Severe and Multiple Disabilities
Delays of function in at least one of the following areas, with onset prior to age 3 years:
(1) social interaction
(2) language as used in social communication, or
(3) symbolic or imaginative play.
The disturbance is not better accounted for by Rett’s Disorder or Childhood Disintegrative Disorder
Autism refers to: …a developmental disability verbal and nonverbal communication and social interaction, generally evident before age 3, that adversely affects a child’s performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change in daily routines, and unusual responses to sensory experiences. The term does not apply if a child’s educational performance is adversely affected primarily because the child has a serious emotional disturbance.
Characteristics of Children and Youth with Autism (Eaves,
1992)
Affective and Cognitive Indifference
Examples: avoids eye contact; does not like to be hugged; likes to spin jars, lids, tops, and other objects
Expressive Affect
Examples: cries on happy occasions; cries and screams when desires are not met
Passive Affect
Examples: walks on tiptoes, twirls, and overreacts to environmental changes
Anxiety and Fears
Examples: Has excessive fear of loud sounds or noises
Cognition
Examples: exhibits unique speech patterns; has recorded low intellectual levels
Traumatic Brain Injury refers to:…an injury to the brain caused by external force resulting in total or partial functional disability or psychosocial impairment or both that adversely affects 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, psychosocial behavior, physical functions, information processing, and speech. The term does not include brain injuries that are congenital or degenerative or brain injuries induced be birth trauma.
Traumatic Brain Injury: Levels of Severity (Mira, Tucker,
& Tyler, 1992)
Signs of concussion or a blow resulting in some after-effects, such as dizziness or loss of consciousness, for less than an hour; no skull fracture; majority of brain injuries are mild.
Loss of consciousness for 1 to 24 hours or evidence of a skull fracture; may develop secondary neurological problems such as swelling within the brain and subsequent complications; neurosurgery may be required.
Loss of consciousness for more than 24 hours, or evidence of contusion (actual bruising of brain tissue) or intracranial hematoma (bleeding within the brain); long-term medical care is likely; typical sequalae (consequences) include motor, langauge, and cognitive problems.
Taxonomy of Physical Health Conditions (Smith, Polloway, Patton, & Dowdy, 1995)
Orthopedically Impaired refers to: …a severe, orthopedic impairment which adversely affects educational performance. The term includes impairments caused by congenital abnormality (e.g., clubfoot, absence of some member), and impairments from other causes (e.g., fractures or burns which cause contractures, amputation, cerebral palsy).
Other Health Impaired refers to: … limited strength, vitality, or alertness, due to chronic or acute health problems, such as a heart condition, tuberculosis, rheumatic fever, nephritis, asthma, sickle cell anemia, hemophilia, epilepsy, lead poisoning, leukemia, or diabetes, which adversely affects educational performance.
Accounts for 30-40% of all cases of pediatric cancer
Most common form of cancer in childhood is a cancer of the blood-forming organs (I.e., bone marrow, spleen, and lymph nodes)
Results in an overabundance of immature white blood cells that crowd red blood cells and platelets
Treatment usually includes radiation, chemotherapy, drug therapy, and sometimes cranial radiation
Prognosis is much better today—80% are symptom-free after five years
Definition- Cerebral palsy is a condition caused by damage to the brain, usually occurring before, during, or shortly following birth. “Cerebral” refers to the brain, and “palsy” refers to a disorder or movement or posture. Cerebral palsy is neither progressive nor communicable. It is also not “curable” in the accepted sense, although education, therapy and applied technology can help persons with cerebral palsy lead productive lives. It is not a disease and should not be referred to as such. It can range from mild to severe.
Incidence
Between 500,000 and 700,000 Americans have some degree of cerebral palsy.
One in every 500 children has cystic fibrosis.
Cystic fibrosis is an inherited, fatal disease.
On the average, children will live to their mid-teens.
Characteristics: Chronic pulmonary involvement and pancreatic deficiency.
Symptoms include bronchial obstruction by abnormal secretions, a dry cough, and susceptibility to infections. The exocrine glands secrete an abnormal amount of mucus throughout the body.
Deaf-Blind refers to:… concomitant hearing and visual impairments, the combination of which causes such severe communication and other developmental and educational needs that they cannot be appropriately educated without special education services beyond those that would be provided solely for students with hearing impairments or visual impairments.
Definition: Juvenile diabetes is a metabolic disorder that results from the body’s inability to burn sugars and starches. Inadequate amounts of insulin are produced by the pancreas. Glucose (sugar) then builds up in the blood.
Hyperglycemia (Ketoacidosis)
Occurs when there is too much sugar in the body
Hypoglycemia (Insulin Reaction)
Occurs when there is too little sugar in the body.
Types of Seizures: An Overview
Involves a large part of the brain
Involves only a small part of the brain
Grand mal seizure; results in a loss of consciousness followed by convulsions
Petit mal seizure; results in a lapses of consciousness for brief periods of time
The Epilepsy Foundation of America (1992) suggests that the following are significant signs of the disorder:
1. Staring spells
2. Tic-like movements
3. Rhythmic movement of the head
4. Purposeless sounds and body movements
5. Head drooping
6. Lack of response
7. Eyes rolling upward
8. Chewing and swallowing movements
AIDS is one of the leading causes of death among children, ages 1 to 4.
Over 30% of infants born to women who are HIV positive will remain HIV positive.
Over 90% of children with HIV suffer developmental disabilities that result in some degree of mental and/or physical impairment.
Testing for HIV infection is difficult in children under 15 months of age because some antibodies may not be measurable.
Postmortem exams have revealed that in many cases of pediatric AIDS, brain mass is greatly reduced due to either microencephaly or brain atrophy.
Muscular dystrophy includes nine genetic disorders that vary in terms of genetic transmission patterns, age of onset, rate of progression, and muscle involvement.
In this type of muscular dystrophy, fat cells and connective tissue replace muscle tissue. Ultimately, children with this type lose the ability to walk, and functional use of arms and hands will be affected. Most individuals with this form of muscular dystrophy die before young adulthood.
This type of muscular dystrophy is found in both girls and boys. Onset is typically during adolescence. Progression is slower than in the Duchennne form. Some individuals will live a normal life while other may become totally disabled.
Spina bifida means “cleft spine.” Spina bifida is an incomplete closure in the spinal column. The three types of spina bifida (from mild to severe) are:
Spina Bifida Occulta
Meningocele
Myelomeningocele
There is an opening in one or more of the verebrae without damage to the spinal cord
The meninges, or protective covering around the spinal cord, have pushed out through the opening in the vertebrae in a sac called “meningocele.” how ever, the spinal cord remains intact.
This is the most common and severe form of spina bifida, in which a portion of the spinal cord itself protrudes through the back.