Lecture 2 Developmental Disabilities - January 8, 2025

The Department of Psychology Developmental Disabilities PSYC-3230-01 Winter 2025 January 8, 2025 Lecture 2 Dr. Philip W. R. Ricciardi, C. Psych. Adjunct Associate Professor I acknowledge that I am on land and surrounded by water, originally inhabited by Indigenous Peoples who have travelled this a...

The Department of Psychology Developmental Disabilities PSYC-3230-01 Winter 2025 January 8, 2025 Lecture 2 Dr. Philip W. R. Ricciardi, C. Psych. Adjunct Associate Professor I acknowledge that I am on land and surrounded by water, originally inhabited by Indigenous Peoples who have travelled this area since time immemorial. This territory is within the lands honored by the Wampum Treaties; agreements between the Anishinaabe, Haudenosaunee, Lenni Lenape and allied Nations to peacefully share and care for the resources around the Great Lakes. Specifically, I would like to acknowledge the presence of the Three Fires Confederacy (Ojibwe, Odawa, Potawatomi) and Huron/Wendat Peoples. I am dedicated to honoring Indigenous history and culture while remaining committed to moving forward respectfully with all First Nations, Inuit and Métis. Announcements Each set of lecture slides will contain an announcement slide. This typically will be the third (3rd) slide. This slide will contain relevant information about the course, such as content of exams, when readings are uploaded to Brightspace, etc. Before e-mailing either me or the GA, please refer to this slide as it will likely answer your question. A system of context to International Classification of understand disabilities Functioning, Disability and Health (ICF) The International Classification of Functioning, Disability and Health, known more commonly as ICF, is a classification of health and health-related domains. As the functioning and disability of an individual occurs in a context, ICF also includes a list of environmental factors. International Classification of Diseases, 11th Revision (ICD- 11) Structure 06 Mental, behavioural or of the ICD- neurodevelopmental disorders 11 Neurodevelopmental disorders 6A00 Disorders of intellectual development  06 Mental, behavioural or Structure neurodevelopmental disorders Description of the Mental, behavioural and ICD-11 neurodevelopmental disorders are syndromes characterized by clinically cont’d significant disturbance in an individual's cognition, emotional regulation, or behaviour that reflects a dysfunction in the psychological, biological, or developmental processes that underlie mental and behavioural functioning. These disturbances are usually associated with distress or impairment in personal, family, social, educational, occupational, or other important areas of functioning. What are Developmental Disabilities? Developmental disabilities are a group of conditions due to an impairment in physical, learning, language, or behavior areas. These conditions begin during the developmental period, may impact day-to-day functioning, and usually last throughout a person’s lifetime. Most developmental disabilities are thought to be caused by a complex mix of factors. These factors include genetics; parental health and behaviors (such as smoking and drinking) during pregnancy; complications during birth; infections the mother might have during pregnancy or the baby might have very early in life; and exposure of the mother or child to high levels of environmental toxins, such as lead. For some developmental disabilities, such as fetal alcohol syndrome, which is caused by drinking alcohol during pregnancy, we know the cause. But for most, we don’t. Examples of developmental disabilities include, but are not limited to: ADHD, autism spectrum disorder, cerebral palsy, hearing loss, intellectual disability, learning disability, vision impairment, and other developmental delay What is the difference between Developmental Disabilities, intellectual disability, dual diagnosis, & comorbidity? Developmental Disabilities Intellectual Disability (ID – DSM-5) ASD FASD Cerebral Palsy LD Dual Diagnosis Always involves an Intellectual Disability plus a psychiatric disorder such as anxiety, depression or psychosis. Comorbidity or Co-occurrence Involves at least two diagnosis, such as Autism Spectrum Disorder and Cerebral Palsy or Fragile X Syndrome and Visual Impairment, or an Intellectual Disability and a Physical Impairment Developmental delay is a descriptive term to indicate that some aspect of the child’s development is delayed, such as delayed speech, or walking, or cognitive development. What are Neurodevelopmental Disorders? Cognitive-related disorders (e.g., involving functions of the brain) that are ultimately due to genetic causes and that are present from early childhood are known as neurodevelopmen­tal disorders. These disorders can also be under­stood as a group of conditions that typically have their onset in various developmental periods, most often in early childhood. In physical and more medically understood terms, neurodevelopmental disor­- ders can be characterized as impairments of the brain and cen­tral nervous system. From a psychological perspective, neurodevelopmental disorders are commonly defined as condi­tions of abnormal brain function that typically adversely affect What are Neurodevelopmental Disorders? (cont’d) It is also important to note that neurodevelop­mental disorders are innate to an individual. Such disorders can be thought of as the hard wiring of the brain and central ner­vous system that an individual is born with. The causes of various neurodevelopmental disorders include genetic influences, disorders of the immune system, infectious diseases and bacterial infections, nutritional deficiencies, expo­- sure to toxins, physical trauma, medications that may be averse to a particular individual, and even severe emotional deprivation. A primary consideration in all of these causes includes the Types of Neurodevelopmental Disorders to be discussed Clinical syndromes and disabilities that are most currently and consistently included under the category of neurodevelopmental disorders include: intellectual disabilities, communication and language disorders, specific learning disorders (reading, written language, and mathematics), autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD) and related executive function deficits, nonverbal learning disability, and  The RHPA framework is intended to : Diagnosis: better protect and serve the Regulated public interest; Health be a more open and accountable Professions Act system of self-governance; (RHPA) 1991 provide a more modern framework for the work of health professionals; provide consumers with freedom of choice; and provide mechanisms to improve quality of care. https://www.ontario.ca/laws/statut e/91r18  scope of practice -- a statement that describes what the profession does; Key controlled acts (procedures or activities which may pose a risk to the public if not features of performed by a qualified practitioner); health regulatory colleges -- a corporation the RHPA – that governs each regulated health profession responsible for regulating the 1991 practice of the profession and governing its members according to the RHPA; Health Professions Regulatory Advisory Council -- an independent, arms-length advisory body to the Minister of Health and Long-Term Care with a mandate to advise the Minister of a number of items related to the regulation of health professions; and Health Professions Appeal and Review Board -- an independent third party with a mandate to review registration and complaints decisions of the health regulatory College.  “Intellectual disability is characterized by The American significant limitations both in intellectual functioning and in adaptive behavior as Association of expressed in conceptual, social, and practical adaptive skills. This disability originates before Intellectual & age 18. The following five assumptions are essential to the application of this definition: Developmental Limitations in present functioning must be considered, within the context of community, Disabilities environments typical of the individual’s age, peers, and culture. (AAIDD) Valid assessment considers cultural and linguistic diversity as well as differences in definition communication, sensory, motor and behavioral factors. Within an individual, limitations often coexist with strengths. An important purpose of describing limitations is to develop a profile of needs supports. With appropriate personalizes supports over a sustained period, the life functioning of the person with intellectual disability, generally will improve. “.  The ICF (WHO, 2001) is a classification The system developed by the WHO that International focuses on the 'components of health'. It Classification of encompasses all aspects of health and Functioning, describes them in terms of health Disability, and domains and health-related domains. Health (ICF): A It is intended to be a universal Global Model to classification system, meaning that it is Guide Clinical about all people, not just people with Thinking and disabilities. Practice in It is intended as a complementary Childhood classification system to the WHO's Disability International Classification of Diseases (Stewart & Rosenbaum, 2003) (ICD). The WHO chose a 'biopsychosocial' approach to health, functioning and disability in the ICF model, in order to provide "a coherent view of different  National & international socio-politico trends Factors impacting upon the Developm field of developmental ental disabilities Disabilitie s in National: Community Ontario living, inclusion & increasing knowledge of disabilities: http://www.ldao.ca/ https://www.ldatschool.ca/  Services and Ontario Ministry of Supports to Community and Promote the Social Services. Social Inclusion of Persons with http://www.mcss.gov. Provincially: Developmental Changing role on.ca/en/mcss/publica Disabilities Act, tions/developmentalS of government 2008 ervices/servicesSuppo (e.g., universal rtsSocialInclusion.asp accessibility) x In July 2011, this law officially http://www.mcss.gov. replaced the on.ca/documents/en/ Developmental mcss/publications/dev Services Act elopmental/DSplainla nguage_en.pdf  The definition is as follows (Service Definition Ontario, 2011, c. 14, s. 3 (1)): of Developmental disability: Developm ental 3 (1) A person has a developmental Disabilitie disability for the purposes of this Act if the person has the prescribed significant s limitations in cognitive functioning and adaptive functioning and those limitations, a. originated before the person reached 18 years of age; b. are likely to be life-long in nature; and c. affect areas of major life activity, such as personal care, language skills, learning abilities, the capacity to live independently as an adult or any other prescribed activity.  A new definition for a developmental What the disability The new definition of developmental legislation disability is not based strictly on IQ. It also considers how a person handles common includes demands in life and how independent they are compared to others of a similar age and background. The new definition will be applied fairly and consistently across Ontario. New, modern language The legislation talks about services and supports. Supports are more flexible and provide many forms of assistance. This gives people more choice and independence. A new application and assessment process The new application and assessment process will be consistent, fair and standardized across Ontario.  One of the largest changes has been the broadening of the definition of developmental disabilities. Changes It now includes individuals with provincially diagnoses for example, of mild forms of Autism Spectrum Disorder or, Fetal Alcohol Spectrum Disorder. Person centered approach and modifying the role of community agencies Direct funding (e.g., Special Services at Home Programs)  The Education Act allows for the The designation of students as “exceptional” within five (5) categories of exceptionality: Education Behaviour, Communication (autism, deaf & hard of hearing, language Act impairment, & Learning disability), Intellectual (giftedness, mild (Ontario) intellectual disability, & developmental disability), Physical (Physical disability and/or Blind/low vision), Multiple. Identifications of exceptionalities are simply legislative definitions or descriptions, they do not represent clinical diagnoses, but are sometimes confused with clinical diagnoses made for example using the DSM-5 or ICD- 11. What is an Exceptional Student? A student is identified as exceptional through the Identification, Placement and Review Committee (IPRC) process. The IPRC process is prescribed by law, under Regulation 181/98 (Regulation 181 – Education Act) of the Education Act. The IPRC is a formal process used by school boards to decide whether the student is exceptional and in need of special education programs and services. The committee, consisting of the principal (or designate) and two staff from the school board, meets to decide whether a student is exceptional and to determine the placement that will best meet the student’s needs. The committee uses information from observations, test results and assessments to determine whether the student meets the criteria to be identified as exceptional. The IPRC then decides if the student is exceptional and which category of exceptionality best describes the student’s needs.  One key change is a shift in language from negative terms such as 'impairment', 'disability' and 'handicap' to the neutral terms Understandin 'body function and structure', g the 'activity', and 'participation', respectively. conceptual Another change is that the term framework of 'disability' is now an umbrella term to represent the dynamic the ICF interaction between person and environment. It encompasses a series of bi- directional arrows that link elements of health, functioning and disability. As the components are now link it  ICD-11 (who.int) Health Conditions (disease or disorder  Body Functions are physiological functions of body systems (including psychological functions). Body Structures are anatomical parts of the Definition body such as organs, limbs and their components. Impairments are problems in body function or of structure such as a significant deviation or loss. Activity is the execution of a task or action by an compone individual. Participation is involvement in a life situation. nts of the Activity Limitations are difficulties an individual may have in executing activities. ICF Participation Restrictions are problems an individual may experience in involvement in life situations. Environmental Factors make up the physical, socal and attitudinal environment in which people live and conduct their lives..  The ICF model of functioning and disability provides many more 'points of entry' for people seeking both to enhance activity and participation of children whose functional well-being is at The ICF & risk, and to prevent secondary impairments. 'Clinical The first and most obvious factor to identify is that the 'environment' around Thinking’ a child involves their family. It recognizes the differences between people's 'capacity' and 'performance’. The 'capacity' qualifier describes an individual's ability to execute a task or action at the highest probable level of functioning. The 'performance' qualifier describes  Performance 1. Learning and applying knowledge 2. General tasks and demands 3. Communication 4. Mobility Activities and 5. Self-care Participation 6. 7. Domestic Life Interpersonal interactions and Domains relationships 8. Major Life Areas 9. Community, social and civic life Performance Capacity Want to know what the child is capable & Capacity of doing at their best (their 'capacity’). Assessment occur in an environment most conducive to the child's best performance School-based 'performance' may be The International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY)  The International Classification of The Functioning, Disability and Health International for Children and Youth (ICF-CY) is a Classification WHO approved “derived” classification based on the of International Classification of Functioning, Functioning, Disability and Health (ICF). Disability and As a derived classification, it Health for includes further detailed Children and information on the application of Youth (ICF- the ICF when documenting the relevant aspects of functioning and CY) health in children and youth.  Cons May lead to isolating & segregating individuals from others Pros and Denying personal freedoms, human rights, and preventing procreations. Stereotyping Cons to Disability Pros Helps to assist and identify people with special Terms needs. Can protect the rights and needs of these groups. Common basis for understanding. Classification helps to broaden understanding. Advocacy and self-advocacy. Focuses attention and identifies specific set of issues.  You have now been presented a number of models or frameworks with which to consider developmental disabilities. Why is this? Trends & Clearly what is happening over time is a change in our understanding and perspecti perspective on developmental disabilities ves Often understood within the context of certain categories, intellectual capacities, communication skills, and/or behavior, or slower rate of development Reliance on this perspective calls for a determination of what is normal.