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Moderately Intellectually Disabled
Anna Gallacher, Liz Cunningham, Megan Morelli, Megan Weaver
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Intellectually Disabled
On October 5, 2010, U.S. President Barack Obama officially signed bill S into federal law. Rosa’s Law removes the terms “mental retardation” and "mentally retarded" from federal health, education and labor policy and replaces them with people first language: “individual with an intellectual disability” and “intellectual disability.” Local government New York: Senate bill 7889 was signed into law by Governor Paterson on July 13, 2010
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Intellectually Disabled
The R-word is the word 'retard(ed)'. Why does it hurt? The R-word hurts because it is exclusive. It's offensive. It's derogatory. Eliminating the R-word from all usages is a starting point toward creating more accepting attitudes and communities for all people. Language affects attitudes and attitudes affect actions.
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What is Intellectual disability (ID)?
A developmental disability characterized by significant limitations in intellectual functioning and two or more adaptive skill areas. Other terms: Cognitive Disability Mental Deficiency Mentally Handicapped
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What is Intellectual disability (ID)?
Intellectual functioning is defined by an IQ test Adaptive skills refer to skills needed for daily life. Ability to produce and understand language Self-care skills Social skills Functional academic skills (reading, writing, math) Job related skills
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Degrees of intellectual disability Based on a level of functioning
Mild 85% of ID population IQ Score: 55-70 Can often acquire academic skills up to about the 6th grade level Have the greatest opportunity to become self-sufficient and live independently with community and social support Moderate 10% of ID population IQ Score: 35-54 Can carry out work and self care tasks with moderate supervision Are able to function successfully within supervised communities like group homes
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Degrees of intellectual disability Based on a level of functioning
Severe 3-4% of ID population IQ Score: 20-40 May master very basic self care skills and some communication skills Most can live successfully in a group home Profound 1-2% of ID population IQ Score: Below 20 Retardation is often caused by an accompanying neurological disorder Require a high level of structure and supervision
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Another Classification System Based on level of required support
American Association on Mental Retardation (AAMR) has developed another diagnostic classification system that focuses on individuals capabilities rather than their limitations. Intermittent support: needed only occasionally (mild) Limited Support Extensive Support Pervasive Support: daily, life long (profound)
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Prevalence 1% of the general population = 2.5 million people in the United States. 10.3% of students ages 6-21 served under the IDEA. 1.5:1 male to female ratio
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Applied Behavioral Analysis (ABA)
Utilizes two researched-based theories for how individuals learn: Classical conditioning Operant conditioning ABA rewards a person for making a correct choice. Incorrect choices are not rewarded. ID students learn cause and effect and eventually associate a correct choice with a reward promoting positive behavior while decreasing behaviors that do not warrant a reward.
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Example Suppose a student needs to learn to raise his hand before speaking in a classroom. ABA Break Down: 1) Raise the hand. 2) Raise the hand while remaining silent. 3) Keep the hand raised, remaining silent, until the teacher acknowledges you. 4) Once the teacher acknowledges you, put the hand down. 5) After the hand is down, speak.
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Rewards Must be valuable or desired. Each student will find different things rewarding. Only rewards that are intrinsically rewarding have a motivational effect. At first, rewards are immediate and concrete. Snacks and food rewards For behaviors that require more sustained effort, such as remaining on task for 30 minutes, a more sustained reward may be allowed to play an exciting game
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Reward System As students become familiar with the instruction and reward process, a more abstract "token" reward system can be introduced. Token reward systems use visual representations. Common examples are stickers placed on a chart, or beads placed on a bracelet. These represent a student's progress towards an ultimate, concrete reward.
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Discrete vs Chained Skills
Discrete skills - consist of a single step, have a definite beginning and ending, and can be counted as correct or incorrect. Example: Flashcards to teach numerals or fractions Chained skills- a series of discrete steps that are linked together sequentially to form a targeted skill Example: Long Division
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Characteristics Mental age range: 1-5 years old IQ ranges: 35-49
10% to 25% of all cases of intellectual disability Language: functional although intelligibility may be greatly impaired; limited ability to use a communication device Self-help: partial to nearly complete Social skills: diminished ability to form relationships; may distinguish own needs and wants but disregard the needs of others Academic skills: unlikely to progress beyond second-grade level Vocational status: capable of some degree of productive unskilled or semi-skilled labor performed under close supervision, or in sheltered workshops with ability to travel alone in familiar surroundings Adult status: seldom marry, but capable of self-management required for independent living; adapts well to life in a community living environment as well as supervised group homes
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Characteristics: Cognitive Functioning
Deficits in cognitive functioning and learning styles characteristic of individuals with intellectual disability effect the following areas: Memory Learning Rate Attention Generalization of Learning Motivation
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Memory Students with intellectual disability have difficulty remembering information. Students with intellectual disability have trouble retaining information in short-term memory. Short- term memory, or working memory, is the ability to recall and use information that was encountered just a few seconds to a couple of hours earlier. Students with intellectual disability require more time than their nondisabled peers to automatically recall information and therefore have more difficulty handling larger amounts of cognitive information at one time.
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Learning Rate The rate at which individuals with an intellectual disability acquire new knowledge and skills is well below that of typically developing children. A frequently used measure of learning rate is trials to criterion—the number of practice or instructional trials needed before a student can respond correctly without prompts or assistance. For example, while just 2 or 3 trials with feedback may be required for a typically developing child to learn to discriminate between two geometric forms, a child with an intellectual disability may need 20 to 30 or more trials to learn the same discrimination. However, slowing down the process is not the answer. Students with mental retardation benefit from opportunities to learn to “go fast”.
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Attention Students with an intellectual disability often have trouble attending to relevant features of a learning task and instead may focus on distracting irrelevant stimuli. In addition, individuals with an intellectual disability often have difficulty sustaining attention to learning tasks. These attention problems compound and contribute to a student’s difficulties in acquiring, remembering, and generalizing new knowledge and skills.
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Generalization of Learning
Students with disabilities, especially those with mental retardation, often have trouble using their new knowledge and skills in settings or situations that differ from the context in which they first learned those skills.
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Motivation Some individuals with an intellectual disability develop learned helplessness, a condition in which a person who has experienced repeated failure comes to expect failure regardless of his or her efforts. In an attempt to minimize or offset failure, the person may set extremely low expectations for himself and not appear to try very hard. When faced with a difficult task or problem, some individuals with an intellectual disability may quickly give up and turn to or wait for others to help them. Some acquire a problem-solving approach called outer- directedness, in which they seem to distrust their own responses to situations and rely on others for assistance and solutions. The current emphasis on teaching self-determination skills to students with an intellectual disability is critical in helping them to become self-reliant problem solvers who act upon their world rather than passively wait to be acted upon.
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Characteristics: Adaptive Behavior
By definition children with an intellectual disability have substantial deficits in adaptive behavior. These limitations can take many forms and tend to occur across domains of functioning. They include deficits in: Self-care and Daily Living Skills Social Development Behavioral Excesses and Challenging Behavior
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Self-care and Daily Living Skills
Individuals with an intellectual disability who require extensive supports must often be taught basic self-care skills such as dressing, eating, and hygiene.
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Social Development Making and sustaining friendships and personal relationships present significant challenges for many persons with mental retardation. Limited cognitive processing skills, poor language development, and unusual or inappropriate behaviors can seriously impede interacting with others.
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Behavioral Excesses and Challenging Behavior
Students with an intellectual disability are more likely to exhibit behavior problems than are children without disabilities. Difficulties accepting criticism, limited self-control, and bizarre and inappropriate behaviors such as aggression or self-injury are often observed in children with an intellectual disability .
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Assessments Bayley Scales of Infant Development
Differential Ability Scales (DAS) Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R) Wechsler Intelligence Scale for Children-III (WISC-III) Wechsler Adult Intelligence Scale - Revised (WAIS-R) Stanford-Binet Intelligence Scale 4th Ed. McCarthy Scales of Children's Abilities
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Bayley Scales of Infant Development
Measures mental and physical, as well as emotional and social, development. The test, which takes approximately 45 minutes, is administered individually by having the child respond to a series of stimuli. The Mental Scales, which measure intellectual development, assess functions such as memory, learning, problem-solving ability, and verbal communication skills. Often, the Bayley scales are used to determine whether a child is developing normally and provide for early diagnosis and intervention in cases of developmental delay, where there is significant tardiness in acquiring certain skills or performing key activities. Additionally, they can be used to qualify a child for special services and/or demonstrate the effectiveness of those services.
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Differential Ability Scales (DAS):
The Differential Ability Scales is an individually administered battery of cognitive and achievement tests for children and adolescents aged 2 years, 6 months through 17 years, 11 months. It is divided into three levels: Lower Preschool (ages 2 years, 6 months through 3 years, 5 months) Upper Preschool (aged 3 years, 6 months through 5 years, 11 months) School-Age (6 years, 0 months through 17 years, 11 months) The DAS was designed to measure specific, definable abilities and to provide interpretable profiles of strengths and weaknesses.
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Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R)
The WPPSI-R is an individually administered, norm-referenced, standardized test for children ages 3 years to 7 years 3 months to assess intelligence. It is organized into 2 groups of subtests, perceptual-motor (performance) and verbal. This instrument cannot be used with severely disabled children (IQ's below 40) and, with younger children, may need to be administered over two sessions due to the length of time required to complete the assessment.
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Wechsler Intelligence Scale for Children-III (WISC-III)
This intelligence test is the universal standard which School Psychologists use most often. This version of the Wechsler is standardized for children from age 6 to 16. The test is divided into two main sections. The Verbal Scale measures how well children are able to express themselves verbally and how well they are able to understand what is being said to them. The Performance Scale measures the nonverbal areas of being able to perceive spatial relationships; such as in putting puzzles together, and being able to transfer visual information rapidly. Using test interpretation, the three I.Q. scores and the specific pattern of strengths and weaknesses indicate how well the child is able to learn and whether there are any specific learning disabilities. This information is then used to predict at what academic level the child should be functioning.
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Wechsler Adult Intelligence Scale - Revised (WAIS-R)
One of the most frequently used tests of adult intelligence, it is based upon a series of subtests with two general categories of items, verbal and performance. Verbal items deal with general information, vocabulary, arithmetic tests, comprehension, similarities, analogies, etc. Performance items deal with picture arrangement and completion, block designs, and spatial relations. The test was revised in 1981 and is familiarly known as the WAIS-R, pronounced 'waiss-are.' The WAIS-R covers an age range of 16 years, 0 months to 74 years, 11 months.
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Stanford-Binet Intelligence Scale 4th Ed.
This intelligence test is also considered to be a standard tool of many School Psychologists. This test has been fairly recently revised and now provides multiple I.Q. scores (called S.A.S.'s) instead of a single I.Q. score, as before. In addition to being able to measure the verbal and nonverbal areas of a child's development, the Binet also provides a quantitative score, measuring the child's mathematical reasoning, and a memory score, measuring the child's short-term memory. The materials in this test are very appealing to children. The child has little chance to become bored with this test since the activities are changed frequently.
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McCarthy Scales of Children's Abilities
The McCarthy tests children ages 2½ to 8½. The purpose of the test is to evaluate the general intelligence level of children. identifies strengths and weaknesses in several ability areas. verbal, perceptual-performance, quantitative, memory, motor, and general cognitive skills.
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Assessment Modification Procedures
Be sure the student can read the test and understand the terms. If she cannot, have someone read it to her and explain terms she does not know. Allow extra time to complete the test or give only selected questions. Consider giving breaks during the test. If the student has difficulty writing, create a multiple-choice format, or give an oral exam with questions that are appropriate to her ability and with language she understands. In multiple-choice questions, do not use “all of the above” or “none of the above” as choices, and in true-false questions, do not use “always”, “sometimes”, and “never”. If necessary, give the student a set of questions or problems different from those given to her classmates. Have the student demonstrate understanding through an alternate format. This may be a performance rather than written test, or an oral or physical demonstration in response to questions.
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Etiology
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Placement
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Related Services
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Accommodations/Modifications
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Accommodations for physical needs…
Follow the advice of the child's occupational therapist, physiotherapist and specialist teacher (particularly for supporting movement around school, safety and confidence, adaptations for independence in self help, adaptations for the classroom and promoting learning)
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Accommodations for classroom…
Make any adaptations in the classroom inclusive individual computer in the classroom, not at the back of the classroom individual chairs that can move and fit with different tables so the child can work in different locations Help to develop a school that is physically accessible for everyone
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Modifications for language…
Use simple and familiar language Keep sentences short and concise Avoid ambiguous words Use active rather than passive verbs Avoid sarcasm, idioms, and other figurative language
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Modifications for supporting visual skills…
Place children near the front of the class Use larger type Use simple and uncluttered presentation Provide additional help with skills involving hand-eye coordination (pencil sharpener) Support children in depth judgments Use peers to help children in large spaces (hall buddy) Use lines and signs on floors and walls to help direction and to understand limits of space
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Modifications for motor skills…
Wrist and finger strengthening activities and hand-eye coordination practice Use a wide range of multi-sensory activities and materials Practice skills in real and meaningful situations to increase motivation (building blocks, science experiments, etc.) Provide additional guidance and encouragement when learning motor skills Encourage independence in small self-help skills (buttons / zippers) Practice - all motor skills improve with practice Incorporate motor skills exercises with other forms of learning
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Modifications for memory…
Help the child to understand longer sentences and instructions by filtering out the more important bits of information from a block (simplify) Lists or help sheets of the most important information or instructions, displayed on the wall and given individually Teach rehearsal techniques by repeating information Support rehearsal by cumulative, sequential visual frames (telephone numbers, addresses, times tables) Give students practice in taking messages - graduating from simple to complex Limit the amount of verbal instructions at any one time Repeat individually to ID child any information/instructions given to class as a whole Play a memory game!!
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Materials/Equipment
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Technological Materials / Equipment
Talking books in iPad: Story Mouse app Pictures and audio Phonics Practice on iPad: Phonics Genius Over 6,000 words grouped by sounds Visual and auditory Ability to record and replay speaking Quizzes Neo 2: small word processor to replace handwriting if it’s not a possibility
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Non-Tech Materials/ Equipment for Writing
Pencil grips can address many specific hand grasp problems with the wide variety of pencils and pencil grips provided. Raised-Line Paper extra space and raised lines to increase spatial awareness for students Slant Boards clip to hold paper in place and incline to help students’ posture while writing
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Non-Tech Materials/ Equipment for Reading
E.Z.C. Reader Strips bookmarks that have a see- through space for students to follow along while reading (Middle/ High School) E.Z.C. Reader Guiding Paws card with paw print on it for finger placement and see-through section for guided reading (Elementary)
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Communication Activity
Discuss: How did you feel trying to communicate using this method? al/inhandout4.htm
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Curriculum Effective instruction of students with mild to moderate mental retardation, including those with Down Syndrome, requires a blend of patience, understanding, and a belief that they can learn, coupled with the realization that progress may be slow. Help these students blend in with other students. Make sure they are as involved in class routines as other students Provide preferential seating for these students. Avoid placing possibly distracting students next to a student with a mild to moderate intellectual disability. When possible, provide a “buddy” that can help the student. You may need to alternate this responsibility as it can be rather time consuming. If parental permission is given, talk to the class about the student. Explain the student’s abilities and disabilities. Let them know what to expect in class and how they can be respond. Consider asking an older, well-respected student who has been in a class with a student with mild to moderate intellectual disability to come talk to the students about her experience.
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Adapting instruction to students with mild to moderate intellectual disability can be time consuming. It will require flexibility, creativity, and advance planning - you will probably also need the assistance of the general classroom or special education teachers. Explain new terms and use consistent terminology. Provide written or pictorial guides to assist the student in learning new terms or skills. When necessary, alter the amount of work expected, or give alternate assignments to students with mild to moderate intellectual disability Make sure you have the student’s full attention and eye contact when giving directions. Use vocabulary that the student will understand. These students may need to repeat directions back to you, or tell you what they are to do “in their own words”.
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Use concrete materials and hands-on experiences
Use concrete materials and hands-on experiences. The ability to touch and “do” will greatly enhance the learning experience for students with mild to moderate intellectual disability. Felt notes or raised staff lines will help provide concrete experience with abstract concepts. Present learning tasks in small, sequential steps. Make sure the student has completed the first step before moving to the next step. Continue to monitor the student’s understanding through the class or lesson. Reinforce newly learned skills often. Students with mild to moderate intellectual disability require consistent review and practice of skills.
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Life Skills Instruction
Leisure Skills Social Skills Self-Determination Skills Choice Making Decision Making Goal Setting Problem Solving Self-awareness Self Advocacy Independent Living Skills Money (Banking and Purchasing) Grocery Shopping (Purchasing) Home Maintenance Skills Meal Planning and Preparing Restaurant Skills (How to order properly) Safety Skills Self Care Skills Functional Reading and Math Skills
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Instructional Methodologies Classroom Information and Curriculum
Present information visually (e.g. overhead projector, posters, pocket charts, chalkboard). Use simple directions. Break down directions into small steps Assign fewer problems to a page/reduce length of assignments Give students more freedom to choose their work activities. Allow extra time to complete tasks. Avoid large group and whole class instruction
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Instructional Methodologies Attention
Use prompts, cues and lighting to capture their attention. Try using different colored or textured backgrounds for work. Minimize or remove distractions (avoid seating students near a window, door or high traffic area) Focus on one sense at a time or completing one task at a time. Look at the student to give directions; look away while he is processing the request. A student may not be able to sit on the floor without back support; use a chair, pillow or prop.
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Instructional Methodologies Reading
Since reading is language made visual, it is the ideal means of helping a student with ID with expressive language Prerequisite Skills: Listening and attending skills. Sit quietly and listen to a book Point to pictures Hold a book right side up and read from left to right Finger tracking‖ Make predictions
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Instructional Strategies Reading
Listening center: books and songs on tape Tracking text with finger and eyes Utilize high interest reading material. Encourage singing, clapping, and dancing Repetition and practice!
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Instructional Methodologies: Writing
Word journal Hands on activities: play dough, sky writing, writing in the sand, with paint
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Instructional Methodologies Math
Create functional, real world applications of acquired content: Example: Grocery Store (1) Map out route through store based on grocery list: geometry (2) Counting money to pay for groceries: Money (3) How much time they have to shop: Time and Measurement
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Instructional Methodologies Math
Assign fewer problems Allow more time Teach real world, independent living skills (currency, banking and budgets, time, shopping and cooking). Teach students with Down syndrome to sketch out problems, and then write out the arithmetic for the solution afterwards. Draw a graph/chart/picture. Act problems out Build on prior knowledge. Review learned concepts at the beginning of each math lesson. Practice should be fun, varied in content, and relevant to real life.
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Instructional Methodologies Math Manipulative
Skills which can be taught with manipulates include: Sorting and classification (e.g., puzzles of increasing complexity; matching objects and pictures; sorting by color, shape, size or function; sorting by opposites or exclusion); and Sequencing and patterns (e.g., beads or stacking cups; sequencing cards that teach first, next, last; arrange pictures to tell a story or describe past events)
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Instructional Methodologies Communication
Finger Cuing is the term used when the teacher or therapist taps his or her own mouth when speaking. This alerts the student to watch the speaker‘s mouth as he or she models the sounds or words. Finger pacing refers to holding up one finger at a time to model the sequence of sounds, syllables or words. This alerts a student to articulate or slow down.
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Instructional Methodologies Socialization
Teach, Model, and Practice Knows the major routines of the day. A visual timetable can help here. How to participate appropriately in a small group. How to respond to requests and instructions from the class teacher. How to work in an organized manner. How to cares for others in the group and is aware of their feelings.
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Post Secondary/Vocational
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Recreational Programs
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Recreational Programs
Best Day! Best Day Foundation helps children with special needs build confidence and self-esteem through safe, fun, adventure activities like surfing, body-boarding, kayaking, snow sports, and more. Seabright, New Jersey
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Recreational Programs
Camp Bright Star Camp activities include swimming, sports, games, arts and crafts, music, creative arts, special events, and trips. Special events have included a carnival, camp play, talents show, picnics and a magic show. In the past, trips have been taken to bowling alleys, mini-golf, Riverhead Aquarium and the movies. Huntington, Long Island
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Recreational Programs
Yoga classes Karate classes
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Organizations and Agencies
The Arc of the United States. NY chapter NYSARC, Inc. is America's largest non-profit organization supporting people with intellectual and other developmental disabilities and their families since NYSARC is the New York State Chapter of the Arc. They are a family-led organization, your advocates, your guides, and your educators. We're your friends. Like any good friend, we're not happy unless you and your loved ones live a rich, full life. American Association on Intellectual and Developmental Disabilities AAIDD promotes progressive policies, sound research, effective practices, and universal human rights for people with intellectual and developmental disabilities.
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Organizations and Agencies
Best Buddies Best Buddies is a nonprofit organization dedicated to establishing a global volunteer movement that creates opportunities for one-to-one friendships, integrated employment and leadership development for people with intellectual and developmental disabilities (IDD). Their mission is to establish a global volunteer movement that creates opportunities for one-to-one friendships, integrated employment and leadership development for people with intellectual and developmental disabilities (IDD).
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Bibliography: Children’s Literature
Title: Leslie's Story : A Book About a Girl With Mental Retardation Author: Martha McNey, Leslie Fish Summary: Describes the home and school life of twelve-year-old Leslie, a girl with mental retardation, and discusses mental retardation in general. Title: My Friend Jacob Author: Clifton, Lucille Summary: Sammy is a young boy who lives next door to Jacob, a teenager with mental retardation. They are best friends. Jacob teaches Sammy to name cars. Sammy teaches Jacob to knock before he enters Sammy’s room. The black and white drawings are somewhat muted and may be difficult for some children to see. The print is rather small and there are many lines of print on a page, but there is good contrast. Title: My Sister Is Different Author: Betty Ren Wright Summary: Carlo tells us what it is like to have an older sister with mental retardation.
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More Children’s Books Taking Down Syndrome to School (Special Kids in School) By: Jenna Glatzer, Karen Schader and Tom Dineen I Can, Can You? By: Marjorie W. Pitzer My Friend Isabelle By: Eliza Woloson, Illustrated by: Bryan Gough Why Are You Looking At Me?: I Just Have Down Syndrome By: Lisa Tompkins My Up & Down & All Around Book By: Marjorie Pitzer M.Ed., Illustrated by: Marjorie Pitzer Princess Jaycee: The Little Princess with Down Syndrome By: Mrs. Alessia Russell, Illustrated by: Shawna Windom Kids Like Me…Learn ABCs By: Laura Ronay, Illustrated by: Jon Wayne Kishimoto Don’t Call Me Special: A First Look at Disability By: Pat Thomas, Illustrated by: Lesley Harker What I Like About Me! Allia Zobel Nolan, Illustrated by: Miki Sakamoto A Rainbow of Friends P. K. Hallinan We’re Different, We’re the Same (Sesame Street) (Pictureback(R) By: Bobbi Kates, Illustrated by: Joe Mathieu It’s Okay To Be Different By: Todd Parr My Friend Has Down Syndrome By: Jennifer Moore-Mallinos, Illustrated by: Marta Fabrega Special People, Special Ways By: Arlene Maguire, Illustrated by: Sheila Bailey
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Bibliography: professional Literature
Families and Mental Retardation: New Directions in Professional Practice By: Diane T. Marsh Equal Treatment for People with Mental Retardation: Having and Raising Children By: Martha A. Field, Valerie A. Sanchez Mental Retardation: New Insights for the Healthcare Professional: 2011 Edition By: Q. Ashton Acton, PhD
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Activity Create or find a passage of text that is very difficult for anyone to read or understand. Have some of the words be words that are also difficult to pronounce. Pick a person to read the passage out loud and immediately explain what it means. If they stumble or get confused, pick on someone else to continue. Keep doing that. This is how it often feels to people who have intellectual disabilities who are treated without respect. People are not patient with them, expect them to respond quickly when they need some time to process information, make them feel bad for not understanding what others seem to understand easily. Be sure to explain that this is not the way people should be treated.
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Webliography cteristics-children-mental-retardation/?page=2 es/mental_retardation.htm f/10_22.pdf
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Webliography EdUFKA910ek%3D& retardation.html al-retardation/ neurological-disorders/79002-tips-for-teaching- students-with-an-intellectual-disability/
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