1. Low Incidence Disabilities

2. Prevalence Very low incidence disabilities include those with prevalence rates between 1/10 th and ½ of a percent Three very low incidence categories include: – Multiple disabilities – Deaf-Blindness – Traumatic brain injury (TBI)

3. Categories

4. Prevalence

6. Multiple-Severe Disabilities People with multiple disabilities will likely require on-going and intensive support throughout their lives They generally require the support of many specialists The emphasis for these students is on developing skills that promote independence

7. Multiple-Severe Etiology Like other disabilities, multiple factors are responsible – Heredity – Before, during, and after birth problems – Low birth weight – Unknown factors

8. Multiple-Severe Characteristics Students may have trouble: – Generalizing information – Communicating – With memory – Participating in the community without supports Students may have medical problems such as: – Seizure disorders – Vision or hearing impairments – Heart disease – Cerebral Palsy

9. Deaf-Blindness To be included in this category, students must have a combined vision and hearing deficit – Have visual acuity of 20/70 or worse in the better eye – An auditory deficit of 30 dB in the better ear Deaf-blindness is NOT absolute -- many Deaf-blind individuals can: – Move around independently – Read enlarged print – Recognize faces – Read sign language – Understand some sounds / recognize familiar voices

10. Deaf-Blindness Etiology Pre-mature birth Heredity Associated with risk factors including poverty and access to health care

11. Deaf-Blindness Characteristics Students have restricted vision and hearing, but the degree is not uniform; each individual is impacted differently Around 60% of these students have other disabilities besides their visual and hearing impairments – most commonly cognitive disabilities Common problem areas include: – Feelings of isolation – Communication – Mobility

12. TBI - breakouts Find TBI in IDEA (you have been there before), and read it. Prepare a 2 sentence summary for you notes.

13. Traumatic Brain Injury IDEA writes, – “...an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child’s educational performance. The term applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem-solving; sensory, perceptual, and motor abilities; psycho-social behavior; physical functions; information processing; and speech. The term does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma.”

14. Traumatic Brain Injury Todd writes, TBI is – an acquired injury to the brain, ranging from mild to severe, – adversely affecting educational performance, and – does not include brain injuries at birth.

15. Traumatic Brain Injury The 1990 authorization of IDEA made TBI a separate category – prior they were served under the Learning Disabilities category Medical advances since 1960s are saving more children who might not have survived

16. Prevalence Males are about 1.5 times as likely as females to sustain a TBI – why?

17. Prevalence Males are about 1.5 times as likely as females to sustain a TBI – why? The two age groups at highest risk for TBI are – 0 to 4 year olds, and – 15 to 19 year olds

18. Prevalence Males are about 1.5 times as likely as females to sustain a TBI – why? The two age groups at highest risk for TBI are – 0 to 4 year olds, and – 15 to 19 year olds African Americans have the highest death rate from TBI One million children annually experience head injury – (but only 15,000 to 16,000 have lasting effects) It is estimated that every teacher will come in contact with at least one student with TBI

19. Question: Cause What is the leading cause of TBI?

20. TBI Etiology The leading causes of TBI are (BIAA, 2007) : – Falls (28%) (think bike/skateboards, playground etc); – Car crashes (20%); – Hit by something (19%); and – Assaults (11%) Also caused by child abuse (for children under 2)

21. TBI Characteristics Students with TBI often experience: – Reduced stamina – Seizures – Headaches – Hearing loss – Vision problems – remember: More often does not result in long- term disability

22. TBI Instruction Students with TBI have difficulty with multistep tasks They need: – Consistent schedule and routine – Reduced distractions – Shortened assignments – Lots of opportunities for practice of new skills (notice the similarity between TBI and learning disability / ADHD)

23. Assessment IDEA and No Child Left Behind laws require that students with disabilities be part of statewide testing. Most students with these severe disabilities (multiple- disabilities, Deaf-blind, severe TBI) will participate in alternative assessments – Portfolio – Alternate assessment aligned to alternate standards * – Modified administration (construct irrelevant) – Accommodated administration (construct relevant)

24. Alternate Assessments Text indicates 1% - but no! – A maximum of 2% of all students are eligible to be administered alternate assessments – Depends on technical adequacy documentation (reliability and validity evidence) – Alternate assessments must still be aligned with the state's standards The IEP of a student who takes an alternate assessment must include a statement of why the child cannot participate in the regular assessment.

25. Assignment Watch the video (linked on our class website) In 2-3 sentences… – How is the soldier’s experience similar to a student’s? – Why are mTBI and PTSD coupled together in this video? – (note: video is about 20 minutes long, but the first 15mins are the most important)