1. Chapter 12 Low Incidence Disabilities: Severe/Multiple Disabilities, Deaf-Blindness, and Traumatic Brain Injury
William L. Heward Exceptional Children: An Introduction to Special Education, 8e Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey All rights reserved.

2. Severe and Multiple Disabilities
Severe disability
Significant disabilities in intellectual, physical, and/or social functioning
Multiple disabilities
Multiple disabilities means concomitant impairments, that causes such severe educational problems that they cannot be accommodated in special education programs solely for one impairment
William L. Heward Exceptional Children: An Introduction to Special Education, 8e Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey All rights reserved.

3. Characteristics and Prevalence
Slow acquisition rates for learning new skills
Poor generalization and maintenance of newly learned skills
Limited communication skills
Impaired physical and motor development
Deficits in self-help skills
Stereotypic and challenging behavior
Prevalence
Estimates range from 0.1% to 1% of the population
William L. Heward Exceptional Children: An Introduction to Special Education, 8e Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey All rights reserved.

4. Causes
In almost every case of severe disabilities, a brain disorder is involved
Chromosomal disorders
Genetic or metabolic disorders that can cause serious problems in physical or intellectual development
Severe disabilities may develop later in life from head trauma
In about one-sixth of all cases, the cause cannot be clearly determined
William L. Heward Exceptional Children: An Introduction to Special Education, 8e Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey All rights reserved.

5. Traumatic Brain Injury (TBI)
Definition
an acquired injury to the brain
Resulting in total or partial functional disability
Adversely affects a child’s educational performance
TBI is the most common acquired disability in childhood
William L. Heward Exceptional Children: An Introduction to Special Education, 8e Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey All rights reserved.

6. Curriculum: What Should Be Taught?
1. Functional skills - activities of daily living skills (ADLs) 2. Age-appropriate skills 3. Making choices skills 4. Communication skills 5. Recreation and leisure skills
William L. Heward Exceptional Children: An Introduction to Special Education, 8e Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey All rights reserved.

7. Instructional Methods: How Should Students Be Taught?
Instruction must be carefully planned, systematically executed, continuously monitored
The student’s current level of performance must be assessed
The skill to be taught must be defined clearly
The skill may need to be broken down into smaller component steps
The teacher must provide a clear prompt to cue the child
The student must receive feedback and reinforcement
Strategies that promote generalization and maintenance must be used
The student’s performance must be directly and frequently assessed
William L. Heward Exceptional Children: An Introduction to Special Education, 8e Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey All rights reserved.

8. Partial Participation, Positive Behavioral Support, and Small Group Instruction
Students can be taught to perform selected components or an adapted version of the task
Positive behavioral support
Use of functional assessment methodologies to support student’s placement
Advantages of small group instruction
Skills learned in small groups may be more likely to generalize
Provides opportunities for social interaction
Provides opportunities for incidental or observation learning from other students
May be a more cost-effective use of teacher’s time
William L. Heward Exceptional Children: An Introduction to Special Education, 8e Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey All rights reserved.

9. Where Should Students with Severe and Multiple Disabilities Be Taught?
Benefits of the neighborhood school and inclusion
More likely to function responsibly as adults in a pluralistic society
Integrated schools are more meaningful instructional environments
Parents and families have greater access
Helps develop range of relationships with nondisabled peers
Students with severe disabilities are more likely to develop social relationships with students without disabilities if they are included at least part of the time in the regular classroom
William L. Heward Exceptional Children: An Introduction to Special Education, 8e Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey All rights reserved.

10. The Challenge and Rewards of Teaching Students with Severe and Multiple Disabilities
Teachers must be sensitive to small changes in behavior
The effective teacher is 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
William L. Heward Exceptional Children: An Introduction to Special Education, 8e Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey All rights reserved.