Understanding Developmental Disabilities

• "Disability" should not be interchanged with "handicap" or "handicapped."
• "Handicap" refers to the challenges a person with a disability faces when interacting with the environment and society.
• People with disabilities may be feared; education can diminish this dread.
• People with disabilities are willing to share experiences to educate others.

Defining Developmental Disabilities

• "Developmental disabilities" encompass physical, learning, language, or behavioral impairments.
• These disabilities cause substantial functional limitations, manifest in childhood, persist throughout life, and require ongoing support.
• Diagnosis typically occurs before age 22 and is likely lifelong.
• Most developmental disorders are diagnosed by school age when children lag behind peers.

Levels of Disability

• Disability can occur at three levels: impairment, limitation in activity, and restriction in participation.
• Early support for parents and child is important for social inclusion.

Cognitive Disabilities

• Cognitive disabilities affect thought processes and comprehension, including intellectual disability, learning disabilities, Asperger's, and brain injury.
• Individuals may process information differently or more slowly.

Physical vs. Intellectual Disabilities

• Some developmental disabilities are purely physical (e.g., deafness, visual impairment), while others involve intellectual disabilities.
• Cerebral palsy, epilepsy, and autism can cause developmental disabilities, potentially including intellectual disabilities.

Communication Disorders

• Communication disorders are often the first sign of developmental disabilities.
• Symptoms include difficulty understanding sentences or naming objects.
• Older children may struggle with abstract ideas; various aspects of learning may be hindered.

Types of Developmental Disabilities

• Nervous system disabilities
• Sensory-related disabilities
• Metabolic disabilities
• Degenerative disabilities
• Disabilities may limit functions of particular organs.

Nervous System Disabilities

• Affect the brain, spinal cord, and nervous system, impacting intelligence, learning, behavior, speech, language, convulsions, and movement.

Sensory-Related Disabilities

• Affect senses like sight and hearing.
• Communication disorders impair the speech mechanism.
• Autism spectrum disorder (ASD) is considered a lifelong developmental disability.

Metabolic Disabilities

• Genetic conditions that cause metabolism problems, often due to enzyme deficiencies, resulting in varied symptoms and prognoses.
• Phenylketonuria (PKU) is an example.

Degenerative Disabilities

• Infants may appear normal at birth but lose abilities later due to the disorder; can cause physical, mental, and sensory problems.
• Rett syndrome is an example that typically affects girls and is caused by a genetic abnormality.

Newborn Screening

• Newborn screening is part of the public health system and mandated by law to detect congenital, genetic, or metabolic disorders.
• Early detection and treatment can prevent mental retardation or death.
• Five metabolic disorders detected: congenital hypothyroidism, congenital adrenal hyperplasia, galactosemia, phenylketonuria, and glucose-6-phosphate dehydrogenase deficiency.

Severity of Disability

• Ranges from mild (minimal support) to severe (complex support system).
• Children may have single or multiple impairments.
• Interaction between health condition and environmental factors affects development.

Causes of Developmental Disabilities

• Classified into biological and environmental factors.
• Vulnerability during pregnancy refers to susceptibility to injury or alterations.
• Deviancy from normal prenatal development results in developmental disabilities.

Biological Factors

• Examples include chromosomal abnormalities (Down Syndrome), genetic causes (sickle cell), and Rh-incompatibility.
• Birth process risks include.
  • Physical trauma/mechanical injury
  • Anoxia/asphyxia.
• Postnatal risks: injuries, childhood infections, and malnutrition.

Environmental Factors

• Include nutritional deficiencies (iodine, folate)
• Infections (Zika virus, meningitis, measles)
• Exposure to environmental toxins (alcohol, drugs, lead).

Interaction of Genetic and Environmental Causes

• Environmental factors can increase the severity of genetic impairments or create comorbid conditions.
• Avoiding phenylalanine in phenylketonuria can reduce complications.

Risk Factors vs. Causes

• Risk factors heighten the likelihood of disability but are not the direct cause.
• Increased maternal age is a risk factor for Down syndrome but not the cause.

Social Determinants of Health as Risk Factors

• Lower socioeconomic backgrounds increase the risk of poor health and disability due to difficulty accessing healthcare and increased malnutrition.
• Prevalence of developmental disabilities is higher in low- and middle-income countries due to heightened environmental risks.

Exposure to Chemicals

• Many chemicals may damage the central nervous system and cause developmental disabilities.

Environmental Factors Associated with Autism

• Exposure to unsafe chemicals.
• Advanced parental age
• Exposure to air pollution
• Prenatal pesticide exposure
• Maternal obesity
• Maternal diabetes
• Maternal immune disorders
• Extreme prematurity
• Very low birth weight
• Birth difficulties leading to oxygen deprivation

Gene-Environment Interactions

• Early-life exposure to air pollution combines with gene mutations to increase autism risk.
• Lead and mercury affect brain structure development.
• Environmental toxins proposed as triggers include thalidomide, pitocin, cocaine, and alcohol.

Maternal Factors

• Autoantibodies may interfere with children's brain development; maternal diabetes or obesity is linked to increased risk.
• Fever during pregnancy may increase autism risk.
• Metals, pesticides, and other contaminants may be concerning; altered levels of essential metals or exposure to insecticides may increase risks.

Genetic Causes

• Related to brain damage and biochemical imbalance (artificial food colors, flavors, etc).

Intellectual Disability (ID) Terminology and Concepts

• Terminology has changed over time, with "intellectual disability" replacing "mental retardation."
• The term reflects changes in understanding, professional practices, and international terminology.
• Choosing a term should be done carefully and serve a clear purpose.
• Definition includes intellectual and adaptive functioning deficits in conceptual, social, and practical domains.

Intellectual Disability Diagnosis

• Deficits in General Mental Abilities: reasoning, problem-solving, planning, abstract thinking, judgment, learning from instruction and experience, and practical understanding.
• Learners may struggle with perceiving information, applying knowledge, and thinking innovatively.
• Adaptive Functioning: meeting community standards of personal independence and social responsibility.
  • Conceptual (Academic) Domain: memory, language, reading, writing, math reasoning, problem-solving
  • Social Domain: awareness of others' thoughts, empathy, communication skills, friendship abilities and social judgment
  • Practical Domain: learning and self-management across life settings
• Intellectual and adaptive deficits should be present during childhood or adolescence.

Educators and Diagnosis

• Educators cannot diagnose but can help with intervention planning and understanding severity.
• DSM-5 does not use IQ cutoffs to determine severity but rather impairments in conceptual, social, and practical domains.

Degrees of Intellectual Disability

• Mild: some academic success, independent living with minimal support
• Moderate: independent employment with limited skills, needs guidance during stress
• Severe: minimal communication skills, requires complete supervision
• Profound: little cognitive/motor ability, requires 24-hour care

Educational Classifications (Obsolete)

• Educable mental retardation (EMR): IQ 50-75
• Trainable mental retardation (TMR): IQ 25-50
• Severe and profound mental retardation (SPMR): IQ below 25
• Emphasis should be on early identification, intervention, service coordination, and documentation.

Genetic Syndromes

• Genetic syndrome is a wide-ranging error of morphogenesis (malformation/functional defect).
• It is caused by a change in DNA that ultimately deranges gene expression.

Fragile X Syndrome

• A genetic condition that causes learning disabilities and cognitive impairment, more severe in males, and can cause anxiety/hyperactivity.
• Physical features are a long, narrow face, large ears, a prominent jaw and forehead, flexible fingers, and enlarged testicles in males after puberty.
• Infants show sensory integration problems and tactile defensiveness.
• Some characteristics include; tantrum behavior and hyperactivity.
• Most fragile X individuals can be mainstreamed; sensory stimulation should be avoided.
• Vocational intervention in high school can lead to community placement.

Down Syndrome (Trisomy 21)

• A chromosomal condition that causes delays in mental and physical development, including specific physical features.
• Characterized by slower growth, facial appearance, minor anomalies, cardiovascular problems, and greater asynchrony in sensorimotor development.
• Assistance and prompting is often needed, and babbling is delayed.
• Speech impairment is commonly greater than expected.
• Variation exists, and speech may determine school readiness.
• Down syndrome leads to lack of correlation between language production, comprehension, and vocalization.
• Families should identify needs and provide balanced information and positive reinforcement.
• Input may come from child development, physiotherapy, and occupational therapy, along with stimulating home environments.

Prader-Willi Syndrome

• A multifaceted genetic condition affecting many parts of the body; causes emotional outbursts and intellectual impairment.
• This leads to behavioral problems and sleep abnormalities.
• Distinctive facial features of children include a narrow forehead, almond eyes, and triangular mouth and typically experience puberty and relative infertility.
• Cognitive strength is common in visuospatial tasks and short-term memory.
• Includes word-find and jigsaw puzzles.
• Intervention focuses on cognitive strengths/weaknesses and the behavioral disorder.

Fetal Alcohol Syndrome

• Causes distinct facial features (small eye openings, thin upper lip, smooth philtrum), slow development, and birth defects.
• Problems include seizures, delayed development, behavioral problems, poor coordination, and difficulties in motor and/or social skills.
• Strategies include adaptation of academic curricula, avoidance of overstimulation, visual cues, structured routine, and specifically designed areas.

Physical and Other Health Impairments

• Physical disability interferes with mobility, capacity, stamina, and dexterity.
• Examples include poliomyelitis, bone tuberculosis, cerebral palsy, spina bifida, amputations, fractures, and burns.
• Health impairment requires ongoing medical attention (asthma, HIV/AIDS, sickle cell, epilepsy, cancer, type I diabetes, cystic fibrosis).
• Educators should address several questions.
• Where to receive services and accommodations?
  • What curriculum and individual goals?
  • What methods of instruction?
  • Should adaptive devices be used?
  • How to address physical/healthcare needs?
  • How to communicate with parents, families, and healthcare professionals?

Approach to Learning

• Focuses on team approach with parents, teachers, medical professionals, and related professionals.

Educational Placements

• Can provide these services in; regular classrooms, resource rooms, special classes, and other restrictive settings, including hospital and homebound programs.

Consideration of Environmental Modification

• Can provide, but is not limited to, adaptive equipment and accessible facilities.

Consideration of Goals and Curriculum

• Focuses on determining after assessing characteristics, not something that can be prescribed.

Specific Descriptions in Goal Setting

• Focuses on aligning educational goals to functioning in everyday community environments and linking with relevant disciplines.

Learning Disability Definition

• Used by educational and legal systems, referred to as a specific learning disorder by medical personnel.
• Individuals have difficulty in academics, especially in reading, writing, math.
• Affects school, work, daily routines, families, and friendships.
• Immediate action may be needed if a problem is indicated.
• The three areas that are ongoing problems are reading, writing, and math which leads to one's ability to learn.
• This indicates learning disabilities are prevalent.

Causes of Learning Disability

• Causes are unknown and varied, and associated with neurological factors, genetics, neurological illness, or environmental factors.

Diagnosis

• Diagnosis can only be done through formal schooling, language delays, and troubles with earlier milestones.
• Symptoms include the interaction among task demands, severity, abilities, comorbidity, and support systems.

Examples of Symptoms by age

• Preschool.
  • Lack of interest in language sounds.
• Kindergarten.
  • Inability to write and recognize letters.
• Children.
  • Have invented spellings.
• Middle Grades.
  • Have trouble remembering dates or tests etc.
• Adolescents.
  • Often fear reading aloud.

Types of Learning Disabilities

• Include dyslexia, dysgraphia, and dyscalculia.

Definition of Dyslexia

• Indicates problems with precise/fluent word recognition, poor decoding, and spelling.

Definition of Dysgraphia

• Indicates difficulties putting thoughts on paper.

Definition of Dyscalculia

• Indicates difficulties with number-related concepts or performing math calculations.

Severity of Disabilities

• Focuses on a scale of mild to severe and the impact it has on an individual.

Direct Instruction Strategies that Can Be Used

• The goal is to do activities in a lesser time.

Cognitive Instruction Strategies that Can Be Used

• Emphasizes thinking skills to enrich learning.

Multisensory Approaches that can be Used

• Uses two or more sensory tactics to express or take in information.

Metacognitive training that can be Used

• Assists the child in a number of milestones relating to learning.

Additional Strategies that Can Be Used

• Social skills training
• Inclusion strategies
• Peer-mediated instruction
• Computer-assisted instruction
• Has a long-term viewpoint focused on self-knowledge, self-esteem, and self-empowerment.