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Severe and Multiple Disabilities

Chapter 9

Multiple Disabilities (not severe)

Concomitant impairments (such as MRblindness, MR-orthopedic impairment, etc.), the combination of which causes such severe educational problems that they cannot be accommodated in special education programs solely for one of the impairments. The term does not include deaf-blindness. (IDEA)

Severe Disabilities (not multiple)

Refers to children with disabilities who, because of the intensity of their physical, mental, or emotional problems, needs highly specialized education, social, psychological, and medical services in order to maximize their full potential for useful and meaningful participation in society and for selffulfillment. The term includes those children.who have two or more serious disabilities such as deaf-blindness, mental retardation and blindness and cerebral palsy and deafness.

Common Characteristics
1.) extent of support required by students across all adaptive skill areas is usually extensive or pervasive 2.) two or more disabilities typically occurring simultaneously.

Describing The Characteristics

single definition for Severe/Multiple disabilities very difficult


in fact the differences among people with Severe/Multiple disabilities may be greater than the similarities five categories in characteristics helped describe the students

Intellectual Functioning

may vary widely in their academic skills


many have significant impairments in intellectual functioning assessment methodology is inappropriate for many normative samples are problem exposure to academic content may be lacking

Adaptive Skills

includes conceptual, social, and practical competency for functioning and community settings in an age-consistent way majority of population attain some level of independence

Motor Development

usually significant delay in motor development


sensorimotor impairment may result in abnormal muscle tone increased muscle tension and extremely tight muscles resulting in spasticity

Sensory Impairments

hearing and vision impairments are common with population


2 of every 5 students have sensory impairments deaf-blind have varying combinations of vision and hearing impairments

box 9-1 page 259 has suggestions for communication

Communication Skills

almost all experience communication challenges many use argumentative communication devices

Causes

no one single identifiable cause for 30 to 40 % of children born with severe/multiple disabilities majority of known cases relate to prenatal biomedical factors
also complications during birth and after birth

Genetic Metabolic Disorders


abnormality in a parent's genes can cause disorder in the child's metabolism refers to energy, growth and waste disposal which really means a person's chemical process, breaks down toxins (poisons) and moves nutrients in the bloodstream dysfunction can be catastrophic lack of conversion to useful substances accumulate to toxic levels - damaging fetus physical and mental development

Phenylketonuria (PKU) is the absence of enzyme necessary to convert essential amino acid to different amino acid. The result is mental retardation if not treated within the first few weeks of life
2 recessive must be present. two parents have a child together and both have to recessive gene there's a 1 in 4 chances for child to be affected

Preventing

advances in prenatal testing such as amniocentesis, chorionic villi sampling, and umbilical blood sampling, help identify possibly prevent multiple disabilities through fetal therapy

prenatal fetal therapy such as in-utero surgery is rapidly expanding

Identify The Prevalence

in 2001 there were 112,993 students ages 6 to 21 serve with multiple disabilities (.18 % of all students served under IDEA) an additional 1454 students with deafblindness no information on those identified with severe disabilities because IDEA does not serve that population under a separate category

Determining The Presence


most are detected at birth through Apgar test the physician ranks a child on the five physical traits: heart rate, respiratory rate, muscle tongue, gag reflex, and skin color at 1 minute and at 5 minutes after birth a score of 0, 1, or 2 for each trait, with a cumulative score below four are at risk for disabilities see page 264

Educational Placement

45 % spend more than 60 % of their time outside of the general classroom 17 % spend 21 to 60 % of their time outside of the general classroom 11 % spend less than 21 % of their time outside of the general classroom 2 % are at home or in hospital 2 % are in residential facilities 23 % are in separate facility

Assuring Progress General Curriculum


Possible for students to be successful in learning new skills academic and social Partial participation by adapting skill sequence, providing person assistance, and technology Peer tutoring has proven successful