Severe & Multiple Disabilities
* Concomitant impairments
* Cause severe educational problems that cannot be accommodated in a program solely for one impairment
* Example: Severe MR & cerebral palsy
* Physical disabilities can "mask" normal intelligence
* Children with intense physical, mental, or emotional problems
* Need highly specialized education, social, psychological, and medical services
* Experience severe speech/language and/or perceptual/cognitive problems,
* Have abnormal behavior
* May be "medically fragile"
* Most (but not all!) have severe MR
* But they can learn!
* There is no such thing as a human "vegetable" !
* Unable to perform self-care independently
* But can participate when assisted
* Do not have typical social interactions
* But can develop friendships
* Difficulty communicating
* Can use "augmentative communication"
* Motor delays/impairments
* Due to abnormal muscle tone (too low, too high)
* Muscle atrophy, contractures
* Sensory impairments
* Vision & hearing problems
* Special health care needs
* Catheterization
* Tube feeding (G-tube or G-button)
* Respiratory ventilation/suctioning
* No identifiable cause 40% of the time
* Most with known cause are due to prenatal biomedical factors
* Genetic metabolic disorders
* dysfunction in production of enzymes leading to a buildup of toxic substances in the brain
* Brain malformations
Prevention
* Some cases are preventable through:
* Prenatal testing/
* Prenatal fetal surgery
* Postnatal screening for metabolic disorders
* PKU
* Immunizations
* Protect pregnant women from rubella
* Genetic counseling
* Low incidence
* 1-1.6% of special education students
* Most are identified at birth
* Obvious congenital anomalies
* Low APGAR score
* Measure of heart rate, respiratory effort, muscle tone, gag reflex, & color
* IQ tests are not valid for this population
* Developmental assessment
* Standardized developmental checklists
* Does not result in useful information for planning IEP
* Ecological assessment
* Assess skills needed to function in various environments
* Results in development of functional IEP goals
* MAPs
* Making Action Plans -- a curriculum planning process
* Ecological curriculum
* Similar to "life-skills"
* Focus is on learning functional skills & social relationships
* Student participates in shared activity with non-disabled peers
* Multi-level curriculum
* Curriculum overlapping
* Systematic instruction
* Specific procedures with prompts, data collection, positive reinforcement
* Partial participation
* Use of adaptations
* Students today are in many settings
* Residential
* Special school
* Special classes within a neighborhood school
* Totally included in regular classes
* Research supports positive effects of inclusion, with placement in age-appropriate & grade-appropriate settings
* Professionals
* Teachers, paraprofessionals, medical, OT, PT, SLP
* Families
* Siblings, extended family, parent support groups
* Students/Community
* Non-disabled peers participate in MAPs, Circle of Friends
Through the Lifespan
* Early childhood years
* Early intervention is critical!
* Inclusion promotes positive relationships
* Elementary years
* Schools use collaborative problem-solving, cooperative learning, adaptations
* Middle/secondary years
* School service programs provide support
* Adult years
* Need continued support