1. © 2009 The McGraw-Hill Companies, Inc. Students with Severe Disabilities Chapter 12

2. © 2009 The McGraw-Hill Companies, Inc. Taylor/Smiley/Richards, Exceptional Students What is the History of Severe Disabilities? Historically those with severe disabilities were often segregated, maltreated, and institutionalized. Historically those with severe disabilities were often segregated, maltreated, and institutionalized. 1960’s - maternal rubella resulted in rise in number of children with dual sensory losses. 1960’s - maternal rubella resulted in rise in number of children with dual sensory losses. 1960’s - deinstitutionalization began in the U.S. 1960’s - deinstitutionalization began in the U.S. Advocacy organizations sought inclusion in schools and communities Advocacy organizations sought inclusion in schools and communities

3. © 2009 The McGraw-Hill Companies, Inc. Taylor/Smiley/Richards, Exceptional Students What is the Definition of Severe Disabilities? Because severe disabilities is not one of the 13 special education categories, it has no specific definition, but it encompasses the IDEA 04 categories of Because severe disabilities is not one of the 13 special education categories, it has no specific definition, but it encompasses the IDEA 04 categories of multiple disabilities and multiple disabilities and deaf-blindness. deaf-blindness.

4. © 2009 The McGraw-Hill Companies, Inc. Taylor/Smiley/Richards, Exceptional Students What is the IDEA 04 Definition of Multiple Disabilities? Multiple disabilities - “concomitant impairments (such as mental retardation- blindness, mental retardation-orthopedic impairment, etc.) the combination which causes such severe educational needs that they cannot be accommodated in programs solely for one disability.” Multiple disabilities - “concomitant impairments (such as mental retardation- blindness, mental retardation-orthopedic impairment, etc.) the combination which causes such severe educational needs that they cannot be accommodated in programs solely for one disability.”

5. © 2009 The McGraw-Hill Companies, Inc. Taylor/Smiley/Richards, Exceptional Students What is the IDEA 04 Definition of Deaf-Blindness? Deaf-blindness - “hearing and visual impairments, the combination which causes such severe communication and other developmental and educational problems that they cannot be accommodated in special education program solely for children with deafness or children with blindness.” Deaf-blindness - “hearing and visual impairments, the combination which causes such severe communication and other developmental and educational problems that they cannot be accommodated in special education program solely for children with deafness or children with blindness.”

6. © 2009 The McGraw-Hill Companies, Inc. Taylor/Smiley/Richards, Exceptional Students How are Students with Severe Disabilities Classified? Classification can be based on AAMR levels of support system. Most students with severe disabilities will need extensive or pervasive supports. Classification can be based on AAMR levels of support system. Most students with severe disabilities will need extensive or pervasive supports. Intermittent Intermittent Needs support for some activities Needs support for some activities Time-limited Time-limited Needs support during certain periods of time during life Needs support during certain periods of time during life Extensive Extensive Intensive support in one or more environments Intensive support in one or more environments Pervasive Pervasive Intensive assistance in more than one setting on an ongoing basis Intensive assistance in more than one setting on an ongoing basis

7. © 2009 The McGraw-Hill Companies, Inc. Taylor/Smiley/Richards, Exceptional Students What is the Prevalence of Severe Disabilities? Multiple disabilities -.2% (1 in 500) students aged 6-21 Multiple disabilities -.2% (1 in 500) students aged 6-21 Deaf-blindness - also well below 1% of the school-aged population Deaf-blindness - also well below 1% of the school-aged population

8. © 2009 The McGraw-Hill Companies, Inc. Taylor/Smiley/Richards, Exceptional Students What are Some Causes of Severe Disabilities? Genetic or biological Genetic or biological Includes fetal alcohol or other syndromes and viruses and infections such as encephalitis and rubella Includes fetal alcohol or other syndromes and viruses and infections such as encephalitis and rubella Environmental Environmental Includes trauma at birth, poisoning, accidents Includes trauma at birth, poisoning, accidents Lack of nurturance, healthcare, or early intervention may contribute to severe disabilities. Lack of nurturance, healthcare, or early intervention may contribute to severe disabilities.

9. © 2009 The McGraw-Hill Companies, Inc. Taylor/Smiley/Richards, Exceptional Students What are Possible Characteristics of Students with Severe Disabilities? Some have diminished cognitive functioning affecting abstract thinking, learning, attention, and memory. Some have diminished cognitive functioning affecting abstract thinking, learning, attention, and memory. Many have significant physical, health, and communication needs. Many have significant physical, health, and communication needs. Significant developmental delays (including speech, personal- social skills, behavior, motor, learning, attention, memory, mobility, etc.) Significant developmental delays (including speech, personal- social skills, behavior, motor, learning, attention, memory, mobility, etc.) Difficulty learning self-care skills Difficulty learning self-care skills Need for repetition to acquire skills Need for repetition to acquire skills Difficulty in the transfer and generalization of skills Difficulty in the transfer and generalization of skills

10. © 2009 The McGraw-Hill Companies, Inc. Taylor/Smiley/Richards, Exceptional Students How are Students with Severe Disabilities Identified? Often identified at birth or shortly thereafter by a physician Often identified at birth or shortly thereafter by a physician Neonatal screening, medical evaluations Neonatal screening, medical evaluations Communication disorders may be diagnosed by a speech-language pathologist. Communication disorders may be diagnosed by a speech-language pathologist.

11. © 2009 The McGraw-Hill Companies, Inc. Taylor/Smiley/Richards, Exceptional Students What are Some Common Assessments for School-Aged Students with Severe Disabilities? IQ may be assessed for school-aged population. IQ may be assessed for school-aged population. Adaptive behavior scales Adaptive behavior scales Dynamic assessments Dynamic assessments

12. © 2009 The McGraw-Hill Companies, Inc. Taylor/Smiley/Richards, Exceptional Students What Early Childhood Assessments May be Used with Children with Severe Disabilities? Medical evaluations Medical evaluations Communication evaluations Communication evaluations Transdisciplinary evaluations Transdisciplinary evaluations Assessment of family functioning Assessment of family functioning

13. © 2009 The McGraw-Hill Companies, Inc. Taylor/Smiley/Richards, Exceptional Students How are Individuals with Deaf-Blindness Identified? Audiologists assess hearing - loss at 40 dB or greater represents a significant hearing loss Audiologists assess hearing - loss at 40 dB or greater represents a significant hearing loss Ophthalmologists or optometrists assess vision - visual acuity 20/70 in the best eye with the best possible correction represents low vision Ophthalmologists or optometrists assess vision - visual acuity 20/70 in the best eye with the best possible correction represents low vision IDEA only requires a combination of hearing and vision loss that requires special education not that the student be legally blind and deaf. IDEA only requires a combination of hearing and vision loss that requires special education not that the student be legally blind and deaf.

14. © 2009 The McGraw-Hill Companies, Inc. Taylor/Smiley/Richards, Exceptional Students What Should I Teach Students with Severe Disabilities? Access to the general education curriculum should be available in early childhood and for school-aged children, with adaptations as needed. Access to the general education curriculum should be available in early childhood and for school-aged children, with adaptations as needed. Functional skills may also be needed and identified through ecological inventories, functional behavior assessments, and alternate assessments. Functional skills may also be needed and identified through ecological inventories, functional behavior assessments, and alternate assessments. Self-care Self-care Cognition Cognition Communication Communication Motor skills Motor skills Social interaction Social interaction Prepare for transition to adult living Prepare for transition to adult living

15. © 2009 The McGraw-Hill Companies, Inc. Taylor/Smiley/Richards, Exceptional Students How Should I Teach Children with Severe Disabilities? Learning skills will require more time and repetition. Learning skills will require more time and repetition. Base instruction on student’s needs. Base instruction on student’s needs. Adapt the general education curriculum goals and objectives accordingly. Adapt the general education curriculum goals and objectives accordingly. Teach chronologically age-appropriate skills. Teach chronologically age-appropriate skills. Use discrete, distributed, and massed-trial teaching. Use discrete, distributed, and massed-trial teaching. Provide for partial participation. Provide for partial participation. Use naturalistic teaching strategies. Use naturalistic teaching strategies. Work closely with paraprofessionals and families. Work closely with paraprofessionals and families.

16. © 2009 The McGraw-Hill Companies, Inc. Taylor/Smiley/Richards, Exceptional Students What are Considerations for the Instructional Environment? Students with severe disabilities and peers without disabilities can both benefit from inclusive education. Provide for peer interactions. Students with severe disabilities and peers without disabilities can both benefit from inclusive education. Provide for peer interactions. Use community-based instruction where the student will learn best - including job sites, public transportation, shopping venues, etc. Use community-based instruction where the student will learn best - including job sites, public transportation, shopping venues, etc. Provide needed supports in all environments. Provide needed supports in all environments. Adapt according to sensory needs (lighting, positioning, seating, technology, grouping, etc.). Adapt according to sensory needs (lighting, positioning, seating, technology, grouping, etc.).

17. © 2009 The McGraw-Hill Companies, Inc. Taylor/Smiley/Richards, Exceptional Students What Types of Instructional Technology Can be Used? Choose the technology that helps the individual perform the desired skills in the most effective and efficient manner. Choose the technology that helps the individual perform the desired skills in the most effective and efficient manner. Adaptive equipment needed for feeding, dressing, toileting Adaptive equipment needed for feeding, dressing, toileting Alternative/augmentative communication aids Alternative/augmentative communication aids Decide the assistive technology needed based on the IEP. Decide the assistive technology needed based on the IEP.

18. © 2009 The McGraw-Hill Companies, Inc. Taylor/Smiley/Richards, Exceptional Students What Are Some Considerations for the General Education Teacher? Welcome all students to your room. Welcome all students to your room. Show concern for the success of all students. Show concern for the success of all students. Adjust the classroom and learning environment. Adjust the classroom and learning environment. Implement adaptations and instructions to meet individual needs. Implement adaptations and instructions to meet individual needs. Select effective teaching methods and materials. Select effective teaching methods and materials. Collaborate with special educators and parents. Collaborate with special educators and parents. Assess effectiveness of instruction for student. Assess effectiveness of instruction for student.