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https://padlet.com/morelandjunecohort/njfm5xjrkmpfok5c/wish/2239389057

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It is estimated that about 37,000 students aged 3-21 have orthopedic impairment, which accounts for about 1% students out of the students covered under the IDEA

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It means simultaneous impairments (for example, intellectual disability with blindness or intellectual disability with an orthopedic 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. The term does not include deaf- blindness.

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IDEA defines Emotional Disturbance as:

"a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a student’s educational performance:

1. An inability to learn that cannot be explained by intellectual, sensory, or health factors

2. An inability to build or maintain satisfactory interpersonal relationships with peers and teachers

3. Inappropriate types of behavior or feelings under normal circumstances

4. A general pervasive mood of unhappiness or depression, or

5. A tendency to develop physical symptoms or fears associated with personal or school problems. The term includes schizophrenia. The term does not apply to students who are socially maladjusted, unless it is determined that they have an emotional disability."

(Hayer, 2021)

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What is the frequency of ED among students?

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What is the frequency of ED among students?

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According to an article published in Education week, entitled Students With Emotional Disabilities: Facts About This Vulnerable Population, approximately 6% of students between the ages of 6-21 are diagnosed with emotional disturbance. (Samuels, 2018)

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Source: Students With Emotional Disabilities: Facts About This Vulnerable Population, 2018 (https://www.edweek.org/leadership/students-with-emotional-disabilities-facts-about-this-vulnerable-population/2018/03)

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(TBI) occurs when a severe jolt or blow to the head leads to brain damage. It can also result when an object such as a bullet or shrapnel pierces the brain. TBIs are commonly caused by sports injuries, falls, acts of violence, and collisions involving drivers or bikers.

https://www.psychologytoday.com/us/basics/traumatic-brain-injury

https://mayoclinic.org/diseases-conditions/traumatic-brain-injury/symptoms-causes/syc-20378557

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TBIs are quite common. About 2.87 million emergency department visits, hospitalizations, and deaths were attributed to TBIs in the United States in 2014, according to the Centers for Disease Control and Prevention. The number of TBIs increased by 53 percent between 2006 and 2014. In 2019, there were 61,000 TBI-related deaths.

https://www.psychologytoday.com/us/basics/traumatic-brain-injury

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Concussions are often overlooked or misdiagnosed, but early recognition is key to recovery. According to the CDC, signs of a concussion include:

* Headaches

* Nausea or vomiting

* Exhaustion

* Dizziness

* Vision problems

* Sensitivity to light and sound

* Problems with attention, concentration, memory, and brain fog

* Atypical anxiety, irritability, or sadness

* Atypical sleep patterns or difficulty falling asleep

Yes, there seems to be a clear connection between TBI and psychiatric symptoms. A 2013 study that followed 1.4 million Danish citizens found that individuals with TBI were four times more likely to develop a mental illness. People who received a TBI were 65 percent more likely to develop schizophrenia, 59 percent more likely to develop depression, and 28 percent more likely to develop bipolar disorder.

Another study found that experiencing depressive symptoms after a head injury is more common than not; the prevalence of depression after TBI was greater than 50 percent. Yet another found that people who received a concussion in the past were three times more likely to die by suicide.

Head injuries can cause subtle or pronounced changes in personality. In more severe cases, the injured person may have angry outbursts or make impulsive decisions. The person may be frustrated when reminded of their losses, for instance, the inability to drive. As one woman described after her husband's brain injury, "It was as if two versions of Alan resided within him. One was rational and easy-going, but the other was frightening and even dangerous at times."

These changes can lead to distrust due to unpredictability, emotional pain for the caregiver, unresolved conflicts, and considerations of physical safety. Anger management strategies can help address these challenges and repair relationships after a TBI.

Medical professionals can adhere to guidance that can increase the chances of a successful recovery. This includes:

1. Neuroprotection through restorative interventions: stabilizing the brain immediately after the injury through measures such as rest at home or managing blood pressure, sedation, and ventilation at the hospital.

2. Understanding the natural history of the recovery process for each individual: tracking and personalizing the recovery process rather than treating patients indiscriminately.

3. Implementing the appropriate therapeutic modality throughout injury and recovery: introducing interventions such as medication and rehabilitative therapies.

4. Determining what compensatory mechanisms the nervous system develops during healing and providing appropriate intervention: for example, dizziness may signal that the body isn't ready for certain stimuli or depression may signal that the patient is realizing the extent of their limitations.

5. Implement an appropriate rehabilitation process: rehabilitation may include working to restore previous functions, compensating when function can't be restored, or adapting the person's environment.

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Traumatic Brain Injury (TBI) occurs when a severe jolt or blow to the head leads to brain damage. It can also result when an object, such as a bullet or shrapnel, pierces the brain.

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Augmentative and Alternative Communication (AAC) technologies. Electronic and software based devices can give a voice to a child who has lost the capacity to speak or who wishes to learn how to speak.

Environmental Control Technologies (ECT) can help a child to interact with their immediate home environment (open windows, turn on lights operate their TV etc.) even if they do not have the physical capacity to do so.

Walking aids, manual wheelchairs, and powered wheelchairs can restore or bestow independent mobility.

Today there are myriad Assistive Technologies available designed to enable a child to independently access ICT, a computer, smartphone, or tablet device, with many of the accessibility tools built into the devices’ operating systems.

Access tools including switches, specialist keyboards, mice and pointing devices including eye tracking technologies can enable even the most physically and cognitively challenged child to interact with technology at home and in the classroom.

Specialist software can help a child type more efficiently to complete class-based activities or homework, it is possible for a child to speak directly to a computer and through voice recognition technology to have their words appear on screen.

Assistive Technologies can also be used to open up the world of gaming and social media to children who are otherwise unable to participate in these activities. As we all know all work and no play…

Other software packages and apps can help a child with a severe cognitive impairment develop cause and effect and turn taking skills and to develop numeracy and literacy skills.

More recently, apps and programmes have been developed to help young people with challenges they may face with their memory or their management of emotions and moods, especially when transitioning, for example between schools, to college and University

https://childbraininjurytrust.org.uk/2021/05/assistivetechnology/

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Everybody is an individual. It is quite a concept to contemplate, that on a planet of nearly seven billion people no two individuals are exactly the same. So, when the unthinkable happens and one of that seven billion sustains a brain injury it would be, I suggest, fair to say the needs of that individual will be truly unique.

Working as an Assistive Technologist for the past 26 years I have learned that supporting an individual with an acquired brain injury is in part a complex tapestry made up of input from numerous professions and disciplines and factors including (but by no means limited to) the impact of the injury, personal and family goals, personal characteristics, immediate environment, all of which influence the development of a bespoke, person centred approach that can meet the needs of the individual as they recover, rehabilitate, and adapt to their new lives.

In many instances that approach will include the provision and use of Assistive Technology. Assistive Technology as defined by the Word Health Organisation (WHO)

Assistive technology enables people to live healthy, productive, independent, and dignified lives, and to participate in education, the labour market and civic life. Assistive technology reduces the need for formal health and support services, long-term care, and the work of caregivers.

In the case of a brain injury and depending on when an individual was injured, Assistive technology can be used to restore function, to enable a child to participate in activities that they were able to before their injury, or help a child to develop function, use appropriate assistive technologies to learn how to do the things they wish and need to do as they grow up.

Assistive Technology can be used in numerous ways for numerous reasons. The assistive technology spectrum can be used to help individuals with physical sensory or cognitive impairments (in the case of a brain injury it can often be all three) enabling them to overcome the challenges they face post injury.

Common applications of Assistive Technology in the realms of brain injury can include:

Augmentative and Alternative Communication (AAC) technologies. Electronic and software based devices can give a voice to a child who has lost the capacity to speak or who wishes to learn how to speak.

Environmental Control Technologies (ECT) can help a child to interact with their immediate home environment (open windows, turn on lights operate their TV etc.) even if they do not have the physical capacity to do so.

Walking aids, manual wheelchairs, and powered wheelchairs can restore or bestow independent mobility.

Today there are myriad Assistive Technologies available designed to enable a child to independently access ICT, a computer, smartphone, or tablet device, with many of the accessibility tools built into the devices' operating systems.

Access tools including switches, specialist keyboards, mice and pointing devices including eye tracking technologies can enable even the most physically and cognitively challenged child to interact with technology at home and in the classroom.

Specialist software can help a child type more efficiently to complete class-based activities or homework, it is possible for a child to speak directly to a computer and through voice recognition technology to have their words appear on screen.

Assistive Technologies can also be used to open up the world of gaming and social media to children who are otherwise unable to participate in these activities. As we all know all work and no play...

Other software packages and apps can help a child with a severe cognitive impairment develop cause and effect and turn taking skills and to develop numeracy and literacy skills.

More recently, apps and programmes have been developed to help young people with challenges they may face with their memory or their management of emotions and moods, especially when transitioning, for example between schools, to college and possibly employment.

These are just a few examples of assistive technologies available currently and the list of products and solutions is growing by the day.

A full understanding of the range of Assistive Technologies currently available and in the pipeline is far beyond the capacity of this article (and the author, most probably).

Perhaps it would better to give an example of a practical application of Assistive Technology for a specific issue and a specific child.
Ruby (not her real name) was injured when she was struck by a car. She sustained numerous physical injuries and a traumatic brain injury. Following her recovery and a period of rehabilitation, Ruby wished to return to the family home to live with her parents and brother. In this instance I was asked to assess Ruby as her old family home did not meet her needs and she was moving into a new home. It was her and her families' desire that Ruby's home was to be as accessible as possible. Ruby is unable to stand and walk, she has little movement in her right arm and hand and her left hand and arm is stiff and difficult to move. Ruby has a mild cognitive impairment, and she finds to difficult to speak and be heard. What we decided was to source and install technologies that worked in combination with the existing Assistive Technologies already being used by Ruby. Ruby has a powered wheelchair to help her move around independently. Ruby is able to drive her powered wheelchair with her left hand, she can steer her wheelchair, adjust her seat height and backrest position using her wheelchair joystick. Ruby has access to a tablet with a rugged case in the event that it is dropped. Her tablet is equipped with apps that assist Ruby, including one which she can use to talk when people are unable to understand her. When considering how she would interact with and control her home environment We needed to ensure that Ruby's existing technology and the skills she had already put so much effort into acquiring were not lost. As is often the case one size does not fit all and in the Assistive Technology world one supplier cannot fully meet the needs of a diverse population with equally diverse needs. What we settled on was a hybrid system that allowed Ruby to use her wheelchair and tablet as controllers and using them she was able to open and close her doors to turn on her lights and to control her home entertainment equipment. In addition, we decided to investigate if Ruby's speech was potentially clear enough for her to benefit from using her voice (as smart speakers can offer cost effective and easy to use solutions) to control her environment. Ruby was provided with a Google home smart speaker and the technology was linked to her environmental control. Ruby was found to be able operate the speaker with some success, but her speech was sometimes too slow and indistinct to operate the device and it was not considered to be a reliable alternative to her existing controls. However, all is not lost as Ruby is now exploring two potential solutions to help her overcome the challenges she faces. Solution one is an app that uses artificial intelligence to translate what Ruby says and then output a voice command that a standard smart speaker can understand. The second is a newly developed smart speaker that can learn to accommodate differences in the user's speech including the volume and the rate at which words are spoken. Ruby and her family are still on their journey to enable Ruby to live as independent life as she is able to, but we can say for this particular individual it is certain that Assistive Technology will play a part in helping Ruby to achieve her goals.
Written by Paul Doyle - Assistive Technologist - click here to find out more about Paul's work.

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Assistive Technology - Child Brain Injury Trust

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Everybody is an individual. It is quite a concept to contemplate, that on a planet of nearly seven billion people no two individuals are exactly the same. So, when the unthinkable happens and one of that seven billion sustains a brain injury it would be, I suggest, fair to say the needs of that individual will be truly unique.

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Method of Instruction

-Repeat directions
-Circulate teacher around room
-Provide visual prompts
-Provide immediate feedback
-Point out similarities to previous
learning & work
-Use manipulative materials
-Teach to current level of ability
(use easier materials)
-Speak clearly
-Pre-teach or reteach
-Use peer tutor or partner
-Use small group instruction
-Use simple sentences
-Use individualized instruction
-Pause frequently
-Use cooperative learning
-Encourage requests for
clarification, repetition, etc.
-Use examples relevant to
student’s life
-Demonstrate & encourage use of technology

https://cbirt.org/sites/cbirt.org/files/resources/classroomaccommodations_ocamp.pdf&ved=2ahUKEwjPiNiapub7AhUUp3IEHVd_BvgQFnoECCIQAQ&usg=AOvVaw2wK_p3TzocmoEG9yoLSJdU

https://research.avondale.edu.au/cgi/viewcontent.cgi%3Farticle%3D1372%26context%3Dteach&ved=2ahUKEwjPiNiapub7AhUUp3IEHVd_BvgQFnoECCEQAQ&usg=AOvVaw0OOcq1vtl7tbNNLSUprKQ6

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An orthopedic impairment is an impairment that stems from many kinds of medical condition: disease, anomalies that occurred in utero, etc. Specifically, educational orthopedic impairment is when a child's access to education is limited because of said medical conditions.

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Those with orthopedic impairments are susceptible to a multitude of challenges, including equal access. These can be physical: not providing wheelchair ramps, desks that are not large enough, no buttons for door opening, etc. They can also be educational: not providing interpreters/notetakers, no access to online lectures, etc. Although the ADA protects students with disabilities, there are always accounts of those who need special accommodation (not just those with orthopedic impairment) being refused their legal right to equal access.

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In this video, Joss Perring shares his struggles and triumph with the educational system. We can gain perspective to a life that we cannot know from first-hand experience.

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Finding Where You Belong: A Story of Disability and Education | Joss Perring | TEDxBrighton

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Some helpful accommodations for those with orthopedic impairments would be unique to the medical conditions one might have. However there are some general accommodations that would be helpful:
1. Allowing extended time for test/exams
2. Allowing for extra time for the student to change classes
3. Providing alternate means for notetaking/communication such as special keyboards or text-to-talk devices.
4. Providing easier access to elevators and having emergency plans in place for when they cannot be used

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As defined by the IDEA, it means "impairment in hearing, whether permanent or fluctuating, that adversely affects a child’s educational performance but that is not included under the definition of deafness."

As is clear from the definition, it is often connected to deafness in terms of the scope of an individual's hearing loss.

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Because "hearing impairment" is a broad spectrum, and hearing loss occurs naturally with age, it is difficult to find an exact number of how many people are hearing impaired. However, the CDC's two most recent surveys can give us a rough estimate: between 1.7-5 children per 1,000 have hearing loss.

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Centers for Disease Control and Prevention

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Data and Statistics About Hearing Loss in Children | CDC

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Studies have shown a range of estimates for the number of children with hearing loss…

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How to know if a student is hearing impaired

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How to know if a student is hearing impaired

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Like many learning difficulties, hearing impairment can develop in early childhood. Teachers should be aware of signs a student may be hearing impaired:

Not responding

Problems concentrating

Speaking at inappropriate volume

Difficulty linking reading to speech

Unable to hear with any background noise

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Going through school with a hearing impairment or deafness can be a frustrating, isolating and ultimately unproductive experience for a child without the right support. As a teacher, it can be equally challenging to teach a hearing-impaired child effectively without adequate tools or training. For both, it can sometimes feel like there's an imaginary pane of glass keeping each from communicating effectively with the other. The ideal environment for many hearing-impaired children to learn is one in which they are not singled out as different but instead, benefit from the kind of adjustments which go unnoticed by others but are truly transformative for the child this blog provides the information you need to handle hearing impairments with confidence. At Engage Education we have a dedicated SEND team.

What is a hearing impairment?

Hearing impairment and deafness are not necessarily the same thing. Hearing loss greater than 90 decibels is generally categorised as deafness, but any impediment to hearing - whether temporary, permanent or fluctuating - impacts not only a child's experience in the classroom but their social and emotional development, literacy skills and speech and language abilities.

What types of hearing impairment are there?

According to the National Deaf Children's Society , there are over 50,000 children and young people in the UK with hearing impairments, but this does not mean that they all have the same conditions or needs. There are three main types of hearing impairment that you may come across in children:

Sensorineural deafness (nerve deafness)
Permanent hearing loss in the inner ear is usually caused by the cochlea not working effectively

Auditory Neuropathy Spectrum Disorder (ANSD)
A problem occurring more deeply within the ear, where sounds are received normally by the cochlea, then become disrupted as they travel to the brain

Conductive deafness
Usually temporary, sometimes permanent. Sound can't pass effectively through the outer and middle ear to the inner ear. Caused by blockages such as wax or fluid. The latter is known as - can last for up to three months and is very common in preschool children

How can I spot signs of hearing impairment in a child?

While hearing impairments are often identified in babies, they may not develop or make themselves known for several years. This means that it's important to keep an eye out for the signs of hearing impairment in the classroom, particularly in young children - as at some point in your career you could find that you are teaching a child with an undiagnosed hearing impairment.

Here are some of the common signs of hearing impairments that you can look for in young children:

Not responding when their name is called

Problems with concentration, excessive tiredness and frustration with work that starts to affect their behaviour

Watching your lips intently as you speak

Speaking too loudly or too quietly

Watching others do something before attempting it themselves

Becoming increasingly withdrawn from others in the classroom

Delayed speech and communication development

Mishearing or mispronouncing words

Not being able to hear what's happening if there is any background noise

Making minimal contributions to classroom discussion

Difficulty with reading and linking it to speech

If you reconise the student to fall under the SEND Code of practice

How does hearing impairment affect learning?

, with only 44% leaving school with two or more A Levels, and 43% reaching the expected standard for reading, writing and maths at key stage 2 (KS2) when finishing primary school. Hearing and learning go hand-in-hand, so the impairment of this function means much more for a child than simply struggling to hear. Any hearing impairment which is not handled effectively has an adverse effect on a child's development, preventing them not only from taking in new information but learning to interact, relating to others and making friends. It's extremely important to Hearing-impaired children struggle at every stage of their education include SEND pupils in mainstream schools.

A child whose hearing impairment negatively affects their learning is likely to withdraw further into themselves throughout their education, which has a knock-on effect throughout the rest of their life. The frustration of being unable to express themselves and communicate both inwardly and outwardly is highly damaging and can impact future employment and their relationships with both others and themselves.

Everyday frustrations in the classroom are not as simple as an absence of individual attention from the teacher. A child with a hearing impairment does not necessarily require constant additional help but rather a mindful and sensitive approach to teaching the whole class - not facing the whiteboard to speak, minimising background noise and using visual aids as much as possible.

Strategies for supporting a child with a hearing impairment in school

It's vital that children with hearing impairments are given the right support from as early a stage as possible. If you have a child with a hearing impairment in your class, teaching in a way that fully supports them may seem a daunting prospect, but there is plenty of support and many ideas available.

Classroom equipment

A radio aid is a microphone worn by the teacher that connects to a hearing aid, and can also be passed to other pupils during activities such as group reading. This will help the child to feel part of the class and ensure that they don't miss any important information.

Dedicated staff

For schools that have the budget to employ one, a communication support worker or learning support assistant can provide hugely valuable help. Whether in the classroom all or some of the time, they can ensure the child is supported while you are able to give proportionate attention to other pupils.

Make sure that you don't turn away from the class while talking and ensure that the child has understood every task or instruction (and they aren't automatically looking to copy others after you have spoken). You can also sit the child right at the front of the class to give them the best possible chance of learning as hearing technologies only have an optimal range of one to three metres.

Meet with parents regularly

Having an open line of communication with the child's parents will help to ensure that the child has consistent support both at school and home. Meeting with the parents face-to-face will enable you both to discuss any concerns you may have and track the child's progress. Often the child may be confiding in the parents about issues that they are struggling with which they are too embarrassed to bring up in the classroom.

A 'hearing buddy'

If the child has to take off their hearing aid at any point during the day (for example during a sports lesson) you can allocate them a 'hearing buddy' (perhaps their closest friend) who can help to repeat any information that the child may have missed.

Preventing bullying

Although being bullied can happen to any child, children who are considered different in some way can be targeted by bullies. This can be because the hearing-impaired child's teaching arrangements are different, because they look different due to wearing a hearing aid, or because they are less able to pick up on social cues from their peers. The child could also find it harder to make friends and have a reduced ability to stand up for themselves. Childline has lots of advice and support available for children who are deaf or hard of hearing in their 'Deaf Zone' which you can refer children to who are old enough to use the website.

There are also ways in which a teacher can prevent bullying:

Raising awareness in the school - empathy and kindness can be taught. For example celebrating Deaf Awareness Week at school will open up discussions about the challenges faced by hard of hearing children and increase understanding. Your class could hold a school assembly in mime to the rest of the school. Your students could also put themselves in the child with hearing impairments shoes by learning to sign their names or by taking part in a sponsored silence.

Foster a sense of community in the classroom - in this way, other students will watch out for bullying and make a stand against it. You could have class morning meetings where students are encouraged to share their experiences and you can establish any class rules together including anti-bullying ideas.

Be aware of 'gateway behaviours' and nip them in the bud - things like eye rolling and ignoring, cruel laughter, excluding or staring can signal bullying or lead to escalated bullying. The child laughing cruelly may not realise the deep and lasting psychological impact they could be having on the child they are laughing at (especially if the child who is being bullied is pretending to laugh back) so class discussion, rather than focusing on one child's behaviour, can be helpful.

Using Makaton

is a simplified form of sign language, incorporating symbols and gestures, and is normally used with children with additional needs.

Makaton is usually taught at Nursery, Reception and Year 1 level. The actions are fun so that it helps shy children as well as those with special educational needs. Children who have trouble communicating can often be moody, quick to anger or simply retreat into themselves, so Makaton allows them to better communicate and relieves any stress they may be feeling. Given the importance of ensuring that deaf children have access to a rich language environment, Makaton should not be seen as an alternative or substitute for British Sign Language (BSL) or Sign Supported English .

Helpful links:

NHS hearing loss - https://www.nhs.uk/conditions/hearing-loss/symptoms/

British Sign website - https://www.british-sign.co.uk/

The Makaton Charity - https://www.makaton.org/

National Deaf Children's Society - https://www.ndcs.org.uk/

SEND Careers with Engage

If you would like a new role teaching in a SEND setting on a permanent, long-term, or short-term basis, full or part-time, our expert SEND team will be able to find the perfect role for you at one of our wonderful partner schools.

Register here!

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How to support a child with a hearing impairment in school - Engage Education

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We're an award winning teacher recruitment agency with offices in the UK, Australia, Canada and Ireland. We pride ourselves on getting to know you, the teachers, and our aim is to find you the perfect school for your skills. Get in touch today for a free consultation.

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If possible, organize the classroom in a way that students can see the teacher and their classmates (for example, a U-shape arrangement)

Don't speak with your back turned to the students

Limit background noise

Use visual materials

Include captions

Consistently check for comprehension

Provide supplemental written materials

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According to the National Institute on Deafness and Other Communication Disorders, health professionals make use of assistive devices such as:

"Assistive listening devices (ALDs) help amplify the sounds you want to hear, especially where there’s a lot of background noise. ALDs can be used with a hearing aid or cochlear implant to help a wearer hear certain sounds better."

"Augmentative and alternative communication (AAC) devices help people with communication disorders to express themselves. These devices can range from a simple picture board to a computer program that synthesizes speech from text."

"Alerting devices connect to a doorbell, telephone, or alarm that emits a loud sound or blinking light to let someone with hearing loss know that an event is taking place."

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What are assistive devices?

The terms assistive device or assistive technology can refer to any device that helps a person with hearing loss or a voice, speech, or language disorder to communicate. These terms often refer to devices that help a person to hear and understand what is being said more clearly or to express thoughts more easily. With the development of digital and wireless technologies, more and more devices are becoming available to help people with hearing, voice, speech, and language disorders communicate more meaningfully and participate more fully in their daily lives.

What types of assistive devices are available?

Health professionals use a variety of names to describe assistive devices:

Assistive listening devices (ALDs) help amplify the sounds you want to hear, especially where there's a lot of background noise. ALDs can be used with a hearing aid or cochlear implant to help a wearer hear certain sounds better.

Augmentative and alternative communication (AAC) devices help people with communication disorders to express themselves. These devices can range from a simple picture board to a computer program that synthesizes speech from text.

Alerting devices connect to a doorbell, telephone, or alarm that emits a loud sound or blinking light to let someone with hearing loss know that an event is taking place.

What types of assistive listening devices are available?

Several types of ALDs are available to improve sound transmission for people with hearing loss. Some are designed for large facilities such as classrooms, theaters, places of worship, and airports. Other types are intended for personal use in small settings and for one-on-one conversations. All can be used with or without hearing aids or a cochlear implant. ALD systems for large facilities include hearing loop systems, frequency-modulated (FM) systems, and infrared systems.

Hearing loop (or induction loop) systems use electromagnetic energy to transmit sound. A hearing loop system involves four parts:

A sound source, such as a public address system, microphone, or home TV or telephone

An amplifier

A thin loop of wire that encircles a room or branches out beneath carpeting

A receiver worn in the ears or as a headset

Amplified sound travels through the loop and creates an electromagnetic field that is picked up directly by a hearing loop receiver or a telecoil (see sidebar), a miniature wireless receiver that is built into many hearing aids and cochlear implants. To pick up the signal, a listener must be wearing the receiver and be within or near the loop. Because the sound is picked up directly by the receiver, the sound is much clearer, without as much of the competing background noise associated with many listening environments. Some loop systems are portable, making it possible for people with hearing loss to improve their listening environments, as needed, as they proceed with their daily activities. A hearing loop can be connected to a public address system, a television, or any other audio source. For those who don't have hearing aids with embedded telecoils, portable loop receivers are also available.

What's a telecoil?

A telecoil, also called a t-coil, is a coil of wire that is installed inside many hearing aids and cochlear implants to act as a miniature wireless receiver. It was originally designed to make sounds clearer to a listener over the telephone. It also is used with a variety of other assistive listening devices, such as hearing loop (or induction loop) systems, FM systems, infrared systems, and personal amplifiers.

The telecoil works by receiving an electromagnetic signal from the hearing loop and then turning it back into sound within the hearing aid or cochlear implant. This process eliminates much of the distracting background noise and delivers sound customized for one's own need. For people who are hard-of-hearing who do not have a telecoil-equipped hearing aid or cochlear implant, loop receivers with headsets can provide similar benefits but without the customized or "corrected sound" feature that matches one's hearing loss pattern.

Many cochlear implants have a telecoil built into the sound processor, or can use an external telecoil accessory with both hearing aid compatible telephones and public loop systems. A simple switch or programming maneuver performed by the user activates this function.

See the NIDCD fact sheet Hearing Aids for more information.

FM systems use radio signals to transmit amplified sounds. They are often used in classrooms, where the instructor wears a small microphone connected to a transmitter and the student wears the receiver, which is tuned to a specific frequency, or channel. People who have a telecoil inside their hearing aid or cochlear implant may also wear a wire around the neck (called a neckloop) or behind their aid or implant (called a silhouette inductor) to convert the signal into magnetic signals that can be picked up directly by the telecoil. FM systems can transmit signals up to 300 feet and are able to be used in many public places. However, because radio signals are able to penetrate walls, listeners in one room may need to listen to a different channel than those in another room to avoid receiving mixed signals. Personal FM systems operate in the same way as larger scale systems and can be used to help people with hearing loss to follow one-on-one conversations.

Infrared systems use infrared light to transmit sound. A transmitter converts sound into a light signal and beams it to a receiver that is worn by a listener. The receiver decodes the infrared signal back to sound. As with FM systems, people whose hearing aids or cochlear implants have a telecoil may also wear a neckloop or silhouette inductor to convert the infrared signal into a magnetic signal, which can be picked up through their telecoil. Unlike induction loop or FM systems, the infrared signal cannot pass through walls, making it particularly useful in courtrooms, where confidential information is often discussed, and in buildings where competing signals can be a problem, such as classrooms or movie theaters. However, infrared systems cannot be used in environments with too many competing light sources, such as outdoors or in strongly lit rooms.

Personal amplifiers are useful in places in which the above systems are unavailable or when watching TV, being outdoors, or traveling in a car. About the size of a cell phone, these devices increase sound levels and reduce background noise for a listener. Some have directional microphones that can be angled toward a speaker or other source of sound. As with other ALDs, the amplified sound can be picked up by a receiver that the listener is wearing, either as a headset or as earbuds.

What types of augmentative and alternative communication devices are available for communicating face-to-face?

The simplest AAC device is a picture board or touch screen that uses pictures or symbols of typical items and activities that make up a person's daily life. For example, a person might touch the image of a glass to ask for a drink. Many picture boards can be customized and expanded based on a person's age, education, occupation, and interests.

Keyboards, touch screens, and sometimes a person's limited speech may be used to communicate desired words. Some devices employ a text display. The display panel typically faces outward so that two people can exchange information while facing each other. Spelling and word prediction software can make it faster and easier to enter information.

Speech-generating devices go one step further by translating words or pictures into speech. Some models allow users to choose from several different voices, such as male or female, child or adult, and even some regional accents. Some devices employ a vocabulary of prerecorded words while others have an unlimited vocabulary, synthesizing speech as words are typed in. Software programs that convert personal computers into speaking devices are also available.

What augmentative and alternative communication devices are available for communicating by telephone?

For many years, people with hearing loss have used text telephone or telecommunications devices, called TTY or TDD machines, to communicate by phone. This same technology also benefits people with speech difficulties. A TTY machine consists of a typewriter keyboard that displays typed conversations onto a readout panel or printed on paper. Callers will either type messages to each other over the system or, if a call recipient does not have a TTY machine, use the national toll-free telecommunications relay service at 711 to communicate. (See Telecommunications Relay Services for more information.) Through the relay service, a communications assistant serves as a bridge between two callers, reading typed messages aloud to the person with hearing while transcribing what's spoken into type for the person with hearing loss.

With today's new electronic communication devices, however, TTY machines have almost become a thing of the past. People can place phone calls through the telecommunications relay service using almost any device with a keypad, including a laptop, personal digital assistant, and cell phone. Text messaging has also become a popular method of communication, skipping the relay service altogether.

Another system uses voice recognition software and an extensive library of video clips depicting American Sign Language to translate a signer's words into text or computer-generated speech in real time. It is also able to translate spoken words back into sign language or text.

Finally, for people with mild to moderate hearing loss, captioned telephones allow you to carry on a spoken conversation, while providing a transcript of the other person's words on a readout panel or computer screen as back-up.

What types of alerting devices are available?

Alerting or alarm devices use sound, light, vibrations, or a combination of these techniques to let someone know when a particular event is occurring. Clocks and wake-up alarm systems allow a person to choose to wake up to flashing lights, horns, or a gentle shaking.

Visual alert signalers monitor a variety of household devices and other sounds, such as doorbells and telephones. When the phone rings, the visual alert signaler will be activated and will vibrate or flash a light to let people know. In addition, remote receivers placed around the house can alert a person from any room. Portable vibrating pagers can let parents and caretakers know when a baby is crying. Some baby monitoring devices analyze a baby's cry and light up a picture to indicate if the baby sounds hungry, bored, or sleepy.

What research is being conducted on assistive technology?

The National Institute on Deafness and Other Communication Disorders (NIDCD) funds research into several areas of assistive technology, such as those described below.

Improved devices for people with hearing loss
NIDCD-funded researchers are developing devices that help people with varying degrees of hearing loss communicate with others. One team has developed a portable device in which two or more users type messages to each other that can be displayed simultaneously in real time. Another team is designing an ALD that amplifies and enhances speech for a group of individuals who are conversing in a noisy environment.

Improved devices for nonspeaking people

More natural synthesized speech
NIDCD-sponsored scientists are also developing a personalized text-to-speech synthesis system that synthesizes speech that is more intelligible and natural sounding to be incorporated in speech-generating devices. Individuals who are at risk of losing their speaking ability can prerecord their own speech, which is then converted into their personal synthetic voice.

Brain-computer interface research
A relatively new and exciting area of study is called brain-computer interface research. NIDCD-funded scientists are studying how neural signals in a person's brain can be translated by a computer to help someone communicate. For example, people with amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease) or brainstem stroke lose their ability to move their arms, legs, or body. They can also become locked-in, where they are not able to express words, even though they are able to think and reason normally. By implanting electrodes on the brain's motor cortex, some researchers are studying how a person who is locked-in can control communication software and type out words simply by imagining the movement of his or her hand. Other researchers are attempting to develop a prosthetic device that will be able to translate a person's thoughts into synthesized words and sentences. Another group is developing a wireless device that monitors brain activity that is triggered by visual stimulation. In this way, people who are locked-in can call for help during an emergency by staring at a designated spot on the device

Where can I get more information?

The NIDCD maintains a directory of organizations that provide information on the normal and disordered processes of hearing, balance, taste, smell, voice, speech, and language.

Use the following keywords to help you search for organizations that can answer questions and provide printed or electronic information on assistive devices:

For more information, contact us at:

NIDCD Information Clearinghouse
1 Communication Avenue
Bethesda, MD 20892-3456
Toll-free voice: (800) 241-1044
Toll-free TTY: (800) 241-1055
Email: nidcdinfo@nidcd.nih.gov

NIH Publication No. 11-7672
December 2011

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Assistive Devices for People with Hearing, Voice, Speech, or Language Disorders

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What are assistive devices? The terms assistive device or assistive technology can refer to any device that helps a person with hearing loss or a voice, speech, or language disorder to communicate.

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My best friend since childhood is deaf in one ear, which I suppose would fall under the category of "hearing impairment". I know to stand to one side of him when we're having a conversation so he can hear me. He can sometimes miss audial details, such as dialogue in a movie. Thinking back to our school days, I'm not sure that all of our teachers were aware of his hearing impairment. It certainly affected his ability to pay attention in class. It reminds me hearing impairment is a learning difficulty that has a chance of going undiagnosed by students and teachers alike.

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Meaning of Slow learner - Someone who has the ability to learn necessary academic skills, cognitive skills but at the rate and depth much below average same age peers.
Definition - A child can be described as a slow learner if his or her thinking skills develop at a notably slower rate than that of his or her peers. The child will carry on through the exact same developmental stages as his or her peers but at a comparatively slow rate. Also, the child typically has below-average intelligence.

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How common is the slow learning disability  among children.

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How common is the slow learning disability  among children.

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Approximately 6.5 million people in the US have this category of disability. The vast majority of children identified — 78% — had mild intellectual disability while 12% were classified in the moderate category and 1% were considered severe or profound.

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Slow learners are stuck between a rock and a hard place: their cognitive abilities are too high to be considered for an intellectual disability, but same abilities are usually too low to be considered for a learning disability.

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Most people think that if their child is a slow learner, it makes him incompetent, or he is not trying hard enough. Neither is true! One of the hardest things for parents to accept is that their child is a slow learner. When dealing with a child who struggles to learn, you can take steps to help make his life easier. Before doing that though, it is essential to learn who a slow learning child is.

Who is a Slow Learning Child?

A slow learning child is a child that hits his developmental markers at a much slower rate than compared to his peers. It is commonly misunderstood that these children fail at learning or are merely 'dumb'. The truth is that every child has his own pace to learn and develop. Some children naturally learn much faster, and others are known to take their time to learn the same concepts and lessons.

What Are The Characteristics of A Slow Learning Child?

A slow learning child is one that struggles to hit basic developmental milestones that can broadly be categorised into four groups - developmental, social, personal or educational. Here are a few symptoms of slow learning child:

Social: A child who has social learning disabilities is usually known to relate to children younger to him more often and avoid interacting with peers. Such children are also prone to behaviour that is associated with children younger than their age. These children are often just labelled as introverts due to the inability to connect with their peers leading them to be quieter or more reserved.

Personal: Children with personal learning problems seem to have less control over their emotions. They tend to fall back to anger quickly, get frustrated faster than most, express emotions like anxiety for seemingly minor issues or get depressed over setbacks. These children are most likely to have significant problems with self-esteem, confidence and are prone to acts of aggression or emotional instability.

Educational: Children with learning or educational disabilities take longer to process and understand the information provided to them. These children may be proficient in intellectual knowledge, but it takes them longer to understand & grasp the concepts.

What Causes Slow Learning in Kids?

Most parents may wonder why some children are slow learners. The truth is that there is no clear answer. Yet, there are a few underlying reasons that can be the main causes but these causes may not be specific to your child.

Trauma - Your child could have gone through a trauma in the past which is causing a delay in his development. It is now widely accepted that trauma of any nature - be it physical, psychological or emotional - can have the same impact on children.

Premature Birth - One of the reasons for problems while learning is the premature birth. This can also be the reason behind your child having a slower rate of brain development.

Medical - Another common cause for learning issues could be medical - diseases of the brain or nervous system can cause problems for children to hit learning milestones. These are often treatable, but when not treatable, they are manageable.

Pampering - The most common cause for learning delays is the over-pampering nature of parents. At times, the learning process requires action and failure. A lot of children who are pampered are known to have the problems solved for them, which is why they never learn or adapt.

Challenges of A Slow Learning Child

A child who is diagnosed as a slow learner can face many challenges in his lifetime. He may struggle to keep up with his peers, find it difficult to stay motivated while learning, go through many bouts of depression or anxiety or struggle to communicate and build connections with people. To understand the possible challenges that your child may face as a slow learner, talk to a child learning and developmental specialist.

How to Help and Handle A Slow Learner?

There are numerous ways to help a child who is a slow learner. Here are a few methods that are known to help slow learners:

Motivation is one of the most essential requirements for children who are slow learners. To help them continue learning and to keep them motivated, it is important to praise them when they get a concept or technique correctly. Even the smallest victory should be acknowleged and praised.

As with any child, a slow learning child will be motivated to stay the course and learn as much as possible if there is a reward at the end of it. Try setting rewards for milestones to keep your child motivated and to help him focus on the task at hand.

When working with a child who is a slow learner, it is important to set small targets that are achievable and within reach. As a parent, it is your responsibilty to understand what is achievable for your child.

Make sure you reinforce the notion that failure isn't a bad thing. Be realistic with teachers and other caregivers as well as with yourself that your child will fail more often than other children. When he does, do not berate him. Instead, encourage him to try again.

Be it a teacher, your partner, parents, the babysitter or any other caregiver, be open about your child's struggle. Let them know the situation and educate them about how to handle the situation with your child as a slow learner.

Do not compare your child to other children. This will only de-motivate you as well as your child. Stay patient when working with him and be sure that he will hit the milestones in front of him, even if it is at a much slower rate. Make sure you do not lose you patience and scream at him, as this will only demotivate him.

Whether it be post-it notes, reminders on calendars or calculators, keep room for visual and auditory aids when working with your child. These aids can be beneficial at a sub-conscious level. Find aids that can be used passively so your child continues to learn.

Being vocally supportive is essential when dealing with slow learners. Encourage your child to keep at it until he succeeds. Just knowing you believe in your child will keep him motivated to keep learning and trying.

FAQ's

Here are some frequently asked questions about slow learning children.

1. How are Slow Learners Different from Those who have Learning Disability?

A learning disability is a physiological condition that prevents the child from learning in the same way as others. They can still learn at the same pace as their peers if they are taught in a different manner that works around the condition. For instance, Dyslexic children can learn as fast as any other child if they are read to instead of being made to read.

Slow learners have problems keeping up with their peers due to the inability to grasp a concept or understand what is taught to them. Slow learners have developmental issues whereas, children with learning disabilities do not.

2. Is Slow Learning and ADHD The Same?

ADHD is an issue that is focused on attention retention. Slow learners struggle to hit learning milestones due to the inability to grasp information quickly.

3. Does Slow Learning Mean My Child has Autism?

No. Autism is a condition where the child does not identify with social interactions and norms. Slow learning may be a symptom of it, but not all slow learners have autism.

It is essential to remember that a child should never be self-diagnosed as a slow learner. If you think your child may have trouble learning, contact your doctors and have him tested to be sure of his condition.
Also Read: How to Deal with Highly Sensitive Child

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Slow Learner Child: Characteristics, Challenges & Tips to Handle

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When you learn your child may have difficulty learning, it can be challenging, there are things you can do to make your child's and your life easier when dealing with a slow learner child. Read more on characteristics, causes, challenges & tips to handle slow learning children.

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Tips to Teach and Improve Slow Learners | LOGIC ROOTS

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How to tackle these special children with their cognitive development. 

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How to tackle these special children with their cognitive development. 

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Suggestions that follow are a starting point for developing instructional strategies that specifically address their learning needs.

Develop Lessons that Incorporate the Student’s interests, needs, and experiences. This helps address the short attention spans of slow learners. Also, these students should be made to feel that some of the instruction has been designed with their specific interests or experiences in mind.

Frequently VARY the Instructional Technique: Switching from lecture to discussion and then to work provides the variety that slow learners need to stay engaged in the learning process. In addition to keeping their attention, variety in instructional technique offers them the opportunity to see the same content presented in different ways.

Incorporate Individualized Learning Materials: Slow learners respond favourably to frequent reinforcement of small segments of learning. Therefore, programmed texts and interactive computer instruction often are effective in remediation of the basic skills of slow learners.

Incorporate Audio and Visual Materials: One common characteristic among slow learners is that they often learn better by seeing and hearing than by reading. Incorporating films, videotapes, and audio into lessons helps accommodate the instruction to the strategies learning modalities among slow learners.

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LOGIC ROOTS - Reinventing how kids practice Math

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Tips to Teach and Improve Slow Learners | LOGIC ROOTS

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This means a disability affecting a child aged two (by September 30) to six, inclusive (age two up to age seven), who is experiencing developmental delays, as measured by appropriate diagnostic instruments and procedures, in one or more of the following areas: physical development, cognitive development, communication development, social or emotional development, adaptive development, or has an established physical or mental condition that has a high probability of resulting in developmental delays.

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With reference to international statistics, developmental delay occurs in approximately 10 to 15 per 100 persons in the general population. Amongst them, about one to three persons have significant global developmental delay.

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There was a student before me who had a hearing impairment and needed to wear a hearing aid to hear others. When he was about 8 years old, it was found that his hearing was weaker than that of ordinary people, because when he was young, his parents just thought that he did not like to communicate with others, and did not find that he had a hearing impairment. Later, they found that he had a comprehensive examination. Because of his hearing impairment, his language expression ability is also weaker than that of other children, so he is unwilling to answer questions in class. Later, our classroom activities were divided into group discussions, and the student slowly began to be willing to speak and express his ideas.

More development delay performance can be found in the below link
https://www.youtube.com/watch?v=5t88zBJkWLI

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Autism is NOT a desease, it's another way of seeing the world.

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Autism is NOT a desease, it's another way of seeing the world.

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Autism spectrum disorder (ASD) is a developmental disability caused by differences in the brain. People with ASD often have problems with social communication and interaction, and restricted or repetitive behaviors or interests.

However, being autistic does not mean you have an illness or disease. It just means your brain works in a different way from other people. As stated in this video, a better question could be "should we treat children with autism with therapy or celebrate them for who they are?".

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Autism Spectrum: Atypical Minds in a Stereotypical World

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According to Centers for Disease Control and Prevention, the overall incidence of Autism Spectum Disorder (ASD) was 1 in 44 (or 23.0 per 1,000) American children aged 8 years, based on data collected in 2018. Scientists also found that the prevalence of ASD among boys was 4.2 times as among girls.

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The Centers for Disease Control and Prevention released its latest prevalence estimates for autism, finding 1 in 44 or 2.27% of American 8-year-olds have an autism spectrum disorder.
Miss a day, miss a lot. Subscribe to The Defender's Top News of the Day. It's free.
The Centers for Disease Control and Prevention (CDC) released its latest prevalence estimates for autism. The center reports that 1 in 44 or 2.27% of American 8-year-olds have an autism spectrum disorder (ASD).

This rate is a 23% increase from two years ago when the figure was 1 in 54 children. The new prevalence reflects a 3.39 fold jump in numbers since the CDC began collecting data in 2000.

The study, published in the Dec. 3, Morbidity and Mortality Weekly Report, uses the Autism and Developmental Disabilities Monitoring (ADDM) Network to estimate the number of children with ASD and other developmental disabilities living in different areas of the U.S.

These reports are typically released every two years. The current report studied a total of 5058 8-year-old children with ASD in: Arizona, Arkansas, California, Georgia, Maryland, Minnesota, Missouri, New Jersey, Tennessee, Utah and Wisconsin. Prevalence rates ranged from 1.6% in Missouri to 3.9% in California.

SafeMinds reached out to Walter M. Zahorodny, Ph.D., to gain insights from this devastating new prevalence report. Zahorodny is the principal investigator of the New Jersey ADDM Network and has been involved with these prevalence reports since their inception in 2000.
The following is a transcript of our discussion:
SafeMinds: This new ADDM Network report was released a little earlier compared to other reporting periods. Why did that happen?

Zahorodny: The new report was released four months earlier than the typical ADDM pattern. Usually, the ADDM reports come out in March or April in order to be linked with Autism Awareness Month.

This report is the first time the Network used a different method of case finding. The new method is less comprehensive and less time-consuming, which allowed for quicker completion of the study activities.

SafeMinds: The new autism prevalence rate is 1 in 44 for 8-year-old children surveyed in 2018, up from 1 in 54 from the previous reporting period (2016). That rate seems to be a steeper increase compared to other reporting periods. Can you give us any insights on why this occurred?

Zahorodny: The increase from 1 in 54 in 2016 to 1 in 44 in 2018 is steeper than in some earlier cycles. I think that most of the 2018 increase may be due to the inclusion of California into the ADDM Network.

SafeMinds: We have spoken to you previously about the high reported rates of autism in New Jersey, but this report shows that California has the highest rate of autism in the country. Did this surprise you? Why do you think Californians showed the highest rate?

Zahorodny: I am surprised that California has the highest rate of autism. New Jersey had been the leading indicator of autism prevalence for almost 20 years. Since the ADDM Network never conducted autism surveillance in California, no one had an idea of what to expect.

I think California showed a higher rate because autism is prevalent in the U.S. and when you look carefully in a metropolitan area with good levels of health care and education, you will find high rates of autism.

SafeMinds: Did the overall male to female autism ratio stay constant in this report compared to other reporting periods? What is the autism prevalence rate for boys? What is the rate for girls?

Zahorodny: The ADDM average rate for boys was 3.6%, and the rate for girls was .8%. Boys outnumber girls by about 4 to 1, as most previous surveillance shows. I'd call your attention to the fact that the rate of autism among boys in California was 6.4%, however. That is an unprecedented estimate and will call for continued monitoring and research.

SafeMinds: Did the prevalence rate in this reporting period stay consistent across ethnicities and races? Were there any disparities or signals discovered?

Zahorodny: In most ADDM states, autism prevalence is similar across races. In a few states, Hispanic children with autism were less likely to be identified. It is gratifying that the race/ethnicity disparities in autism identification may be declining in many regions.

SafeMinds: Last October, we spoke to you about a New Jersey report which showed that middle-income families showed a greater rate of autism compared to high-income or low-income families. Did this report look at socioeconomic status?

Zahorodny: This is the first time an ADDM report provided information about socioeconomic status (SES). In this regard, the distribution of autism seems to be shifting. For the first ten years of surveillance in New Jersey and throughout the network, autism prevalence estimates were significantly higher in high SES communities.

This report no longer shows the positive association of wealth and autism prevalence. In some states, prevalence is highest in low SES communities, while in New Jersey autism was most prevalent in the mid-SES communities. It is too early to know whether this shifting continues and what it means.

SafeMinds: This report was calculated and written during the pandemic. Did COVID affect data collection or any other parts of the reporting process?

Zahorodny: It is very likely that COVID-19 restrictions affected data collection at some ADDM sites. It is hard to evaluate the overall effect of COVID-19 on our estimates, however.

SafeMinds: Were there any surprises in this report?

Zahorodny: I am surprised that California has the highest rate of autism. New Jersey had been the leading indicator of autism prevalence for almost 20 years. Since the ADDM Network never conducted autism surveillance in California, no one had an idea of what to expect.

SafeMinds: Is there any good news?

Zahorodny: The good news is that the ADDM Network now includes a region in California, which will be able to provide high-quality prevalence findings going forward.

SafeMinds: What is your takeaway from this ADDM report?

Zahorodny: This report shows that autism prevalence has increased continuously over twenty years in the U.S. and that autism affects as many as 4% of children born in 2010.

Autism rates have not plateaued and so future estimates are likely to continue upward. Since the revised ADDM method is faster, but less comprehensive. It is likely to underestimate the actual number of true cases and may miss children from underserved communities.

If autism already affects 4-7% of 8-year-children in many New Jersey areas as shown in our recent study and 4% in California according to the new ADDM findings, understanding the factors driving the rise in ASD prevalence should be a public health priority.

In addition, better strategies to improve early detection of autism are needed, as is novel research to identify environmental triggers and risk factors for ASD.
Originally published by SafeMinds. The views and opinions expressed in this article are those of the authors and do not necessarily reflect the views of Children's Health Defense.

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1 in 44 American Children Has Autism, CDC Reports

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The Centers for Disease Control and Prevention released its latest prevalence estimates for autism, finding 1 in 44 or 2.27% of American 8-year-olds have an autism spectrum disorder. Miss a day, miss a lot. Subscribe to The Defender's Top News of the Day. It's free.

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The main signs and symptoms of autism involve problems in the following areas: Communication skills, social skills, and restrictive, repetitive, and stereotyped behavior. Above is the screening and diagnosis suggested by CDC.

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Centers for Disease Control and Prevention

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Diagnosing autism spectrum disorder (ASD) can be difficult because there is no medical test, like a blood test, to diagnose the disorder. Doctors look at the child's developmental history and behavior to make a diagnosis.

ASD can sometimes be detected at 18 months of age or younger. By age 2, a diagnosis by an experienced professional can be considered reliable []. However, many children do not receive a final diagnosis until much older. Some people are not diagnosed until they are adolescents or adults. This delay means that people with ASD might not get the early help they need.

Diagnosing children with ASD as early as possible is important to make sure children receive the services and supports they need to reach their full potential []. There are several steps in this process.

Developmental Monitoring

Developmental monitoring is an active, ongoing process of watching a child grow and encouraging conversations between parents and providers about a child's skills and abilities. Developmental monitoring involves observing how your child grows and whether your child meets the typical developmental milestones, or skills that most children reach by a certain age, in playing, learning, speaking, behaving, and moving.

Parents, grandparents, early childhood education providers, and other caregivers can participate in developmental monitoring. CDC's Learn the Signs. Act Early. program has developed free materials, including CDC's Milestone Tracker app, to help parents and providers work together to monitor your child's development and know when there might be a concern and if more screening is needed. You can use a brief checklist of milestones to see how your child is developing. If you notice that your child is not meeting milestones, talk with your doctor or nurse about your concerns and ask about developmental screening. Learn more about CDC Milestone Tracker app, milestone checklists, and other parent materials.

When you take your child to a well visit, your doctor or nurse will also do developmental monitoring. The doctor or nurse might ask you questions about your child's development or will talk and play with your child to see if they are developing and meeting milestones.

Your doctor or nurse may also ask about your child's family history. Be sure to let your doctor or nurse know about any conditions that your child's family members have, including ASD, learning disorders, intellectual disability, or attention deficit/hyperactivity disorder (ADHD).

Developmental Screening

Developmental screening takes a closer look at how your child is developing.

Developmental screening is more formal than developmental monitoring. It is a regular part of some well-child visits even if there is not a known concern.

The American Academy of Pediatrics (AAP) recommends developmental and behavioral screening for all children during regular well-child visits at these ages:

In addition, AAP recommends that all children be screened specifically for ASD during regular well-child visits at these ages:

Screening questionnaires and checklists are based on research that compares your child to other children of the same age. Questions may ask about language, movement, and thinking skills, as a well as behaviors and emotions. Developmental screening can be done by a doctor or nurse, or other professionals in healthcare, community, or school settings. Your doctor may ask you to complete a questionnaire as part of the screening process. Screening at times other than the recommended ages should be done if you or your doctor have a concern. Additional screening should also be done if a child is at high risk for ASD (for example, having a sibling or other family member with ASD) or if behaviors sometimes associated with ASD are present. If your child's healthcare provider does not periodically check your child with a developmental screening test, you can ask that it be done.
View and print a fact sheet on developmental monitoring and screening pdf icon [657 KB, 2 Pages, Print Only]
Developmental Diagnosis

A brief test using a screening tool does not provide a diagnosis, but it can indicate whether a child is on the right development track or if a specialist should take a closer look. If the screening tool identifies an area of concern, a formal developmental evaluation may be needed. This formal evaluation is a more in-depth look at a child's development and is usually done by a trained specialist such as a developmental pediatrician, child psychologist, speech-language pathologist, occupational therapist, or other specialist. The specialist may observe the child give the child a structured test, ask the parents or caregivers questions, or ask them to fill out questionnaires. The results of this formal evaluation highlight your child's strengths and challenges and can inform whether they meet criteria for a developmental diagnosis.

A diagnosis of ASD now includes several conditions that used to be diagnosed separately; autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS), and Asperger syndrome. Your doctor or other healthcare provider can help you understand and navigate the diagnostic process.

The results of a formal developmental evaluation can also inform whether your child needs early intervention services. In some cases, the specialist might recommend genetic counseling and testing for your child.

References

1. Lord C, Risi S, DiLavore PS, Shulman C, Thurm A, Pickles A. Autism from 2 to 9 years of age. Arch Gen Psychiatry. 2006 Jun;63(6):694-701.

2. Hyman SL, Levey SE, Myers SM, Council on Children with Disabilities, Section on Developmental and Behavioral Pediatrics. Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Pediatrics. 2020 Jan;145(1).

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Screening and Diagnosis | Autism Spectrum Disorder (ASD) | NCBDDD

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Autism Spectrum Disorders (ASDs) are a group of developmental disabilities that can cause significant social, communication and behavioral challenges. CDC is working to find out how many children have ASDs, discover the risk factors, and raise awareness of the signs.

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To help people on the autism spectrum, ATs are categorized in helping with communication, learning, building social skills, and facing sensory challenges, and safety concerns.

There three types of assistive technologies that can e used for autism:
1. Low-tech AT: Anything that needs no electricity
Example: weighted vest, sensory balls, picture boards, etc.
2. Mid-tech AT: Simple enough to be relatively inexpensive and easy to operate
Example: battery-operated sensory toys, visual timers, social skills videos, etc.
3. High-tech AT: Digital technology that can include anything from augmentative communication technology for non-verbal people to robots built to increase social skills in children on the spectrum.

In many areas, assistive technology can help tackle the difficulty of learning for students on the autism spectrum:
1. Communication:

Low-Tech AT:

picture boards and picture cards

Mid-Tech AT:

speech-generating apps

2. Learning:

Low-Tech AT:

stress balls

worry beads

weighted vests

standing desks

ordinary written planners

color-coded schedules

visual reminders

Mid-Tech AT:

watches with alarms

visual timers

sound-blocking headphones

calculators

audiobooks and recordings

High-Tech AT:

mind mapping software

speech to text software

3. Social Skills

Low-Tech AT:

social stories

social skills cards and games

Mid-Tech AT:

video modeling and apps

High-Tech AT:

interactive artificial intelligence and robots

4. Sensory Challenges

Mostly low- or mid-tech

Therapists:

trampolines, swings, brushes, balls, and similar tools

Classroom teachers:

canceling headphones, weighted vests, and tinted glasses

Apps:

used for sensory "breaks"

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How Technology Can Help People With Autism

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From weighted blankets to socially responsive robots, there is an incredible range of assistive technology available to help those with autism.

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7 tips for teaching students on the autism spectrum

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7 tips for teaching students on the autism spectrum

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For writing：sticker pages form DO2.com;crabby writer；shape and robots tracing.
For listening:Earback hearing aid deaf-aid;
Vibration alarm clock;Tactile mouse

For speaking:Audio book;Auxiliary communication system.

More details-The samples of  treatment

1. Physical growth retardation: If the physical growth retardation of children is caused by simple nutritional factors,  we can balance the diet at an early stage, reasonably arrange the children's eating habits, and avoid picky eating. Vegetables, fruits and meat can be properly eaten together to ensure the normal nutritional requirements of children's physical development.

2. Motor retardation: schools can provide some targeted training suitable for children, such as local limb lifting.

3. Language development retardation: if language development retardation is caused by language environment problems, professional teachers often imitate language with children, encourage children to speak and guide them to speak correctly, so as to improve children's language development retardation.

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https://www.youtube.com/watch?v=5t88zBJkWLI

https://www.ssmhealth.com/cardinal-glennon/developmental-pediatrics/developmental-delay

https://www.dhcas.gov.hk/en/developmental_delay.html

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My own experience with students on the autism spectrum

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My own experience with students on the autism spectrum

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From my personal experience, I have worked with several students who have been diagnosed as on the autism spectrum for about two months in my PE classes.

Everyone of them are different, or unique. The most serious one hasvery obvious signs of delayed language skills, movement skills, and cognitive skills.

At the school where I work now, we facilitate these kids with several services other than differentiated education:

Firstly, each of the students with serious ASD signs is companied with one shadow teacher that sits with them, go to different classes with them, and study together with them.

Secondly, the school hires a full-time on campus psychiatrist to work with all the teachers, students, and parents. In the situation that these students disrupt normal class so badly, shadow teachers take them to the psychiatrist to calm them down and develop further treatments.

Thirdly, we are now facilitated with individual learning center, in which these special kids can learn what they are interested in and on their own pace. Teachers take turns to take care of the individual learning center and shadow teachers play a more important role in accomodating the special needs of these students.

At last, in my PE classes, I tend to treat these special kids as normal pupils unless their behaviour disrupts the whole class so badly. Personally, I believe these kids are more sensitive than others and are willing to feel included in the classes. I am very glad to see that other students are aware that these special students need special care and encouragement. For the past two months, we have been encouraging these students to participate in the activities that the rest of the classes has been doing. This results in an obvious improvement in the behaviour of these students on the autism spectrum. I am so pleased to see that happen.

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1. Centers for Disease Control and Prevention. (2022, March 28). Signs and symptoms of autism spectrum disorders. Centers for Disease Control and Prevention. Retrieved December 5, 2022, from https://www.cdc.gov/ncbddd/autism/signs.html#:~:text=Autism spectrum disorder (ASD) is,, moving, or paying attention.

2. Maenner MJ, Shaw KA, Bakian AV, et al. Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2018. MMWR Surveill Summ 2021;70(No. SS-11):1–16. DOI: http://dx.doi.org/10.15585/mmwr.ss7011a1external

3. Rudy, L. J. (2021, February 8). Overview of assistive technology for autism. Verywell Health. Retrieved December 5, 2022, from https://www.verywellhealth.com/assistive-technology-for-autism-5076159

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Emerging Technologies to Enhance Learning among Slow Learners

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Assistive technologies and a few moral practice policies will have a positive effect on the child suffering from it. This article by Annamalai University , presents an extensive list and the strategies involved. 

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Assistive technologies and a few moral practice policies will have a positive effect on the child suffering from it. This article by Annamalai University , presents an extensive list and the strategies involved. 

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More than the child, the parent and the educator needs to sustain self-confidence in applying the strategies to help improve the child in areas the child lags or feels backwards.

Special accommodations which can help are as follows,

Compensatory Teaching.

Alter the presentation of content to circumvent a student’s fundamental weakness or deficiency. Supplement the coaching period with additional learning resources and activities like group discussions, cooperative learning, etc.

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Emerging Technologies to Enhance Learning among Slow Learners

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Other Health Impairment (OHI)by Jenny Chang

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Other Health Impairment (OHI)by Jenny Chang

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IDEA's definition of OHI:
"Other health impairment means having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that—

(i) Is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and Tourette syndrome; and

(ii) Adversely affects a child’s educational performance."

The disabilities included in this category are actually very different from one another, but they all share :

"limited strength, vitality, or alertness due to chronic health problems; and

an educational performance that is negatively affected as a result."

https://www.parentcenterhub.org/ohi/

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Other Health Impairment | Center for Parent Information and Resources

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Tourette Syndrome (TS) is a "neurodevelopmental disorder that becomes evident in early childhood or adolescence. It is part of the spectrum of Tic Disorders and is characterized by motor and vocal tics."

Some people diagnosed Tourette might not have to suffer from Tics Disorders after they become older; however, some might still have to. According to Tourette Association of America, "It is common for people with TS to be affected by another co-occurring condition," such as Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive Compulsive Disorder (OCD).

Unfortunately, there's no cure for TS yet.

https://tourette.org/about-tourette/overview/
https://tourette.org/research-medical/cooccurring-conditions/

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Tourette Syndrome: An Overview - Tourette Association of America

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Tourette Syndrome is a neurological disorder that becomes evident in early childhood or adolescence. It is part of the spectrum of Tic Disorders.

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Tourette Syndrome: What Students Want Teachers to Know

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TS is not rare.

"It’s estimated that 2% of the population has Tourette syndrome. This may be a conservative estimate, since many people with very mild tics may be unaware of them and never seek medical attention. A study by Kurlan, McDermott, et al. (2001) indicates that over 19% of children in regular education classes have tics and over 23% of children in special education classes have tics."

"1 out of every 160 children between the ages of 5-17 in the United States has TS and that 1 out of every 100 children has TS or another Tic Disorder."

https://www.parentcenterhub.org/ohi-tourette/
https://tourette.org/about-tourette/overview/

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Links updated, July 2015
See fact sheets on other disabilities

The Individuals with Disabilities Education Act (IDEA), our nation's special education law, defines 14 categories of disability under which a child may be found eligible for special education and related services. One of those categories is " Other Health Impairment," or OHI, for short. Within OHI's definition, numerous disabilities and medical conditions are explicitly named. Tourette syndrome is one such.

This short resource page accompanies a longer fact sheet on Other Health Impairment and provides a brief overview of Tourette syndrome and connections to sources of additional information.

A Brief Look at Tourette Syndrome

Tourette syndrome is a neurobiological disorder characterized by tics (involuntary, rapid, sudden movements) and/or vocal outbursts that occur repeatedly. It's an inherited, neurological disorder that is first noticed in childhood, usually between the ages of 7 and 10. The syndrome is four times as likely to occur in boys as in girls.

Tourette sydrome was once strongly associated with the exclamation of obscene words or socially inappropriate remarks. In fact, only a small minority of people with Tourette's have this symptom. For most, Tourette's involves:

tics, along a range of simple (e.g., rapid eye-blinking, facial grimacing, shoulder-shrugging) to complex (involving several muscle groups, such as hopping, bending, or twisting); and

vocalizations, also along a range of simple (throat-clearing, sniffing, grunting) to complex (involving words or phrases).

It's estimated that 2% of the population has Tourette syndrome. This may be a conservative estimate, since many people with very mild tics may be unaware of them and never seek medical attention. A study by Kurlan, McDermott, et al. (2001) indicates that over 19% of children in regular education classes have tics and over 23% of children in special education classes have tics.

What about treatment? According to the National Institute of Neurological Disorders and Stroke's fact sheet on the syndrome (listed below, under resources):

Because tic symptoms do not often cause impairment, the majority of people with TS require no medication for tic suppression. However, effective medications are available for those whose symptoms interfere with functioning.

Are children with Tourette syndrome automatically eligible for special education and related services? The plain answer is: No. Eligibility will depend on several factors and a careful study of the evaluation results. As IDEA makes clear in its definition of "other health impairment," having the syndrome is not the only condition to be met for eligibility. (For one, the child's educational performance must be adversely affected as a result of the syndrome.)

Interestingly, Tourette syndrome was explicitly added to this disability category in the 2004 Amendments to IDEA. According to the U.S. Department of Education, the syndrome was specifically named in the definition of "other health impairment" because:

...Tourette syndrome is commonly misunderstood to be a behavioral or emotional condition, rather than a neurological condition. Therefore, including Tourette syndrome in the definition of other health impairment may help correct the misperception of Tourette syndrome as a behavioral or conduct disorder and prevent the misdiagnosis of their needs. (71 Fed. Reg. at 46550)

Resources of More Information on Tourette Syndrome

National Tourette Syndrome Association
http://tsa-usa.org/

Tourette Syndrome "Plus"
http://www.tourettesyndrome.net/

Tourette Syndrome Fact Sheet
from the National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov/disorders/tourette/detail_tourette.htm

Información en español.
http://tsa-usa.org/TouretteAssocEspanol/bienvenidos.html

Información en español.
http://espanol.ninds.nih.gov/trastornos/sindrome_de_tourette.htm

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Links updated, July 2015 See fact sheets on other disabilities The Individuals with Disabilities Education Act (IDEA), our nation's special education law, defines 14 categories of disability under which a child may be found eligible for special education and related services. One of those categories is " Other Health Impairment," or OHI, for short.

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Tics are sudden twitches, movements, or sounds that people with TS do repeatedly. They can occur without warning. Whenever they occur, students with TS might not be able to take part in the class and in the long run they result in students' academic performances. "Flexibility plays a key role in supporting the success of students with health impairments as many health conditions by nature are unpredictable." Under this circumstance, my school and the student's parent had come up a accommodation plan together:

1. When not in school the student will attend class remotely. It will be his/her choice to turn on the video if requested by the teacher.

2. The student will arrange a schedule to meet teachers at school if absent during the week to take assessments, to submit assignments or to clarify lessons.

3. If the student is unable to keep to his/her schedule and inform his/her teachers, the mother will send an email to teachers.

4. All assessments will be completed at school.

5. All class assignments and notes are posted on subject matter TEAMS.

https://granite.pressbooks.pub/understanding-and-supporting-learners-with-disabilities/chapter/other-health-impairments/

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Considering that handwriting is not an easy task for students with TS, both my student and I think that the use of computer plays a very important role in our classes:
1.  Microsoft TEAMS
When the student is not able to attend class, we would have online classes via TEAMS. Student will also be requested to turn in assignments available in electronic format on TEAMS.

2. Recording App/voice recorder
To check the student's pronunciation or reading comprehension development, I would ask the student to practice reading the vocabulary or articles.

3. Video
If the student couldn't join group works such as oral presentation or role play, then he/she would be requested to do it on his own and submit the video to me.

4. Google Suite
Student's weekly response as well as my feedback and some assignments will be put in online documents such as excel, word, and PPT. Both student and I agree that we use google suite.

5. Audio Books
If the student has difficulty in reading books, audio books provide a way for him/her to experience the books.

https://tourette.org/10-things-teachers-can-students-tourette-syndrome/

https://guides.library.illinois.edu/c.php?g=520752&p=3561163

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1. Other Health Impairments. Granite State College. (n.d.). Retrieved December 5, 2022, from https://granite.pressbooks.pub/understanding-and-supporting-learners-with-disabilities/chapter/other-health-impairments/

2.  Other Health Impairment. Center for Parent Information & Resources. (n.d.). Retrieved December 5, 2022, from
https://www.parentcenterhub.org/ohi/

3. Tourette Syndrome. Center for Parent Information & Resources. (n.d.). Retrieved December 5, 2022, from https://www.parentcenterhub.org/ohi-tourette/

4. Educational Issues. National Association of special Education Teachers. (n.d.). Retrieved December 5, 2022, from https://www.naset.org/professional-resources/exceptional-students-and-disability-information/other-health-impairments/educational-issues

5. Co-Occurring Conditions. Center for Parent Information & Resources. (n.d.). Retrieved December 5, 2022, from https://tourette.org/research-medical/cooccurring-conditions/

6. 10 Things Teachers Can Do For Students with Tourette Syndrome. Tourette Association of America. (n.d.). Retrieved December 5, 2022, from https://tourette.org/10-things-teachers-can-students-tourette-syndrome/

7. Tourette Syndrome: An Overview. Tourette Association of America. (n.d.). Retrieved December 5, 2022, from https://tourette.org/about-tourette/overview/

8. Tourette Syndrome: Common Assistive Technologies. Illinois Library. (n.d.). Retrieved December 8, 2022, from https://guides.library.illinois.edu/c.php?g=520752&p=3561163

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Skip to Main Content

It looks like you're using Internet Explorer 11 or older. This website works best with modern browsers such as the latest versions of Chrome, Firefox, Safari, and Edge. If you continue with this browser, you may see unexpected results.

What are assistive technologies?

The Technology Related Assistance to Individuals with Disabilities Act of 1988 described an assistive technology device as "any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities."

Assistive technologies can be "high tech" and "low tech:" from canes and lever doorknobs to voice recognition software and augmentative communication devices (speech generating devices).

Recording Devices

Recording devices can be useful for people with Tourette Syndrome in situations such as classes or work. Some physical tics might make it difficult to take notes and keep up with teachers or presentations. A recording device can allow a person with Tourette Syndrome to go over recorded moments with less pressure and more control.

Many smartphones have recording capabilities, but often the sound recordings are not high quality. Other options include:

Writing Help

Word processors and speech-to-text devices can aid individuals with physical tics that make it hard to write or hold on to a writing device. Many computers will come with free word processing applications, like Microsoft's WordPad and Apple's Pages. Some examples of software and standalone devices include:

Reading Help

People with Tourette Syndrome might find it difficult to read if they have a physical tic that prevents them from holding reading material or if they have visual tics that make it hard to focus on text. Audiobooks, scanning pens, and text-to-speech software can aid individuals with reading materials online or in print. Some options include:

Audiobooks are a great way to experience books if you have reading difficulties. Narrators read text aloud and the files are often available on CD and MP3. Libraries often provide access to audiobooks, both in physical formats like CDs and MP3 files. Audible is a company that produces audiobooks and is a fee-based option if you do not want to wait for library audiobooks to be available.

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LibGuides: Tourette Syndrome: Common Assistive Technologies

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Skip to Main Content It looks like you're using Internet Explorer 11 or older. This website works best with modern browsers such as the latest versions of Chrome, Firefox, Safari, and Edge. If you continue with this browser, you may see unexpected results.

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Being a private math tutor, Most of my students are struggling with slow learning disorders, For many of them math is a subject of a night mare! I use remedial teaching approach for them. I use activities, techniques, and practices to eliminate weaknesses or deficiencies that the slow learner is known to have.

For example deficiencies in basic math skills are reduced or eliminated by reteaching the content that was not learned earlier. Patience is virtue! 🙂

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Nicole Stacey

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"Speech or language impairment means a communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment, that adversely affects a child’s educational performance."

https://sites.ed.gov/idea/regs/b/a/300.8/c/11

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I have found that, according to the National Institutes of Health, the disability of speech or language impairment is common, with a high incidence level of 7.7%:

Nearly 1 in 12 (7.7 percent) U.S. children ages 3-17 has had a disorder related to voice, speech, language, or swallowing in the past 12 months.

The prevalence of voice, speech, language, or swallowing disorders is highest among children ages 3-6 (11.0 percent), compared to children ages 7-10 (9.3 percent), and children ages 11-17 (4.9 percent).

5 percent of U.S. children ages 3-17 have a speech disorder that lasted for a week or longer during the past 12 months.

3.3 percent of U.S. children ages 3-17 have a language disorder that lasted for a week or longer during the past 12 months.

https://www.nidcd.nih.gov/health/statistics/quick-statistics-voice-speech-language

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Quick Statistics About Voice, Speech, Language

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Statistics on voice, speech, language, and swallowing disorders among both adults and children in the U.S.

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Speech or language impairment is a broad category with many accommodations. I've picked a few from this large list (https://thespeechroomnews.com/wp-content/uploads/2018/04/IEP-Accomodations.pdf) that I've found work well in my classroom with young learners:

- Model good speech production in the classroom
- Allow the student time to express themselves (do not interrupt a slow speaker)
- Shorten and/or modify oral directions
- Provide visuals to enhance explanation of new material, especially with abstract concepts
- Emphasize multi-sensory learning for vocabulary
- Reduce amount of pressure to communicate in the classroom

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The struggle may be real but we shall overcome some day with flying colors! 🙂

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https://www.understood.org/en/articles/classroom-accommodations-for-slow-processing-speed
https://data.unicef.org/topic/child-disability/overview/
https://www.cuemath.com/learn/slow-learners/
https://padlet.com/khmb523/p8twb88ziz47jzuo/wish/2408028966
https://padlet.com/khmb523/p8twb88ziz47jzuo/wish/2408021990
https://padlet.com/khmb523/p8twb88ziz47jzuo/wish/2408026014

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Assistive Technology for Kids with Learning Disabilities: An Overview

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If your child has a learning disability, he or she may benefit from assistive technology tools that play to their strengths and work around their challenges.

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Why do some people naturally excel at learning instruments, languages, or technology while others take longer to pick up new knowledge? Learning requires the brain to encode information, changing its neural "wiring" and creating networks between brain regions.

In a new study, researchers at the School of Engineering and Applied Science and the Max Planck Institute for Dynamics and Self-Organization in Germany looked at how brain activation patterns might affect how long it takes for new information to really stick in the brain.

Earlier research has suggested that part of what might slow down learners is over-thinking. A 2015 study led by Danielle Bassett, Eduardo D. Glandt Faculty Fellow and associate professor in the Department of Bioengineering, showed a correlation between slow learning and cognitive control: the brain's ability to regulate itself by activating the necessary networks and inhibiting unnecessary activity. In that study, when people unnecessarily engaged parts of the brain linked to cognitive control, they were more likely to take longer to learn a simple task.

But beyond what might make an individual learn more slowly, the researchers want to know what sort of geometric patterns of brain activity make for better learning.

Their new study was led by Bassett and Evelyn Tang, who was an Africk Family Postdoctoral Fellow in Bassett's Complex Systems Lab before starting at the Max Planck Institute this fall. Sharon Thompson-Schill, Christopher H. Browne Distinguished Professor and chair of Psychology, also contributed to the study.

The study was published in the journal Nature Neuroscience.

Read more at Penn Engineering.

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Researchers detect brain differences between fast and slow learners | Penn Today

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Why do some people naturally excel at learning instruments, languages, or technology while others take longer to pick up new knowledge? Learning requires the brain to encode information, changing its neural "wiring" and creating networks between brain regions.

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Slow learners typically do not have a disability, even though they need extra support. They are stuck between a rock and a hard place: their cognitive abilities are too high to be considered for an intellectual disability, but same abilities are usually too low to be considered for a learning disability.

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Slow Learning is an idea.

In short, Slow Learning

promotes deep learning

crosses genres, disciplines

is grounded in the interests of the learner

champions the pleasures of learning

promotes inquiry and dialogue

lasts a lifetime

allows for authentic learning

seeks unmediated experiences

supports, and is supported by learning in community

Sound familiar? In many ways, Slow Learning draws inspiration from

Slow Food, informal education, unschoolers, deschoolers, and homeschoolers

and is joined by a movement of

edupunks, and other DIY Educators

Hey, Who You Calling Slow?

In no other context does the term "slow" carry a more negative charge than in education. To be labeled a "slow learner" is to be denigrated to very bottom of the achievement-hungry educational hierarchical heap. Even the Microsoft Word thesaurus offers stupid, thick, and dense as synonyms for slow. And yet, slow learning may be the best opportunity for a deep and meaningful lifelong education.

In public schools we celebrate those who catch on quickly and encourage those who learn to perform before others. We often neglect the achievement of students whose development or whose compliance with state-mandated standards is deemed by our impatient demands as behind schedule. Even worse, we label students, keep them from opportunities that encourage learning that is broader, deeper, richer. Even for students who jump through the hoops of formal education easily and quickly, the current greed for speed often cheapens learning experiences, resulting in shallow learning.

Slower learning adults, in the long run, have the advantage. An adult who learns at a slower pace, but continues to learn outside school walls, may realize opportunities that others never do. Slow learners can take on self-directed, community supported ventures in business, the arts, social justice, and other areas that may have little to do with their chosen field of specialization in school.

The intentionally slow learner controls of the pace and direction of learning. She is responsible for her own curriculum, the nature of her learning, her choice of teachers, mentors, community. She chooses and is responsible for the outcomes and the impact of her learning.

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Slow Learning is an idea. In short, Slow Learning promotes deep learning crosses genres, disciplines is grounded in the interests of the learner champions the pleasures of learning promotes inquiry and dialogue lasts a lifetime allows for authentic learning seeks unmediated experiences supports, and is supported by learning in community Sound familiar?

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Intellectual and slow learning disability

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Intellectual and slow learning disability

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What are some difficulties with diagnosing ED?

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What are some difficulties with diagnosing ED?

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1. Often students with other disabilities are misdiagnosed with ED. (Hayer, 2021)
2. Children with ED are often perceived as “bad” or “misbehaving” by teachers, administrators, and classmates. (Lynch, 2018; Lynch, 2022)
3. Diagnosis and help generally comes late in a students academic career. (Samuels, 2018)
4. Children need to be observed over a long period of time. (Cable, 2014)

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Specific Learning Disability by Louanne van Riet

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Specific Learning Disability by Louanne van Riet

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What is it?
“A disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in an imperfect ability to listen, think, speak, read, write, spell, or do mathematical calculations.”

https://www.fcps.edu/academics/academic-overview/special-education-instruction/procedural-support-disability-categories

Types of learning disorders include dyslexia, dysgraphia, and dyscalculia. The disorders may vary in severity from mild to severe and are characterised by impairment in reading, writing and mathematics.

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An estimated 5 to 15% of school age children struggle with a learning disability.
Learning disabilities are considered high incidence disabilities and can often occur together.

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1. More time for written assignments and tests
2. Smaller class sizes
3. Constant daily routines and feedback
4. Tidy calm spaces for learning
5. Allow for verbal answers to tests
6. Present information in differentiated ways (video, audio)

https://www.ldonline.org/ld-topics/ieps/accommodations-students-ld

https://ldaamerica.org/info/successful-strategies-for-teaching-students-with-learning-disabilities/

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Deafness and hearing impairment are similar in that they both refer to a loss of hearing. Where they differ is that deafness means “profound hearing loss … [or] a person has very little to no hearing ability.” (Villines, 2022)

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Age is one of the greatest risk factors in developing hearing loss, the elderly suffer more than the young.

There is a high level of children born in the USA, with around 66% of households have a child with some detectable level of hearing loss. Around 15% of adults in the US have at least some trouble hearing. Adult males are more likely than females to experience hearing loss, and non-Hispanic white males have the highest risk. 1/8 children aged 12 or older have experienced some sort of hearing loss in both ears. (National Association of the Deaf, 2021)

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However, deafness, according to the IDEA definition, is much more rare and uncommon. Approximately 0.7% of the population in the USA is considered deaf, and around 0.09% of children aged 6-17 are considered deaf. (Mitchell, 2019)

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The student may be hard of hearing if they:

Are unresponsive when their name is called or they are addressed

They have trouble concentrating or tire easily

Delayed speech development

Socialization issues

General difficulties with hearing (How to Support a Child With a Hearing Impairment in School, 2022)

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Deaf students need some special considerations and accommodations to be able to learn and participate properly in class.

Captions should be used with videos.

Be aware of noise levels in class, as assistive devices may be sensitive to background noise levels.

It is not required to learn sign language, but it is recommended to learn a few signs in order to have your student feel more welcome and to help connect with them

A deaf child may be in need of an interpreter in class.

Many students have developed the ability to read lips to some extent, so the teacher should limit the amount of time not facing the class or covering their mouth with their hands, a microphone, or a shadow while speaking. (Downs et al., 2000)

Make sure the teacher and interpreter are both lit properly

Provide study guides and vocabulary lists ahead of time

Check back frequently to see if they understand (Staake, 2019)

Note taking is very difficult for students

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Greetings, Introducing Yourself and Small Talk in American Sign Language

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There are a variety of tools and devices that a student can use in class to facilitate education.

Hearing aids amplify the sounds around the wearer so they can better participate in conversations and hear better. (Manning, 2021)

Other kinds of assistive listening devices (ALD) can send a signal from a microphone to a listening device attached to the listener. Some devices may have neckloops to carry a microphone or receiver. In a classroom setting, some devices can be placed near the teacher or in the centre of a group so that the listener can hear and participate. (Manning, 2021) The advancement of audio technology can also help with eliminating unnecessary background noise. (Department of Human Services, n.d.)

Speech to text software takes speech and converts it to text so deaf people are able to read what's being said. In a post COVID world, masks in many parts of the world are still a common occurrence, so technology that can work around masks are important to have as many deaf people read lips to supplement the use of hearing aids or other types of ALD. Some more powerful apps can convert text live while others merely convert specific words or phrases. (National Deaf Children's Society, 2020) Old versions of speech to text software merely translate words one by one, sometimes creating confusing sentences with homophones or other easy mistakes. New versions are able to examine context and go back and change words so that they make more sense, creating a more accurate translation.

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Accommodations 101: Assistive Listening Devices

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Using augmented reality glasses could also be a great benefit to deaf students. The glasses cited in the video state that the glasses automatically translate words into subtitles that the wearer can read. (Tech Talk: Smart AI Glasses to Tackle Hearing Loss | Technology for the Hearing-Impaired | WION News, 2022)
Though, this particular technology may only be useful in quiet places or by being paired with other ALD devices or technology. There are also pricing limitations.

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Tech Talk: Smart AI glasses to tackle hearing loss | Technology for the hearing-impaired | WION News

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(pictured device is similar to Grandpa's)
My grandfather suffers from around 95% overall hearing loss. He has hearing aids and an ALD (a radio frequency microphone that connects to a hearing aid). Though, he's 97 and has always been very stubborn, so he doesn't charge his devices as often as he should.
When visiting, we normally have to charge his devices for him. Even with his devices, his hearing loss is so profound, that we still have to speak fairly loudly.
He's also never really been much of a speaker, so he was always content to listen to family and to now just be around family. And eat terrible, Americanized (Canadian) Chinese food.

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As part of my interviews, I interviewed a friend who's an ASL interpreter in Canada. Her observations include:

1. There are many kinds of Deaf people and they have their own culture and communities, similar to other social groups.

2. Students can have trouble multitasking visually as they need to see the words and then put their attention on the lesson.

1. -For example, in a coding class, the student needed to see the ASL interpretation and then needed to see a recording of the clicks and other information from the screen.

3. Teachers shouldn't rely just on just closed captioning for videos as some students grew up deaf, so sign language is their native language.

1. -The teacher may need to give the interpreter a heads up for videos so the interpreter can prepare ahead of time.

4. Sign language is more literal and direct than spoken languages, so the interpreter may also need time to prepare and interpret concepts properly.

5. Interpreters will interpret everything around them, so if students are talking, the interpreter will often sign that too. If a student asks a question during a test, the interpreter will sign that, and the answer given by the teacher.

6. There must be a certain level of trust between the interpreter and the student that things are being accurately interpreted.

7. When communicating via an interpreter, do not talk to the interpreter like the student or Deaf person is not there, speak directly to the Deaf person, the interpreter is just there to give a voice to someone and facilitate conversation.

8. A vast majority of deaf children are born to hearing parents. If the parents learn and teach sign language to their children, they tend to do much better as they have language acquisition.

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1. Villines, Z. (2022). Hearing Impaired vs. Deaf: What's the Difference? WebMD. Retrieved December 4, 2022, from https://www.webmd.com/connect-to-care/hearing-loss/hearing-loss-versus-deaf

2. National Association of the Deaf. (2021, March 25). Quick Statistics About Hearing | NIDCD. NIDCD. Retrieved December 4, 2022, from https://www.nidcd.nih.gov/health/statistics/quick-statistics-hearing

3. Mitchell, R. E. (2019, January 17). How Many Deaf People Are There in the United States? Estimates From the Survey of Income and Program Participation. Journal of Deaf Studies and Deaf Education. Retrieved December 4, 2022, from https://academic.oup.com/jdsde/article/11/1/112/410800

4. How to support a child with a hearing impairment in school. (2022, November 15). Engage Education. Retrieved December 4, 2022, from https://engage-education.com/blog/how-to-support-a-child-with-a-hearing-impairment-in-school/

5. Downs, S., Owen, C., & Vammen, A. N. (2000, January). Make a Difference: Tips for Teaching Students who are Deaf or Hard of Hearing. University of Maryland and Balitomore. www.umaryland.edu

6. Manning, M. (2021, January 27). Can a Deaf Person Hear With a Hearing Aid? WebMD. Retrieved December 4, 2022, from https://www.webmd.com/connect-to-care/hearing-loss/can-a-deaf-person-hear-with-a-hearing-aid

7. Department of Human Services. (n.d.). Assistive listening devices / Deaf and Hard of Hearing. Minnesota.gov. Retrieved December 4, 2022, from https://mn.gov/deaf-hard-of-hearing/assistive-technology/assistive-listening-devices/

8. Staake, J. (2019, September 6). How to Help Students Who are Deaf/Hard of Hearing Succeed in School. WeAreTeachers. Retrieved December 4, 2022, from https://www.weareteachers.com/children-deaf-hard-of-hearing/

9. Tech Talk: Smart AI glasses to tackle hearing loss | Technology for the hearing-impaired | WION News. (2022, August 1). YouTube. Retrieved December 4, 2022, from https://www.youtube.com/watch?v=5lFL7ajHM70

10. National Deaf Children's Society. (2020, June 3). Speech to text apps to help conversation with deaf children and young people. National Deaf Children's Society. Retrieved December 8, 2022, from https://www.ndcs.org.uk/blog/apps-to-help-conversation-with-deaf-children-and-young-people-speech-to-text/

11. Hanna, T. (2020, December 2). Speech to text for deaf users aids in accessibility. TechTarget. Retrieved December 8, 2022, from https://www.techtarget.com/searchenterpriseai/feature/Speech-to-text-for-deaf-users-aids-in-accessibility

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Visual impairment is a disability that affects a a student's vision or abilities to see properly. In order for a student to be defined as visually impaired it must be a condition that effects their day to day performance in school. Examples of visual impairment include blindness and partial sight. They tend to need some type of assistive technology or helper to help them with educational performance.

https://www.iu1.org/departments/special-education-services/visual-impairment-support#:~:text=The%20Individuals%20with%20Disabilities%20Education,both%20partial%20sight%20and%20blindness.

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The philosophy of the Intermediate Unit 1 vision support program is that all students who are visually impaired are valuable and important individuals, much more like other children than different from them. The ultimate goal of the vision support program is to prepare students with varying degrees of visual impairment to function as productive members of society.

The Individuals with Disabilities Education Act (IDEA) defines "visual impairment including blindness" as an impairment in vision that, even with correction, adversely affects a child's educational performance. The term includes both partial sight and blindness.

Vision support services may be direct or indirect in the areas of:

Concept skills

Academic skills

Auditory skills

Sensory and motor skills

Orientation and mobility skills

Career and vocational skills

Organizational and productivity skills

Braille skills

Recreation and leisure skills

Assistive technology skills

Social skills

Independent daily living skills

Utilization of low vision skills

Assistive Technology

In today's society, technology plays an important part in the lives of all individuals. For students with visual impairments, the need for assistive technology is of paramount importance in assuring a student's access to a wide-range of functional, educational, and social opportunities.

The legal definition of an assistive technology device according to IDEA is any item, piece of equipment or product system, whether acquired commercially off the shelf, modified or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities. For students with visual impairments, it also creates a more even "playing field" which permits those students to compete more effectively within the educational setting and with their sighted peers in today's job market.

In the area of visual impairment assistive technology is divided into two broad categories depending upon the individual's functional vision capabilities or lack of vision: low vision devices and blindness devices.

Assistive technology may run the continuum from "no tech" environmental adaptations and modifications to "low tech" magnification including magnifiers and large print materials; audio books and tape recorders; use of a cane or the use of a Braille Writer or slate and stylus to "high tech" devices such as modified computer systems, portable note takers, Closed Circuit Television (CCTV), refreshable Braille displays, and reading systems for both low vision and blind students.

The provision of assistive technology is highly individualized and should only be provided after the student has had an assistive technology evaluation. It should be remembered that there is no "best way or best device," only the one that works best for each student based upon their specific needs in a variety of settings. The goal for each student should be to maximize their independence in all areas of life and to prepare them to be contributing members of society.

Orientation and Mobility Instruction

The Individual with Disabilities Education Act includes orientation and mobility services under the category of "related services", which are defined as "supportive services as are required to assist a child with a disability to benefit from special education".

Specifically, according to IDEA, orientation and mobility services are services provided to blind or visually impaired students by qualified personnel to enable those students to attain systematic orientation to and safe movement within their environments in school, home, and community. Orientation and mobility services include teaching students the following, as appropriate: spatial and environmental concepts and use of information received by the senses to establish, maintain or regain orientation and line of travel; to use the long cane to supplement visual travel skills or as a tool for safely negotiating the environment for students with no available travel vision; to understand and use remaining vision and distance low vision aids; and other concepts, techniques, and tools.

As part of the expanded core curriculum, orientation and mobility is a vital area of learning. Both components are necessary for safe and efficient travel within the environment. Orientation involves knowledge of one's distance and direction relative to things observed or remembered in the surroundings and keeping track of these "self-to-object" spatial relationships as they change during locomotion. Mobility means moving safely, gracefully, and comfortably. Areas of instruction include concept development, gross motor skills, visual efficiency skills, pre-cane and cane skills, orientation techniques and aids, accessing transportation systems, personal safety, and self-advocacy. These skills should be instructed at age-appropriate levels throughout the school years in a variety of indoor and outdoor environments.

Every visually impaired student has the right to an assessment by an orientation and mobility instructor who can determine the student's instructional needs in the areas of orientation and mobility. Based on the needs identified in the assessment, every visually impaired student has the right to instruction by an orientation and mobility instructor which will lead to the most independent, safe and efficient movement skills, appropriate for each student.

Downloads

Online Resources

For More Information

For more information about the Vision Impairment Support program at IU1, please contact:

Walinda Nicholson
Supervisor of Special Education
724-366-0056
walinda.nicholson@iu1.org

Dr. Kristin J. Szewczyk
Assistant Executive Director/Title IX Coordinator
724-938-3241 ext. 242
kristin.szewczyk@iu1.org

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The philosophy of the Intermediate Unit 1 vision support program is that all students who are visually impaired are valuable and important individuals, much more like other children than different from them. The ultimate goal of the vision support program is to prepare students with varying degrees of visual impairment to function as productive members of society.

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Model showing how glaucoma effects the eye

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Types of Visual Impairment and Incidence

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Types of Visual Impairment and Incidence

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Visual Impairment types can be categorized by 4 levels:

Partially sighted - this could include condition such as near-sightedness or far-sightedness. According to the World Health Organization this is the most common visual impairment and effects around 2.2 billion people.

Low-Vision - This refers to someone with a condition that is not necessarily distance related and usually is more severe. Common examples include Glaucoma and Cataracts.

Legally Blind - someone who is very limited in what they can see and has 20/200 vision. In other words, a legally blind person can only see 20 feet ahead as opposed to a person who can see 200 feet ahead.

Totally Blind - someone who can't see and needs non-visible ways of communication or assistance such as Braille.

Colorblindness is another visual impairment that is worth mentioning as it is common amongst people diagnosed with a visual impairment disability. There are various types of color blindness but usually it involves some difficulty in how one sees color as a whole or certain colors when they are together.

For a full explanation on different types of Visual Impairment disabilities and disorders refer to this link: https://www.disabled-world.com/disability/types/vision/

Incidence:
Visual impairment is very common and can be classified as a disability with high incidence. According to the World Health Organization this effects about 2.2 billion people around the world. Of those 2.2 billion, 1 billion have severe or moderate visual impairments. Those diagnosed with blindness are commonly aged 50 and above, but still can effect all ages.

Link to WHO page on Visual Impairment: https://www.who.int/news-room/fact-sheets/detail/blindness-and-visual-impairment

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Updated/Revised Date: 2022-04-08
Author: Disabled World | Contact: Disabled World (Disabled-World.com)
Additional References: Blindness and Vision Loss Publications

Synopsis: Explanation of vision disabilities as a type of disability. Includes information regarding normal vision, moderate visual impairment, severe visual impairment, blindness and legally blind classifications. Visual impairment (vision impairment, vision disability) is defined as a decreased ability to see to a degree that causes problems not fixable by usual means, such as glasses or medication. In the United States, the terms "partially sighted", "low vision", "legally blind" and "totally blind" are used by schools, colleges, and other educational institutions to describe students with visual impairments.

Main Document

The number of different vision conditions that can affect a person's eyesight are varied in the way they do affect the person's daily life. Some of these conditions have a minor effect, while others may have a much larger effect.

Visual impairment (vision impairment, vision disability) is defined as a decreased ability to see to a degree that causes problems not fixable by usual means, such as glasses or medication. Visual impairment can be due to disease, trauma, or congenital or degenerative conditions. In the United States, the terms "partially sighted", "low vision", "legally blind" and "totally blind" are used by schools, colleges, and other educational institutions to describe students with visual impairments.

Eye disorders which can lead to visual impairments can include retinal degeneration, albinism, cataracts, glaucoma, muscular concerns that result in visual disturbances, corneal disorders, diabetic retinopathy, congenital disorders, and infection. Visual impairment can also be caused by brain and nerve disorders, in which case it is usually termed cortical visual impairment (CVI). Various conditions require only eyeglasses or contact lenses to correct the person's vision. Other conditions may require surgery.

Vision Conditions

There are a number of eye problems and conditions that may make it more difficult for a person to see things clearly, yet do not cause loss of vision. An example of this is, 'Myopia,' or, 'Nearsightedness,' where a person sees nearby objects clearly, but has difficulty focusing on objects that are more distant.

'Hyperopia,' or, 'Far-sightedness,' is another example of a vision condition; this one involves the ability to see distant objects clearly, with difficulty focusing on nearby objects.

A third example of an eye condition that does not cause loss of vision is, 'Astigmatism,' where the person's vision appears blurred at any distance. These conditions are common and can often be corrected with eyeglasses or contact lenses.

Low Vision

The term, 'Low Vision,' sometimes also referred to as, 'Vision Loss,' means that even though a person may use eyeglasses, contact lenses, medication, or surgical techniques to improve their vision; they still have difficulty seeing.

Most persons develop low vision due to eye disease or health conditions. There are some common causes of low vision among adults in America.

'Diabetic Retinopathy,' is a condition in which Diabetes has damaged tiny blood vessels inside the person's retina, causing low vision.

'Age-Related Macular Degeneration,' is a condition in which the cells in a person's retina that allow them to see fine details have died.

'Glaucoma,' is a condition in which the fluid pressure in a person's eyes slowly rises, damaging their optic nerve.

'Cataracts,' are a condition that involves a clouding of the lens in a person's eye.

Receiving prompt treatment for these conditions may prevent them from getting worse, making regular eye exams crucial.

Illustration of a healthy eye alongside of an image featuring an eye with glaucoma.

Cataracts

As many as 10 million people around the world suffer from cataracts. In Germany alone, more than 600,000 cataract operations are performed each year.

Cataracts can be either congenital or acquired; age-related opacification of the lens is the most common type. The main symptom of cataract is slowly progressive worsening of vision, but glare disability and nearsightedness can also be signs of the disease.

Cataract operations are now usually performed on an outpatient basis. The eye is anesthetized, pretreated with antibiotics, and surgically opened. New approaches permit the operation to be performed through an incision smaller than 2 mm.

In the phacoemulsification technique, the lens is emulsified and aspirated away through a vibrating hollow needle. The surgeon then implants an intraocular artificial lens. Patients without any other diseases of the eye can achieve a visual acuity of 1.0 or even better. Special optical designs for the artificial lens can further optimize the quality of vision and thereby improve patient satisfaction.

Vision Terms

According to the International Classification of Diseases, There are 4 levels of visual function:

Blindness

Normal vision

Severe visual impairment

Moderate visual impairment

Moderate visual impairment combined with severe visual impairment are grouped under the term low vision: low vision taken together with blindness represents all visual impairment.

There are some different terms used to describe levels of vision disability. These terms include, 'Partially Sighted,' 'Low-Vision,' 'Legally Blind,', and 'Totally Blind.'

Partially Sighted means the person has some form of visual disability that may require special education.

Low-Vision is usually used to refer to persons who experience a more severe loss of vision that is not necessarily limited to distance vision. Persons with low-vision may be unable to read a newspaper at an average distance with eyeglasses or contacts, and may need large print or Braille.

Persons who are legally blind have less than 20/200 vision in their better eye, or a very limited field of vision, often 20 degrees at its widest point.

Persons who are totally blind are unable to see and often use Braille or other non-visual forms of media.

Eye disorders lead to vision loss; visual impairment is a consequence of a functional loss of vision rather than the eye disorder itself. Retinal degeneration, muscular problems, albinism, corneal disorders, congenital disorders, and infections can also lead to vision impairment.

Color Blindness

Approximately one in twelve men, and one out of every two-hundred women, experience a form of colorblindness. One misconception that many people have is that persons with colorblindness see only black and white. In actuality, there are many types and degrees of colorblindness.

Monochromasy is the form most associated with colorblindness, where people see no colors.

Protanomaly is referred to as, 'red-weakness,' and the person views a shift in the hue of red colors towards green and additional effects.

Deuteranomaly is also referred to as, 'green-weakness,' and the person has difficulty telling differences in the red, orange, yellow, and green regions of the color spectrum.

Persons with Dichromasy cannot tell the difference between red, orange, yellow, and green.

Persons with Protanopia find that the brightness of colors such as red, orange, and yellow is greatly reduced; they may appear as black or dark gray.

Persons with Deuteranopia experience the same vision issues as persons with Protanopia, but the dimming is not as great.

Vision Loss Facts and Statistics

The Lancet Global Commission on Global Eye Health

Over 90% of vision loss could be avoided.

55% of people with vision loss are women.

73% of people with vision loss are over 50 years old.

Poor eye health leads to an increased risk (up to 2.6 times) of mortality.

Over 90% of those with vision loss live in low and middle-income countries.

Unaddressed poor vision results in a global economic productivity loss of $411 Billion each year.

1.1 billion people experience vision loss, primarily because they do not have access to eye care services.

Children with a vision impairment are up to 5 times less likely to be in formal education and often achieve poorer outcomes.

The number of people with vision loss will rise from 1.1 billion to 1.7 billion people by 2050, mainly due to population growth and population aging.

Eye care needs are expected to increase substantially; projections estimate half of the global population (4.8 billion) will need access to regular eye care services to prevent/treat sight loss by 2050.

Leading Causes of Vision Loss Include:

Un-operated cataracts, responsible for vision loss in 100 million people.

Uncorrected refractive error, which is responsible for distance vision loss in 161 million people and near vision loss in an additional 510 million people.

Age-related macular degeneration (AMD), glaucoma and diabetic retinopathy accounting for 8.1 million, 7.8 million and 4.4 million people with vision loss respectively.

56 million people have other cause of vision loss.

Vision Facts (WHO):

80% of all visual impairment can be prevented or cured.

82% of people living with blindness are aged 50 and above.

About 90% of the world's visually impaired live in low-income settings.

285 million people are estimated to be visually impaired worldwide: 39 million are blind and 246 have low vision.

The number of people visually impaired from infectious diseases has reduced in the last 20 years, according to global estimates work.

Globally, uncorrected refractive errors are the main cause of moderate and severe visual impairment; cataracts remain the leading cause of blindness in middle and low-income countries.

Facts About Blindness:

Every seven minutes, someone in America loses their sight permanently - (Research to Prevent Blindness).

There are an estimated 15 million blind or visually impaired people in the United States - (Prevent Blindness America).

Nationally, among persons ages 21 to 64 who are visually impaired, defined as any difficulty or inability to see words and letters even when wearing glasses or contact lenses, only 41.5% are employed; among individuals unable to see words and letters, this figure decreases to 29.9% - (J.M. McNeil, 2001).

Leading causes of new cases of blindness are, in order, age-related macular degeneration, glaucoma, diabetic retinopathy, cataracts, and optic nerve atrophy - (Prevent Blindness America).

In 2000, 1.7 million of 10.5 million California residents age 45 or older, and 755,000 of 3.5 million who are 65 or older, had a self reported vision problem - (Arlene R. Gordon Research Institute of Lighthouse International).

Adaptive Technology for Vision Disability

Persons with low vision or other visual disabilities have several adaptive technologies available for their use.

Subtopics and Associated Subjects

Disabled World is an independent disability community founded in 2004 to provide disability news and information to people with disabilities, seniors, their family and/or carers. See our homepage for informative reviews, exclusive stories and how-tos. You can connect with us on social media such as Twitter and Facebook or learn more about Disabled World on our about us page.

Disabled World provides general information only. The materials presented are never meant to substitute for professional medical care by a qualified practitioner, nor should they be construed as such. Financial support is derived from advertisements or referral programs, where indicated. Any 3rd party offering or advertising does not constitute an endorsement.

* Cite This Page (APA): Disabled World. (2022, April 8). Vision Disability: Types and Information. Disabled World. Retrieved December 3, 2022 from www.disabled-world.com/disability/types/vision/

* Permalink: <a href="https://www.disabled-world.com/disability/types/vision/">Vision Disability: Types and Information</a>

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Vision Disability: Types and Information

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Updated/Revised Date: 2022-04-08Author: Disabled World | Contact: Disabled World (Disabled-World.com)Additional References: Blindness and Vision Loss Publications Synopsis: Explanation of vision disabilities as a type of disability. Includes information regarding normal vision, moderate visual impairment, severe visual impairment, blindness and legally blind classifications.

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What assistive technologies are available for helping students with ED? 

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What assistive technologies are available for helping students with ED? 

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1. Educreations.com: this is an open-source platform that allows teachers to record their lessons for students to review. (High tech)
2. Livebinder.com: a tool that helps students access the internet safely with supervision and guidance from their teachers. (High tech)
3. Talk light: helps teachers and students stay aware of noise levels in a classroom, encouraging a much calmer and controlled classroom environment. (Mid tech)
4. A timer: provides a visual representation of how much time is left for a task, helping students focus. (Low tech)

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1. Use of text to speech or speech to text programs: They are enormously beneficial to students with SLD as they provide ways to bypass the difficulties in decoding or writing words.
https://www.ldatschool.ca/assistive-technology/

2. Alternative keyboards: Special programmable keyboards that can be customised to meet the needs of the student to help their learning for example adding more graphics for comprehension or reducing input choices.
https://www.readingrockets.org/article/assistive-technology-kids-learning-disabilities-overview

3. Use of ipads in class: They can be used for numeracy activities and for help in practicing spelling or to bypass handwriting.
https://www.ldatschool.ca/assistive-technology/

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This difficulty is caused by the damage of brain.

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This difficulty is caused by the damage of brain.

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It can happen in different ages or before birth. The common one is Down syndrome with genetic problem causing the damage of the brain. The kids with intellectual disability usually have difficulty to express themselves clearly and solve the problem in their daily life. Therefore, they need special treatment and professional assistance to support them.

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Centers for Disease Control and Prevention

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What is intellectual disability?

Intellectual disability is a term used when there are limits to a person's ability to learn at an expected level and function in daily life. Levels of intellectual disability vary greatly in children. Children with intellectual disability might have a hard time letting others know their wants and needs, and taking care of themselves. Intellectual disability could cause a child to learn and develop more slowly than other children of the same age. It could take longer for a child with intellectual disability to learn to speak, walk, dress, or eat without help, and they could have trouble learning in school.

Intellectual disability can be caused by a problem that starts any time before a child turns 18 years old - even before birth. It can be caused by injury, disease, or a problem in the brain. For many children, the cause of their intellectual disability is not known. Some of the most common known causes of intellectual disability - like Down syndrome, fetal alcohol syndrome, fragile X syndrome, genetic conditions, birth defects, and infections - happen before birth. Others happen while a baby is being born or soon after birth. Still other causes of intellectual disability do not occur until a child is older; these might include serious head injury, stroke, or certain infections.

What are some of the signs of intellectual disability?

Usually, the more severe the degree of intellectual disability, the earlier the signs can be noticed. However, it might still be hard to tell how young children will be affected later in life.

There are many signs of intellectual disability. For example, children with intellectual disability may:

sit up, crawl, or walk later than other children

learn to talk later, or have trouble speaking

find it hard to remember things

have trouble understanding social rules

have trouble seeing the results of their actions

have trouble solving problems

What can I do if I think my child may have intellectual disability?

Talk with your child's doctor or nurse. If you or your doctor think there could be a problem, you can take your child to see a developmental pediatrician or other specialist, and you can contact your local early intervention agency (for children under 3) or public school (for children 3 and older). To find out who to speak to in your area, you can contact the Parent Center in your state: www.parentcenterhub.org/find-yourcenter/external icon .

To help your child reach his or her full potential, it is very important to get help for him or her as early as possible!

Page last reviewed:

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Intellectual disability is a term used when there are limits to a person's ability to learn at an expected level and function in daily life. Levels of intellectual disability vary greatly in children. Children with intellectual disability might have a hard time letting others know their wants and needs, and taking care of themselves.

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Prevalence estimation of intellectual disability

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Prevalence estimation of intellectual disability

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https://ijpds.org/article/view/1342

Incidence rate is 2% for the overall population, 3.8% for children aged between 0 and 15 years, 1.5% for citizens aged 16 years or older.

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Introduction

According to most recent meta-analysis findings, the prevalence of intellectual disability ranges from 0.05 - 1.55% globally [1]. Reviewing 20 studies (from Australia, Canada, China, Denmark, Finland, India, Norway, Taiwan &amp; Sweden), McKenzie and colleagues showed that intellectual disability prevalence was highly variable. Estimates based on studies using child/adolescent data ranged from 0.22 % to 1.55 % [2, 3] while estimates based on studies using adult data ranged from 0.05 % to 0.8 % [4, 5]. Estimates based on data that included both children/adolescents and adults ranged from 0.10 % to 1.30 % [6, 7]. Regarding prevalence over time, seven studies provided estimates across multiple years [2, 8-13]. Of these, one study revealed an increase over time [11], three reported decreasing prevalence [8, 12-13], while three identified no time trend [8, 10, 2].

The authors partly attributed this variability in prevalence to heterogeneity in study settings, methodologies, and case definitions. Specifically, studies tended to vary in data source i.e. administrative data (e.g. health, education, social services data or data from national registries) or national household survey data. Moreover, administrative data-based studies were distinct from studies based on national household survey data in relation to intellectual disability classification. Classification of intellectual disability in administrative data-based studies tended to be determined by clinical diagnosis, a recognized classification system (ICD; DSM; AAMR), psychological assessments, use of intellectual disability services, legal definition, and/or receipt of special education. However, intellectual disability classification in studies based on national household survey data tended to be based on survey questions (all slightly different) designed to ascertain the presence of intellectual disability.

Notably, variation in the format and content of these survey questions, particularly in studies based in the same country and administered during the same time, returned varying intellectual disability prevalence estimates. For instance, where intellectual disability prevalence estimates were derived from adult participant responses to two separate Canadian national household surveys that used different questions to ascertain the presence of intellectual disability, prevalence varied from 0.2% in one survey (survey question = ' Do you have autism or any other developmental disorder such as Down's syndrome, Asperger's syndrome, or Rett syndrome') to 0.5% in the other (survey question = ' Has a doctor, psychologist or other health professional ever said that you had a developmental disability or disorder (examples provided)') [14]. Moreover, where intellectual disability prevalence estimates were generated using child/adolescent participant data from two separate longitudinal US national household surveys (1997 - 2008; 2001 - 2011) that also used different questions to ascertain the presence of intellectual disability, prevalence varied from less than 0.4% in one study (survey question = ' Has a doctor or health professional ever told you that [survey child] has any of the following conditions? (included-autism, mental retardation)' [2] to greater than 0.6% in the other (survey question = ' What caused disability/limitation? (options included mental retardation) ' [10].

While poorer classification of intellectual disability has notable effects on prevalence estimation, it has also been shown to dramatically influence assessments of related morbidity. For instance, Lin and colleagues [5] employed three algorithms (broad, intermediate &amp; narrow) to vary the sensitivity/specificity of intellectual disability classification. They found that using the narrow algorithm classified substantially more individuals with psychiatric co-morbidities than using the intermediate algorithm. These findings provided useful evidence of how intellectual disability mis/classification might disrupt or compromise our assessment of other factors that are important in attaining a clearer understanding of the epidemiology of intellectual disability. Given that national administrative and household panel survey data are widely used to inform prevalence estimates of intellectual disability, our study used two separate sources of national survey data from Northern Ireland to investigate the effects of survey question ambiguity/specificity on intellectual disability prevalence estimation. We used 2011 Census data from Northern Ireland, that contained citizen responses to specific health condition categories. One of these, crudely specified intellectual disability (Do you have any of the following conditions which have lasted, or are expected to last, at least 12 months? 'A learning difficulty, an intellectual difficulty, or a social or behavioural difficulty'). We also used data from the 2007 Northern Ireland Survey on Activity Limitation and Disability (NISALD) [15]. This asked participants to separately report the presence of 'a learning difficulty', 'an intellectual difficulty' or 'a social or behavioural difficulty'. See Table 1 for question content comparisons between surveys.

Our study had four objectives:

First, we sought to compare the sex, age, geographic, and health-related distributions of the overall samples from both surveys. We did this (i) to demonstrate the comparability of the data from both surveys and (ii) to assess whether comparisons based on survey content that varied between surveys (i.e. highly variable health condition survey content) were less reliable than comparisons based on content that was identical between surveys (e.g. sex, age, geographical location).

Second, we sought to compare the prevalence estimate of intellectual disability generated from the 2011 Census data with the prevalence estimate of intellectual disability generated from the NISALD data to assess how survey item specificity affects intellectual disability prevalence estimation.

Third, we sought to compare the sex, age, geographical, economic-activity and health-related distributions of the intellectual disability subsamples from both surveys to assess whether the adoption of a cruder classification of intellectual disability would influence the distribution and comparison of these variables.

Finally, we sought to report the socio-demographic and health-related characteristics of those individuals who endorsed the intellectual difficulty item from the 2007 NISALD survey. In doing this, we wanted to profile the Northern Irish intellectual disability population using the more explicit and specific descriptor of intellectual disability, and, in so doing, provide a benchmark against which the more explicit 2021 Census data relating to intellectual disability can be measured in the future.

Method

Data sources

1. 2007 Northern Ireland Survey of people with Activity Limitations and Disability (NISALD)

The NISALD [15] was conducted by the Northern Ireland Statistics and Research Agency (NISRA) during 2006-2007. The survey aimed to provide an up-to-date, accurate picture of the prevalence and circumstances of adults and children living with a disability in Northern Ireland. Although the NISALD comprised of two strands i.e. (1) private households and (2) communal establishments (excluding places of detention and military establishments), only data and findings from the private household strand have been released publicly and, as such, the current study relates to disability and activity limitations within private households in Northern Ireland only.

There was no comprehensive register of people with disabilities in Northern Ireland (i.e. no sampling frame) from which to sample potential respondents for the NISALD survey. To overcome this obstacle, NISRA selected a random sample of 12,000 households from the Northern Ireland Valuation and Lands Agency Database, which contains a record of all domestic households in Northern Ireland, to serve as the study sampling frame. Selected households were posted a letter in advance which contained detailed information about the NISALD, its purpose, and that their household would be contacted in due course with respect to potential participation. Of the initial sample of 12,000 households, 10,984 (84% of random sample) were eligible addresses. Subsequently, NISRA contacted each eligible household to conduct a screening exercise with one member of the household (largely via telephone, but also via face-to-face interview if requested or if the household did not have a telephone) during which information was requested on each member living in the household. Information sought included basic demographic information on each member of the household, as well as the presence and level of difficulty associated with 15 disabilities or activity limitations (in accordance World Health Organisation (WHO) International Classification of Functioning, Disability and Health (ICF) 16) that had lasted or were expected to last six months (see Table 1).

In total, 23,689 screening interviews were conducted with 18,517 adults and 5,172 children in eligible households. Individuals within the household who reported: (1) more than one mild limitation that affected activities sometimes; (2) at least one mild limitation that affected activities often; or (3) one or more moderate/severe limitation (n=4,185; 3,865 adults and 320 children), were considered as having some medical, social or environmental factor that affected their ability and therefore were deemed eligible to complete a questionnaire designed to further assess the nature of their activity limitations and disability.

Multiple members of the same household could complete this questionnaire if they met the eligibility criteria, which was conducted via face-to-face interviewing in the respondent's own home. Adult and child versions of the main questionnaire were largely similar with only minor amendments to wording for children. All interviews for respondents aged 15 years or younger were conducted in proxy form with the parent or guardian.

The main questionnaire collected information on: how the disability or activity limitation affected daily life; use of aids, specialised equipment or medication; management of disabilities; supports and care needed/received; general health; use of health and social care services; education; employment and training; social participation, leisure and attitudes of others; transport and travel; housing; crime and fear of crime; additional costs relating to living with a disability (e.g. goods, services, equipment or medication), income and benefits; and general background information. Approximately 85% of those who were eligible and invited to participate in the main interview did so (n=3,543; 3,262 adults and 281 children). Data from NISALD is available for researchers to access via the UK Data Service, study number 7236 ( https://beta.ukdataservice.ac.uk/datacatalogue/studies/study?id=7236).

2. 2011 Census

The Census aimed to collect information on all residents of Northern Ireland (N=1,744,966) living in both private households (N=1,723,942) and communal establishments (N=21,024). Census data was obtained from 1,723,180 residents (98.8% of entire population), of which 1,702,217 lived in private households and 20,963 lived in communal establishments. Because communal establishment data was unavailable for the NISALD survey, it has been excluded from the analysis of Census data in this study. The Census form indicated that the householder (the person who owned or rented the accommodation and was responsible for paying the household bills) was responsible for ensuring that the questionnaire was completed and returned, although it did not provide instructions as to who should complete the separate sections of the Census form relating to each individual household member. It was generally assumed, however, that parents would have completed the individual forms on behalf of younger children while older children would have self-reported. In the 2011 Census, individuals were asked whether they had any of a list of health conditions (see Table 1) which had lasted or were expected to last, at least twelve months. There was also an option to report no health conditions.

Key differences in the methodologies of the 2007 NISALD and the 2011 Census in relation to measuring the prevalence of disability and other health conditions in Northern Ireland are summarised in Table 1. For the purposes of this investigation, the most notable difference between the two sources related to the separation of intellectual difficulty from learning difficulty and social or behavioural difficulty in the NISALD, compared to the aggregation of these three conditions in the 2011 Census. Thus, the NISALD presented a unique opportunity to explicitly identify those individuals who had an intellectual difficulty or developmental delay.

2007 Northern Ireland Survey on Activity Limitations and Disability

2011 Census

Introductory statement/question

The survey is only interested in difficulties or activity limitations that have lasted or are expected to last 6 months or more. Do you/any of the people in your household have any difficulty...

Do you have any of the following conditions which have lasted, or are expected to last, at least 12 months?

Dexterity

Dexterity difficulties (by that I mean lifting, carrying, grasping or holding objects); cannot lift, carry, grasp or hold at all; or use specialised equipment to help them with these actions?

An intellectual difficulty or developmental delay. This may not have a name but include things like Down's syndrome, autism, Fragile X Syndrome and other conditions.

A social or behavioural difficulty, for example difficulty making friends or aggressive outbursts etc. These may be associated with conditions such as autism, Attention Deficit Hyperactivity Disorder, Asperger's Syndrome or may have no apparent cause or name.

Data analysis

First, we compared the 2007 NISALD and the 2011 Census in relation to the distribution of age, sex, region using Nomenclature of Territorial Units for Statistics (NUTS), and disability (both in terms of distinct disabilities categories and the overall number of health conditions reported). To overcome the complex issue of comparing the 2007 NISALD (sample) with the 2011 Census (population), standardised difference scores were computed using the stddiffi command in Stata 15 [17] to test for differences in relation to key socio-demographic and disability characteristics between the two data sources. Unlike other statistical tests (e.g. chi-square), the standardised difference score is not influenced by sample size [18], and can be more informative than p-values for comparing across data sources that differ in relation to sample size [19]. Standardised differences of 0.2, 0.5, and 0.8 represent small, medium, and large standardised differences respectively [20]; standardised difference scores of less than 0.1 suggests no meaningful differences between data sources in relation to the distribution of the variable under consideration [21].

Second, we estimated and compared the prevalence and 95% confidence intervals of any learning difficulty, intellectual difficulty, and/or social-behavioural difficulty across the two data sources. To achieve comparability with the 2011 Census, a binary variable was generated for the 2007 NISALD data to represent endorsement/experiences across the three individual categories (i.e., any learning difficulty, intellectual difficulty, and/or social/behavioural difficulty). These two stages of analyses included all individuals living in private households who participated in the Census (N=1,702,217) and all adults/children who completed the 2007 NISALD screening interview (N=23,689), not just those who met the disability criteria for completing the main questionnaire.

Third, we recorded the prevalence estimates separately for any learning difficulty, any intellectual difficulty, and any social/behavioural difficulty for the NISALD only (comparable data in 2011 Census was not available).

Fourth, we compared the socio-demographic and health-related characteristics of individuals reporting any learning difficulty, intellectual difficulty and/or a social or behavioural difficulty (LD) in NISALD compared to the Census.

Finally, given that the 2007 NISALD contained an indicator that more explicitly identified those with intellectual disability (comparable data not available in the Census), we examined the socio-demographic and health characteristics associated with endorsement of this indicator.

Results

Comparability of 2007 NISALD and 2011 Census

The 2007 NISALD and the 2011 Census had similar distributions for sex, age, and region; standardised difference scores for these comparisons were all <0.10 (see Table 2) suggesting no meaningful differences in the distribution of these characteristics between the two data sources.

The medium effect size of >0.5 for number of health conditions indicates that the 2007 NISALD and the 2011 Census differed considerably in relation to the number of health conditions experienced. Specifically, the 2007 NISALD had a higher percentage of individuals with no disability/health conditions and a higher percentage of individuals with multiple comorbid health conditions, when compared to the 2011 Census.

Prevalence of learning difficulty, intellectual difficulty and/or social/behavioural difficulty in the general population

The prevalence of experiencing any learning difficulty, intellectual difficulty, and/or social/behavioural difficulty in the NISALD was lower than that obtained via the 2011 Census (1.6% vs. 2.0%). Of the three conditions, based on the NISALD data alone (comparable estimates for the 2011 Census were not available), the prevalence was highest for any learning difficulty, followed by social or behavioural difficulty, and then intellectual difficulty (see Table 3).

Correlates of learning difficulty, intellectual difficulty, and/or social/behavioural difficulty in the general population

As presented in Table 4, there was little difference in the sex distribution of any learning difficulty, intellectual difficulty and/or social/behavioural difficulty between the 2007 NISALD and the 2011 Census (standardised difference score <0.01), with approximately 70% of those satisfying this indicator being male.

Small-to-medium effect sizes were evident for the other characteristics. Specifically, a higher percentage of younger people (0-15 years) with any learning difficulty, intellectual difficulty and/or social/behavioural in NISALD compared to the Census. Higher percentages of individuals with any learning difficulty, intellectual difficulty and/or social/behavioural difficulty in NISALD lived outside the Belfast/Outer Belfast area, were not economically active, and had a greater number of health conditions, compared to those in the 2011 Census.

Socio-demographic and health-related characteristics of intellectual difficulty

Finally, we focused on the 2007 NISALD data separately to identify the characteristics of individuals reporting any intellectual difficulty (see Table 5 for prevalence and 95% confidence intervals). The majority of individuals surveyed with an intellectual difficulty (overall and in both age categories) were male, living outside Belfast and the Outer Belfast area, had a severe intellectual difficulty, had multiple comorbid health conditions (communication difficulties were highly prevalent, as were learning difficulties and other social/behavioural difficulties) but, in general, self-reported that their health was good or very good. A higher proportion of those age 16 years or over resided in the East or West and South NUTS regions of Northern Ireland and reported difficulties with vision, chronic illness and head injury compared to those aged 0-15 years. A higher proportion of those age 0-15 years resided in the Outer Belfast or North NUTS regions of Northern Ireland and reported social or behavioural difficulties compared to those aged 16 years or over.

Disability and other health-related characteristics

Discussion

Survey comparisons of sex, age, geographic, and health-related distributions

Relating to sex, age and geographic location, the NISALD delivered an accurate and reliable representation of the Northern Ireland population (as enumerated in the 2011 Census). Standardised difference scores for these comparisons were all <0.10. A key advantage of national survey programmes, such as NISALD, is that samples are carefully constructed to be statistically representative of the whole population and quality control is generally of a high standard [22]. The representativeness of the NISALD data therefore, based on these key demographic characteristics, was not unexpected. However, there was a notable difference in relation to the distributions of number of health conditions between data sets. A higher proportion of the NISALD sample (82.3%) indicated an absence of household disability compared with Census household data (disability absence = 68.7%). A higher proportion of the NISALD sample also reported the presence of four or more disabilities (7.2%) compared with Census household data (>4 disabilities = 3.8%). While the higher degree of specificity of health condition classification in the NISALD may have accounted for these differences, there is evidence that the distribution of health status responses may be influenced by mode of administration [23, 24]. For instance, it may have been the case that the crude self-report in the Census was not picking up the more serious health conditions that the detailed face-to-face/telephone interview was capturing by providing respondents with an opportunity for clarification. This means that the NISALD might have obtained a more complete and accurate distribution of health limitations when compared to the Census.

Intellectual disability prevalence estimate comparisons between the 2011 Census data and the NISALD data

Satisfied that the data from both sources could be reliably compared, our findings indicated that intellectual disability, as crudely approximated by the recoded 2007 NISALD data and the 2011 Census data, returned an overall prevalence rate of 1.6 - 2%. For those aged 0-15 years, prevalence estimates were 3.6 and 3.8% respectively, and for those aged 16 years or older, prevalence estimates were 1.1 and 1.5% respectively.

While these estimates were within range of some internationally cited population prevalence estimates of 1-3% [25, 26] they were generally above those cited in the most recent meta-analysis of international intellectual disability prevalence estimation by McKenzie et al. (0.05 - 1.55%) [1]. However, extricated from 'learning difficulty' and 'social or behavioural difficulty', intellectual disability alone returned an overall prevalence rating of 0.5% (0-15 years = 1.3%; 16 years or over = 0.3%) which was more consistent with this meta-analysis estimate range. More importantly however, these estimates were consistent with those derived from studies in the meta-analysis that employed survey questions as the mode of intellectual disability classification (estimates ranged from ~0.2 - ~1%). While a high proportion of these individuals also recorded the presence of a learning difficulty (70%) or a social or behavioural difficulty (54%), these data suggested that, when defined and distinguished from other forms of disability, intellectual disability specifically in Northern Ireland, as recorded within private households, may be less prevalent than has previously been suggested/reported [27].

Notably, this 0.5% prevalence estimate was also consistent with estimates derived from other Northern Ireland administrative data sources (e.g. Northern Ireland GP register data, Northern Ireland Health &amp; Social Care Trust data, Northern Ireland Housing Executive data) [28] and with the most widely used estimate of the number of adults in England known to have an intellectual disability [29]. Derived from GP registers in the National Health Service (NHS), 0.5% (n=206,132) of patients were identified as having an intellectual disability in England in 2013 (N=53.3m) (these data however were restricted to individuals over 18 years of age, were under-representative of people with mild learning disabilities and included those living in residential settings - three important distinctions from the NISALD data).

Using the 2011 Census general population base (i.e. N=1,770,217) and the prevalence of intellectual disability of 0.5% (95%CI 0.4-0.7%), a crude approximation (based on 2011 Census general household population figures and an unchanged prevalence of intellectual disability between 2007 and 2011) is that between 7,081 and 12,392 individuals living in private households in Northern Ireland met the NISALD criterion for an intellectual disability in 2011. Given the limitations of the NISALD data (detailed in limitations section below) and the many barriers and obstacles individuals with intellectual disability commonly face in accessing timely, appropriate and effective health care [30-38] we believe the estimates derived from our data analysis and the English GP register data in 2013, while consistent, are likely to be underestimates.

Socio-demographic and health-related characteristics of those individuals who endorsed the more specific intellectual difficulty item from the 2007 NISALD survey

Using the cruder classification of intellectual disability from the Census, it was clear that the ID subsample distributions of age and geographical location, shown to be comparable at an overall population level, were, in this context, statistically different. In fact, sex was the only variable that did not statistically differ between intellectual disability subsamples when the data was framed using the classification of intellectual disability from the Census. While the differences in general health between subsamples were negligible, notable disparities between the number of health conditions were evident. Lin and colleagues [5], demonstrated how more precise classification of intellectual disability resulted in the identification of higher rates of comorbidity. While the cruder classification of intellectual disability in this analytic step may have affected comorbidity comparisons between data sources, it would seem logical that the greater level of specificity in each of the other NISALD health conditions also influenced findings.

Intellectual disability subsample comparisons of sex, age, geographical, economic-activity and health-related distributions from both surveys, as derived from the 2011 Census and NISALD Census-comparator items.

Using the explicit intellectual disability indicator from the NISALD data it was possible to more accurately locate the regions in Northern Ireland where individuals with intellectual disability live and to describe Northern Ireland's intellectual disability population in relation to several important socio-demographic and health related characteristics. Compared to the NISALD measure of intellectual disability, the 2011 Census recorded a larger proportion of the population with intellectual disability in two of the five NUTS regions and a lower proportion of intellectual disability in the remaining three regions. Notable differences were evident in relation to Belfast (NISALD intellectual disability =6.9% versus Census '11=15%) and in relation to Western and Southern Northern Ireland (NISALD ID=29.3% versus Census '11=22.6%). The NISALD intellectual disability indicator also returned a much younger age profile and suggested a more severe morbidity/comorbidity profile compared to the 2011 Census data.

While a minimum prevalence rate of 10% was evident for all but one (long-term pain) of the 13 health conditions, communication difficulties (50%), and chronic illness (45.6%) (in addition to learning difficulty and social and behavioural difficulty) were particularly prevalent. These rates are not unexpected. Poor communication is recognized as a significant barrier for people with intellectual disability [39-42] while increased longevity amongst the intellectual disability population has led to a rise in secondary conditions such as obesity and Type 2 diabetes as well as an increased prevalence in a number of chronic illnesses [43-45].

A notable advantage of the NISALD was its supplementary data on disability severity. While distinguishing intellectual disability from learning difficulties and social and behavioural difficulties is critical for defining, locating and responding to intellectual disability effectively, qualifiers of 'mild', 'moderate' and 'severe' are commonly employed by health care practitioners to indicate the level of support that is required by individuals with varying levels of intellectual impairment [46]. NISALD therefore afforded an opportunity to recognise that over 65% of those living with an intellectual disability in Northern Ireland experienced severe impairment.

These findings clearly highlight the importance of definition and specificity in the detection and classification of intellectual disability in the general population. They also reveal the value of supplementing Census data with high quality national survey data. Given that household probability survey sampling will almost certainly under detect phenomena such as intellectual disability, it can be expected that the prevalence estimate of 0.5% reported here will fall short of the Census household prevalence rate in 2021 (although census returns may also under-report).

Limitations

Several important limitations must be acknowledged in relation to the proposed findings. First and most importantly, the current set of analyses were restricted to people living in private households. This means that individuals in residential care were excluded. Given their residential status we also suspect that our findings will be heavily weighted towards younger people with intellectual disability.

Second, as is commonly the case with national survey programmes and the investigation of low prevalence phenomena, the number of people with intellectual disability in the NISALD data (n=130) limited our analyses e.g. half of the intellectual disability sample was under 15 years of age therefore more in-depth analyses of e.g. health indicators and economic activity known to be age variant, were restricted.

Third, while the NISALD data offered a more explicit measure of intellectual disability, compared to the 2011 Census, it was not without its own definition complications. The NISALD intellectual disability item explicitly referred to an intellectual 'difficulty' rather than 'disability' and included autism as an exemplar condition which was also included as a condition under the social or behavioural difficulty item. The precise interpretation of this intellectual disability indicator by respondents therefore was unknown and may have influenced item endorsement.

Fourth and finally, as identified by Murphy [28], the 2007 NISALD and the 2011 Census are only two data sources that provide information on the landscape of intellectual disability in Northern Ireland. Ultimately, it is important to strive towards collating and combining all available and relevant information at a regional-level to ensure that prevalence estimates of intellectual disability in Northern Ireland are as accurate as possible. Indeed, there has been a surge in the use of the 'capture-recapture method' in epidemiological research in recent years for this specific purpose [47]. Although not without limitations [48], capture-recapture techniques have been used in attempts to estimate or adjust for the extent of incomplete ascertainment of cases (e.g. for specific health conditions or diseases such as alcohol use problems [49], using information from overlapping lists of cases derived from distinct sources. Whilst this method may well offer a potentially useful avenue for future intellectual disability research in Northern Ireland, the potential utility of the capture-recapture method would largely depend on gaining access to data relating to the prevalence of intellectual disability from multiple different government and community/voluntary services and agencies (e.g. GP registers, Health and Social Care Trust data; community day service attendance; residential care homes and sheltered accommodation), which has historically proven difficult in an Northern Ireland context.

Preparing for the future

The future import and potential of these sources of data for informing the assessment of need of people with intellectual disabilities, healthcare planning and government policy in Northern Ireland cannot be understated. The United Nations Convention on the Rights of People with Disabilities requires States Parties to commit to the collection of appropriate information, including statistical and research data to enable them to formulate and implement policies to give effect to the Convention [50]. According to Glover [22] 'if an issue is both visible and quantifiable in official statistics, it becomes much harder for public bodies locally and nationally to ignore.' (p.15). In other countries, data linkage approaches have provided the basis for the type of service use and needs assessment work that is fundamental to reviewing healthcare policy [e.g. 51, 52]. Once Northern Ireland's new and improved Census 2021 intellectual disability indicator comes 'on line' [53], citizens (with the support of carers/family members where necessary) will be afforded the opportunity to officially and specifically record the presence of ' An intellectual or learning disability (for example Down syndrome)'. Moreover, specific separate options to also record ' A learning difficulty (for example dyslexia)' and/or ' Autism or Asperger syndrome ' will further enhance the specificity and improve the measurement of intellectual disability in the next Northern Ireland Census. A variety of other administrative data resources will also have the potential to unlock the full policy potential of this more explicit and specific intellectual disability measure (e.g. national mortality statistics, health service data, education data).

Conclusion

A burgeoning international research literature continues to detail the extreme disadvantages that are disproportionately faced by those in society living with an intellectual disability. Worryingly, this extreme population-specific disadvantage is further and significantly compounded by the fact that those living with intellectual disability, in many countries, remain unseen. Intellectual disability specifically, at a population level, has either remained unrecorded and undetected or has been camouflaged, hidden, or buried within general health data, that have referred to limitations in day-to-day activities or inability to work as a result of health problems or disability. We hope that these findings will highlight the availability, utility and import of intellectual disability data in Northern Ireland, and promote and stimulate future use of this data in the region. We also hope that these findings will incentivise those in power to facilitate Northern Ireland data custodians to share/link available intellectual disability relevant data where possible. Finally, we believe that the current findings lay some useful foundations for the more advanced and sophisticated intellectual disability statistical modelling that will be possible in the years to come and the policy changes that will emerge as a consequence.

Statement of Conflicts of Interest

The authors declare they have no conflicts of interest.

Ethics Statement

Ethical approval for this study was issued by Ulster University's Research Governance - Reference Number 16/0032 and the Administrative Data Research Network (Re: PROJ-099 - Learning Disability and Northern Ireland: Achieving Proportionate Universalism through Administrative Data Research).

Acknowledgements

The help provided by the staff of the Northern Ireland Mortality Study (NIMS) and the Northern Ireland Longitudinal Study (NILS) Research Support Unit is acknowledged. The NIMS is funded by the Health and Social Care Research and Development Division of the Public Health Agency (HSC R&amp;D Division) and NISRA. The NILS-RSU is funded by the ESRC and the Northern Ireland Government. The authors alone are responsible for the interpretation of the data and any views or opinions presented are solely those of the author and do not necessarily represent those of NISRA/NILS.

The Administrative Data Research Network takes privacy protection very seriously. All information that directly identifies individuals will be removed from the datasets by trusted third parties, before researchers get to see it. All researchers using the Network are trained and accredited to use sensitive date safely and ethically, they will only access the data via a secure environment, and all of their findings will be vetted to ensure they adhere to the strictest confidentiality standards.

The help provided by the staff of the Administrative Data Research Network Northern Ireland (ADRC-NI) and the Northern Ireland Statistics and Research Agency (NISRA) Research Support Unit is acknowledged. The ADRC-NI is funded by the Economic and Research Council (ESRC). The authors alone are responsible for the interpretation of the data and any views or opinions presented are solely those of the author and do not necessarily represent those of the ADRC-NI. The NIMS data has been supplied for the sole purpose of this project.

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Prevalence estimation of intellectual disability using national administrative and household survey data: The importance of survey question specificity

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According to most recent meta-analysis findings, the prevalence of intellectual disability ranges from 0.05 - 1.55% globally [1]. Reviewing 20 studies (from Australia, Canada, China, Denmark, Finland, India, Norway, Taiwan & Sweden), McKenzie and colleagues showed that intellectual disability prevalence was highly variable.

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https://numberdyslexia.com/assistive-technology-for-students-with-intellectual-disabilities/#:~:text=Educational%20aids%3A%20Screen%20readers%2C%20voice,books%2C%20communication%20cards%2C%20etc.

Educational aids include Screen readers, voice recognition programs, text-to-speech software, graphic organizers, proof-reading software.

Communication aids include Audio books, communication cards.

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Last Updated on February 4, 2022 by Editorial Team

Intellectual disabilities grapple about 8% of the US population, according to an NCBI finding. Lack of intellectual curiosity, or of power to question or reason or take interest in exploring is a big elephant that needs addressing. Usually, people are judged on the basis of their academic performance, communication skills, etc. It cuts off a major chunk of creative and highly imaginative individuals who may have a different set of skills other than those set as benchmarks.

Thanks to the inclusive model of education that accommodations are made available to students with intellectual disabilities. Using these resources, such students can also learn and absorb things like their peers! This significant change is attributed to assistive technology for students with intellectual disabilities.
Let's explore in this post:

Examples of assistive technology in the classroom to accommodate intellectual disabilities

How assistive technology helps intellectually deficient students

Types of assistive technology and their applications

Challenges of implementing assistive technology

Here we go!
An institute that offers accommodations earns the requisite recognition from authorities when its classrooms are equipped enough to help students with intellectual deficiencies. These technology-assisted classrooms are designed with tools to help intellectually disabled students with diverse learning needs. The tools help them to demonstrate their abilities and be as responsive in class as their non-disabled classmates. In a typical classroom provided with assistive technology, you can expect featureslike:

Tools of common use such as hearing aids,

Pens with special grip,

Alternative computer peripherals like keyboards and mouse

speech-to-text recognition tools

spell and grammar checkers

touch control devices

AT visualizers

Advanced computer-enabled communication tools

Graphic Organizers

The idea behind using these AT accommodations is to make the classroom environment suitably comfortable for students with diverse learning needs. These assistive technology devices help work the way around disabilities and provide the learners with fair chances to be at par with their peers. It is observed that the students managing intellectual disabilities suffer from a lack of cognition, social skills, and have various learning difficulties to overcome.

How assistive technology helps intellectually deficient students?

The need to ease the learning process with assistive tools got the right solution in technological interventions. Artificial intelligence and predictive modeling techniques have paved the way for the introduction of AT devices for intellectually deficient students. It is the encouraging outcomes that have ignited the interest of the educational authorities towards the use of AT devices and solutions.

McNicholl, et al, in their study concluded that ATs can increase social participation and extract better engagement from intellectually challenged students. Motivation to read and write can be strengthened by the use of assistive technology in education.

Socially assistive robots and their roles are explained by Dr. Christine, in the review of AT for training individuals with ASDs. The review concludes that SARs prove their efficacy in building social skills like eye contact maintenance, imitation skill, and other verbal communication abilities. Hence, the overall participation of intellectually disabled students increases and improves in quality.

The role of assistive technology is not operational in nature alone. Since the students find comfortable solutions that complement their needs perfectly, they open up more freely and display better confidence in solving problems and expressing knowledge. When their basic problems of organizing thoughts, doing numbers, or expressing ideas are solved, they can concentrate on applying their real talent and deliver desired outcomes, sometimes even better than those considered 'non-disabled'.

In essence, the role of ATs is to act as a link that is normally missing between the students with intellectual deficits and their environs. The improvement in cognition and communicability allow such students to actively participate, communicate and receive information correctly, which is quite necessary for knowledge build-up.

Types of assistive technology for IDs and their applications

Assistive technology is a supplementary solution to be given to the person with disabilities of any kind to fill the gap caused by those. These can be classified as:

Cognition aids: These are employed to assist people lacking in memory retention, attention, and thinking skills. Time management tools, graphic organizers, activity planners and reminders are the popular examples of cognition aids.

Educational aids: Screen readers, voice recognition programs, text-to-speech software, graphic organizers, proof-reading software, etc. to provide ease of reading and writing for students with sensory and intellectual deficits.

Communication aids: Audio books, communication cards, etc. help enable communication in augmentative manner, and sometimes, as an alternative to speech too.

Math tools: Certain speech recognition software are designed to allow students to do calculations over microphone and display results to the evaluator.

All the AT devices mentioned above serve the needs of students having different kinds of intellectual disabilities. Since the focus is always on encouraging participation in education and making the subjects feel and act as non-disabled peers, their use should be recommended after a thorough analysis of the requirement of the individual. One size does not fit all when it comes to assistive technology devices, remember that!

Challenges of implementing assistive technology

Assistive technology implementation and adoption rate is low at present. Especially in low and middle-income groups, finances pose a challenge. The students may get support in the classroom, but what about practicing at home? This gap is quite glaring and the search for solutions for the same is still on. A need for national policy to provide assistive technology solutions has been felt for uniform implementation.

Training need for using AT devices is another detriment to seamless adoption. The personnel at work and the teachers at school have to be adequately familiar with the product and its use to not get distracted from the assistive solutions they wear or wield.

Integration with the usual work environment has to be smooth. Assistive technology is supposed to be an enabler of the learning process. Hence, the make and the application have to match the comfort level of the user. Thus, the product development thorough customization and eventually, further improvement, needs continuous evaluation and refining.

Take Away

It is society's loss if the hidden talents of people with intellectual disabilities are not recognized, refined, and put to use. To get a better workforce from the given population, the educational needs of all sorts of learners should be met. Assistive technology helps decrease the chances of dropouts and offers requisite help to people with different learning abilities to accomplish their academic endeavors, and also, to live a life of reduced dependence on others. For intellectual deficiencies, assistive technology comes as a workable solution and helps find the way around these. The only concerns may be the want for adequate training in the use of ATs and the cost involved!
References:
[1] Sarah Ko & Linda S. Petty (2020) Assistive technology accommodations for post-secondary students with mental health disabilities: a scoping review, Disability, and Rehabilitation: Assistive Technology Journal

[2] Adelman, H. S., & Taylor, L. (1986). Summary of the survey of fundamental concerns confronting the LD field. Journal of Learning Disabilities, 19(7), 391-393.

[3] Aoife McNicholl, Hannah Casey, Deirdre Desmond & Pamela Gallagher (2021) The impact of assistive technology use for students with disabilities in higher education: a systematic review, Disability, and Rehabilitation: Assistive Technology, 16:2, 130-143

[4] Effects of assistive technology for students with reading and writing disabilities, Idor Svensson, Et al, Disability Rehabilitation Assistive Technology, 2021 Feb;16(2):196-208.

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Assistive Technology For Students With Intellectual Disabilities - Number Dyslexia

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Intellectual disabilities grapple about 8% of the US population, according to an NCBI finding. Lack of intellectual curiosity, or of power to question or reason or take interest in exploring is a big elephant that needs addressing. Usually, people are judged on the basis of their academic performance, communication skills, etc.

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Through hands-on activity, students with intellectual disability can be engaging and playful, and also learn new skills from it. "Evidence-based strategy" is effective. The learning environment should be quiet. The instruction should be simple and easy to be understood step by step. It is also important to cooperate with parents to understand more about the specific characteristic of student.

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Students with intellectual disability find it harder to learn, which means they need extra time and help to learn new skills. While intellectual disability can look different from one student to another, students with intellectual disability may experience differences in their:

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One of my cousin has intellectual disability. So I always show my empathy to those kids with similar situation. Their life can be tough and their parents can be very stressful. However, with professional guidance, those kids can learn new skills and support their life in a positive way. All we need to do is be patient, be supportive and persistent with them. They can do more then we expect if they have the encouragement and instructions!

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There are many technologies and media out there designed for visually impaired who need assistance in learning and other areas of daily life. These may include but not limited to :

Screen readers that provide auditory media

Screen magnifiers

Websites designed for visually impaired

Reading magnifiers (including glasses)

Long cane for mobility

Braille

Students who are visually impaired also may be provided with services for mobility and use of technologies to maximize their education and living environments.
*This is a US policy and may defer among other countries.

Sources:
https://www.iu1.org/departments/special-education-services/visual-impairment-support#:~:text=The%20Individuals%20with%20Disabilities%20Education,both%20partial%20sight%20and%20blindness.

https://www.disabled-world.com/disability/types/vision/

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Within the classroom
- Create routines and schedules to provide structure and stability.
- Encourage participation and group work so that students do not feel isolated.
(Cable, 2014)

- Increase the amount of time allotted to a student to finish a certain job.
- Divide larger tasks into smaller ones. Build in reinforcement for task completion when students complete each mini-assignment. Wait until pupils have completed the current task before distributing the next one.
- Once a student has proven competence, reduce the amount of practice items that the learner must complete.
-Follow low-interest tasks with high-interest activities so that kids may take breaks from more challenging or less engaging pursuits.
(For Teachers, n.d.)

Outside the classroom
- Have trained counselors on staff and available. (Samuels, 2018)
- Consider providing universal mental health screening (Samuels, 2018)
- Creating an emotional curriculum, where "focuses on the validity of emotions, the effect that emotions have on students in the classroom, and the fact that emotions play while participating in an academic curriculum. " (Wing, 2022)

I recommend reading Wing, 2022 for a more comprehensive and descriptive list of strategies and accommodations.

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Resources for students, teachers and families

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Resources for students, teachers and families

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AACAP | American Academy of Child and Adolescent Psychiatry | AACAP offers Facts for Families, a series in English, Spanish, and several other languages that includes many briefs on specific mental disorders, including the ones mentioned in this publication.  (Wing, 2022)

American Psychological Association | The APA is also a fountain of information and support on specific emotional disturbances. (Wing, 2022)

Educational strategies for children with emotional and behavioral problems - http://cecp.air.org/aft_nea.pdf (For Teachers, n.d.)

Center on Positive Behavioral Interventions and Support - http://www.pbis.org/ (For Teachers, n.d.)

Book: Teaching Students with Emotional Disturbance: A Practical Guide for Every Teacher by Bob Algozzine & James Ysseldyke (For Teachers, n.d.)

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The educational programs for students with a serious emotional disturbance need to include attention to:The student's individualized education program (IEP) will spell out what accommodations the student is to receive in class and during testing. If you're not part of the team that develops the student's IEP, ask for a copy of this important document. Also check with your school district for guidance on local policy and appropriate classroom accommodations for students with emotional disorders. Appropriate Interventions

mastering academics

developing social skills

increasing self-awareness, self-esteem, and self-control

Career education (both academic and vocational programs) is also a major part of secondary education and should be a part of every adolescent's transition plan in his or her Individualized Education Program (IEP).

Support the student's inclusion. - Emotional disturbances, by their very nature, can make it difficult for people to build or maintain satisfactory interpersonal relationships. You can support the student with an emotional disturbance in subtle but meaningful ways, especially during group work, cooperative learning activities, peer interactions, and team projects. There may also be times to let the student work alone, take a break, or have a hall pass for some quiet time apart.
Accommodations typically associated

Although accommodations will vary depending on the nature of the student's emotional disturbance, often the appropriate accommodations will address:
Accommodation/Differentiation strategies
Set clear behavioral rules and expectations for the entire class. - Students with emotional disturbances are frequently the targets (rather than the initiators) of other students' misbehaviors. Having a stated, explicit classroom management plan provides a solid structure by which both teacher and students can address inappropriate behavior, understand consequences, and develop a shared approach to behavior in class and toward one another. This IRIS training module may help you set up such a plan. Links to Teacher forums, information, strategies

Other Resources Recognize the student's accomplishments. - Some students benefit from working toward a tangible goal on an hourly, daily, or weekly basis. With a bonus points system, students earn points that can be saved up and cashed in for rewards at a later time. When designing a point system for students with emotional disturbance and behavioral problems, it is important to design the task and its time frame to fit the points. If the payoff is too far into the future, the student may give up on the task. Students may also be encouraged to record their progress on a chart or record sheet that enables them to see their progress toward the goal.

Encourage organization and routine. - Teach students to keep track of their assignments, grades, and targeted behaviors using reminders such as assignment sheets, daily schedules and to-do lists. Help students manage their time by establishing routines for making transitions between lessons, getting and putting away materials, and requesting assistance. Students can have cue cards on their desk or notebook to serve as visual cues for transition steps. Provide time-management reminders, such as 10-, 5-, or 2-minute warnings before clean-up time, to establish time limitations for completing work.

side effects of medication

behavioral unpredictability

impairments in concentration and memory

Extend the amount of time that a student is given to complete a particular task.

Break down assignments into smaller ones. As students finish each mini-assignment, build in reinforcement for task completion. Wait to distribute the next assignment until students have been successful with the current one.

Reduce the number of practice items that a student must complete, once the student has demonstrated mastery.

Follow low-interest activities with high interest activities so that students get breaks from difficult or less interesting activities from time to time.

Plan short review lessons or readiness activities to help orient the student to a particular learning task.

Book: Teaching Students with Emotional Disturbance: A Practical Guide for Every Teacher by Bob Algozzine & James Ysseldyke
Learn how emotional disturbance impacts learning and gain strategies for responding to anxiety issues, opposition and noncompliance, tantrums, disruptiveness, inattention, task avoidance, and more.

References
Educational strategies for children with emotional and behavioral problems. (n.d.). Retrieved from http://cecp.air.org/aft_nea.pdf
Emotional disturbance. (n.d.). Retrieved from http://www.ldonline.org/article/6033/
Teaching students with emotional disturbances: 8 tips for teachers. (n.d.). Retrieved from http://nichcy.org/teaching-students-with-e-d

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The educational programs for students with a serious emotional disturbance need to include attention to:The student's individualized education program (IEP) will spell out what accommodations the student is to receive in class and during testing. If you're not part of the team that develops the student's IEP, ask for a copy of this important document.

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Specific Learning Disability: Categories of Students with Disabilities

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1. US Department of Education. (2018, May 25). Sec. 300.8 (c). Retrieved December 6, 2022 from https://sites.ed.gov/idea/regs/b/a/300.8/c

2. WebMD Connect to Care Staff. (2022). What Is Hearing Impairment? WebMD. Retrieved December 6, 2022 from
https://www.webmd.com/connect-to-care/hearing-loss/what-is-hearing-impairment

3. Centers for Disease Control and Prevention. (32 July, 2022). Data and Statistics About Hearing Loss in Children.
Retrieved December 6, 2022 from
https://www.cdc.gov/ncbddd/hearingloss/data.html

4. How to support a child with a hearing impairment in school. (2022, November 15). Engage Education. Retrieved December 6, 2022, from https://engage-education.com/blog/how-to-support-a-child-with-a-hearing-impairment-in-school/

5. Tacchi, E. & Peake, A. (2006). Hearing Loss | Chapter 4: Teaching Strategies and Accommodations. Trinity University. Retrieved December 6, 2022 from https://www.trinity.edu/sites/students-vision-hearing-loss/hl-teaching#communication

6. Australian Disability Clearinghouse on Education and Training. (2022). Inclusive Teaching: Deaf and Hard of Hearing. Retrieved December 6, 2022 from
https://www.adcet.edu.au/inclusive-teaching/specific-disabilities/deaf-hearing-impaired

7. National Institute on Deafness and Other Communication Disorders. (2019, November 12). Assistive Devices for People with Hearing, Voice, Speech, or Language Disorders. Retrieved December 6, 2022 from
https://www.nidcd.nih.gov/health/assistive-devices-people-hearing-voice-speech-or-language-disorders

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Multiple disabilities represent approximately 5% of all children with disabilities, and multiple disabilities eligibility criteria differ. Criteria vary based on the combination of disabilities allowed and the level of severity. There was no discernable pattern to the different combinations that were permitted.