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Multiple Disabilities Vanessa G. Cabag

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Page 1: Multiple disabilities

Multiple Disabilities

Vanessa G. Cabag

Page 2: Multiple disabilities

Multiple Disabilities

Vanessa G. Cabag

Persons with multiple disabilities have a combination of two or more serious disabilities (e.g., cognitive, movement, sensory), such as mental retardation with cerebral palsy.

Definition

Page 3: Multiple disabilities

Multiple Disabilities

Vanessa G. Cabag

The U.S. federal government definition includes those who have more than one impairment, "the combination of which causes such severe educational needs that they cannot be accommodated in special education programs solely for one of the impairments“Dual sensory impairment, or deaf-blindness, is defined as a separate disability group.Multiple disabilities have interactional,

rather than additive, effects, making instruction and learning complex.

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Multiple Disabilities

Vanessa G. Cabag

In 1996 Fred Orelove and Dick Sobsey defined this group as individuals with mental retardation who require extensive or pervasive supports and who also possess one or more significant motor or sensory impairments and/or special health care needs. These physical and medical problems result in the presence of two or more of the following characteristics: restriction of

movementskeletal deformitiessensory disorders

seizure disorderslung and breathing control; or

other medical problems related to these characteristics, such as skin breakdown or bladder infections.

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Multiple Disabilities

Vanessa G. Cabag

CausesIn nearly half of the children born with multiple disabilities there is no identifiable cause. In the rest of the known causes there are:

Chromosomal abnormalities,Developmental disorders of the brain,Metabolic disorders; and Negative prenatal environmental influences.

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Multiple Disabilities

Vanessa G. Cabag

Primary Measures Used to Diagnose

Early assessment of:

movement limitationsmuscle tone and flexibilityseizure activity

breathing controlsucking and swallowingvision and hearing; and

Individual intelligence tests &

Tests of adaptive behavior

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Multiple Disabilities

Vanessa G. Cabag

genetic makeup are also, and prenatal assessment of genetic material or physical identification of deformities via sonograms may be conducted.

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Multiple Disabilities

Vanessa G. Cabag

Accurate psychological testing of these individuals is challenging due to their frequent limitations in controlled movement, vision, hearing, communication, or cooperative behavior.Thus, interviews with family members and educators regarding the person's adaptive behavior skills (i.e., communication, self-care, home living, social skills, community use, self-direction, health and safely, functional academics, leisure, and work) may be more informative and reliable than a norm-based IQ or achievement score.

Page 9: Multiple disabilities

Multiple Disabilities

Vanessa G. Cabag

CharacteristicsPeople with multiple disabilities have a combination of various disabilities that may include:

speechphysical mobilitylearningmental retardation

visualhearingbrain injury; andpossibly others.

They may also have sensory losses and behavior and /or social problems.

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Multiple Disabilities

Vanessa G. Cabag

Perhaps the most significant characteristic of many people with multiple disabilities is

deficits in the area of communication,

making it difficult for them to communicate their wants, needs, and pains to those around them.

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Multiple Disabilities

Vanessa G. Cabag

This limitation can be devastating to the emotional and intellectual development of the child, but can be addressed through the use of assistive technology and augmentative communication systems.

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Multiple Disabilities

Vanessa G. Cabag

Children ages 3 to 5 are considered to have multiple disabilities when they demonstrate concomitant cognitive, physical, and/or sensory impairments which result in severe delays in development. Children with multiple disabilities will typically share deficits in five distinct areas of development:intellectual

functioningadaptive skillsmotor skillssensory functioningcommunication skills

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Multiple Disabilities

Vanessa G. Cabag

This disability category includes those students with the most severe physical, cognitive, and communicative impairments. Most of the students served under the multiple disability category do have some level of cognitive impairment, but the specific diagnosis of this impairment can often be ambiguous or undetermined.It should be noted however, that these students can also have average or even above-average intelligence. The common connection between students in this category is not just that they have two or more coexisting impairments, but that they generally need extensive support across many skill areas.

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Multiple Disabilities

Vanessa G. Cabag

Prevalence

Definitions of this highly variable group with both severe and multiple disabilities are less precise than some other disability groups, making an estimate of their prevalence difficult. Prevalence ranges from less than .25 percent to .50 percent of the population; and is considered relatively uniform across socioeconomic classes.

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Multiple Disabilities

Vanessa G. Cabag

Variety of Diagnostic Labels(1)severe or profound levels of mental

retardation (IQ scores below 40)(2)mental retardation that requires extensive or

pervasive supports for an extended time(3)autism, childhood disintegrative disorder, or

Rett syndrome (several types of autism spectrum disorders)

(4)various genetic disorders accompanied by extensive mental retardation (e.g., Tay-Sachs disease, untreated phenylketonuria, tuberous sclerosis, Lesch-Nyhan syndrome)

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Multiple Disabilities

Vanessa G. Cabag

Individuals with several autism spectrum disorders, by definition, have significant developmental delays in communication and social interaction, and may exhibit extensive limitations in many adaptive skills. Thus, their disability may be extensive enough to fit the definition for mental retardation and severe disabilities, though this is not true for all persons identified with autism (e.g., Asperger's syndrome).

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Multiple Disabilities

Vanessa G. Cabag

Implications of Educational Legislation

Legislation in the early 1970s addressed the right to education and other rehabilitation services for all individuals with disabilities. In 1975 the Education for All Handicapped Children Act (known since 1990 as the Individuals with Disabilities Education Act, or IDEA) formed the legal basis for public education for all children, including those with severe and multiple disabilities.

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Multiple Disabilities

Vanessa G. Cabag

IDEA added requirements that are especially valuable for these individuals, including:

(1)early intervention starting at birth or whenever a disability is suspected;

(2) related services such as physical, occupation, and speech and language therapy, including augmentative and alternative communication (AAC) methods;

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Multiple Disabilities

Vanessa G. Cabag

(3) the requirement for a plan and services to facilitate transition to work and adulthood; and

(4) a value placed on inclusion in general education with nondisabled peers.

Most states provide services to these students until age twenty-two or beyond, focusing upon functional skill development.

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Multiple Disabilities

Vanessa G. Cabag

Prior to the 1975 law mandating public education for all children, students with severe and multiple disabilities, if educated, received services in institutions or settings operated by parent groups or state mental health departments. When laws enacted in the mid-1970s required publicly funded special education, most schools established programs for these students but continued to isolate them from their nondisabled peers in separate buildings or self-contained classrooms in elementary schools.

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Multiple Disabilities

Vanessa G. Cabag

Currently in many states, the "least restrictive environment" for most of these students is the age-appropriate school setting alongside nondisabled peers, though not necessarily in the general education classroom. Currently, a majority of these students are served in separate classrooms for most of the school day.

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Multiple Disabilities

Vanessa G. Cabag

Since 1975 U.S. courts have defined specific portions of special education law. For those with severe and multiple disabilities, several legal battles have resulted in:

(1)summer educational programs being required in many states to lessen or prevent skill regression;

(2) interventions that enable students to stay at school (e.g., providing catheterization for those unable to urinate voluntarily);

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Multiple Disabilities

Vanessa G. Cabag

(3) related services and technology to assist with movement, positioning, speech, and alternate forms of communication;(4) the mandate to educate all students with disabilities, and not limit services based on an assessment of educational potential; and(5) the provision of regular opportunities for interaction with nondisabled peers and inclusion in general education classrooms–or justification for not providing these opportunities.

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Multiple Disabilities

Vanessa G. Cabag

While all states are required to provide a free and appropriate education for these students, there are many differences in how localities implement the law and thus in the actual quality of educational services for these students.

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Multiple Disabilities

Vanessa G. Cabag

Educating Students with Severe and Multiple Disabilities

When compared to their peers, most students with severe and multiple disabilities learn more slowly, forget more readily, and experience problems generalizing skills from situation to situation.

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Multiple Disabilities

Vanessa G. Cabag

These characteristics are best addressed when educators follow accepted practices.

First, the public education of these students must start early and continue at some level throughout life.Second, all students typically need speech and language intervention, while many others will need physical and occupational therapy. Students with sensory impairments may need interpreters and mobility trainers, while some with medical needs may require nursing services or supervision.

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Multiple Disabilities

Vanessa G. Cabag

Third, because the educational teams of students are often large, close collaboration between members is essential if their expertise is to result in improved student functioning. The benefits of integrating therapy into natural activities is widely accepted over the traditional practice of isolated, or pull-out, therapy.

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Multiple Disabilities

Vanessa G. Cabag

Fourth, curriculum for these students tends to be;

functional in naturereflecting skills needed in everyday life across domesticleisureschoolcommunityvocational domains

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Multiple Disabilities

Vanessa G. Cabag

Students are taught to;

make choicescommunicate in functional ways (which may include AAC methods such as signing, use of pictures, etc.)develop useful skills that reduce their dependence on otherslearn social skills suited to their chronological age

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Multiple Disabilities

Vanessa G. Cabag

Fifth, when skills are taught in multiple, normalized settings, generalization problems are lessened. Thus, communication and social skills are most effectively taught in the context of interactions with typical classmates, while job and community skills are best taught during community-based instruction.

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Multiple Disabilities

Vanessa G. Cabag

Trends and ControversiesSeveral important trends, some considered controversial because they advocate the inclusion of these students in general education with the necessary supports, reflect improvements in the lives of these students.

First, through advancements in medicine and technology these individuals not only experience longer lives, but also have better options in mobility, communication, sensory augmentation, and other areas.

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Multiple Disabilities

Vanessa G. Cabag

Second, starting in the 1960s, there has been gradual improvement in societal attitudes toward people with significant disabilities. This has led to legal protections, special education, community living alternatives, supported employment, and an increase in relevant supports.

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Multiple Disabilities

Vanessa G. Cabag

Third, with the Timothy W. decision (Timothy W. v. Rochester, New Hampshire, School District, 1989), "free and appropriate education for all" was reaffirmed, schools were required to keep current with best practices for educating those with significant disabilities, and the procedure of selecting who can and cannot learn was declared illegal.

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Multiple Disabilities

Vanessa G. Cabag

The current trend to include individuals with severe or multiple disabilities in classrooms and community activities with their nondisabled peers has been particularly controversial.

Special education placement data show gradual growth of students with disabilities who are placed in a general education setting, but much slower growth for students with severe and multiple disabilities. Schools have complained that they are not able to include these students or provide the necessary supports and services to achieve a meaningful education for all involved.

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Multiple Disabilities

Vanessa G. Cabag

Some general education teachers have communicated an unwillingness to have these students in their classrooms, even with support, and they also may lack the required skills necessary to teach these children in a general education classroom.However, there are numerous examples of schools meaningfully including these students in ways that promote social and educational participation, as well as evidence to support the benefits of inclusion for both students with severe disabilities and typical classmates. More research, the dissemination of information on inclusion, and improvements in teacher training are needed.

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Multiple Disabilities

Vanessa G. Cabag

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Multiple Disabilities

Vanessa G. Cabag

THANK YOUAnd

GOD BLESS

Prepared by: Miss Vanessa G. Cabag