1. Multiple and Severe Disabilities

2. Definition (From IDEA) Multiple disabilities means concomitant impairments, 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.

3. Definition (another part of IDEA) Severe disabilities refers to children with disabilities who, because of the intensity of their physical, mental, emotional problems, need highly specialized education, social, psychological and medical services in order to maximize their full potential for useful and meaningful participation in society and for self fulfillment.

4. Definition Includes: –severe emotional disturbances –autism –severe and profound mental retardation – those who have two or more serious disabilities such as deaf-blindness, mental retardation and blindness, and cerebral palsy and deafness.

5. Special and Major categories Children with Autism and Pervasive Development Disorders (not otherwise specified NOS)-Heward 13.4Heward 13.4 Deaf-blind Impairment-Heward 13.3Heward 13.3 Mental Retardation and Cerebral Palsy

6. Incidence and Prevalence Less than.5% of total special education population 124,199 total of 5 million 94,034 multiple disabilities 28,813 autism 1,352 deaf blindness

7. Etiology varied, related to various causes, genetic, pre, peri and post natal traumas

8. Characteristics Intellectual Functioning-many have severe impairments, but some are discriminated by evaluation. Difficulty performing traditional academic tasks but those that have the ability can succeed in general education class. Self-care-with support, can learn to take care of dressing, hygiene, etc. Social skills-because of lack of interaction, little chance to practice. Delayed motor development Sensory impairment-hearing and visual impairments are common Many health care needs Communication disorders Heward 13.2

9. Learning Characteristics severe speech, language and/or perceptual- cognitive deprivations

10. Behavioral Characteristics failure to respond to pronounced social stimuli self-mutilation self-stimulation manifestation of intense and prolonged temper tantrums rudimentary verbal control fragile physiological conditions

11. Educational Programs Curriculum related to functioning in projected environment: –interacting with peers, –working in groups, –participating, –communicating, complying with adult requests –community skills Heward 13.5

12. Instructional Priorities The skill to be learned has immediate utility for the student The skill has desirability The skill is acquired in a social context and is the product of social interaction The skill is acquired in the actual physical contexts that the student will use when requested The skill is practical and will be used when needed and frequently. The skill is age appropriate, supporting independence. The skill is adaptable and can be generalized in different situations.

13. Instructional Methods Task analysis Reinforcers replaced by natural cues in the environment Access to daily routine activities. Inclusion to the degree possible. Heward 13.9 Technology Heward 13.6

14. Contemporary Trends and Issues Confusing MR for other disabilities, such as hearing impairments Complicated collaboration is necessary Early intervention Generalization and maintenance of learned behaviors. Use of aversive procedures Family issues.