Children with Severe &

Multiple Disabilities
Introduction
Severe & Multiple Disabilities
Persons with multiple disabilities have a combination of two or more serious
disabilities (e.g., cognitive, movement, sensory), such as mental retardation
with cerebral palsy.
Definition according to IDEA:
“Multiple disabilities refers to concomitant [simultaneous] impairments (such
as intellectual disability-blindness, intellectual disability-orthopedic
impairment, etc.), the combination of which causes such severe educational
needs that they can not be accommodated in a special education program
solely for one of the impairments. The term does not include deaf- blindness.”
(Understanding “Multiple Disabilities”, 2016)
Multiple Disabilities:
Children ages 3 to 5 are considered to have multiple disabilities when they demonstrate concomitant
cognitive, physical, and/or sensory impairments which result in severe delays in development. Children with
multiple disabilities will typically share deficits in five distinct areas of development:
• intellectual functioning
• adaptive skills
• motor skills Click to add text
• sensory functioning
• communication skills
This disability category includes those students with the most severe physical, cognitive, and communicative
impairments. Most of the students served under the multiple disability category do have some level of
cognitive impairment, but the specific diagnosis of this impairment can often be ambiguous or
undetermined. It should be noted however, that these students can also have average or even above-
average intelligence. The common connection between students in this category is not just that they have
two or more coexisting impairments, but that they generally need extensive support across many skill areas.
Characteristics
People with severe or multiple disabilities may exhibit a wide range of
characteristics, depending on the combination and severity of disabilities and
the person’s age.
Most common characteristics include:
• limited speech or communication
• difficulty in basic physical mobility
• tendency to forget skills through disuse
• trouble generalizing skills from one situation to another
• a need for support in major life activities a variety of medical issues may
accompany severe disabilities
How are Students with Severe Disabilities
Classified?
Classification can be based on AAMR levels of support system. Most
students with severe disabilities will need extensive or pervasive
supports.
• Intermittent Needs: support for some activities
• Time-limited: Needs support during certain periods of time during life
• Extensive: Intensive support in one or more environments
• Pervasive: Intensive assistance in more than one setting on an
ongoing basis Intensive
Causes
In most cases, the cause of severe and multiple disabilities is unknown
Most common causes may include:
• abnormal chromosomes
• developmental problems in the brain
• environmental issues
• disorder in genetic metabolism
• complications during or after birth
• head trauma and disease later on in life
Assessments Used to Identify the Disability
Common for a pediatrician to make the diagnosis right after birth or within the first year of a child’s life, as
they miss certain developmental milestones
When a concern is identified, formal assessments are given by an interdisciplinary team:
Pediatrician, speech and language pathologists, physical/occupational therapists, and early intervention
specialists
Assessments include evaluation of:
• Fine and gross motor skills
• Reflexes Vision / Hearing
• Breathing control
• Sucking and swallowing Seizure Activity
• Most common assessments include individual intelligence tests and tests of adaptive behavior Children are
often diagnosed at a very young age
• When assessing children with multiple disabilities, they typically share deficits in Intellectual functioning
Adaptive skills Motor skills Sensory functioning Communication skills
Interventions for Multiple Disabilities
Early diagnosis and early intervention is key to treating children and youth with multiple disabilities
Early Childhood Years
• Services and supports are both child- and family-centered and holistic
• Include infant stimulation programs to provoke sensory, cognitive, and physical responses that help newborns connect with their environment
Preschool Aged Children
• Continued emphasis on family involvement
• Goal is to maximize social communication, motor skills, cognitive skills, self-care, play, etc. for child Develop child’s social interaction and
classroom participation skills and prepare the child for a transition into inclusive school placements “The earlier, the better”
Elementary School Years
• Self-determination- to enhance a child’s independence level both in the community and at home
• Positive relationships with parents and family members show support for the child and more collaboration when working with school
programs
• Effective educational programs focus on function skills- skills that will be meaningful to the child in multiple environments
• Assistive technology can be used to increase, maintain or improve functional capabilities of students with multiple disabilities (includes
communication aids)
Adolescent Years
• Important goals for transitioning to adult life: Establish a network of friends/allies Develop ability to use community resources on a regular
basis
• Secure a paid job that supports use of community resources and interactions with peers Establish independence in making lifestyle decisions
Teaching Students with Severe and Multiple Disabilities
•Teaching students with severe disabilities is difficult and demanding. It
requires teachers to:
• be well organized, firm, and consistent
• be knowledgeable about one-to-one and small group instructional
formats
• be able to work cooperatively with other teachers and related service
professionals
• maintain accurate records and constant planning for future needs of
students
• be sensitive to small changes in behavior
• be consistent and persistent in evaluating and changing instruction to
improve learning and behavior
•Working with students who require instruction at its very best can be highly
rewarding to teachers
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