schizophrenia.
In the 1940s, researchers in the United States began to use the term "autism" to describe
children with emotional or social problems. Leo Kanner, a doctor from Johns Hopkins
University, used it to describe the withdrawn behavior of several children he studied. At
about the same time, Hans Asperger, a scientist in Germany, identified a similar condition
that’s now called Asperger’s syndrome infact now falls under social communication disorder.
The definition of Autism spectrum disorder has changed over time. The definition or the
diagnostic criteria that is followed across the world is a standard set of criteria used to
classify all behavioural and psychological disorders which is called the Diagnostic and
Statistical Manual for Mental Disorders (DSM). This unit describes ASD as per the DSM V ,
which is quite different from DSM IV.
Lets read the definitions and see what emerges--
Autism is a neurodevelopmental disorder characterized by impaired social interaction,
verbal and non-verbal communication, and restricted and repetitive behavior.

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Autism spectrum disorder is a serious neurodevelopmental disorder that impairs a child's
ability to communicate and interact with others. It also includes restricted repetitive
behaviors, interests and activities - Mayo Cliniic
According to National Autistic Society- Autism is a lifelong developmental disability that
affects how a person communicates with, and relates to, other people. It also affects how they
make sense of the world around them.
It is a spectrum condition, which means that, while all people with autism share certain
difficulties, their condition will affect them in different ways. Some people with autism are
able to live relatively independent lives but others may have accompanying learning
disabilities and need a lifetime of specialist support. People with autism may also experience
over- or under-sensitivity to sounds, touch, tastes, smells, light or colours.
According to American Psychiatric Association's Diagnosis and Statistical Manual of
Mental Disorders (DSM-5) - Autism spectrum disorder (ASD) is defined as a single disorder
that includes disorders that were previously considered separate — autism, Asperger's
syndrome, childhood disintegrative disorder and pervasive developmental disorder not
otherwise specified.
The term "spectrum" in autism spectrum disorder refers to the wide range of symptoms and
severity.
After reading through these definitions we can say that the common areas of difficulty are in
the following –
 Persistent deficits in social communication and social interaction across multiple contexts

 Restricted, repetitive patterns of behavior, interests, or activities

 Symptoms must be present in the early developmental period (but may not become fully
manifest until social demands exceed limited capacities, or may be masked by learned
strategies in later life).
 Symptoms cause clinically significant impairment in social, occupational, or other
important areas of current functioning.

 These disturbances are not better explained by intellectual disability (intellectual

developmental disorder) or global developmental delay.

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Since the change in diagnosis criteria, we need to also know a bit about social
communication disorder because the diagnosis of Aspergers syndrome according to DSM
IV now gets covered under DSM V.

Social Communication Disorder –

SCD is characterized by a persistent difficulty with verbal and nonverbal communication that
cannot be explained by low cognitive ability. Symptoms include difficulty in the acquisition
and use of spoken and written language as well as problems with inappropriate responses in
conversation. The disorder limits effective communication, social relationships, academic
achievement, or occupational performance.

Symptoms must be present in early childhood even if they are not recognized until later when
speech, language, or communication demands exceed abilities

Children with SCD have difficulty with pragmatics—the unspoken, subtle rules of spoken
language that allow people to connect. They don’t always understand the give-and-take of a
conversation. Some of them monopolize conversations or interrupt a lot. Others hesitate to
talk at all. It’s not because these children are rude or their parents haven’t taught them
manners. It is difficult for children with SCD to learn how to use language in socially
appropriate ways .

Wow that’s quite a bit isn’t it. It is now time to think. Read about Autism in DSM IV and
in the following table put down the difference-

S.NO Areas DSM IV DSMV

1 Definition

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 2 Types

3 Diagnostic

Criteria

4 Age of Onset

Characteristics of children with ASD

Autism is characterized by marked difficulties in behaviour, social interaction,
communication and sensory sensitivities. Some of these characteristics are common among
people with autism; others are typical of the disability but not necessarily exhibited by all
people on the autism spectrum.
1. Social skills

Basic social interaction can be difficult for children with autism spectrum disorders.
2. Speech and language

Problems with speech and language comprehension are a sure sign of the autism spectrum
disorder.
3. Restricted behavior and play

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 Children with autism spectrum disorders are often restricted, rigid, and even obsessive in
their behaviors, activities, and interests
4. Sensory Issues
Children with autism may have sensory issues which interfere with their functioning in
everyday life.
5. Exceptional Skills
Some children with autism have exceptional skills, such as great memory, calendar skills, or
information about countries their capitals, presidents, and so on; or they read way beyond
their age
Let’s see each of these areas in more details.. but before that
It is important to remember that one child with autism will be completely different from
another child with autism. So one child may not speak at all, be very withdrawn, and have
few self-help skills, another child may not speak but be completely able to take care of his
own needs, and a third may speak, attend the local school, but have great difficulties in
interacting with other children. That is why autism is called a spectrum disorder, because
children can be as different from each other as the colours of the rainbow!

1. Social Skills –
• Unusual or inappropriate body language, gestures, and facial expressions

• Lack of interest in other people or in sharing interests or achievements

• Unlikely to approach others or to pursue social interaction; comes across as aloof and
detached; prefers to be alone.

• Difficulty understanding other people’s feelings, reactions, and nonverbal cues.

• Resistance to being touched.

• Difficulty or failure to make friends with children the same age.

2. Speech & Language Skills

• Delay in learning how to speak (after the age of 2) or doesn’t talk at all.

• Speaking in an abnormal tone of voice, or with an odd rhythm or pitch.

• Repeating words or phrases over and over without communicative intent.

• Trouble starting a conversation or keeping it going.

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 • Difficulty communicating needs or desires.

• Doesn’t understand simple statements or questions.

• Taking what is said too literally, missing humor, irony, and sarcasm

Reading the above two sections makes us realise how difficult it must be for children
with ASD to be able to manage in this social world. We live in a social world. Everything
we do, whether buying an ice-cream, borrowing a pencil, making a request, asking for help
from a classmate, all require us to be able to interact with others. Neurotypical children do
this effortlessly. ‘How do I draw the busy shopkeeper‘s attention to ask for the ice-cream I
want’; ‘how loud do I speak when teacher is teaching and I have to ask the girl next to me for
a pencil’; ‘what tone do I use when asking a classmate for help’; all of these are skills that we
have intuitively. We do not have to ‘learn’ them. Yet children with autism, often struggle
with these social communication skills. A lot of this comes from our ability to understand
how others think and feel. To know that since teacher is teaching, I whisper, ―Atul, please
lend me a pencil‖ and not speak in my usual loud voice cause teacher will not want to be
interrupted while teaching.
The child with autism will have a very literal understanding of communication. So when a
teacher tells a student who is drawing pictures during math class, ― ‘Oh yes!! draw a few
more pictures. No need to do your math work’, we know that the teacher is being sarcastic
and wants us to stop drawing and start computing. But the child with autism with his
difficulty in understanding what the teacher is really thinking and feeling, might interpret the
words to mean that he has permission to continue with his drawing and ignore the math class.
As our social understanding develops we know when to stay sitting, when it is okay to move
around, or interrupt a conversation or how to respond if someone calls our name.
Additionally, without being taught, we learn to vary our behaviour with different people. So
we change our behaviour based on whether I am speaking to my mother, or my teacher, or
my friend. We also change our behaviour according to different social situations.
3. Restricted behavior and play –
Play is an important part of development. Accepted knowledge says that all children would
naturally gravitate to the playground. But children with autism ‗play‘ in ways that seem
unusual to others: flapping, spinning, rocking, and unwilling to take turns. They have
difficulty in joining in play that requires a great deal of social give and take. In fact, the
school playground, a fluid and unstructured place during recess, is a place where children

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with autism have the greatest difficulty. This is the place where the most teasing and bullying
takes place leading to most students with autism preferring to stay away. Some behaviours
seen in children with ASD -
 Repetitive body movements (hand flapping, rocking, spinning); moving constantly.
 Obsessive attachment to unusual objects (rubber bands, keys, light switches).
 Preoccupation with a specific topic of interest, often involving numbers or symbols
(maps, license plates, sports statistics).
 A strong need for sameness, order, and routines (e.g. lines up toys, follows a rigid
schedule). Gets upset by change in their routine or environment.
 Clumsiness, abnormal posture, or odd ways of moving.
 Fascinated by spinning objects, moving pieces, or parts of toys (e.g. spinning the
wheels on a race car, instead of playing with the whole car).

4. Sensory Issues –
Individuals with ASDs have sensory processing deficits which can lead to over stimulation,
stress or in some instances extreme fear. They may be hypo or hypersensitive to any of the
senses. That means what a neurotypical child may consider as a warm hug , children with
ASD who are hypersensitive may feel it is harsh squeezing. Many children with an ASD
find human touch to be uncomfortable and human interaction to be stressful because of
language and perception issues.
Now … all the characteristics have been discussed. So read them well and in the space
given below put down what you have understood .

Areas of deficit Examples

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3.4 TOOLS AND AREAS OF ASSESSMENT
Assessment is the systematic process of collecting information about the child , his past and
current levels of performance, his strengths and weakness, in order to help make educational
decisions about his future.
Proper assessment is important, because basis that , the teaching methods and the kind of help
the child will receive will be decided or planned.
Assessment of children with ASD has to be broad based because the symptoms may overlap
with other disabilities. The areas that are assessed include cognition (knowledge and
understanding), communication (language and non-verbal), social, behavioural and adaptive
skills.
The team of specialists involved in diagnosing a child may include:
 Child psychologists
 Child psychiatrists
 Speech pathologists

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 Developmental pediatricians
 Pediatric neurologists
 Audiologists
 Physical therapists
 Special education teachers

Diagnosing an autism spectrum disorder is not a brief process. There is no single medical test
that can diagnose it definitively; instead, in order to accurately pinpoint the child's problem,
multiple evaluations and tests are necessary.
The information is collected through-
Parent interview – In the first phase of the diagnostic evaluation, the background
information about the child’s medical, developmental, and behavioral history is collected.
Rating scales, checklists, and/or inventories completed by the family member(s)/caregiver,
teacher, and/or individual. Findings from multiple sources (e.g., family vs. teacher vs. self-
report) may be compared to obtain a comprehensive profile of communication skills. When
possible, parent checklists should be provided in their native language to obtain the most
accurate information
Medical exam – The medical evaluation includes a general physical, a neurological exam,
lab tests, and genetic testing. A full screening to determine the cause of his or her
developmental problems and to identify any co-existing conditions.
Hearing test – Since hearing problems can result in social and language delays, they need to
be excluded before an autism spectrum disorder can be diagnosed. A formal audiological
assessment where the child is tested for any hearing impairments, as well as any other hearing
issues or sound sensitivities that sometimes co-occur with autism is done.
Observation – Developmental specialists will observe the child in a variety of settings to
look for unusual behaviours associated with the autism spectrum disorders. The child playing
or interacting with other people is observed.
Depending on the symptoms and their severity, the diagnostic assessment may also include
speech, intelligence, social, sensory processing, and motor skills testing. These tests can be
helpful not only in diagnosing autism, but also for determining what type of intervention the
child needs:
Speech and language evaluation – A speech therapist evaluates the child's speech and
communication abilities for signs of autism, as well as looking for any indicators of specific
language impairments or disorders.
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Cognitive testing – The child may be given a standardized intelligence test or an informal
cognitive assessment. Cognitive testing can help differentiate autism from other disabilities.
Adaptive functioning assessment –Evaluation for their ability to function, problem-solve,
and adapt in real life situations is also an important area. This may include testing social,
nonverbal, and verbal skills, as well as the ability to perform daily tasks such as dressing and
feeding self.
Sensory-motor evaluation – Since sensory integration dysfunction often co-occurs with
autism, and can even be confused with it, an occupational therapist assesses fine motor, gross
motor, and sensory processing skills.
Assessment will result in
 Data that contribute to the diagnosis of ASD;

 Description of the characteristics and severity of communication-related symptoms;

 Recommendations for intervention, priorities and goals, and supports;

 Referral to other professionals for further testing if other disorders/conditions are

suspected or for additional data to confirm the diagnosis of ASD.

Wow!!!! So much about assessment. Lets do a quick check

You have read the assessment

and the area of assessment. As a
special educator. What aspects
will you check? Make a checklist
of 20 items to screen out a child
with ASD. The child is three years old

Items for assessment Response Comment

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6

10

11

12

13

14

15

16

17

18

19

20

So now, you all are aware of what is ASD and how does one assess them and also what areas we
need to look at.

Lets now move on to how does one teach the kids. There are two terms that we must familiarize
ourselves with – One is teaching approach and the other is teaching method. Teaching approaches
are a set of principles, beliefs, or ideas about the nature of learning which is translated into the
classroom and teaching methods are a systematic way of doing something. It implies an orderly
logical arrangement of steps. It is more procedural.

3.5 Instructional Approaches

There are many different opinions about how best to help children with autism. But generally
there are two general approaches to instruction:
Behavioural Approach - They are built on the premise that most human behaviour is learned
through the interaction between an individual and his or her environment. Behavioural
interventions aim to teach and increase targeted positive behaviours and reduce or eliminate
inappropriate or non-adaptive behaviours. The adult will systematically encourage certain
responses from the child and then respond in planned ways designed to either increase or
84
decrease certain behaviors. Behavioral approaches also carefully measure progress and
modify strategies based on the data collected.
Developmental Approach-
Developmental approaches are often more spontaneous in the way that adults will respond to
the child, and the child’s behavior. For children functioning at early stages of development,
emphasis is put on encouraging the child to develop his own ideas and to engage in social
interactions in reciprocal ways. In many of these approaches, the focus is on thinking about
the ‘whole child’ including the child’s regulatory and sensory challenges. The assumption
that the child is an active learner;
Instruction in naturally occurring environments;
Creating motivating contexts and routines;
Building on the child’s interests;
Development of goals based on child’s current level of development as well as his or her
individual strengths and needs;
Acknowledgement of all attempts to communicate; and
The recognition that “learning is transactional in nature, meaning that it addresses the
interdependent and reciprocal nature among the child with ASD social environment, and the
interaction between the individual and the environment over time”.
Advocates of these approaches assume that individual development and learning are complex
dynamic processes that take place within a social context. Relationships are not just a desired
developmental outcome; they are the means through which the growing child learns to
communicate, regulate his or her emotions, and establish a foundation for complex thinking
and increasingly complex social interaction. Developmental relationship-based approaches
focus on enhancing relationships between caregivers and children in ways that support the
child’s movement through typical levels of development.
3.6 - Teaching Methods
There are many educational methods and strategies available to families and schools today.
We must encourage the families to look at all of the methods and, along with the child’s
teacher or other professionals, decide on what method , or combination of methods best fit
the child and the family. While there are no conclusive studies showing that one method is
better than another, we do know that the most affective are intensive and implemented as
early as possible. Some teaching methods based on the approaches are :
 Discrete Trial Instruction

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  Floor time

 Pivotal Response Training

 TEACCH Method

It is important that families and educators identify specific skills that they would like to work
on, and continually monitor instruction to see if progress is being made. If progress is not
being made, it is critical that the team seeks to understand why this may be, and how
instruction might change to better address the child’s needs.
We now give examples of the first three approaches listed above (discrete trial instruction;
activity-based instruction; developmental intervention) to demonstrate that the same skill can
be taught in a variety of ways. The skill that is exemplified below is “imitating an adult.”
Discrete Trial Instruction (DTI)
The "Discrete Trial" method is a frequently used intervention based on Applied Behavior
Analysis (ABA). It is a method of teaching in simplified and structured steps. Instead of
teaching an entire skill in one go, the skill is broken down and “built-up” using discrete trials
that teach each step one at a time. Here, specific skills are taught to a child in a one-on-one
structured learning setting. Usually, a child is given a specific instruction by his teacher, and
the child responds. The child is either rewarded for a correct response, or provided with a
correction for an incorrect response.
Eg - Read the example to see how "Imitation" is taught by the teacher.
Reena sits across from Suraj, making sure he is looking at her and paying attention. She says, "do this" as she
touches her own nose. If Suraj imitates the action by touching his own nose, Reena will praise him ("Good job,
Suraj!") and give him a reward such as a raisin, which he loves. If does not touch his nose, Reena will "prompt"
him to touch his nose by taking his hand and helping him touch his nose. Reena may repeat this sequence for a
total of 10 times in a row each day, until Suraj can touch his nose consistently when asked to "do this."

Floor Time
Its premise is that adults can help children expand their circles of communication by meeting
them at their developmental level and building on their strengths.
Floortime Method, challenges children with autism to push themselves to their full potential.
It develops “who they are,” rather than “what their diagnosis says. Floortime encourages
parents to engage children literally at their level – by getting on the floor to play. In
Floortime, therapists and parents engage children through the activities each child enjoys.
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They enter the child's games. They follow the child's lead. Therapists teach parents how to
direct their children into increasingly complex interactions.
Pivotal Response Training –
Pivotal Response Treatment (PRT) is based on behavioral treatments for autism. Derived
from applied behavioral analysis (ABA), it is play based and child initiated. Its goals include
the development of communication, language and positive social behaviors and relief from
disruptive self-stimulatory behaviors.
Rather than target individual behaviors, the PRT therapist targets “pivotal”(focused , central)
areas of a child's development. These include motivation, response to multiple cues, self-
management and the initiation of social interactions. The philosophy is that, by targeting
these critical areas, PRT will produce broad improvements across other areas of sociability,
communication, behavior and academic skill building.
Motivation strategies are an important part of the PRT approach. These emphasize “natural”
reinforcement. For example, if a child makes a meaningful attempt to request, say, a stuffed
animal, the reward is the stuffed animal – not a candy or other unrelated reward. Though used
primarily with preschool and elementary school learners, PRT can also help adolescents and
young adults.
TEACCH: TEACCH is a structured teaching method that provides an organized school
environment with a strict schedule, visual teaching methods and short, clear instructions.
TEACCH programs can easily be personalized.
Sensory Integration Therapy: Therapists use sensory integration therapy to help children
with autism who have repetitive behavior or sensory issues. The therapy can help some
children develop language skills, especially with vocal exercises.
Children with autism who may be in your class have a different learning style. This is
because they view the world differently. They respond to the stimuli from the environment
differently than those without autism. The class room might cause at times a sensory
overload. The social nature of a school or class room may make it difficult for a person with
autism to function as he / she will have difficulty with social communication. The person
with autism is predominantly a strong visual & experiential learner.
Remember all visuals and activities you use to support your teaching will not only help your
student with autism but all your students.
The child with autism has his/her own strengths, which can prove beneficial for learning as
well as participation in the school activities.

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Some methods that can be used in school settings are –

A child with Autism usually has:

 Good visual memory

 Good long term memory
 Ability to discriminate between pictures
 Ability to match similar objects, pictures etc.
 Ability to identify particular visuals
 Some scan very quickly (For reading & looking at any visuals)
 Some may look at any presented materials for short time and then look away.
 Most CWA learn quickly through experience (eg. number are understood better if CAW
uses number in the environment using objects , acting out words like ―run‖, ―quick‖, ―
slow‖
 Routines that have a concrete function like snack time , getting ready for going home.
 Many are independent in everyday activities like eating, computer games etc. But have fine
motor and motor coordination issues like buttoning, tying shoe laces , and sports .
 They like routine and predictability and need to be told beforehand of any change of routine.
 Structure and organization increases the progress.

So ‘how do I as a special educator help the students in a regular class’?? Must be the question
on your minds, because all the above methods are extremely structured and need to be carried
out on a one-to-one basis . Some methods are
• Use visual timetables and visual cues to indicate changes.
• Send home the timetable as soon as possible.
• Use photographs for example, new teachers, students in class or playground.
• Ensure the student has strategies to stay calm. A quiet area, walkman with calming
music and favourite book or activity.
• ‘Buddy System’ who helps the student find the next class
• Provide structured and predictable environment
• Note aspects of the tasks and activities that create frustration
• Plan for transitions and prepare the student for change
And finally remember the following because to make the interventions work, team work is
essential!!

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 When developing an educational approach for the child with the evaluation
team, here are some things to keep in mind as a special educator
 Begin intervention as soon as possible.
 Develop an intervention that is focused and on-going.
 Engage the child in activities with others as frequently as possible.
 Develop an individualized program that meets the child's specific needs.
 Collaborate closely with child's teachers and therapists.
 Encourage all professionals to sit down together as a collaborative team to develop
instructional programs, monitor progress, and modify as needed.
 Focus on developing your child's communication skills, social skills, and
relationships.
 Create predictable environments, and use visual cues to help understand school and
family routines.
 Work with your child's teachers and therapists to ensure the effectiveness of his
educational program and make changes as needed to ensure continued growth and
progress.

3. 7 Vocational Training And Career Opportunities

It has been known for decades that individuals with autism spectrum disorders (ASD),
including those with significant impairment or who have behaviors that others find
challenging, can work when they are given appropriate supports. Individuals with ASD will
also benefit from employment. Benefits include improved emotional state, greater financial
gain, decreased anxiety, greater self-esteem, and greater independence. Nonetheless,
employment outcomes for individuals with ASD have traditionally been poor . Even those
who do find work are often underemployed or do not hold onto jobs for a long period of time.
Just because there are not much records for individuals with ASD doesn’t mean that most
cannot work. People with ASD can work when we can help them find the right job match and
when appropriate and individualized supports are built in. It is important to recognize that
each person with ASD is unique. Even those who share a common specific diagnosis differ
dramatically from one another in their skills, interests, motivation, ability to communicate,
behavior, and social ability. In itself, the knowledge that an individual has an ASD diagnosis
is of little use to a professional helping the person find and keep a satisfying job. Instead, the
employment specialist must develop a thorough understanding of the individual’s unique
characteristics, learning style, strengths, and, most importantly, interests .
Achieving a Good Job Match: Considerations For Placement Planning and Assessment

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The most important consideration in helping an individual with ASD find a job is the job
match. When helping a person with ASD find a good job match, three broad areas must be
considered:
1. The interests and skills of the person with ASD;
2. The individual with ASD’s learning style; and
3. The environmental demands on the worker with ASD—including communication,
sensory, social, and organizational.
It is imperative to match the job to the unique set of strengths, interests, and passions that the
person with ASD brings to the situation.
For example - Jay loves to travel in vehicles and would spend most of his day in a car if he
could. His team is trying either to carve out a delivery position for him with an existing
company or help him start his own delivery business.
Reena is very interested in women’s and baby clothes. She works in a department store re-
shelving and re-hanging clothes left in the changing rooms. Alicia hangs the clothes
according to size using the color codes on the tags.
Shama with autism was very limited in her communication and as having a history of
challenging behavior. However, she also is very meticulous and detailed oriented. This helps
her in being extremely efficient in her work shelving books in a library.
Even Dr. Temple Grandin as a child , became obsessed with cattle handling equipment at her
aunt’s ranch. She was encouraged to pursue her interests and went on to become one of the
world’s leading experts on the design of cattle handling facilities.
It is not essential that a job initially be a perfect match with the person’s skills. For example,
a person with ASD might find a job (s)he is interested in but not have all the necessary skills
to perform the job independently. Persons with ASD can learn new skills throughout their
lives. Additionally, the skills that a person can independently demonstrate currently tells us
little about what that person can do with appropriate supports. The discrepancies between the
demands of the job and the person’s existing skills must be assessed so that those
discrepancies might be reduced through teaching or accommodation. Assessment needs to be
a dynamic process that looks at how a person performs in response to various supports over
time.
An important aspect of determining appropriate supports is assessing the individual with
ASD’s learning style. For example, many—but not all—individuals with ASD are visual
learners and respond well to visual prompts. Many do well with picture or written cues.
Others may respond well to a combination of visual and verbal prompts. Asking a person

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with ASD to imitate a task performed by a co-worker may be the best strategy in some cases.
Another common strategy is to provide the employee with an example of a completed
product. Often parents, family members, former teachers and others who know a person well
have a good understanding of a person’s learning style.
It is also important to assess the work environment to determine the match between the
communication, sensory, social, and organizational demands of the job and the needs of the
individual with ASD. Again, the match between the demands of the environment and the
needs of the individual does not have to be perfect. It is possible to introduce
accommodations and instruction that will help create a better fit between the employee with
ASD and the environment.
After some potentially good job matches for an individual with ASD, based on his or her
unique skills and interests, have been identified, it is important to examine in more detail the
communication, sensory, social, and organizational demands of the job. In each of these four
categories, the following sections will address:
 Possible issues that could interfere with success,
 The match between the work environment and the person’s needs, and
 Possible supports and accommodations.
 What should be assessed?
 Interests and strengths (often assessed through person-centered planning)
 Specific work skills
 Learning style
 Communication skills and required supports, including need for augmentative or
alternative communication (AAC)
 Social interaction and behavior and effective supports
 Sensory issues—need for certain sensory inputs to relax or need to avoid certain stimuli
 Need for structure and predictability and effective supports for the individual
 The physical and social environment of a potential workplace
 Who Can Help?
 The individual with ASD
 Family members or friends who know the person well
 Former teachers
 Residential support staff
 Occupational Therapists (OT) and Physical Therapists (PT), especially regarding motor
and sensory considerations
 Speech therapists, for communication assessement or to help design AAC
 Potential employers or co-workers

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So we can see that for having a or planning a career or choosing a vocation can be done, if we
are able to identify all the areas effectively, also train the young adults preservice and support
them in service..
3.8 Summary
Finally students we have come to the end of this module/paper. I am sure you have got a
good understanding about autism . We have started with what is autism and the definition of
autism, we have also seen a comparison between DSM IV and DSM V diagnosis. We moved
on to characteristics, as well as assessment. This was followed by the various approaches and
methods of handling kids with autism. Finally we ended the module with how to lead them
towards careers and vocation.

3.9 Please answer the following questions ( Study Questions)

Q1 . Write down the definition of ASD.
Q2 What is the difference between ASD and Social communication disorder?
Q3. List down the characteristics of ASD.
Q4 Compare behavioural and developmental approach of handling kids with ASD.
Q5 In an inclusive classroom what kind of adaptations can you use to help the students.

3.10 References
 Pierangelo, R., & Giuliani G.A. (2003). Transition services in Special Education,
Allyn & Bacon, London.
• Smith, D.D. (2003). Introduction to Special Education Teaching in an Age of
opportunity. Allyn & Bacon, Boston.
http://www.mayoclinic.org/diseases-conditions/autism-spectrum-
disorder/basics/definition/con-20021148
http://www.autism.org.uk/about-autism/introduction/what-is-autism.aspx
http://www.pbs.org/parents/inclusivecommunities/autism4.html
http://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935303&section=Assessment#Ea
rly_Indicators
http://muautismrepetitiveplaypatterns.blogspot.in/
http://www.helpguide.org/articles/autism/autism-spectrum-disorders.htm
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http://www.communityinclusion.org/article.php?article_id=266

3.11 Suggested Readings

 Myles, B.S., & Simpson, R.L. (2003). Asperger’s syndrome: A guide for educators and
parents. PRO-ED, Texas.
• Reddy G.L., & Rama, R. (2000). Education of Children with Special Needs.
Discovery Pub, New Delhi.
• Siegel, B. (1996). The World of Autistic Child. Oxford University Press, New York. .
• Simpson, R. L., & Myles, B, S. (2008). Educating Children and Youth with Autism:
Strategies for Effective Practice. Pro Ed. Texas

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 PAPER B8 : Introduction to Neuro Developmental Disabilities

(LD, MR(ID), ASD)

Intellectual Disability :Nature, Needs and

Intervention Unit
Dr Preeti Verma
2
INDEX

2.1 Introduction
2.2 Learning Objectives
2.3 Definition, Types and Characteristics
2.4 Tools and Areas of Assessment
2.5 Strategies for Functional Academics and Social Skills
2.6 Assistive Devices, Adaptations, Individualized Education Plan, Person Centered Plan, Life Skill
Education
2.7 Vocational Training and Independent Living
2.8 Study Questions
2.9 References
2.10 Suggested Readings

2.1 Introduction

If you look around your surrounding, you will realize that not all people function the same way as you do.
Some may be quick, some may be slow, and some may not be able to see or hear or may not be able to move
around like you. You may have heard them as being called blind, deaf or physically challenged. You may
have heard them being labeled as ‘disabled’. You may also have seen people who can't mentally function at
normal level like most of us. They may not be able to control their body movement, their intelligence, social
interaction as well as language since the birth or early childhood. In this case, we are referring them as mental
retardation or intellectual disability. A disability is any continuing condition that restricts everyday
activities. It is an impairment that limits functioning.

An intellectual disability (ID, formerly mental retardation) is a type of disability that results from limited
mental capacity. The cause of Intellectual disability are many. These include genetics, brain injury, and certain
medical conditions. There is no treatment for intellectual disability as it is not a disorder. Instead, individuals
with ID are provided additional supports which help people to enjoy a satisfying life despite their disability.

People with limited mental abilities struggle to develop the skills needed for independent living. Without these
skills, it is hard to live in a safe and socially responsible manner. Children with ID’s usually develop more
slowly than their peers. They usually sit, walk, and talk much later than other children. This delayed
development means they do not act their age. Limited mental capacity makes learning very difficult. Therefore,
learning new information and skills is challenging. It is also difficult to apply information in a practical and
functional manner. People with ID have trouble grasping complex and abstract concepts. This affects their
ability to develop important social skills. This is because social skills are complex and abstract.

IDs can coexist with psychiatric disorders. Therefore, no single set of symptoms can completely describe an ID.
Nonetheless, you will find it useful to discuss some common characteristics. The management of ID requires
early diagnosis and intervention, along with health care and appropriate supports lessens disability and
optimizes progress in functioning.

Providing services to help individuals with intellectual disabilities has led to a new understanding of how we
define the term. After the initial diagnosis is made, we look at a person’s strengths and weaknesses. We also
look at how much support or help the person needs to get along at home, in school, and in the community. This
approach gives a realistic picture of each individual. It also recognizes that the “picture” can change. As the
person grows and learns, his or her ability to get along in the world grows as well.

2.2 Learning Objectives

 Explain the characteristics and types of Intellectual disability.

 Describe the tools, areas of assessment
 Prepare and apply intervention strategies functional academics and social skills.
 Describe assistive devices and adaptations,
 Explain individualized education plan, person centered plan and life skill education

 Explain the characteristics and types of Autism Spectrum Disorder.
 Describe the tools, areas of assessment and apply intervention strategies.
 Discuss the importance of vocational training and independent living

2.3 Definition, Types and Characteristics
Let us first learn what Intellectual Disability is. The term “Intellectual Disability” (ID) has widely replaced the
term Mental Retardation (MR) for policy, administrative and legislative purposes in most countries. Mental
retardation is a developmental disorder characterized by significant, concurrent deficits in general
intelligence and adaptive behaviours. This is included under the category of psychiatric disorders in the
international classification. It is a lifelong condition, associated with a wide range of sensori-motor problems,
psychiatric and behavioural disorders (Salvador-Carulla & Bertelli, 2008).

Henceforth we would be using the term ID instead of MR. However in some definitions and references you will
still read the term MR. The question as to whether IDD are a disability or a health condition remains a hotly
debated one, with two co-existing approaches used as a basis for new conceptualizations of this entity. Based on
a health condition perspective, MR is currently coded as a disorder in ICD (category F.70). At the same time,
impairments in intellectual functions that are central components of IDD can be classified within WHO’s
International Classification of Functioning, Disability and Health (ICF) and therefore seen as a part of disability.

Intellectual disability (ID) is a neurodevelopmental disorder with multiple etiologies that is characterized by
deficits in intellectual and adaptive functioning presenting before 18 years of age.The adaptive deficits are due to
intellectual impairment and affect social, conceptual or practical functioning, or a combination of these, in one or
more settings (eg, school, home). ID is highly heterogeneous and encompasses a broad spectrum of functioning,
disability, and strengths.
ID exists within a spectrum of severity that ranges from mild to profound. Standardized intelligence quotient (IQ)
testing is no longer used to classify the severity of impairment in ID. The severity of ID is defined according to
the level of support needed to address impaired adaptive functioning. The cause of ID, the presence of
comorbidities, and the severity of impairment, affect when and how a child presents with ID. Children with mild
ID present later and have better clinical functioning than those with more severe ID.

Let us study few definitions of ID. Intellectual disability is a disability that occurs before age 18. People with this
disability experience significant limitations in two main areas: 1) intellectual functioning and 2) adaptive
behavior (the use of everyday social and practical skills) (AAIDD, 2010).

The ICF is a classification of health and health-related conditions for children and adults that was developed by
World Health Organization (WHO) and published in 2001. The WHO would like the ICF classification system to
be considered a partner to the ICD (International Classification of Diseases and Related Health Problems) system
used in the U.S. and abroad. Whereas the ICD classifies disease, the ICF looks at functioning. Therefore, the use
of the two together would provide a more comprehensive picture of the health of persons and populations.
The diagnostic and statistical manual of mental disorders (DSM-IV-TR), published by American Psychiatric
Association, mentions that three essential components of feature of mental retardation to diagnose a person
with mental retardation (American Psychiatric Association [DSM-IV-TR], 2000). The three diagnostic criteria
for Mental Retardation are as below:
 Criterion A. Significantly sub-average intellectual functioning: an IQ of approximately 70 or below on an
individually administered IQ test (for infants, a clinical judgment of significantly sub-average intellectual
functioning).
 Criterion B. Concurrent deficits or impairments in present adaptive functioning (i.e. .e., the person's
effectiveness in meeting the standards expected for his or her age by his or her cultural group) in at least
two of the following areas: communication, self-care, home living, social / interpersonal skills, use of
community resources, self-direction, functional academic skills, work, leisure, health, and safety.
 Criterion C. The onset is before age 18 years.
Types of Intellectual Disability

Intellectual disabilities are categorized by their severity. Experts divide the types of cognitive impairment into
four categories: mild intellectual disability, moderate intellectual disability, severe intellectual disability, and
profound intellectual disability. The degree of impairment from an intellectual disability varies widely. While IQ
scores are still relevant, DSM V does not place so much emphasis on degree of impairment but on the type of
intervention.
The category details are as follows:

Mild Intellectual Disability:

Approximately 85% of individuals with an intellectual disability fit into this category and many even achieve
academic success, are often able to acquire sixth-grade level academic skills. A person who can read, but has
difficulty comprehending what he or she reads, they attain reading and math skills up to grade levels 3 to 6. They
also often have the skills necessary to live independently and hold a job, but may need assistance if under
unusual stress.Their IQ is between 50 to 70 and are slower than typical in all developmental areas. There are no
unusual physical characteristics. They are able to learn practical life skills, blend socially and function in daily
life

Moderate Intellectual Disability:

About 10% of people with intellectual disabilities fit into this category. The IQ scores lies between 35 to 49.
Noticeable developmental delays (i.e. speech, motor skills) and physical signs of impairment (i.e. thick tongue)
may be observed.These individuals benefit from social skills and vocational training. They are able to learn basic
health and safety skills and can complete self-care activities. They can often learn to travel from place to place
independently and hold an unskilled job with supervision.People with moderate intellectual disability have fair
communication skills, but cannot typically communicate on complex levels. They may have difficulty in social
situations and problems with social cues and judgment. These people can care for themselves, but might need
more instruction and support than the typical person.

Severe intellectual disability:

Their IQ score falls between 20 to 34.Considerable delays in development are observed. They understand speech,
but little ability to communicate, are able to learn daily routines. They may learn very simple self-care and need
direct supervision in social situations. Only about 3 or 4 percent of those diagnosed with intellectual disability
fall into the severe category. These people can only communicate on the most basic levels. They cannot perform
all self-care activities independently and need daily supervision and support. Most people in this category cannot
successfully live an independent life and will need to live in home setting.

Profound Intellectual Disability:

About 1 to 2 percent of people with intellectual disabilities fall into this category.Their IQ is less than 20. There
are significant developmental delays in all areas,with obvious physical and congenital abnormalities. They are
not capable of independent living, require close supervision and sometimes attendant to help in self-care
activities. They depend on others for all aspects of day-to-day life and have extremely limited communication
ability. May respond to physical and social activities. Frequently, people in this category have other physical
limitations as well.

Remember

Intellectual disability is a disability characterized by significant limitations both

in intellectual functioning (reasoning, learning, problem solving) and in adaptive behavior, which
covers a range of everyday social and practical skills. This disability originates before the age of
18.

Characteristics:

Now let us learn about the characteristics of Intellectual disability. Intellectual disability refers to significantly
sub average general intellectual functioning resulting in or associated with concurrent impairments in adaptive
behavior and manifested during the developmental period. Characterized by two dimensions: limited intellectual
ability and difficulty in coping with the social demands of the environment.

As we have read earlier that ID means substantial limitations in age-appropriate intellectual and adaptive
behavior. Although many individuals with Intellectual disability make tremendous advancements in adaptive
skills, most are affected throughout their life span (Hawkins, Eklund, James & Foose, 2003). Many children with
Intellectual disability are not identified until they enter school and sometimes not until the second or third grade,
when more difficult academic work is required. Most students with mild ID are able to cope with academics
almost up to the sixth-grade level and are able to learn vocational skills well enough to support themselves
independently or semi-independently.
Children with moderate retardation show significant delays in development during their preschool years. As they
grow older, discrepancies in overall intellectual development and adaptive functioning generally grow wider
between these children and same age peers.
Individuals with severe and profound mental retardation are almost always identified at birth or shortly
afterward. Most of these infants have significant central nervous system damage, and many have additional
disabilities and/or health conditions.
Let us study the areas of deficits:
Cognitive Functioning
Deficits in cognitive functioning and learning styles are characteristic of individuals with mental retardation
include poor memory, slow learning rates, attention problems, difficulty generalizing what they have learned,
and lack of motivation. Students with mental retardation have difficulty remembering and retaining information
in short-term memory (Bray, Fletcher, & Turner, 1997). These children are unable to retain the information
absorbed. The extent of inability to remember things will depend on the severity of the condition. People with
mild ID can retain quite a bit of information. It's not that children with ID cannot learn it's just that they take
longer to do so. Individuals with mental retardation acquire new knowledge and skills at a much slower rate as
compared to typically developing children.

Students with ID also have low attention spans and find it difficult to concentrate on a particular task and
complete it.They often have trouble attending to relevant features of a learning task and instead may focus on
distracting irrelevant stimuli. In addition, individuals with mental retardation often have difficulty sustaining
attention to learning tasks (Zeaman & House, 1979). These attention problems compound and contribute to a
student’s difficulties in acquiring, remembering, and generalizing new knowledge and skills.They are unable to
generalize and think abstractly. In other words have trouble using their new knowledge and skills in settings or
situations that differ from the context in which they first learned those skills.

Adaptive Behavior
In the definition given above, we have read that children with intellectual disability have substantial deficits in
adaptive behavior. Adaptive functioning refers to the application of skills learned so as to live life independently.
Limitations in self-care skills and social relationships as well as behavioral excesses are common characteristics
of individuals with intellectual disability. The extent of dependence will again depend on the severity of the
condition. People with profound characteristics may generally depend on others throughout their lives. These
limitations can take many forms and tend to occur across domains of functioning.
Such children have poor communication skills. They find it very difficult to listen, understand, and respond in
conversations. Their social skills are also on the lower side. Although they are affectionate and endearing people,
they find it difficult to make new friends and sustain friendships. They lose focus during conversations, do not
maintain eye contact, and interrupt frequently. Building relationships is not easy for most of them. Limited
cognitive processing skills, poor language development, and unusual or inappropriate behaviors can seriously
impede interacting with others.
Students with intellectual disability are more likely to exhibit behavior problems than are children without
disabilities. Difficulties accepting criticism, limited self-control, and bizarre and inappropriate behaviors such as
aggression or self-injury are often observed in children with intellectual disability. Thus, limited intellectual ability
impairs ability to adjust to new circumstances, solve problems and make decision.
Motivation:
Students with intellectual disability often exhibit a lack of interest in learning or problem-solving tasks. Some
also develop learned helplessness, a condition in which a person who has experienced repeated failure comes to
expect failure regardless of his or her efforts. When faced with a difficult task or problem, some individuals with
intellectual disability may quickly give up and turn to others or wait for others to help them.
Speech and Language:

Due to diminished intellectual functioning and associated neurological conditions, many children
with intellectual disability have delayed language and speech problems.

Now … all the characteristics have been discussed. Revise them using the points given below.

Points to Remember

Characteristics of Intellectual Disability

 2-4 years behind in all areas of cognitive development (e.g. reasoning, problem-solving, working
memory)
 Low achievement in most or all academic areas (e.g. reading comprehension, mathematics, written
expression)
 Short attention span and easily distractible
 Delays in speech development
 Difficulties with learning concepts
 Academic difficulties last across the school years
 May seem to learn more slowly than do other students
 Difficulty with memory
 Difficulty using academic strategies (e.g. note taking, memorizing definitions)
 Difficulty with generalization of information to other material
 Difficulty generalizing material learned in one setting to another (e.g., from school to the community)
 Difficulties with more advanced academic skills related to content (e.g. math word problems,
identifying themes and symbols in literature)
 Delays in language may affect reading
 May have difficulty comprehending and summarizing what has been read
 Weak vocabulary (knowledge of words)
 May operate at a concrete rather than abstract level of thinking
 Difficult in remembering things
 Unable understand how things work
 Trouble in understanding social rules
 Trouble seeing the consequences of their actions
ACTIVITY:

Write in the space given below, atleast ten characteristics of intelectual disability the way you have
understood. Support it with examples.

Characteristics Examples

Now compare your list of characteristics to those given above, highlight any differences, mark with any
coloured pen and relearn.

2.4 Tools and Areas of Assessment:

DSM-5 emphasizes the need to use both clinical assessment and standardized testing of intelligence when
diagnosing intellectual disability, with the severity of impairment based on adaptive functioning rather than IQ
test scores alone. In DSM-5, intellectual disability is considered to be approximately two standard deviations or
more below the population, which equals an IQ score of about 70 or below. The assessment of intelligence across
three domains (conceptual, social, and practical) will ensure that clinicians base their diagnosis on the impact of
the deficit in general mental abilities on functioning needed for everyday life.

Assessment tools are instruments for obtaining information that can be used to make judgments about children's
disability, learning behavior and characteristics or programs using means other than standardized instruments.

Different tools are

 Observations
 Interviews
 Questionnaires
 Rating Scales
 Checklists

Observations:
Observation may be defined as a systematic viewing of a specific phenomenon in its proper setting or the
specific purpose of gathering data for a particular study. Observation includes seeing, hearing, perceiving. It is
concerned with planned watching, recording, and analysis of observed behaviour as it occurs in a natural setting.
Observation may be defined as a systematic viewing of a specific phenomenon in its proper setting or the
specific purpose of gathering data for a particular study. When the observer employs explicitly formulated rules
for the observation and recording of behaviour, it becomes a systematic observation. These rules are called
observation schedules. This approach works well for areas that are difficult to assess with pencil and paper tests
or when multiple opportunities are provided for students to demonstrate acquisition of skills and knowledge over
time. Often, observations are some of the most important information you can gather.

Behavioral observations may be used clinically (such as to add to interview information or to assess results of
treatment) or in research settings (to see which treatment is more efficient or as a Dependent Variable)
Types of observation
 Participant and non participant observation
 Controlled and uncontrolled observation

Participant and Non participant:

Both Participant and Non participant are based on the role of the observer. In participant observation, observer
participates actively, for an extended period of time. Assumes that observer will become accepted member of the
group or community. It is possible that there may be lack of objectivity on the part of the observer.

In non-participant observation, the observer attempts to observe people without interacting with them. They may
be told that they are being observed or they may not be informed of being observed. Observer is detached from
situation so relies on their perception that may be inaccurate.

Controlled and Uncontrolled observation:

Both controlled and uncontrolled observation are based on the rigor of the system adopted. In controlled
observation greater control of sampling and extraneous variables is possible. It permits stronger generalizations
and checks on reliability and validity. Particular types of behavior are looked for and counted and the
implementation of controls may have an effect on behaviour
How to prepare for Observation
 What to look at
 Pre specify/decide the objectives
 Select on the event / person to watch (Initially may be unfocused)
 How to observe
 Observation by broad sweep
 Observation of nothing in particular
 Searching by paradoxes
 Searching for problems
 Where and when to look
 Systematic and principled approach
 Reflexive decision making
 What to record
 Verbatim, key phrases, key elements, narratives
 Formatted recordings – tally counts, audio, video recordings
 Time Sampling and Situation sampling

Interview

We need to gather information from parents, caregivers, teachers and other professionals. This can be done
through interviewing people. Let us see what is an interview and what are the different types of interviews.
Interviews may be defined as two-way systematic conversation between an investigator and an informant,
initiated for obtaining information relevant to as a specific study. It involves not only conversation, but also
learning from the respondents’ gestures, facial expressions and pauses, and his environment. Interviewing
requires face-to-face contact or contact over telephone and calls for interviewing skills. It is carried out by using
a structured schedule or an unstructured guide. Interview is the only suitable method for gathering information
from illiterate or less educated respondents. It is useful for collecting a wide range of data from factual
demographic data to highly personal and intimate information relating to a person's opinions, attitudes, values,
and beliefs, past experience and future intentions. Interview is required when qualitative information is
required or probing is necessary to gather more data. It is easier also for people to talk than to write. Once
rapport is established, even confidential information may be obtained. Interview enables the investigator to
grasp the behavioural context of the data furnished by the respondents. It permits the investigator to seek
clarifications and brings to the forefront those questions, that, for one reason or another, respondents do not
want to answer. Thus, interview is the method of collecting data involves presentation or oral-verbal stimuli and
reply in terms of oral-verbal responses.

An interview can be conducted in many ways and for a variety of purposes. There are two kinds of Interviews:
structured or unstructured.

Structured interview as the name implies, designed to provide a diagnosis for an interviewee by detailed
questioning in a "yes/no" or "definitely/somewhat/not at all" forced choice format. It is broken up into different
sections reflecting the diagnosis in question. Often Structured interviews use closed questions, which require a
simple pre-determined answer. Examples of closed questions are "When did this problem begin? Was there any
particular stressor going on at that time? Can you tell me about how this problem started?" Closed interviews
are better suited for specific information gathering. Pre decided questions or interview schedule are prepared.
Questions are arranged in order; clarification can be sought on vague answers. Analysis can be quantitative and
qualitative.

Unstructured interviews can be less structured and allow the interviewee more control over the topic and
direction of the interview. Unstructured interviews are better suited for general information gathering, and
structured interviews for specific information gathering. Unstructured interviews often use open questions,
which ask for more explanation and elaboration on the part of the interviewee. Examples of open questions are
"What was happening in your life when this problem started? How did you feel then? How did this all start?"
Open interviews are better suited for gathering general information. There are no pre-determined questions, the
process lacks direction and control.
The Interview Process
 Before the interview
 Prepare the questionnaire / interview schedule
 Get to know your interviewee
 During the interview
 Make a connection / establish rapport
 Learn to listen
 While asking questions – decide types of questions depending on the responses that are required
 Carry the interview forward
 Record the interview
 After the interview
 Thank
 Organize information

Questionnaires:
Questionaires are one of the most common instrument to collect information. It contains a set of questions
logically related to a problem under study. It aims at eliciting responses from the respondents.The content,
response structure, the wordings of questions, question sequence, etc. are the same for all respondents. The
questions in the questionnaire have to be read, understood and filled in by the respondents . There is no need for
face to face question answer session.Questionnaires can be described as ‘schedules’ when used for directly for
interviewing and can make use of checklists and rating scales

Factors to consider while constructing questionnaires

 Determine the type of data required and its logical sequence
 Check level of respondents’ knowledge
 Decide data gathering method – interview or mailing?
 Draft the Instrument – decide the broad categories, sequencing, specific questions under the categories
 Evaluate the draft – take expert guidance
 Pre test
 Specify procedures and instructions
 Design the format

Rating Scales:

Rating is a term applied to expression of opinion or judgment regarding some situation, object or character.
Rating Scale is a technique used in measuring responses such as feelings, perception, likes, dislikes, interests,
and preferences. It is an instrument that requires the rater to assign the rated objects that have numerals
assigned to them. Rating scales present users with an item and ask them to select from a number of choices. The
rating scale is similar in some respects to a multiple-choice test, but its options represent degrees of a particular
characteristic. A rating scale is a set of categories designed to elicit information about a quantitative or a
qualitative attribute. This is a recording form used for measuring individual's attitudes, aspirations and other
psychological and behavioural aspects, and group behaviour. The rating scale involves qualitative description
of a limited number of aspects of a thing or of traits of a person.

When we use rating scales, we judge properties of objects without reference to other similar to other similar
objects. Rating scale refers to a scale with a set of points, which describe varying degrees of the dimension of
an attribute being observed. Opinions are usually expressed on a scale of values. The type of information
collected can influence scale construction.

Types of rating scale:

Graphic rating scale: is defined as any rating scale consisting of points on a continuum, and is a generic label
given to a broad category of rating formats: Never, seldom, sometimes, usually, always

Numerical rating scale: In a typical numerical scale, a sequence of defined numbers is supplied to the rater. The
rater assigns to each stimulus to be rated an approximate number in line with these definitions or descriptions.

Descriptive rating scale: Each rating level is defined, often in detail and is not necessarily assigned a point
value. Having good descriptions for rating levels lessens some of the problems identified for graphic scales and
does not force a teacher to quantify performance, if that is not appropriate

Checklists:

It consists of a prepared list of items pertinent to an object or a particular task. The presence or absence of each
item may be indicated by checking 'yes' or 'no' or multipoint scale. The use of a checklist ensures a more
complete consideration of all aspects of the object, act or task. Checklists contain terms, which the respondent
understands, and which more briefly express his views than answers to open-ended question. It is at best when
used to test specific hypothesis. It may be used as an independent tool or as a part of an schedule/questionnaire.

Activity for YOU

1) Investigate each tool given above and prepare a guide for a child whom you need to assess. Choose specific
instrumentation in your study. Be sure to specify if you will use it qualitatively or quantitatively. That will
help you to understand how you will actually use the tool in your information gathering process.

2) Prepare an assessment tool for a child of your choice or the one who has been assigned to you. Use the
tools that you have learnt above and prepare a test.

Areas of Assessment

Assessment is a process of collecting data for the purpose of making decisions about individuals or groups
and this decision-making role is the reason that assessment touches so many people’s lives” (Salvia,
Ysseldyke and Bolt 2007). Going by the definitions of AAMR, Intellectual Disability is “the degree with
which individuals meet the standards of personal independence and social responsibility expected for age and
cultural group” (1983) and “the collection of conceptual, social, and practical skills that have been learned by
people in order to function in their everyday lives” (2002). The diagnostic criteria in DSM-5 mentions,
intellectual disabilities as having two key diagnostic criteria, namely.

 Cognitive/intellectual functioning
 Adaptive functioning

Assessment is a dynamic, ever-changing construct, which is influenced by factors such as cultural norms, age-
related expectations, and a combination of anticipated and idiosyncratic behaviors. It assesses what a person
does in typical situations rather than what a person can do or might do under the best of circumstances.

Let us now learn what assessment of cognitive functioning will includes. It comprises of various mental
abilities like:

 Reasoning
 Problem solving
 Planning
 Abstract thinking
 Judgment
 Academic learning (ability to learn in school via traditional teaching methods)
 Experiential learning (the ability to learn through experience, trial and error, and observation).

Various types of standardized psychological tests are used during the assessment of intellectual disabilities.
These tests assess intelligence (IQ), learning abilities, and behavioral skills. A standardized test is uniformly
designed and consistently administered. This permits comparisons of individual scores against average scores
for the same group. This comparison provides vital information about a person's skills and abilities relative to
their peers. Comparisons between group and individual scores should be matched by age, culture, education,
and other factors know to affect IQ scores.
Previously an IQ score of 70 or below was the recommended cutoff score, which are two standards deviation
below the mean. However, in some cases, although the individual's IQ score is below 70, he or she should not
be diagnosed as mental retardation if there is no obvious disturbance in adaptive functioning. Some others
factor that may result an individual score poorly should be taken into consideration. For example, some of the
factors include the socio-cultural background of an individual; the problem with native language; as well as
related communicative, motor and sensory handicaps (American Psychiatric Association [DSM-IV-TR],
2000). Thus the DSM-5 (APA, 2013) has de-emphasized specific IQ scores. Nonetheless, an assessment of
intellectual functioning remains central to diagnosis. Thus, IQ scores are still very important considerations.
IQ tests have two parts. One part measures verbal abilities. The other part measures spatial abilities. Spatial is
sometimes called performance skills. It refers to movement and the manipulation of three-dimensional space.
Verbal and spatial scores vary widely. One person might have low scores across the board. Another person
might do well in verbal areas but poorly on performance or spatial tests. Therefore, even though two people
have the same total IQ scores, their abilities may be very different.

Adaptive skills comprise everyday competence. Adaptive skills are defined as practical, everyday skills
needed to function and meet the demands of one's environment, including the skills necessary to effectively
and independently take care of oneself and to interact with other people. Limitations in present functioning
must be considered within the context of community environments, including schools and homes, typical of
the individual’s age peers and culture. Within an individual, limitations often coexist with strengths.

Adaptive skills include skills needed to live in an independent and responsible manner. Limited abilities in
these life skills make it difficult to achieve age appropriate standards of behavior. Without these skills, a
person needs additional supports to succeed at school, work, or independent life. Deficits in adaptive
functioning are measured using standardized, culturally appropriate tests.

Assessment of Adaptive skills includes: Conceptual skills (Receptive language, Expressive language,
Reading, Writing, Money concepts, self Direction), Social skills (Interpersonal responsibility, Self esteem,
gullibility, following rules/laws) and Practical skills (daily living skills, instrumental activities, occupational
skills and safety).

Adaptive Skill Assessment

Adaptive skill measures should assess a comprehensive range of skills. AAMR identifies 10 adaptive skill
areas.
 Communication: Speech, language, and listening skills needed for communication with other people,
including vocabulary, responding to questions, conversation skills, etc.
 Community Use: Skills needed for functioning in the community, including use of community resources,
shopping skills, getting around in the community, etc.
 Functional Academics: Basic reading, writing, mathematics, and other academic skills needed for daily,
independent functioning, including telling time, measurement, writing notes and letters, etc.
 Home Living: Skills needed for basic care of a home or living setting, including cleaning, straightening,
property maintenance and repairs, food preparation, performing chores, etc.
 Health and Safety: Skills needed for protection of health and to respond to illness and injury, including
following safety rules, using medicines, showing caution, etc.
 Leisure: Skills needed for engaging in and planning leisure and recreational activities, including playing
with others, engaging in recreation at home, following rules in games, etc.
 Self-Care: Skills needed for personal care including eating, dressing, bathing, toileting, grooming, hygiene,
etc.
 Self-Direction: Skills needed for independence, responsibility, and self-control, including starting and
completing tasks, keeping a schedule, following time limits, following directions, making choices, etc.
 Social:Skills needed to interact socially and get along with other people, including having friends, showing
and recognizing emotions, assisting others, and using manners.
 Work: Skills needed for successful functioning and holding a part-time or full-time job in a work setting,
including completing work tasks, working with supervisors, and following a work schedule.
 Motor Skills: Fine and Gross Motor Development is generaly used for children.
Thus, one can utilize data from each of the 10 adaptive skill areas, three adaptive skill domains (i.e.,
Conceptual, Social, and Practical skills )
The Conceptual skill domain includes:
Communication
Functional Academics
Self-Direction

The Social skill domain includes:

Social Skills
Leisure

The Practical skill domain includes:

Self-care
Home/School Living
Community Use
Health and Safety
Work

Besides Coginitive functioning and adaptive skill assessment, educational assessment is equally important for

• Progress Monitoring: Frequent, data-based measures of IEP goal attainment

• Transition Planning: Assessment of occupational interests and aptitudes that begins by age 14

Tests of IQ and adaptive functioning form the basis for making a diagnosis of intellectual disability. Other
tests (e.g., neuropsychological tests) may provide further detail. However, test scores are not the sole basis for
diagnosis. All relevant information is obtained before a diagnosis is made. This includes interviews from
parents, teachers, observations, and medical history. For instance, some children appear to be smarter or
higher functioning than the testing indicates. These observations are also taken into account along with all the
other data. The diagnostician then compares all the data to the diagnostic criteria for intellectual disabilities.

Previously, we reviewed that intellectual disabilities are defined by two major symptoms. We had stated that
there are limitations in intellectual functioning (mental abilities) and there are limitations in adaptive
functioning or life skills. These life skills include conceptual, social, and practical skills.
A medical evaluation, therefore, is just the beginning of the assessment process. A thorough assessment
usually includes the following:

 comprehensive medical exam

 possible genetic and neurological testing
 social and familial history
 educational history
 psychological testing to assess intellectual functioning
 testing of adaptive functioning
 interviews with primary caregivers
 interviews with teachers
 social and behavioral observations of the child in natural environments

As mentioned, intellectual functioning and adaptive functioning are the primary diagnostic criteria. In the next
section, we will discuss the strategies used for functional academics and social skills.

2.5 Strategies for Functional Academics and Social Skills

A child with a significant intellectual deficit may not be able to cognitively “catch up” to his peers in terms of
intelligence and academic performance. As the child gets older, he further lags behind, particularly if no
appropriate academic supports are implemented. The child with the intellectual deficit will continue to learn
and understand some aspects of the world at a slower pace, but this cognitive growth is less complete and
there will remain significant gaps in the student’s knowledge base, unless some form of functional academic
program is implemented.

Functional academics helps to teach skills that allow students to succeed in school and beyond, it is designed
to teach functional skills which allow each student to succeed in real-life situations at home, school, work and
in the community. It helps to develop critical academic and life skills. The functional academics curriculum
includes a range of areas namely: Pre-requisite concepts, maths, activities of daily living, reading, writing,
communication, social & emotional skills, community orientation, skill oriented activities, art and craft etc.
The teachers tailor the academic programs in above areas to the age, gender, needs and functioning of the
student. Each of the subcomponent is divided into skill level and task analyzed to sequential steps which
ranges from early childhood to transitional skills. Such skills are not taught in isolation but as part of multi-
sensorial approach. Key outcome of functional skills is for the students to exercise maximum sense of control,
engage in self-directed behavior and autonomy over his/her environment.

Functional Academics are a set of specific skills designed to assist students socially, academically, and
behaviorally. These skills cover a wide variety of processes and are individualized for each student. It
prepares students to become participating members of their communities.

In order to develop the child’s potential to the fullest, special education and training should begin as early as
infancy. With the appropriate supports, students with intellectual disability can achieve a high quality of life in
many different aspects. While students with intellectual disability may have limitations in adaptive behaviors,
these limitations may co-exist alongside strengths in other areas within the individual. Independence and self-
reliance should always be primary goals of all instructional strategies employed with students with intellectual
disability.Thus, teachers need to provide direct instruction in a number of skill areas outside of the general
curriculum in order to address the limitations in intellectual functioning and adaptive behavior experienced by
those with intellectual disability. Though these skills are more functional in nature but are essential for the
future independence of the student.

Strategies to teach functional skills

 Use short and simple sentences to ensure understanding.
 Use alternative instructional strategies and alternative assessment methods.
 Teach organizational skills.
 Teach student decision-making rules for discriminating important from unimportant details.
 Use strategies for remembering such as elaborative rehearsal and clustering information together.
 Use strategies such as chunking, backward shaping (teach the last part of a skill first), forward shaping,
and role modeling.
 Use mnemonics (words, sentences, pictures, devices, or techniques for improving or strengthening
memory).
 Use concrete items and examples to explain new concepts.
 Proceed in small ordered steps and review each frequently.
 Provide direct instruction in reading skills.
 Offer "standard" print and electronic texts.
 Provide specific and immediate corrective feedback.
 Use visual supports when relating new information verbally.
 Provide the student with hands-on materials and experiences.
 Break longer, new tasks into small steps.
 Demonstrate the steps in a task, and have student perform the steps, one at a time.
 Address the student and use a tone of voice consistent with their age.
 Avoid long, complex words, technical words, or jargon.
 Ask one question at a time and provide adequate time for student to reply.
 Use heavy visual cues (e.g. objects, pictures, models, or diagrams) to promote understanding.
 Target functional academics that will best prepare student for independent living and vocational contexts.
 Use physical and verbal prompting to guide correct responses, and provide specific verbal praise to
reinforce these responses
 Use of assistive technology. For example, softwares are available that combines reading for meaning with
direct instruction for decoding and understanding, which can be adjusted by the teacher to meet the specific
academic capacities of the student.
 Take advantage of Student strengths and interests in the classroom. e.g., if a student demonstrates an
interest in cars, have opportunities to read about cars, write about cars, do math problems about cars, etc.

An “ecology based curriculum approach” will help to focus on skills that need to be learnt for functional
independence. This is an activity-based approach that helps the teacher to plan instructional programmes, and
emphasizes on utility of learnt skill that requires to be age-appropriate. Instructional plans are not restricted to
classroom learning but directly transfer or generalize to various daily living situations at Home,
Neighborhood, Community from school level. This approach takes into consideration environmental and age
related needs to integrate into communities and enables the teachers to prepare students to smoothly integrate
into their communities. The education of students with intellectual disability should focus on preparing them
for independent living in their own environments in which they live. Transferring learnt skills to integrate into
easily applicable situations is an important pre-requisite for selecting activities in functional academics. Hence
use of functional literacy skills such as reading or writing name and address, filling bank forms, reading
significant billboards and product names of consumer goods. This applies similarly to selecting numeracy
skills such as concepts of time, money, calendar reading, measurements of various items with corresponding
measurement units for mass, weight, distance, volume and quantity of items (Narayan & Myreddy, 2006).

Social skills are defined as “a set of competencies that a) allow an individual to initiate and maintain positive
social relationships, b) contribute to peer acceptance and to a satisfactory school adjustment, and c) allow an
individual to cope effectively with the larger social environment”. Social skills can also be defined within the
context of social and emotional learning — recognizing and managing our emotions, developing caring and
concern for others, establishing positive relationships, making responsible decisions, and handling challenging
situations constructively and ethically (Zins, Weissbert, Wang, & Walberg, 2004). This understanding of what
social skills are, you will be able to evaluate and build students’ social skills within a variety of social
contexts.

Very often, they behave inappropriately in social situations, and are rejected and isolated by their peers. They
are socially incompetent and unable to deal with life’s challenges or to respond effectively to society (Deshler
& Schumaker, 1983). Inappropriate social behaviour of persons with intellectual disability may result from
incorrect perceptions of social situations. They also have problems in detecting and understanding contextual
clues and situations are unable to identify emotional and social relationships, and do not understand others’
feelings and perceptions. They may lack an understanding of cause-effect relationships in social situations.
Quite often they do not know the appropriate way to behave in specific situations, and how to converse in a
different manner with adults and peers. They may not notice how people respond to their behaviour and may
misconstrue social details and inflections (Kronick, 1983).
Social and emotional learning strategies:
 Encourage children to consider how individual actions and words have consequences.
 Develop children’s ability to take different perspectives and viewpoints.
 Teach students to think through situations and/or challenges by rehearsing possible outcomes.
 Create opportunities to practice effective social skills both individually and in groups.
 Model effective social skills in the classroom and at home through praise, positive reinforcement, and
correction and redirection of inappropriate behaviors.
 Discuss effective interactions with specific attention to the steps involved. For example, discuss the
process of a conversation, showing how effective listening makes such interaction possible.
 Role-play scenarios that build social skills.
 Adjust instructional strategies to address social skills deficits.
 Clearly state instructional objectives and behavioral expectations throughout each lesson.
 Simulate “real life” challenges students may encounter at school, home, and in the community to place
social skills in their practical contexts.
 Provide daily social skills instruction.
 Directly teach social skills, such as turn-taking, social distance, reciprocal conversations, etc.
 Break down social skills into non-verbal and verbal components.
 Explains rules / rationales behind social exchanges.
 Provide opportunities to practice skills in many different environments.
 Work to expand the young child’s repertoire of socially mediated reinforcers (e.g. tickling, peek-a-boo,
chase, etc.).
 Model tolerance and acceptance.
 Provide opportunities for students to assume responsibilities.
 Teach other students to ignore inappropriate attention-seeking behaviors.
 Have other students (who demonstrate appropriate behavior) serve as peer tutors.
 Use social stories.
ACTIVITY:

A child with intellectual disability has been admitted in your class. You have to prepare instructional
strategies in functional academics for this child. Hypothesize a case or use the same data on whom you
have done your case study and prepare your instructional strategies.

2.4 Assistive Devices, Adaptations, Individualized Education Plan, Person Centered Plan,
Life Skill Education
Individuals with intellectual disability require supports in domains like home living, community
living, lifelong learning, employment, health and safety, social activities, and protection and
advocacy. Use of technology assists them to become more independent in their lives.
Assistive technology (AT) is a generic term that includes assistive, adaptive, and rehabilitative devices for
people with disabilities. People with intellectual disabilities use assistive technology to compensate for
functional limitations and increase learning, independence, mobility, communication, environmental
control and choice.
Communication: Technology can help individuals to communicate when they are unable to do so with
their voices to communicate. Communication devices are means for communication for a person who
cannot communicate with his or her voice, due to physical and/or cognitive reasons. Augmentative and
alternative communication (ACC) includes all forms of communication (other than oral speech) that are
used to express thoughts, needs, wants, and ideas. Communication boards are also used for people for
whom non-verbal communication is a large part of their communication. Communication boards are boards
or pages in a book that have pictures and words that a person can point to in order to express themselves.
Computers are used as Communicators, that allow a person to communicate audibly by pointing to
particular images, or typing in a message. The computer then “speaks” the word, phrase, or sentence aloud.
Communicators are often used by someone who has difficulty with verbal expression. Some people with a
communication disability may use a “speech to speech” to facilitate communication.

Let us see how and when technology is used

Environmental Controls: Devices to control the environment are important to people with severe or
multiple physical disabilities and/or cognitive disabilities, who have limited ability to move about in their
environment or control electrical appliances. Technology allows a person to control electrical appliances,
audio/video equipment such as home entertainment systems or to do something as basic as lock and unlock
doors.
Mobility: Simple manual to sophisticated computer-controlled wheelchairs and mobility aids such as
walkers and canes are available for a person who cannot walk. Technology is often used to aid finding
direction, guiding users to destinations. Computer cueing systems and robots are also used to guide users
with intellectual disabilities.
Education: Technology is used in education to aid communication, support activities of daily living and to
enhance learning. Computer-assisted instruction can help in many areas, including word recognition, math,
spelling and even social skills. Computers are used as a tool to improve literacy, language, mathematical,
organizational, and social skill development. People who cannot operate the keyboard, there are alternative
ways to access computers.
Activities of Daily Living: Technology assists people with disabilities in their day to day tasks. Support is
given through automated and computerized devices to assist in eating and self care. Audio prompting
devices and video based instructional materials are used to assist a person with memory difficulties to
complete a task, following a sequence of steps for example making a bed or taking medicines or learning
functional life skills such as shopping for grocery, check a bill etc.

Employment: Technology, such as video-assisted training, is being used for job training and job skill
development and to teach complex skills for appropriate job behavior and social interaction. Computerized
prompting systems which use audio cassette recorders help workers manage their time in scheduling job
activities and stay on task.

Sports and Recreation: Adaptations are made in computer games that slows the game for a user who
cannot react as quickly to game moves and decision-making. They provide opportunities for opportunities
 for developing cognitive, social and eye-hand coordination skills. Sports equipment and toys are adapted to
compensate for functional limitations.

Thus, we may say that Assistive technology can help people with intellectual disabilities overcome barriers
towards independence and inclusion. Technology can compensate for a person’s functional limitations.
Assistive device should available in all settings like home, school, work and recreation. There should be
consistency in the kind of technology available, how it is used, and methods for instructing the user on
operating the device. Transitions from one device to another should be made as smooth as possible by
building on and integrating previously learned skills. Technology should be flexible and customized to
accommodate the unique abilities of each person with intellectual disabilities.

Adaptations

Children with intellectual disability have the capability to learn, however they often learn at a slower rate
than their peers. These students generally do not fit into a specific mold, rather they have varying strengths
and weaknesses throughout all subject areas. As teachers, we know the best ways students with special
needs learn is by having adaptations and accommodations that can be used for that specific child, to meet
their needs, so they can be successful in the classroom.

Some adaptations are as simple as moving a distractible student to the front of the class or away from the
window or object that distracts. Other modifications may involve changing the way that material is
presented or the way that students respond to show their learning. These Adaptations, accommodations,
and modifications are based upon the individual needs and the personal learning styles and interests of
children. Modifications are learning outcomes, which are substantially different from the prescribed
curriculum, and specifically selected to meet the student’s special needs. These learning outcomes are
detailed on the student’s IEP. Modifications can be made to:

 What a child is taught, and/or

 How a child works at school.

Modifications or accommodations are most often made in the following areas:

Scheduling: giving the student extra time to complete assignments or tests, breaking up evaluation over
several days
Setting: working in a small group, working one-on-one with the teacher
Materials. providing audiotaped lectures or books, giving copies of notes, books on CD (digital text)
Instruction: reducing the difficulty of assignments, reducing the reading level, using a student/peer tutor
Student Response: allowing answers to be given orally or dictated, using a word processor for written work

Adaptation: Adaptations retain the learning outcomes of a prescribed curriculum, and are provided so the
student can challenge the regular learning outcomes. A child on an adapted program may be well below the
standard of the class, but still may be able to minimally meet the grade level expectations. Class or grade level
comparisons in establishing if a student meets expectations should be avoided. These adaptations can include
alternate formats, instructional strategies and assessment procedures. Adapting the content, methodology,
and/or delivery of instruction are essential elements in special education.
Adaptations include, advanced organizers to assist with following classroom lectures, extended time for
assignments or tests, audio tapes or peer helper to assist with assigned readings, computers to facilitate
completion of written assignments, alternative written assignments, separate settings for tests and exams, and
supervised breaks for tests and exams.

Individualized Educational Plan

An IEP Individualized Education Program is a written document that spells out the child’s learning needs,
the services the school will provide and how progress will be measured. The IEP also helps teachers monitor
the student's progress and provides a framework for communicating information about the student's progress
to parents and to the student. The IEP is updated periodically to record any changes in the student's special
education program and services that are found to be necessary as a result of continuous assessment and
evaluation of the student's achievement of annual goals and learning expectations. Several people, including
parents, are involved in creating the document. The entire process can be a great way to sort out your child’s
strengths and weaknesses. Working on the IEP can help you figure out ways to help him succeed in school.

Contents of the IEP

The IEP must include certain information about the child and the educational program designed to meet his or
her unique needs. In a nutshell, this information consists of:

Current performance: The IEP must state how the child is currently doing in school (known as present
levels of educational performance). This information usually comes from the evaluation results such as
classroom tests and assignments, individual tests and observations made by parents, teachers, related service
providers, and other school staff. The statement about "current performance" includes how the child's
disability affects his or her involvement and progress in the general curriculum.

Annual goals: These are goals that the child can accomplish in a year. The goals are broken down into short-
term objectives. Goals may address academic, social or behavioral, physical and other educational needs. The
goals must be measurable, i.e., it must be possible to measure whether the student has achieved the goals.

Special education and related services: The IEP must list the special education and related services to be
provided to the child. This may include supplementary aids, services, modifications and supports.

Dates and places: The IEP must state when services will begin, how often they will be provided, where they
will be provided, and how long they will last.

Transition service needs: Begins when the child is age 14 (or younger, if appropriate), the IEP must address
the courses your child needs to take to reach his or her post school goals. A statement of transition services
needs must also be included in each of the child's subsequent IEPs.

Besides the above, the IEP must mention the content that needs to be taught whether academic or non
academic, task analysis of the content to be taught step by step, the method of teaching through which the
content would be taught and the teaching learning aid or material that would be used in the teaching learning
process.

Measuring progress: The IEP must state how the child's progress will be measured and how parents will be
informed of that progress. An IEP should be Specific, Measureable, Achievable, Relevant and Timebound.

FIVE PHASES OF IEP PROCESS

Gather Information

Set The Direction

 

Develop IEP

Implement The IEP

Review and update the IEP

An IEP format

Student information
School
Student Name
Age
Disability
Gender
Class
Mother tongue
Medium of Instruction

Short Term Time Content Task Method Materials Method of Remarks

Goal Period Analysis of
Date teaching evaluation

ACTIVITY:

Prepare an IEP for a child whom you have assessed. List out the strengths and deficit areas first.

Person Centered
Person-centered planning (PCP) is a set of approaches designed to assist someone to plan their life and
supports. It is used most often as a life planning model to enable individuals with disabilities or otherwise
requiring support to increase their personal self-determination and improve their own independence. Person
Centered Planning is an ongoing problem-solving process used to help people with disabilities plan for their
future.
Person Centered Planning focuses on what is important to a person, capacities and strengths. It is a process for
continual listening and learning, focusing on what are important to someone now and in the future, and acting
on this in alliance with their family and their friends. The overall aim of person centred planning is “good
planning leading to positive changes in people’s lives and services” (Ritchie et al, 2003). It is flexible and
enables to find new possibilities that are unique to each person.
Person centred planning is based on the social model of disability because it places the emphasis on
transforming the options available to the person, rather than on 'fixing' or changing the person. O’Brien
(1989) listed five key areas important in shaping people's quality of life, and asserting that services should be
judged by the extent to which they enable people to:

 Share ordinary places

 Make choices
 Develop abilities
 Be treated with respect and have a valued social role
 Grow in relationships

The process focuses on discovering the person's gifts, skills and capacities, and on listening for what is really
important to the person ( Snow, O'Brien & Mount). It is based on the values of human rights, interdependence,
choice and social inclusion, and can be designed to enable people to direct their own services and supports, in
a personalized way.

Life Skill Education

Life skills are abilities for adaptive and positive behaviour that enable individuals to deal effectively with the
demands and challenges of everyday life (WHO). It transforms knowledge into positive behavior. Life skills
enable individuals to convert knowledge, attitudes and values into actual abilities - i.e. "What to do and how
to do it".

Life skills include psychosocial competencies and interpersonal skills that help people make informed
decisions, solve problems, think critically and creatively, communicate effectively, build healthy
relationships, empathize with others, and cope with managing their lives in a healthy and productive manner.
Essentially, there are two kinds of skills -those related to thinking termed as "thinking skills" and skills related
to dealing with others termed as "social skills". What is important is self management ie., managing/coping
with feelings, emotions, stress and resisting peer and family pressure. Life skills education is a structured
programme which initiates participatory learning that aims to enhance positive and adaptive behaviour by
facilitating individuals to develop and practise psycho-social skills and function effectively in social
environment.

For children with intellectual disability, life skills based education is essential to enable them to cope with
difficulties in day-to-day life. Life skills include a wide range of knowledge and skill interactions believed to
be essential for independent living (Brolin, 1989). The three major skill areas that need to be addressed are
daily living, personal/social, and occupational skills.

Skills that are essential for independent adult living include managing personal finances, managing a house,
caring for personal needs, being aware of safety, preparing own meal/food, personal grooming and caring for
clothing, showing sense of responsibility and engaging in leisure activities.

Personal and Social skills are critical in maintaining friendships and in any kind of vocation. Lack of
appropriate personal and social skills is often the cause of poor employability and terminations. Individuals
with intellectual disability find it challenging to get along with others and often do not learn by observing.
Thus, skill instruction in these areas should include being aware of self, acquiring self-confidence, learning
socially responsible behavior, maintaining good interpersonal skills, achieving independence, achieving
problem solving skills and communicating with others.
Occupational skills are equally important, without which sustenance in a job becomes difficult. Between 70%
and 80% of students with disabilities are unemployed or underemployed. Early educational efforts need to be
directed towards skill areas like knowing different vocational options, selecting and training for specific
vocation, exhibiting appropriate work habits and behavior, maintaining employment and exhibiting sufficient
physical energy and skills.

2.7 Vocational Training and Independent Living

Vocational training is used to prepare for a certain vocation or craft. Vocational training is education only in
the type of job or vocation a person wants to pursue, forgoing traditional academics. Vocational training, is all
the training needed for a certain job. The training generally focuses on providing students with hands-on
instruction in a specific vocation, and generally allows them to forgo the general education courses associated
with formal education.
The Vocational Training aims at imparting training for work readiness, economical self-sufficiency and
independent living in the community. The training provides the students with an employment experience to
improve their work capacity, quality and speed.

Important vocational skills:

Vocational training should provide students with a curriculum that prepares them for the job/vocation that
they intend to enter. Broad-based knowledge and skills are good, but for students with disabilities, specific
skills are necessary for survival in the workplace, in the community and need to be explicitly taught. Some of
the skills that is essential for independent living and vocational skills are as follows:
Academic Skills
 Reading and writing (e.g., sight-word vocabulary, spelling, handwriting, typing, etc.)
 Math (e.g., basic computation, money, measurement)
 Problem solving
 Listening comprehension
 Speaking
 Computer
 Art or music
Communication Skills
 Following and giving directions accurately
 Communicating information
 Understanding and processing information
 Requesting or offering assistance
Social and Interpersonal Skills
 Answering the phone and taking a message
 Making necessary phone calls to employers and other professionals as part of a job requirement
 Displaying appropriate workplace behavior and etiquette
 Knowing appropriate topics for discussion in the workplace
 Knowing when and when not to socialize on the job
 Learning how to protect themselves from abuse / victimization
 Learning social problem-solving techniques
Occupational and Vocational Skills
There are a number of skills and behaviors that most jobs require. It is important to help students to acquire
skills that will make them productive members in society. Some of these activities include the following:
 Using a punch or signing the register to clock in time
 Arriving to work on time
  Informing when sick
 Requesting for leave
 Using the appropriate voice tone and volume
 Accepting instructions and corrections
 Knowing appropriate interaction with coworkers (i.e., getting along; social problem solving; making
friends; and recognizing personal, professional boundaries)
Some students with mild intellectual disability may be taught to search for appropriate jobs in order to be
independent. These skills include the following:
 Looking for jobs (advertisements in the newspaper and online, Signs of ‘Vacancy’ or wanted)
 Filling out job applications
 Writing resume and cover letter or seeking help from others to write a letter or resume
 Keeping necessary identification documents (photo ID, birth certificate etc.)
 Learning interviewing skills ( answering questions, body posture and language etc.)

Independent living skills instructions, which are designed to meet the unique needs of children with
intellectual disability, includes:
 Activities that are appropriate to his/her life style so what he/she learns applies to their real life
 Teaching methods that fit their learning style
 Individualized teaching based on the existing skills
 Opportunities to learn new skills and further develop existing skills

Independent living skills are abilities that are necessary to live safely on one’s own, without help from
caregivers. Independent Living Skills increases self-reliance and self-confidence. The skills needed for
independent living includes activity of daily living skills ( ADL). ADL skills are the things we normally do
on a daily basis, including any daily activity we perform for self-care. These are tasks that are absolutely
necessary for someone to live independently. Some of the examples of ADL skills are self help eating,
grooming,locomotion skills etc. Some activities are not absolutely necessary for fundamental functioning but
are instumental in enabling an individual to live independently within a community. The skills which aid in
daily living in society are doing housework, maintaining personal hygeine, preparing own meal, taking
medicines, shopping for self which may include groceries, clothes, being able to contact utility services, such
as electrician, plumber, booking gas and cable suppliers. Get help for basic household emergencies, calling a
chemist, taking part in activities for personal fitness, understanding the dangers of smoking, drugs, alcohol
and abusive behaviors seeking help when required,communicating with others, managing money matters etc.

ACTIVITY

List the skills required under each area for vocational and independent living

Academic Skills Communication Social and Interpersonal Occupational and

Skills Skills Vocational Skills
1.
2
3
4
5
6
7
8
9
10

2.8 Study Questions

 Define Intellectual disability. Discuss the different types of intellectual disabilities. Explain with examples.
 List the characteristics of Intellectual disability. Give examples.
 Discuss the tools of assessment.
 Describe the areas of assessment, Discuss the identification criteria of intellectual disability.
 Define the term adaptive behaviour and explain how it may be assessed and what strategies should be used to
these skills.
 Discuss how you would develop social skills in a child with intellectual disability.
 Discuss the importance of vocational training and independent living.
2.9 References

 American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th
ed., Text rev.). Washington, DC: Author.

 Bray, N. W., Fletcher, K. L., & Turner, L.A. (1997). Cognitive competencies and strategy use in
individuals with mental retardation. In W. E. Maclean, Jr. (Ed.), Ellis’ handbook of mental deficiency,
psychological theory and research (pp. 197–217). Mahwah, NJ: Erlbaum.

 Brolin, D. E. (1989). Life Centered Career Education: A Competency Based Approach (3rd ed.).
Reston, VA: The Council for Exceptional Children.

 Deshler DD, Schumaker JB (1983). Social Skills of Learning Disabled Adolescents: Characteristics
and Intervention. Topics in Learning and Learning Disabilities; 3: 15-23

 Hawkins BA, Eklund SJ, James DR, Foose AK. Adaptive behavior and cognitive function of adults
with Down syndrome: Modeling change with age. Mental Retardation. 2003;41:7–28.

 Kronick D (1981). Social Development of Learning Disabled Persons: Examining the Effects and
Treatments of Inadequate Interpersonal Skills. San Francisco: Jossey-Bass Publishers.
 Mount, B (1992) Person Centred Planning; A Sourcebook of Values, Ideas and Methods to Encourage
Person-Centered Development. New York, Graphic Futures

 Narayan J & Myreddy V (2006) Training module on Mental Retardation, Secunderabad, NIMH.

 O'Brien J. (1989) What's worth working for? Leadership for Better Quality Human Services. Syracuse
NY. The Center on Human Policy, Syracuse University for the Research and Training Center on
Community Living of University of Minnesota.
  Ritchie, J., Spenser, L. and O‘Connor, W. (2003). Carrying out qualitative analysis. In Qualitative
research practice – a guide for social science students and researchers (ed. J. Ritchie and J. Lewis), pp.
219-262. Sage Publications, London

 Salvador-Carulla L, Bertelli M.(2008), 'Mental retardation' or 'intellectual disability': time for a

conceptual change. Psychopathology;41(1):10-6. Epub 2007 Oct 18. Review.

 Salvia, J., Ysseldyke, J.E. & Bolt, S. (2007).Assessment in special and inclusive education. (10th
edition). Boston: Houghton Mifflin Company.

 World Health Organization. ICF: International Classification of Functioning, Disability and

Health.Geneva: World Health Organization; 2001.

 Zins, J. E., Weissberg, R. P., Wang, M. C., & Walberg, H. J. (Eds.). (2004). Building academic
success on social and emotional learning: What does the research say? New York, NY: Teachers
College Press.

 Families Leading Planning 'What is Person

CentredPlanning? http://www.familiesleadingplanning.co.uk/Documents/WHAT%20IS%20PERSON
%20CENTRED%20PLANNING.pdf
 http://www.ukessays.com/essays/psychology/case-study-mental-retardation-
psychology-essay.php

2.10 Suggested Readings

 Browning , R, E: Teaching Students with Behaviour and Serve Emotional Problems

 Folk, M. C., & Campbell, J. (1978). Teaching functional reading to the TMR. Education and
Training in Mental Retardation, 13, 322326.
 Jampala, M, B: Methods of Teaching Exceptional Children, 2004
 Kumta, N.B.: Mental Retardation: A Multidisciplinary Approach, K.E.M. Hospital, Bombay
 Lewis J., Ed. D.Reading Instruction and Related Areas with Students Who Have Mental
Retardation, Multiple Disabilities, or Both University of Northern Colorado, National Center on Low
Incidence Disabilities, and the School of Special Education.
 Moyes, R.A Building Sensory Friendly Classrooms to Support Children with Challenging Behaviors:
Implementing Data Driven Strategies, 2010
 Pidikiti, S: A study on “The Families Having Children with Mental Retardation ”, 1998
 Pierangelo, R. & Giuliani G.A.Transition services in Special Education, Allyn& Bacon, 2003
 Reddy G.L. & Rama, R: Education of children with special needs, New Delhi - Discovery Pub.
2000

.
 PAPER B8 :Introduction to Neuro Developmental Disabilities

(LD, MR(ID), ASD)

Autism Spectrum Disorder: Nature, Needs and Unit

Intervention
3
Dr Shyamala Dalvi

INDEX
3.1 Introduction
3.2 Learning Objectives
3.3 Definition, Types and Characteristics
3.4 Tools and Areas of Assessment
3.5 Instructional Approaches
3.6 Teaching Methods
3.7 Vocational Training and Career Opportunities
3.8 Study Questions
3.9 References
3.10 Suggested Readings
3.1 INTRODUCTION

The paper or course deals with Neuro developmental disabilities. Neurodevelopmental disorders
are impairments of the growth and development of the brain or central nervous system or
Neurodevelopmental disorder is known as disruption in growth and development of the brain or
central nervous system .

This Unit deals with autism spectrum disorder. Let’s look at the following case study and answer
a few questions.

Sagar is in Sr.Kg class. He has difficulty communicating with his peers and doesn’t know how to
respond when teacher or his peers speak to him. Though he is unable to initiate conversation he
is fascinated with cars and is able to tell all the models of cars. During the day Sagar becomes
upset and loses his temper when there is a change in the routine or the teacher wants him to
participate in the class activities. He also keeps running back and forth with his hands covering
his ears anytime he feels like in the classroom.

So teachers what do you think !!! Answer these questions

o What difficulties does Sagar have?

o Does he have speech?
o What upsets him ? Why do you think so?
o Why does he keep running ?
3.2 Objectives

After completing the unit the student-teachers will be able to

• Explain the definition and characteristics of Autism spectrum disorder
• Describe the tools and areas of assessment to identify students with autism spectrum disorder
· Discuss and apply appropriate intervention strategies to enhance learning.
• Discuss and elaborate on relevant career opportunities and vocational training

Very different thoughts right!! Lets read on to understand this disability ..

3.3 DEFINITION, TYPES AND CHARACTERISTICS

Autism Spectrum Disorder (ASD) or autism, as is commonly known, is a general term for a
group of complex disorders of brain development like difficulties in social interaction, verbal and
nonverbal communication and repetitive behaviours. Autism is a spectrum disorder because the
symptom ranges from mild learning and social disability to a more complex condition with
multiple difficulties along with various behavioural issues. Children with autism do not lack
skills but their skills do not develop age appropriately and are also uneven. For example, a 4 year
child with autism may have his/her speech development like that of a 2-year old child, gross
motor skills development may resemble like an 4 year, fine motor skills of a 3-year and self-help
skills of a 3-year old child.

The word "autism," which has been in use for about 100 years, comes from the Greek word
"autos," meaning "self." The term describes conditions in which a person is removed from social
interaction -- hence, an isolated self.

Eugen Bleuler, a Swiss psychiatrist, was the first person to use the term. He started using it
around 1911 to refer to one group of symptoms of schizophrenia.

In the 1940s, researchers in the United States began to use the term "autism" to describe children
with emotional or social problems. Leo Kanner, a doctor from Johns Hopkins University, used it
to describe the withdrawn behavior of several children he studied. At about the same time, Hans
Asperger, a scientist in Germany, identified a similar condition that’s now called Asperger’s
syndrome infact now falls under social communication disorder.
The definition of Autism spectrum disorder has changed over time. The definition or the
diagnostic criteria that is followed across the world is a standard set of criteria used to classify
all behavioural and psychological disorders which is called the Diagnostic and Statistical
Manual for Mental Disorders (DSM). This unit describes ASD as per the DSM V , which is quite
different from DSM IV.

Lets read the definitions and see what emerges--

Autism is a neurodevelopmental disorder characterized by impaired social interaction, verbal

and non-verbal communication, and restricted and repetitive behavior.

Autism spectrum disorder is a serious neurodevelopmental disorder that impairs a child's ability
to communicate and interact with others. It also includes restricted repetitive behaviors, interests
and activities - Mayo Cliniic

According to National Autistic Society- Autism is a lifelong developmental disability that affects
how a person communicates with, and relates to, other people. It also affects how they make
sense of the world around them.

It is a spectrum condition, which means that, while all people with autism share certain
difficulties, their condition will affect them in different ways. Some people with autism are able
to live relatively independent lives but others may have accompanying learning disabilities and
need a lifetime of specialist support. People with autism may also experience over- or under-
sensitivity to sounds, touch, tastes, smells, light or colours.

According to American Psychiatric Association's Diagnosis and Statistical Manual of Mental

Disorders (DSM-5) - Autism spectrum disorder (ASD) is defined as a single disorder that
includes disorders that were previously considered separate — autism, Asperger's syndrome,
childhood disintegrative disorder and pervasive developmental disorder not otherwise specified.

The term "spectrum" in autism spectrum disorder refers to the wide range of symptoms and
severity.

After reading through these definitions we can say that the common areas of difficulty are in the
following –
· Persistent deficits in social communication and social interaction across multiple contexts

· Restricted, repetitive patterns of behavior, interests, or activities

· Symptoms must be present in the early developmental period (but may not become fully
manifest until social demands exceed limited capacities, or may be masked by learned
strategies in later life).
· Symptoms cause clinically significant impairment in social, occupational, or other important
areas of current functioning.

· These disturbances are not better explained by intellectual disability (intellectual

developmental disorder) or global developmental delay.

Since the change in diagnosis criteria, we need to also know a bit about social
communication disorder because the diagnosis of Aspergers syndrome according to DSM IV
now gets covered under DSM V.

Social Communication Disorder –

SCD is characterized by a persistent difficulty with verbal and nonverbal communication that
cannot beexplained by low cognitive ability. Symptoms include difficulty in the acquisition and
use of spoken andwritten language as well as problems with inappropriate responses in
conversation. The disorder limitseffective communication, social relationships, academic
achievement, or occupational performance.

Symptoms must be present in early childhood even if they are not recognized until later when
speech,language, or communication demands exceed abilities

Children with SCD have difficulty with pragmatics—the unspoken, subtle rules of spoken
language that allow people to connect. They don’t always understand the give-and-take of a
conversation. Some of them monopolize conversations or interrupt a lot. Others hesitate to talk at
all.It’s not because these children are rude or their parents haven’t taught them manners. It is
difficult for children with SCD to learn how to use language in socially appropriate ways .

Wow that’s quite a bit isn’t it. It is now time to think. Read about Autism in DSM IV and in
the following table put down the difference-
 S.NO Areas DSM IV DSMV

1 Definition

2 Types

3 Diagnostic

Criteria

4 Age of Onset

Characteristics of children with ASD

Autism is characterized by marked difficulties in behaviour, social interaction, communication
and sensory sensitivities. Some of these characteristics are common among people with autism;
others are typical of the disability but not necessarily exhibited by all people on the autism
spectrum.

1. Social skills

Basic social interaction can be difficult for children with autism spectrum disorders.

2. Speech and language

Problems with speech and language comprehension are a sure sign of the autism spectrum
disorder.

3. Restricted behavior and play

Children with autism spectrum disorders are often restricted, rigid, and even obsessive in
their behaviors, activities, and interests

4. Sensory Issues

Children with autism may have sensory issues which interfere with their functioning in
everyday life.
5. Exceptional Skills

Some children with autism have exceptional skills, such as great memory, calendar skills, or
information about countries their capitals, presidents, and so on; or they read way beyond their
age

Let’s see each of these areas in more details.. but before that

It is important to remember that one child with autism will be completely different from another
child with autism. So one child may not speak at all, be very withdrawn, and have few self-help
skills, another child may not speak but be completely able to take care of his own needs, and a
third may speak, attend the local school, but have great difficulties in interacting with other
children. That is why autism is called a spectrum disorder, because children can be as different
from each other as the colours of the rainbow!
1. Social Skills –

• Unusual or inappropriate body language, gestures, and facial expressions

• Lack of interest in other people or in sharing interests or achievements

• Unlikely to approach others or to pursue social interaction; comes across as aloof and
detached; prefers to be alone.

• Difficulty understanding other people’s feelings, reactions, and nonverbal cues.

• Resistance to being touched.

• Difficulty or failure to make friends with children the same age.

2. Speech & Language Skills

• Delay in learning how to speak (after the age of 2) or doesn’t talk at all.

• Speaking in an abnormal tone of voice, or with an odd rhythm or pitch.

• Repeating words or phrases over and over without communicative intent.

• Trouble starting a conversation or keeping it going.

• Difficulty communicating needs or desires.

• Doesn’t understand simple statements or questions.

• Taking what is said too literally, missing humor, irony, and sarcasm

Reading the above two sections makes us realise how difficult it must be for children with
ASD to be able to manage in this social world. We live in a social world. Everything we do,
whether buying an ice-cream, borrowing a pencil, making a request, asking for help from a
classmate, all require us to be able to interact with others. Neurotypical children do this
effortlessly. ‘How do I draw the busy shopkeeper‘s attention to ask for the ice-cream I want’;
‘how loud do I speak when teacher is teaching and I have to ask the girl next to me for a pencil’;
‘what tone do I use when asking a classmate for help’; all of these are skills that we have
intuitively. We do not have to ‘learn’ them. Yet children with autism, often struggle with these
social communication skills. A lot of this comes from our ability to understand how others think
and feel. To know that since teacher is teaching, I whisper, ―Atul, please lend me a pencil‖ and
not speak in my usual loud voice cause teacher will not want to be interrupted while teaching.

The child with autism will have a very literal understanding of communication. So when a
teacher tells a student who is drawing pictures during math class, ― ‘Oh yes!! Draw a few more
pictures. No need to do your math work’, we know that the teacher is being sarcastic and wants
us to stop drawing and start computing. But the child with autism with his difficulty in
understanding what the teacher is really thinking and feeling, might interpret the words to mean
that he has permission to continue with his drawing and ignore the math class.

As our social understanding develops we know when to stay sitting, when it is okay to move
around, or interrupt a conversation or how to respond if someone calls our name. Additionally,
without being taught, we learn to vary our behavior with different people. So we change our
behavior based on whether I am speaking to my mother, or my teacher, or my friend. We also
change our behavior according to different social situations.

3. Restricted behavior and play –

Play is an important part of development. Accepted knowledge says that all children would
naturally gravitate to the playground. But children with autism ‗play‘in ways that seem unusual
to others: flapping, spinning, rocking, and unwilling to take turns. They have difficulty in joining
in play that requires a great deal of social give and take. In fact, the school playground, a fluid
and unstructured place during recess, is a place where children with autism have the greatest
difficulty. This is the place where the most teasing and bullying takes place leading to most
students with autism preferring to stay away. Some behaviors seen in children with ASD -

· Repetitive body movements hand flapping, rocking, spinning); moving constantly.

· Obsessive attachment to unusual objects (rubber bands, keys, light switches).
· Preoccupation with a specific topic of interest, often involving numbers or symbols
(maps, license plates, sports statistics).
· A strong need for sameness, order, and routines (e.g. lines up toys, follows a rigid
schedule). Gets upset by change in their routine or environment.
· Clumsiness, abnormal posture, or odd ways of moving.
 · Fascinated by spinning objects, moving pieces, or parts of toys (e.g. spinning the wheels
on a race car, instead of playing with the whole car).

4. Sensory Issues –

Individuals with ASDs have sensory processing deficits which can lead to over stimulation,
stress or in some instances extreme fear.They may be hypo or hypersensitive to any of the
senses. That means what a neurotypical child may consider as a warm hug , children with ASD
who are hypersensitive may feel it is harsh squeezing. Many children with an ASD find human
touch to be uncomfortable and human interaction to be stressful because of language and
perception issues.

Now … all the characteristics have been discussed. So read them well and in the space
given below put down what you have understood .

Areas of deficit Examples

3.4 TOOLS AND AREAS OF ASSESSMENT

Assessment is the systematic process of collecting information about the child , his past and
current levels of performance, his strengths and weakness, in order to help make educational
decisions about his future.

Proper assessment is important, because basis that , the teaching methods and the kind of help
the child will receive will be decided or planned.

Assessment of children with ASD has to be broad based because the symptoms may overlap with
other disabilities. The areas that are assessed include cognition (knowledge and understanding),
communication (language and non-verbal), social, behavioural and adaptive skills.

The team of specialists involved in diagnosing a child may include:

· Child psychologists
· Child psychiatrists
· Speech pathologists
· Developmental pediatricians
· Pediatric neurologists
· Audiologists
· Physical therapists
· Special education teachers

Diagnosing an autism spectrum disorder is not a brief process. There is no single medical test
that can diagnose it definitively; instead, in order to accurately pinpoint the child's problem,
multiple evaluations and tests are necessary.

The information is collected through-

Parent interview – In the first phase of the diagnostic evaluation, the background information
about the child’s medical, developmental, and behavioral history is collected. Rating scales,
checklists, and/or inventories completed by the family member(s)/caregiver, teacher, and/or
individual. Findings from multiple sources (e.g., family vs. teacher vs. self-report) may be
compared to obtain a comprehensive profile of communication skills. When possible, parent
checklists should be provided in their native language to obtain the most accurate information

Medical exam – The medical evaluation includes a general physical, a neurological exam, lab
tests, and genetic testing. A full screening to determine the cause of his or her developmental
problems and to identify any co-existing conditions.

Hearing test – Since hearing problems can result in social and language delays, they need to be
excluded before an autism spectrum disorder can be diagnosed. A formal audiological
assessment where the child is tested for any hearing impairments, as well as any other hearing
issues or sound sensitivities that sometimes co-occur with autism is done.

Observation – Developmental specialists will observe the child in a variety of settings to look
for unusual behaviours associated with the autism spectrum disorders. The child playing or
interacting with other people is observed.

Depending on the symptoms and their severity, the diagnostic assessment may also include
speech, intelligence, social, sensory processing, and motor skills testing. These tests can be
helpful not only in diagnosing autism, but also for determining what type of intervention the
child needs:
Speech and language evaluation – A speech therapist evaluates the child's speech and
communication abilities for signs of autism, as well as looking for any indicators of specific
language impairments or disorders.

Cognitive testing – The child may be given a standardized intelligence test or an informal
cognitive assessment. Cognitive testing can help differentiate autism from other disabilities.

Adaptive functioning assessment –Evaluation for their ability to function, problem-solve, and
adapt in real life situations is also an important area. This may include testing social, nonverbal,
and verbal skills, as well as the ability to perform daily tasks such as dressing and feedingself.

Sensory-motor evaluation – Since sensory integration dysfunction often co-occurs with autism,
and can even be confused with it, an occupational therapist assesses fine motor, gross motor,
and sensory processing skills.

Assessment will result in

· Data that contribute to the diagnosis of ASD;

· Description of the characteristics and severity of communication-related symptoms;

· Recommendations for intervention, priorities and goals, and supports;

· Referral to other professionals for further testing if other disorders/conditions are

suspected or for additional data to confirm the diagnosis of ASD.

Wow!!!! So much about assessment. Lets do a quick check

You have read the

assessment and the area of
assessment. As a special
educator. What aspects will
you check? Make a checklist
of 20 items to screen out a child with ASD.
The child is three years old

Items for assessment Response Comment

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

So now, you all are aware of what is ASD and how does one assess them and also what areas we
need to look at.

Lets now move on to how does one teach the kids. There are two terms that we must familiarize
ourselves with – One is teaching approach and the other is teaching method. Teaching approaches are
a set of principles, beliefs, or ideas about the nature of learning which is translated into the classroom
and teaching methods are a systematic way of doing something. It implies an orderly logical
arrangement of steps. It is more procedural.
3.5 Instructional Approaches

There are many different opinions about how best to help children with autism. But generally
there are two general approaches to instruction:

Behavioural Approach - They are built on the premise that most human behaviour is learned
through the interaction between an individual and his or her environment. Behavioural
interventions aim to teach and increase targeted positive behaviours and reduce or eliminate
inappropriate or non-adaptive behaviours. The adult will systematically encourage certain
responses from the child and then respond in planned ways designed to either increase or
decrease certain behaviors. Behavioral approaches also carefully measure progress and modify
strategies based on the data collected.

Developmental Approach-

Developmental approaches are often more spontaneous in the way that adults will respond to the
child, and the child’s behavior. For children functioning at early stages of development,
emphasis is put on encouraging the child to develop his own ideas and to engage in social
interactions in reciprocal ways. In many of these approaches, the focus is on thinking about the
‘whole child’ including the child’s regulatory and sensory challenges.The assumption that the
child is an active learner;

Instruction in naturally occurring environments;

Creating motivating contexts and routines;

Building on the child’s interests;

Development of goals based on child’s current level of development as well as his or her
individual strengths and needs;

Acknowledgement of all attempts to communicate; and

The recognition that “learning is transactional in nature, meaning that it addresses the
interdependent and reciprocal nature among the child with ASD social environment, and the
interaction between the individual and the environment over time”.
Advocates of these approaches assume that individual development and learning are complex
dynamic processes that take place within a social context. Relationships are not just a desired
developmental outcome; they are the means through which the growing child learns to
communicate, regulate his or her emotions, and establish a foundation for complex thinking and
increasingly complex social interaction. Developmental relationship-based approaches focus on
enhancing relationships between caregivers and children in ways that support the child’s
movement through typical levels of development.

3.6 - Teaching Methods

There are many educational methods and strategies available to families and schools today. We
must encourage the families to look at all of the methods and, along with the child’s teacher or
other professionals, decide on what method , or combination of methods best fit the child and the
family. While there are no conclusive studies showing that one method is better than another, we
do know that the most affective are intensive and implemented as early as possible. Some
teaching methods based on the approaches are :

§ Discrete Trial Instruction

§ Floor time

§ Pivotal Response Training

§ TEACCH Method

It is important that families and educators identify specific skills that they would like to work on,
and continually monitor instruction to see if progress is being made. If progress is not being
made, it is critical that the team seeks to understand why this may be, and how instruction might
change to better address the child’s needs.

We now give examples of the first three approaches listed above (discrete trial instruction;
activity-based instruction; developmental intervention) to demonstrate that the same skill can be
taught in a variety of ways. The skill that is exemplified below is “imitating an adult.”

Discrete Trial Instruction (DTI)

The "Discrete Trial" method is a frequently used intervention based on Applied Behavior
Analysis (ABA). It is a method of teaching in simplified and structured steps. Instead of teaching
an entire skill in one go, the skill is broken down and “built-up” using discrete trials that teach
each step one at a time. Here, specific skills are taught to a child in a one-on-one structured
learning setting. Usually, a child is given a specific instruction by his teacher, and the child
responds. The child is either rewarded for a correct response, or provided with a correction for an
incorrect response.

Eg - Read the example to see how "Imitation" is taught by the teacher.

Reena sits across from Suraj, making sure he is looking at her and paying attention. She says, "do this"
as she touches her own nose. If Suraj imitates the action by touching his own nose, Reena will praise
him ("Good job, Suraj!") and give him a reward such as a raisin, which he loves. If does not touch his
nose, Reena will "prompt" him to touch his nose by taking his hand and helping him touch his nose.
Reena may repeat this sequence for a total of 10 times in a row each day, until Suraj can touch his nose
consistently when asked to "do this."

Floor Time

Its premise is that adults can help children expand their circles of communication by meeting
them at their developmental level and building on their strengths.

Floortime Method, challenges children with autism to push themselves to their full potential. It
develops “who they are,” rather than “what their diagnosis says.Floortime encourages parents to
engage children literally at their level – by getting on the floor to play. In Floortime, therapists
and parents engage children through the activities each child enjoys. They enter the child's
games. They follow the child's lead. Therapists teach parents how to direct their children into
increasingly complex interactions.

Pivotal Response Training –

Pivotal Response Treatment (PRT) is based on behavioral treatments for autism. Derived from
applied behavioral analysis (ABA), it is play based and child initiated. Its goals include the
development of communication, language and positive social behaviors and relief from
disruptive self-stimulatory behaviors.
Rather than target individual behaviors, the PRT therapist targets “pivotal”(focused , central)
areas of a child's development. These include motivation, response to multiple cues, self-
management and the initiation of social interactions. The philosophy is that, by targeting these
critical areas, PRT will produce broad improvements across other areas of sociability,
communication, behavior and academic skill building.

Motivation strategies are an important part of the PRT approach. These emphasize “natural”
reinforcement. For example, if a child makes a meaningful attempt to request, say, a stuffed
animal, the reward is the stuffed animal – not a candy or other unrelated reward. Though used
primarily with preschool and elementary school learners, PRT can also help adolescents and
young adults.

TEACCH: TEACCH is a structured teaching method that provides an organized school

environment with a strict schedule, visual teaching methods and short, clear instructions.
TEACCH programs can easily be personalized.

Sensory Integration Therapy: Therapists use sensory integration therapy to help children with
autism who have repetitive behavior or sensory issues. The therapy can help some children
develop language skills, especially with vocal exercises.

Children with autism who may be in your class have a different learning style. This is because
they view the world differently. They respond to the stimuli from the environment differently
than those without autism. The class room might cause at times a sensory overload. The social
nature of a school or class room may make it difficult for a person with autism to function as he /
she will have difficulty with social communication. The person with autism is predominantly a
strong visual & experiential learner.
Remember all visuals and activities you use to support your teaching will not only help your
student with autism but all your students.
The child with autism has his/her own strengths, which can prove beneficial for learning as well
as participation in the school activities.
Some methods that can be used in school settings are –

A child with Autism usually has:

· Good visual memory
· Good long term memory
· Ability to discriminate between pictures
· Ability to match similar objects, pictures etc.
· Ability to identify particular visuals
· Some scan very quickly (For reading & looking at any visuals)
· Some may look at any presented materials for short time and then look away.
· Most CWA learn quickly through experience (eg. number are understood better if CAW uses
number in the environment using objects , acting out words like ―runǁ, ―quickǁ, ― slowǁ
· Routines that have a concrete function like snack time , getting ready for going home.
· Many are independent in everyday activities like eating, computer games etc. But have fine
motor and motor coordination issues like buttoning, tying shoe laces , and sports .
· They like routine and predictability and need to be told beforehand of any change of routine.
· Structure and organization increases the progress.

So ‘how do I as a special educator help the students in a regular class’?? Must be the question on
your minds, because all the above methods are extremely structured and need to be carried out
on a one-to-one basis . Some methods are
• Use visual timetables and visual cues to indicate changes.
• Send home the timetable as soon as possible.
• Use photographs for example, new teachers, students in class or playground.
• Ensure the student has strategies to stay calm. A quiet area, walkman with calming
music and favourite book or activity.
• ‘Buddy System’ who helps the student find the next class
• Provide structured and predictable environment
• Note aspects of the tasks and activities that create frustration
• Plan for transitions and prepare the student for change
And finally remember the following because to make the interventions work, team work is
essential!!
 When developing an educational approach for the child with the evaluation
team, here are some things to keep in mind as a special educator
· Begin intervention as soon as possible.
· Develop an intervention that is focused and on-going.
· Engage the child in activities with others as frequently as possible.
· Develop an individualized program that meets the child's specific needs.
· Collaborate closely with child's teachers and therapists.
· Encourage all professionals to sit down together as a collaborative team to develop
instructional programs, monitor progress, and modify as needed.
· Focus on developing your child's communication skills, social skills, and relationships.
· Create predictable environments, and use visual cues to help understand school and
family routines.
· Work with your child's teachers and therapists to ensure the effectiveness of his
educational program and make changes as needed to ensure continued growth and
progress.

3. 7 Vocational Training And Career Opportunities

It has been known for decades that individuals with autism spectrum disorders (ASD), including
those with significant impairment or who have behaviors that others find challenging, can work
when they are given appropriate supports.Individuals with ASD will also benefit from
employment. Benefits include improved emotional state, greater financial gain, decreased
anxiety, greater self-esteem, and greater independence. Nonetheless, employment outcomes for
individuals with ASD have traditionally been poor . Even those who do find work are often
underemployed or do not hold onto jobs for a long period of time.
Just because there are not much records for individuals with ASD doesn’t mean that most
cannot work. People with ASD can work when we can help them find the right job match and
when appropriate and individualized supports are built in. It is important to recognize that each
person with ASD is unique. Even those who share a common specific diagnosis differ
dramatically from one another in their skills, interests, motivation, ability to communicate,
behavior, and social ability. In itself, the knowledge that an individual has an ASD diagnosis is
of little use to a professional helping the person find and keep a satisfying job. Instead, the
employment specialist must develop a thorough understanding of the individual’s unique
characteristics, learning style, strengths, and, most importantly, interests .
Achieving a Good Job Match: Considerations For Placement Planning and Assessment
The most important consideration in helping an individual with ASD find a job is the job match.
When helping a person with ASD find a good job match, three broad areas must be considered:
1. The interests and skills of the person with ASD;
2. The individual with ASD’s learning style; and
3. The environmental demands on the worker with ASD—including communication, sensory,
social, and organizational.
It is imperative to match the job to the unique set of strengths, interests, and passions that the
person with ASD brings to the situation.
For example - Jay loves to travel in vehicles and would spend most of his day in a car if he
could. His team is trying either to carve out a delivery position for him with an existing company
or help him start his own delivery business.
Reena is very interested in women’s and baby clothes. She works in a department store re-
shelving and re-hanging clothes left in the changing rooms. Alicia hangs the clothes according
to size using the color codes on the tags.
Shama with autism was very limited in her communication and as having a history of
challenging behavior. However, she also is very meticulous and detailed oriented. This helps her
in being extremely efficient in her work shelving books in a library.
Even Dr. Temple Grandin as a child , became obsessed with cattle handling equipment at her
aunt’s ranch. She was encouraged to pursue her interests and went on to become one of the
world’s leading experts on the design of cattle handling facilities.
It is not essential that a job initially be a perfect match with the person’s skills. For example, a
person with ASD might find a job (s)he is interested in but not have all the necessary skills to
perform the job independently. Persons with ASD can learn new skills throughout their lives.
Additionally, the skills that a person can independently demonstrate currently tells us little about
what that person can do with appropriate supports. The discrepancies between the demands of
the job and the person’s existing skills must be assessed so that those discrepancies might be
reduced through teaching or accommodation. Assessment needs to be a dynamic process that
looks at how a person performs in response to various supports over time.
An important aspect of determining appropriate supports is assessing the individual with ASD’s
learning style. For example, many—but not all—individuals with ASD are visual learners and
respond well to visual prompts. Many do well with picture or written cues. Others may respond
well to a combination of visual and verbal prompts. Asking a person with ASD to imitate a task
performed by a co-worker may be the best strategy in some cases. Another common strategy is
to provide the employee with an example of a completed product. Often parents, family
members, former teachers and others who know a person well have a good understanding of a
person’s learning style.
It is also important to assess the work environment to determine the match between the
communication, sensory, social, and organizational demands of the job and the needs of the
individual with ASD. Again, the match between the demands of the environment and the needs
of the individual does not have to be perfect. It is possible to introduce accommodations and
instruction that will help create a better fit between the employee with ASD and the environment.
After some potentially good job matches for an individual with ASD, based on his or her unique
skills and interests, have been identified, it is important to examine in more detail the
communication, sensory, social, and organizational demands of the job. In each of these four
categories, the following sections will address:
· Possible issues that could interfere with success,
· The match between the work environment and the person’s needs, and
· Possible supports and accommodations.
· What should be assessed?
· Interests and strengths (often assessed through person-centered planning)
· Specific work skills
· Learning style
· Communication skills and required supports, including need for augmentative or alternative
communication (AAC)
· Social interaction and behavior and effective supports
· Sensory issues—need for certain sensory inputs to relax or need to avoid certain stimuli
· Need for structure and predictability and effective supports for the individual
· The physical and social environment of a potential workplace
· Who Can Help?
· The individual with ASD
· Family members or friends who know the person well
· Former teachers
· Residential support staff
· Occupational Therapists (OT) and Physical Therapists (PT), especially regarding motor and
sensory considerations
· Speech therapists, for communication assessement or to help design AAC
· Potential employers or co-workers

So we can see that for having a or planning a career or choosing a vocation can be done, if we
are able to identify all the areas effectively, also train the young adults preservice and support
them in service..

3.8 Summary
Finally students we have come to the end of this module/paper. I am sure you have got a good
understanding about autism . We have started with what is autism and the definition of autism,
we have also seen a comparison between DSM IV and DSM V diagnosis. We moved on to
characteristics, as well as assessment. This was followed by the various approaches and methods
of handling kids with autism. Finally we ended the module with how to lead them towards
careers and vocation.
3.9 Study Questions

Please answer the following questions

Q1 . Write down the definition of ASD.
Q2 What is the difference between ASD and Social communication disorder?
Q3. List down the characteristics of ASD.
Q4 Compare behavioural and developmental approach of handling kids with ASD.
Q5 In an inclusive classroom what kind of adaptations can you use to help the students.

3.10 References
· Pierangelo, R., & Giuliani G.A. (2003). Transition services in Special Education,
Allyn & Bacon, London.
• Smith, D.D. (2003). Introduction to Special Education Teaching in an Age of
opportunity. Allyn & Bacon, Boston.
http://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/basics/definition/con-
20021148
http://www.autism.org.uk/about-autism/introduction/what-is-autism.aspx
http://www.pbs.org/parents/inclusivecommunities/autism4.html
http://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935303&section=Assessment#Early
_Indicators
http://muautismrepetitiveplaypatterns.blogspot.in/
http://www.helpguide.org/articles/autism/autism-spectrum-disorders.htm
http://www.communityinclusion.org/article.php?article_id=266

3.11 Suggested Readings

· Myles, B.S., & Simpson, R.L. (2003). Asperger’s syndrome: A guide for educators and
parents. PRO-ED, Texas.
• Reddy G.L., & Rama, R. (2000). Education of Children with Special Needs.
Discovery Pub, New Delhi.
• Siegel, B. (1996). The World of Autistic Child. Oxford University Press, New York. .

• Simpson, R. L., & Myles, B, S. (2008). Educating Children and Youth with Autism:
Strategies for Effective Practice. Pro Ed. Texas