developmental disabilities · developmental disabilities attention deficit hyperactivity disorder...

DEVELOPMENTALDEVELOPMENTALDISABILITIESDISABILITIES

DEVELOPMENTAL DISABILITIESDEVELOPMENTAL DISABILITIES

Developmental Disability Developmental Disability –– a diverse a diverse group of severe chronic conditions due to group of severe chronic conditions due to mental and or physical impairments. mental and or physical impairments. People with developmental disabilities People with developmental disabilities have problems with major life activities, have problems with major life activities, such as language, mobility, learning, selfsuch as language, mobility, learning, self--help and independent living. help and independent living. Developmental disabilities begin anytime Developmental disabilities begin anytime from birth to 22 years of age and usually from birth to 22 years of age and usually last throughout the person’s lifetime.last throughout the person’s lifetime.

DEVELOPMENTAL DISABILITIESDEVELOPMENTAL DISABILITIES

Attention Deficit Hyperactivity Disorder (ADHA)Attention Deficit Hyperactivity Disorder (ADHA)40 per 1,000 children 340 per 1,000 children 3--5% 5%

Mental RetardationMental Retardation 9.7 per 1,000 children9.7 per 1,000 children 1 % 1 % AutismAutism 3.4 per 1,000 children 0.3% 3.4 per 1,000 children 0.3% Cerebral PalsyCerebral Palsy 2.8 per 1,000 children 0.3% 2.8 per 1,000 children 0.3% Hearing LossHearing Loss 1.1 per 1,000 children 0.1% 1.1 per 1,000 children 0.1%

Attention Deficit Hyperactivity Attention Deficit Hyperactivity Disorder (ADHA)Disorder (ADHA)

33--5% of all children5% of all children40 children per 1,000 children40 children per 1,000 children4.4 million youth age 4 to 174.4 million youth age 4 to 172.5 million youth medicated for 2.5 million youth medicated for ADHDADHD7.8 % school age youth as reported 7.8 % school age youth as reported by parentsby parents4:1 to 9:1 boys : girls4:1 to 9:1 boys : girls


Chronic level of inattention and/or Chronic level of inattention and/or Impulsive hyperactivity to the extent that Impulsive hyperactivity to the extent that daily functioning is compromiseddaily functioning is compromisedAbove occurs at levels higher than Above occurs at levels higher than expected for the person’s developmental expected for the person’s developmental stage and must interfere with ability to stage and must interfere with ability to function in different settings, such as function in different settings, such as home and schoolhome and schoolA person with ADHD may struggle in A person with ADHD may struggle in important areas of life, such as peer and important areas of life, such as peer and family relationships and school or work family relationships and school or work performance.performance.


Short attention Short attention spanspanImpulsive actionsImpulsive actionsDistractibilityDistractibilityHyperactivityHyperactivityLow frustration Low frustration tolerancetoleranceTendency to Tendency to become bored

Lack of motivationLack of motivationInability to Inability to recognize future recognize future consequences of consequences of behaviorbehaviorInability to learn Inability to learn from mistakesfrom mistakesSocialization Socialization problemsproblemsbecome bored

MENTAL RETARDATION MENTAL RETARDATION Three conditions:Three conditions:

1. Significantly sub average general intellectual functioning 1. Significantly sub average general intellectual functioning ( IQ of 70 or below on an individually administered IQ test)( IQ of 70 or below on an individually administered IQ test)2. Concurrent deficits or impairments in present adaptive 2. Concurrent deficits or impairments in present adaptive functioning in at least two of these areas, (compared to functioning in at least two of these areas, (compared to standards expected for his or her age by his or her cultural standards expected for his or her age by his or her cultural group)group)communication skillscommunication skills selfself--care care home living home living social/interpersonal skills social/interpersonal skills work work safetysafetyuse of community resources use of community resources leisure leisure healthhealthfunctional academic skills functional academic skills selfself--directiondirection3. Onset before age 183. Onset before age 18

MENTAL RETARDATION MENTAL RETARDATION

The most useful approach for The most useful approach for children with mental retardation children with mental retardation consists of multidisciplinary efforts consists of multidisciplinary efforts directed at many aspects of the directed at many aspects of the child’s life child’s life –– education, social, and education, social, and recreational activities; behavior recreational activities; behavior problems; and associated problems; and associated impairments.impairments.

MENTAL RETARDATION MENTAL RETARDATION School systems vary from state to state in their School systems vary from state to state in their classification of persons who are mentally retarded.classification of persons who are mentally retarded.1 to 3 % of the population is mentally retarded1 to 3 % of the population is mentally retarded1% when persons who have mild mental retardation due to 1% when persons who have mild mental retardation due to cultural and/or social disadvantages are excluded, cultural and/or social disadvantages are excluded, More common in boys than girlsMore common in boys than girls

2 : 1 among those requiring intermittent support2 : 1 among those requiring intermittent support1.5 : 1 among those requiring extensive supports1.5 : 1 among those requiring extensive supports

Due to sexDue to sex--linked disorders, ex. fragile X syndromelinked disorders, ex. fragile X syndrome

MENTAL RETARDATIONMENTAL RETARDATIONNumber of persons classified with moderate, Number of persons classified with moderate,

severe and profound mental retardation severe and profound mental retardation (requiring extensive supports) has not (requiring extensive supports) has not changed in recent decadeschanged in recent decadesalthough research has lessened the effects although research has lessened the effects of mental retardation for someof mental retardation for someother causes have increased mental other causes have increased mental retardationretardation

--prenatal exposure to drugs of abuse, prenatal exposure to drugs of abuse, ex.alcoholex.alcohol

--congenital human immunodeficiency congenital human immunodeficiency virus infection.virus infection.

MENTAL RETARDATIONMENTAL RETARDATIONMildMild 80% of MR population80% of MR population IQ 50IQ 50--7070

Can develop social and communicative skills, able Can develop social and communicative skills, able to achieve in academic subjects to a minimal to achieve in academic subjects to a minimal level, able to adjust socially to point where can level, able to adjust socially to point where can function independently in the community; can function independently in the community; can develop occupational adequacies to a degree so develop occupational adequacies to a degree so that they can support themselves partially or that they can support themselves partially or totally at the adult level;totally at the adult level;Often no longer classified as mentally retarded Often no longer classified as mentally retarded when they become adultswhen they become adultsOften classified as Educable Mentally RetardedOften classified as Educable Mentally RetardedMost can function with intermittent supports or Most can function with intermittent supports or do not require supportsdo not require supportsNearly all are mainNearly all are main--streamed in the classroomstreamed in the classroom

MENTAL RETARDATIONMENTAL RETARDATIONModerate 12% of MR populationModerate 12% of MR population IQ 35IQ 35--4949Can communicate; poor social awareness; Can communicate; poor social awareness; has potential to learn selfhas potential to learn self--help skills, help skills, social adjustment, economic usefulness in social adjustment, economic usefulness in the home, residential school or sheltered the home, residential school or sheltered workshopworkshopOften classified as Trainable Mentally Often classified as Trainable Mentally RetardedRetardedMost would require extensive supportsMost would require extensive supportsMost would be in special education classesMost would be in special education classes

MENTAL RETARDATIONMENTAL RETARDATION

SevereSevere 7%7% of MR populationof MR population IQ 20IQ 20--4040Poor motor development; minimal speechPoor motor development; minimal speechAll would require extensive supportsAll would require extensive supports


Profound < 1% of MR populationProfound < 1% of MR population IQ < 20IQ < 20Gross retardation with minimal capacity to Gross retardation with minimal capacity to function in the function in the sensorisensori--motor areamotor areaAll would require extensive supportsAll would require extensive supports

MENTAL RETARDATIONMENTAL RETARDATIONAmerican Association on Mental American Association on Mental Retardation (AAMR) classifies persons Retardation (AAMR) classifies persons based on their degree of abilities rather based on their degree of abilities rather than their degree of disabilities.than their degree of disabilities.Intermittent Supports to function in Intermittent Supports to function in community [mild]community [mild]Limited Supports to function in community Limited Supports to function in community [moderate][moderate]Extensive Supports to function in Extensive Supports to function in community [severe]community [severe]Pervasive Supports to function in Pervasive Supports to function in community [profound]community [profound]

MENTAL RETARDATIONMENTAL RETARDATIONNumber of persons classified with mild Number of persons classified with mild mental retardation (needing intermittent mental retardation (needing intermittent supports) is constantly being reduced supports) is constantly being reduced

--standards of classification are being standards of classification are being changedchanged

--recognition of and elimination of recognition of and elimination of causes of mental retardationcauses of mental retardation

--early intervention in working with early intervention in working with children diagnosed as mentally children diagnosed as mentally retarded is expanding their potentialretarded is expanding their potential

FACTORS ASSOCIATED WITH FACTORS ASSOCIATED WITH MILD MENTAL RETARDATIONMILD MENTAL RETARDATIONNo specific cause is associated with majority of No specific cause is associated with majority of individuals in categoryindividuals in categoryPsychosocial factors are more commonly Psychosocial factors are more commonly associated with individuals in categoryassociated with individuals in categoryEnvironmental factors identified with categoryEnvironmental factors identified with category--Maternal factors (IQ <80, limited educationMaternal factors (IQ <80, limited education

little positive involvement with childlittle positive involvement with child--Poverty (low socioeconomic status)Poverty (low socioeconomic status)--Family factors (disorganization, large size)Family factors (disorganization, large size)--Poor prenatal carePoor prenatal care--Spoken language patterns of lower complexitySpoken language patterns of lower complexity

FACTORS ASSOCIATED WITH FACTORS ASSOCIATED WITH MODERATE, SEVERE OR PROFOUND MODERATE, SEVERE OR PROFOUND

MENTAL RETARDATIONMENTAL RETARDATIONBiological / pathological factors can be identified in 60Biological / pathological factors can be identified in 60--

75% with IQ <5075% with IQ <50Infections and toxicants (rubella, syphilis, Infections and toxicants (rubella, syphilis, toxoplasmosis, bacterial and viral infections, drugs, toxoplasmosis, bacterial and viral infections, drugs, smoking, caffeine, alcohol, lead)smoking, caffeine, alcohol, lead)Trauma or physical agents (irradiation, trauma)Trauma or physical agents (irradiation, trauma)Metabolism or nutrition (lipid storage diseases, Metabolism or nutrition (lipid storage diseases, carbohydrate disorders, amino acid disorders, etc.)carbohydrate disorders, amino acid disorders, etc.)Gross brain disease (tuberous sclerosis)Gross brain disease (tuberous sclerosis)Unknown prenatal influence (anencephaly, Unknown prenatal influence (anencephaly, microcephalymicrocephaly, , meningomyelocelemeningomyelocele, hydrocephalus), hydrocephalus)Chromosomal abnormality (Down syndrome, Chromosomal abnormality (Down syndrome, KlinefelterKlinefelter syndrome, Fragile X)syndrome, Fragile X)Conditions during prenatal period (Conditions during prenatal period (prematurityprematurity, , postmaturitypostmaturity, low birth weight ), low birth weight )


Persons who have mental retardation Persons who have mental retardation are are individualsindividuals, they differ from , they differ from each other in many wayseach other in many waysGeneralizations are shared by a Generalizations are shared by a number of persons who are mentally number of persons who are mentally retarded, but not by mostretarded, but not by most

MENTAL RETARDATIONMENTAL RETARDATIONGeneralizations : Physical CharacteristicsGeneralizations : Physical Characteristics(Problems mentioned above are more common (Problems mentioned above are more common and more severe the greater the degree of and more severe the greater the degree of retardation)retardation)Hearing, sight, speech and sensory perception Hearing, sight, speech and sensory perception may be inferiormay be inferiorHeight, weight and skeletal maturity may be Height, weight and skeletal maturity may be reduced; some may be obesereduced; some may be obeseInadequate diet, inadequate health care and Inadequate diet, inadequate health care and dental problems are more commondental problems are more commonCoordination, fitness and overall motor Coordination, fitness and overall motor performance is below the averageperformance is below the average

MENTAL RETARDATIONMENTAL RETARDATIONGeneralizations: Generalizations: SociobehavioralSociobehavioral CharacteristicsCharacteristics

Students with mild retardation have more adjustment Students with mild retardation have more adjustment problems, especially selfproblems, especially self--concept, attention deficit problems concept, attention deficit problems and anxietyand anxietyMildly retarded individuals often have poor interpersonal Mildly retarded individuals often have poor interpersonal relationships, are more frequently rejected than accepted relationships, are more frequently rejected than accepted by their peers, the more inappropriate their behavior, the by their peers, the more inappropriate their behavior, the greater the degree of rejectiongreater the degree of rejectionMildly retarded individuals may be impatient, lose interest if Mildly retarded individuals may be impatient, lose interest if goals are out of reach, may respond with fear and goals are out of reach, may respond with fear and aggressionaggressionDue to continued failure, they may have elaborate defense Due to continued failure, they may have elaborate defense mechanisms that result in apathy; these can be reduced by mechanisms that result in apathy; these can be reduced by successful experiences successful experiences thatha result in praiseresult in praise

MENTAL RETARDATIONMENTAL RETARDATIONGeneralizations: Generalizations: Intellectual CharacteristicsIntellectual Characteristics

SubaverageSubaverage cognitive functioning, but able to cognitive functioning, but able to learnlearnLearning is at a slower rate than persons who are Learning is at a slower rate than persons who are not affectednot affectedProblems with memory, especially short term Problems with memory, especially short term memorymemoryProblems with verbal ability, mathematics, logical Problems with verbal ability, mathematics, logical reasoning, etc.reasoning, etc.Difficulty in attention span, recall, transfer, Difficulty in attention span, recall, transfer, conceptualization and symbolizationconceptualization and symbolization

MENTAL RETARDATION MENTAL RETARDATION Percentages of children with mental retardation Percentages of children with mental retardation

who have associated developmental disabilitieswho have associated developmental disabilitiesIntermittentIntermittent

ExtensiveExtensivesupportsupport supportsupport

%% %%NoneNone 6363 1717Cerebral palsyCerebral palsy 66 1919Seizure impairmentsSeizure impairments 1111 2121Sensory impairmentsSensory impairments 2424 5555Psychological/behavioralPsychological/behavioral 2525 5050

AUTISMAUTISMA physical disorder of the brain, A physical disorder of the brain, characterized by impaired communication, characterized by impaired communication, extreme selfextreme self--absorption, detachment from absorption, detachment from reality, and abnormal responses to reality, and abnormal responses to sensory stimulationsensory stimulationAggressive behavior is typically displayed Aggressive behavior is typically displayed toward oneself, with such actions as head toward oneself, with such actions as head bangingbangingOne in four persons with autism have One in four persons with autism have seizuresseizures7% have diagnosis of mental retardation 7% have diagnosis of mental retardation Blindness and/or deafness are commonBlindness and/or deafness are common

CEREBRAL PALSY CEREBRAL PALSY Muscular weakness and difficulty in Muscular weakness and difficulty in coordinating voluntary movement owing coordinating voluntary movement owing to developmental or congenital damage to to developmental or congenital damage to the brainthe brain50% are prone to seizures50% are prone to seizuresRespiratory problems, hearing loss, visual Respiratory problems, hearing loss, visual impairment and contractures are other impairment and contractures are other physical impairments common.physical impairments common.25% have mental retardation25% have mental retardationADHD, Language disorders and learning ADHD, Language disorders and learning disabilities also common disabilities also common

DOWN SYNDROME DOWN SYNDROME A genetic disorder associated with the A genetic disorder associated with the presence of an extra chromosome 21presence of an extra chromosome 21Delayed physical, intellectual and Delayed physical, intellectual and language developmentlanguage developmentWide variation in physical, intellectual and Wide variation in physical, intellectual and language abilitieslanguage abilitiesMost have mild, moderate or severe Most have mild, moderate or severe mental retardationmental retardationHeart defects and gastrointestinal tract Heart defects and gastrointestinal tract abnormalities common abnormalities common

REMINDERREMINDER

Persons who have developmental Persons who have developmental disabilities are disabilities are individualsindividuals, they , they differ from each other in many waysdiffer from each other in many waysGeneralizations are shared by a Generalizations are shared by a number of persons, but not by mostnumber of persons, but not by mostAll persons deserve to be related to All persons deserve to be related to as the individuals that they areas the individuals that they are

developmental disabilities · developmental disabilities attention deficit hyperactivity disorder...

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