Chapter 17: Developmental Delays and Intellectual Disabilities KIN 583- Medical and Pathological Issues Jeff Wascavage

“People with intellectual disabilities have diverse abilities and potential, so educators must be prepared to accept this diversity”. Joseph Winnick- Adapted Physical Education and Sport- 5 th Edition 2

Developmental Delay Temporary diagnosis Inability to achieve age-appropriate neurodevelopmental milestones (language, motor, and social-adaptive development). At risk for Developmental Disabilities, especially Intellectual Disabilities 3

Developmental Delay The presence of a developmental delay does not always indicate a developmental disability. Some issues resolve over time (expressive language or gross motor abilities). 4

High Risk Conditions Prematurity Low Birth Weight Perinatal Complications Chronic Physical Health Conditions Expose to Environmental Hazardous Substances Maternal Functioning comprised by depression Low Socioeconomic Background 5

Newest Definition of Intellectual Disability According to the AAIDD (American Association on Intellectual and Development Disabilities) “Intellectual disability is a disability characterized by significant limitations both in intellectual functioning and in adaptive behavior, which covers many everyday social and practical skills. This disability originates before the age of 18.” No longer using Mental Retardation as a label. 6

Key Terms Intellectual functioning—also called intelligence—refers to general mental capacity, such as learning, reasoning, problem solving, and so on. One criterion to measure intellectual functioning is an IQ test. Generally, an IQ test score of around 70 or as high as 75 indicates a limitation in intellectual functioning. Standardized tests can also determine limitations in adaptive behavior, which comprises three skill types: – Conceptual skills—language and literacy; money, time, and number concepts; and self-direction. – Social skills—interpersonal skills, social responsibility, self- esteem, gullibility, naïveté (i.e., wariness), social problem solving, and the ability to follow rules/obey laws and to avoid being victimized. – Practical skills—activities of daily living (personal care), occupational skills, healthcare, travel/transportation, schedules/routines, safety, use of money, use of the telephone. 7

Classification Methods Degree of intellectual impairment Required supports Domains of disability Etiology 8

1. Degree of Intellectual Impairment 4 degrees of severity – Mild (IQ to approximately 70-75) – Moderate ( IQ to approximately ) – Severe ( IQ to approximately 30-35) – Profound (IQ below 20-25) – Average Intelligent Quotient is 100 with a standard deviation of 15 points (on most tests) 9

2. Required Supports This approach focused on the ability of the individual to function in an inclusive environment. Intermittent – episodic need. Limited- needed for specific periods of time. Extensive- need regularly for an extended period. Pervasive- constant, intense need, and potentially life sustaining. 10

3. Domains of Disability 5 Domains: 1.Pathophysiology-cellular, structural or functional events resulting from injury, disease or genetic abnormality. 2.Impairment- losses that result from a pathophysiological event. 11

3. Domains of Disability 3. Functional Limitation- the restriction or lack of ability to perform a normal function 4. Disability- the inability to perform or limitation in the performance of activities. 5. Societal Limitation- barriers to full participation in society. 12

4. Etiology (Origins/Causes) Mild Intellectual Disability- environmental factors (abusive parents, socioeconomic status) Severe Intellectual Disability- biological origin (genetic syndrome, fetal deprivation, perinatal impairment, exposure to drugs of abuse, and X- chromosome abnormalities) 13

Associated Impairments Intellectual disabilities are often accompanied by other impairments. The prevalence of these associated impairments correlate with the severity of the disability. – Cerebral Palsy – Seizure Disorder – Sensory Impairments – Psychological/Behavioral Disorders – Communication Disorders – ADHD – Feeding Difficulties 14

Diagnostic Testing I.Q Test Diagnostic Adaptive Behavior Scale (DABS) AAIDD suggests that professionals must consider such factors as – community environment typical of the individual’s peers and culture – linguistic diversity – cultural differences in the way people communicate, move, and behavior 15

Diagnostic Adaptive Behavior Scale Scheduled to be released in 2013 Designed for use with individuals from 4 to 21 years old. Provides precise diagnostic information around the cutoff point where an individual is deemed to have “significant limitations” in adaptive behavior. The presence of such limitations is one of the measures of intellectual disability. Measures conceptual skills, social skills, and practical skills. 16

Treatment Educational Services Leisure and Recreational Needs Behavior Therapy Use of Medication Treatment of Associated Impairments Family Counseling 17

Strategies in Physical Education Teach one skill or concept at a time Simple games and activities Small group or one on one instruction Plenty of opportunities to practice skills Specific feedback to reinforce or prompt behaviors Assistive Technology Integrate academic concepts into lessons Learning Labs Specific Goals and Objectives 18

Goals and Objectives Avoid “The Bag of Magic Tricks Syndrome” Goals need to be important to the child, parents, and teachers. Teachers need to identify what tasks are important and work on these skills to help students participate in other inclusive activities. Students need to be working towards meeting specific and measurable objectives. Communicate with parents. 19

Skill Development Paper Toss (Overhand Throwing Activity) – Point non-throwing side/shoulder to the target (i.e., if left handed thrower, point right shoulder/side towards target) – Throwing arm back behind head – Step with your opposite foot towards target (i.e., if throwing with left hand, step towards target with your right foot) – Follow through by letting your throwing arm come across the opposite side of your body or point at target – To get the feel of the full throwing motion throw at something that is far away Cues from PECentral 20

Learning Labs Active Learning Stations – Alphabet Rock Wall – Mathematics Balance Beam – Bean Bag Toss Letter Sounds – Poly Spot Spelling/Counting 21

Curriculum Integration Games that Integrate Academics into Physical Education – Dribble Scrabble – Pyramid Battle (PE Universe) – Scooter Monopoly 22

Curriculum Integration Scooter Monopoly 23

Assistive Technology Personal Computers and Programs iPad applications Communication Devices Reading Software FM Transmitters Alert Systems Visual Planners/Schedules 24

Did you know? 25