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The Better Health Channel provides health and medical information to improve the health and wellbeing of people and the communities they live in. This information is: quality-assured and reliable, up-to-date, locally relevant and easy to understand.

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Intellectual disability (ID), once called mental retardation, is characterized by below-average intelligence or mental ability and a lack of skills necessary for day-to-day living. People with intellectual disabilities can and do learn new skills, but they learn them more slowly. There are varying degrees of intellectual disability, from mild to profound.

What is intellectual disability?

Someone with intellectual disability has limitations in two areas. These areas are:

Intellectual functioning. Also known as IQ, this refers to a person's ability to learn, reason, make decisions, and solve problems.

Adaptive behaviors. These are skills necessary for day-to-day life, such as being able to communicate effectively, interact with others, and take care of oneself.

IQ (intelligence quotient) is measured by an IQ test. The average IQ is 100, with the majority of people scoring between 85 and 115. A person is considered intellectually disabled if he or she has an IQ of less than 70 to 75.

To measure a child's adaptive behaviors, a specialist will observe the child's skills and compare them to other children of the same age. Things that may be observed include how well the child can feed or dress himself or herself; how well the child is able to communicate with and understand others; and how the child interacts with family, friends, and other children of the same age.

Intellectual disability is thought to affect about 1% of the population. Of those affected, 85% have mild intellectual disability. This means they are just a little slower than average to learn new information or skills. With the right support, most will be able to live independently as adults.

What are the signs of intellectual disability in children?

There are many different signs of intellectual disability in children. Signs may appear during infancy, or they may not be noticeable until a child reaches school age. It often depends on the severity of the disability. Some of the most common signs of intellectual disability are:

Rolling over, sitting up, crawling, or walking late

Talking late or having trouble with talking

Slow to master things like potty training, dressing, and feeding himself or herself

Difficulty remembering things

Inability to connect actions with consequences

Behavior problems such as explosive tantrums

Difficulty with problem-solving or logical thinking

In children with severe or profound intellectual disability, there may be other health problems as well. These problems may include seizures, mood disorders ( anxiety, autism, etc.), motor skills impairment, vision problems, or hearing problems.

Continued

What causes intellectual disability?

Anytime something interferes with normal brain development, intellectual disability can result. However, a specific cause for intellectual disability can only be pinpointed about a third of the time.

The most common causes of intellectual disability are:

Genetic conditions. These include things like Down syndrome and fragile X syndrome.

Problems during pregnancy. Things that can interfere with fetal brain development include alcohol or drug use, malnutrition, certain infections, or preeclampsia.

Problems during childbirth. Intellectual disability may result if a baby is deprived of oxygen during childbirth or born extremely premature.

Illness or injury. Infections like meningitis, whooping cough, or the measles can lead to intellectual disability. Severe head injury, near-drowning, extreme malnutrition, infections in the brain, exposure to toxic substances such as lead, and severe neglect or abuse can also cause it.

None of the above. In two-thirds of all children who have intellectual disability, the cause is unknown.

Can intellectual disability be prevented?

Certain causes of intellectual disability are preventable. The most common of these is fetal alcohol syndrome. Pregnant women shouldn't drink alcohol. Getting proper prenatal care, taking a prenatal vitamin, and getting vaccinated against certain infectious diseases can also lower the risk that your child will be born with intellectual disabilities.

In families with a history of genetic disorders, genetic testing may be recommended before conception.

Certain tests, such as ultrasound and amniocentesis, can also be performed during pregnancy to look for problems associated with intellectual disability. Although these tests may identify problems before birth, they cannot correct them.

How is intellectual disability diagnosed?

Intellectual disability may be suspected for many different reasons. If a baby has physical abnormalities that suggest a genetic or metabolic disorder, a variety of tests may be done to confirm the diagnosis. These include blood tests, urine tests, imaging tests to look for structural problems in the brain, or electroencephalogram ( EEG) to look for evidence of seizures.

In children with developmental delays, the doctor will perform tests to rule out other problems, including hearing problems and certain neurological disorders. If no other cause can be found for the delays, the child will be referred for formal testing.

Continued

Three things factor into the diagnosis of intellectual disability: interviews with the parents, observation of the child, and testing of intelligence and adaptive behaviors. A child is considered intellectually disabled if he or she has deficits in both IQ and adaptive behaviors. If only one or the other is present, the child is not considered intellectually disabled.

After a diagnosis of intellectual disability is made, a team of professionals will assess the child's particular strengths and weaknesses. This helps them determine how much and what kind of support the child will need to succeed at home, in school, and in the community.

What services are available for people with intellectual disability?

For babies and toddlers, early intervention programs are available. A team of professionals works with parents to write an Individualized Family Service Plan, or IFSP. This document outlines the child's specific needs and what services will help the child thrive. Early intervention may include speech therapy, occupational therapy, physical therapy, family counseling, training with special assistive devices, or nutrition services.

School-age children with intellectual disabilities (including preschoolers) are eligible for special education for free through the public school system. This is mandated by the Individuals With Disabilities Education Act (IDEA). Parents and educators work together to create an Individualized Education Program, or IEP, which outlines the child's needs and the services the child will receive at school. The point of special education is to make adaptations, accommodations, and modifications that allow a child with an intellectual disability to succeed in the classroom.

What can I do to help my intellectually disabled child?

Steps to help your intellectually disabled child include:

Learn everything you can about intellectual disabilities. The more you know, the better advocate you can be for your child.

Encourage your child's independence. Let your child try new things and encourage your child to do things by himself or herself. Provide guidance when it's needed and give positive feedback when your child does something well or masters something new.

Get your child involved in group activities. Taking an art class or participating in Scouts will help your child build social skills.

Stay involved. By keeping in touch with your child's teachers, you'll be able to follow his or her progress and reinforce what your child is learning at school through practice at home.

Get to know other parents of intellectually disabled children. They can be a great source of advice and emotional support.

Sources

SOURCES:

CDC: "Intellectual Disability."

UpToDate: "Intellectual disability (mental retardation) in children: Definition; causes; and diagnosis."

American Association on Intellectual and Developmental Disabilities.

National Dissemination Center for Children With Disabilities: "Intellectual Disability (formerly Mental Retardation)," "Overview of Early Intervention," "Supports, Modifications and Accommodations for Students," and "10 Basic Steps in Special Education."

Merck Manual: "Mental Retardation/Intellectual Disability."

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Intellectual disability (now the preferred term for mental retardation) is a disorder characterized by cognitive delays. Get the facts from WebMD about its symptoms, causes, and treatments.

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Spontaneous, or de novo, mutations are elevated in people with autism, but only in those who also have intellectual disability. The unpublished data were presented 9 September at the Broad Institute Symposium on the Emerging Genetics and Neurobiology of Severe Mental Illness in Cambridge, Massachusetts.

The results show that people with autism can be divided into genetic subgroups, each with a distinct mode of inheritance, says Mark Daly, co-director of the Program in Medical and Population Genetics at the Broad Institute. Daly presented the results along with Elise Robinson, instructor in medicine at Harvard Medical School.

Studies have shown that severe intellectual disability tends not to be inherited, whereas family members of a person with autism often share traits of the disorder.

The team also presented a new method to determine the likelihood that a de novo mutation found in an individual with autism is related to the disorder.

The researchers divided more than 700people with autism into three groups: those with an intelligence quotient (IQ) of 100 or higher, those with an IQ below 100 and those with such severe language or cognitive difficulties that they were unable to complete an IQ test.

The participants are members of two autism datasets, the Autism Sequencing Consortium and the Simons Simplex Collection. The latter is funded by the Simons Foundation, SFARI.org's parent organization.

Harmful de novo mutations that disrupt the function of a gene are highest in the group unable to take the IQ test, followed by the group with IQs under 100. The group with IQ scores above 100 has the same rate of harmful de novo mutations as the population average.

What's more, the genes affected in the groups with intellectual disability tend to also be present in non-human primates, suggesting that disrupting them would be damaging.

Harmful de novo mutations are so rare that when researchers find them in individuals with a disorder, they usually link this mutation to the disease. But these mutations may be found in someone with autism just by chance, says Kaitlin Samocha, a graduate student in Daly's laboratory.

"How many mutations do you need to see to feel safe saying that a gene is really associated with disease and it's not just a chance event?" she says.

To answer this question, Samocha and her colleagues established a method to score the likelihood that a random de novo mutation would occur in any given gene, based on this gene's specific sequence. To do this, they determined a score for each possible DNA nucleotide change for every possible nucleotide trio, for example, AAA to ACA, or to AGA.

This score is based on the rates of existing single nucleotide polymorphisms from regions that don't code for genes throughout the human genome, taken from the 1000 Genomes Project. When this score is calculated for entire genes, it automatically takes into account gene length: The larger a gene is, the more likely it is to be mutated by chance alone.

Using this method, the researchers compared the coding portion of the genome for 1,078 individuals who have autism with that of 343 unaffected siblings.

Individuals with autism are more likely than their unaffected siblings to have a "pile-up" of harmful significant de novo mutations in individual genes: 48 genes have multiple hits in the autism group, compared with 5 in controls, Samocha says.

In particular, the researchers found five harmful de novo mutations in SCN2A and - using an even larger dataset - ten significant harmful mutations in CHD8. Both genes have been linked to autism in other sequencing studies, supporting the validity of the method.
For more reports from the 2013 Broad Institute Symposium on the Emerging Genetics and Neurobiology of Severe Mental Illness, please click here.

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In autism, intellectual disability ramps up new mutations | Spectrum | Autism Research News

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Spontaneous mutations are elevated in people with autism, but only in those who also have intellectual disability, according to unpublished data presented yesterday at a conference in Cambridge, Massachusetts.

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Robert L. Schalock, PhD, Professor Emeritus and Former Chair of Hastings College, and co-author of the new AAIDD definition manual, talks about the five key assumptions in the definition of intellectual disability, how classification of ID has changed, and what the new manual means for professionals on a practical level.

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A diagnosis of intellectual disability mandates the person meet two criteria. The first criterion is a below-average score on an intelligence test. The second is ongoing limited functioning in daily living skills, which include dressing, self-care, communication, typical age level play or education. The term "intellectual disability" replaces the outdated term "mental retardation" but both terms remain in use. Intellectual disabilities are categorized into four different levels, which are based on the person's intelligence quotient score.

Profound Intellectual Disability

An IQ score below 20 or 25, along with limited daily functioning identify a profound intellectual disability. People with a diagnosis of a profound intellectual disability may live in group or family homes in the community with extensive supports. These supports may include housekeeping, personal care assistance and recreational support. Federal and state government mandate local school districts provide individualized educational supports for children ages 3 to 21. Educational supports for people with profound intellectual disabilities vary but may include adapted schoolwork, feeding and toileting assistance and occupational, speech and physical therapy.

Severe Intellectual Disability

An IQ score in the range of 20 to 40, coupled with limitations in daily living skills, identifies a severe intellectual disability. In general, people with a severe intellectual disability live in group or private homes in the community with supports in employment, homemaking and recreational activities. The local school district provides individualized supports for children ages 3 to 21. Educational supports for children with severe intellectual disabilities often include a paraprofessional in the general education classroom, providing individual help in areas of need and community-living skills. Assessments determine the need for occupational, physical or speech therapy.

Moderate Intellectual Disability

Limited daily living skills and an IQ score between 35 and 55 characterize a moderate intellectual disability. People with moderate intellectual disabilities typically live in private homes in the community. Community supports for this level of intellectual disability vary depending on individual need but may include assistance with job training and placement, and personal budgeting. The local school district serves children ages 3 to 21 in the general educational classroom with paraprofessional assistance as needed. Work must be adapted to meet individual needs of the child. Some children with moderate intellectual disabilities qualify for occupational, physical and speech therapy.

Mild Intellectual Disability

Limitations of daily living skills along with an IQ score in the 50 to 70 range meets the criteria for a diagnosis of a mild intellectual disability. Many people with mild intellectual disabilities do not need assistance living in private homes in the community, but some do. Family members typically assist people with this level of intellectual disability. Assistance with scheduling, shopping and transportation are common. Children ages 3 to 21 receive individualized services from the local school district. Little change in assignments is usually needed but extended time to complete the assignment and tutorial services generally help the student succeed.

About the Author

Jennifer Terry is program director for TriCounty Agency for Intellectual Disabilities. As a University of Alabama graduate, she holds a Masters in rehabilitation counseling and a Bachelor in psychology with an emphasis in child development. She also earned an Associate in business management and second Associate in computer information systems from Bevill State Community College. She holds a grant writing certificate from North Georgia College and State University.

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What Are the Levels of Intellectual Disability?

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A diagnosis of intellectual disability mandates the person meet two criteria. The first criterion is a below-average score on an intelligence test. The second is ongoing limited functioning in daily living skills, which include dressing, self-care, communication, typical age level play or education.

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What Classifies Someone as Being Intellectually Disabled....The Criteria.

Many years ago when people heard of the terminology mental retardation they immediately associated it with someone who was incapable of being taught. However, over the years that terminology has since been reformed to take away from the negative labeling and also to distinguish between different categories of severe disabilities. Mental retardation (which has now been re-termed as intellectually disabled) refers to general sub average intellectual functioning that is co-morbid with deficits in social or adaptive functioning (Heward, 2003). The criteria for classifying someone as being mentally retarded has evolved from simple intelligence testing to a deficit in three different abilities. In order to be classified as being intellectually disabled one must display a deficit in three categories (Heward, 2003).

First, a score of two or more standard deviations below the norm on an intelligence test must be displayed.

Second, a person must display deficits in not only intellectual functioning, but also in adaptive behavior (or more commonly known as the ability to get along in life).

Finally, the third criteria specifies that the deficits must occur during the developmental period in order to distinguish between other disorders that could occur.

Issues with Classifying This Population

The concept of severe disabilities is something in which encompasses a wide range of disabilities, therefore one single definition is difficult to apply to this category. However, severe disabilities can be stated as a person who has a significant deficit in intellectual, physical, and social or behavioral functioning (Heward, 2003). Under this category there are different disabilities which fall into the category of severe disabilities. Those would include multiple disabilities, autism, blindness, deaf or hearing impaired, severe mental retardation, severe emotional disturbance, orthopedic problems which are severe in nature, and any health impairment which is severe (Heward, 2003).

Although mental retardation falls under this category to a degree, the tests or assessment methods generally used with mental retardation do not apply here. Due to the vast categories of severity, intelligence testing may prove to be useless with this population. Instead, education professionals may use developmental progress indicators or the degree of educational need. One issue with this classification system is that it is not generally recognized by IDEA.

What Causes Intellectual Disabilities? Some Thoughts on the Matter

Many people have pondered over what causes a disability and what can be done to intervene prior to its occurrence. Although this seems to be an easy question, it is one which not always comes with an easy answer. For the most part, some of the severe disabilities mentioned are caused by different environmental and genetic discrepancies.

For instance, researchers have isolated the fact that an intellectual disability is caused by more than 250 different variables (Heward, 2003). In fact, the development of a child's intellectual and social being may be influenced prior to birth, shortly after birth, or during a change in one's life (ie. accidents). This can also be said of severe and multiple disability categories. However, as previously mentioned, the same cannot be said for PDD related disorders, which continue to stump researchers. At present, PDD related disorders have not been attributed to a specific thing, although there are speculations.

Curricular Needs for Students With Intellectual Disabilities

The curricular needs for students with severe disabilities should not be considered to be the same for those students in special education with other disabilities (ie. Learning Disabled, LD or Emotionally Disturbed, ED). The needs of this unique population is one in which creates a specific curriculum. For instance, a student who as been classified as having one of the above disabilities probably does not benefit from learning algebra (although this may be something some students can do, such as asperger's students).

Instead, the goals for students with said disabilities might focus (enjoying life, community or social relationships, and school). These types of skills are the skills which would most benefit the student with a severe disability and skills which could generalize to life after school (Monterey County Office of Education, 2005).

Furthermore, another goal of curricular development for this population focuses more on life skills that are needed for the student to be able to take care of oneself and actively engage in life by being as independent as possible. This might include being able to cook for oneself, cleaning, reading ads and filling out applications, driving, budgeting bills, making appointments and other skills such as those. The degree to which goals are needed will be determined by the level of functioning of the student. What may apply to one student might not apply to another student, therefore it is important to determine levels of functioning (Monterey County Office of Education).

In preparing programs for Intellectually Disabled (ID) students collaboration needs to occur between many different levels and agencies. For example, parents and teachers need to collaborate on the needs of the child and what he or she is capable of. In many cases a parent is the best resource a teacher has. They can offer advice as to what a child is capable of accomplishing at home and in school. In addition, teachers need to collaborate with one another for the most effective instruction to occur. Say for instance a student's needs are daily living skills. In this case the physical education teacher and special education teacher could work together to create a curriculum for that particular student to further develop this area. However, the emphasis should be on everyone on the team working together to benefit the student.

Another important factor to consider is the population one works with. Many students who are labeled as ID are not truly ID students. This might be the case with students coming from another country who do not speak the language or whose culture is vastly different than in this country. Cultural and language barriers are sure to be an issue for these students. If these students are tested for disabilities a school needs to consider their culture and language and use measures which reflect that culture. Many times, what they learn in their native country are not what they learn here in the United States. The goals for students with cultural and linguistic implications should not be on assuming they are ID because of what tests say, but on giving them assessments in their native culture, speaking with parents about their abilities, and also speaking with the student.

In conclusion, students who are labeled as ID should not be viewed as incapable. Teachers, parents, and community members need to look at each student as an individual and determine what needs to be done to help that student succeed. In the past mental retardation was viewed as a crutch, but today with the technology and devices we possess we can do more than we ever dreamed for these students.

References

Autism Society of America (2004). What causes autism? Retrieved http://www.autism- society.org/site/PageServer?pagename=autismcauses

NICHY (2004). Severe and or multiple disabilities.

Heward, W.L. (2003). Exceptional children: an introduction to special education (7 th ed). Upper Saddle River, NJ: Merrill.

Monterey County Office of Education. (2005). Special education: students with severe disabilities.

Thomas, G.E. (1996). Teaching students with mental retardation: a life goal curriculum planning approach. Upper Saddle River, NJ: Prentice Hall.

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Teaching Intellectually Disabled Students (Formerly known as MR)

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Many years ago when people heard of the terminology mental retardation they immediately associated it with someone who was incapable of being taught. However, over the years that terminology has since been reformed to take away from the negative labeling and also to distinguish between different categories of severe disabilities.

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As a teacher who teaches kids with severe disabilities, one of my biggest goals is to teach kiddos skills that will help them succeed in the "real world". Yes, I would love for my kids to be able to add and multiply fractions, but realistically, knowing money math will help them to be more successful in their futures.

To work on money math, self-determination, and work skills, I am having classroom jobs that kids will get paid for (WITH REAL MONEY! Note: fake money is pointless for kids with disabilities- the generalization isn't there so don't use it). I have a wide variety of jobs for our class to ensure that even kids with wheelchairs and limited mobility still have a job they can succeed at. I think it's very important to make sure that you have a job that EVERY kid can do in your class. I have seen a lot of severe sped. teachers have class jobs and forget kiddos who are more severe intellectual and physical disabilities.

- Musician: chooses the music and turns music on and off during free-time and circle time. This job is great for kiddos with limited mobility because they can eye gaze or point to choose music and then push play button

- Chef: helps to pass out snack and drinks at snack time

- Custodian: wipes down table before and after snack time and keeps classroom and student free-time area tidy

- Carpenter: sharpens the pencils

- Mail carrier: puts papers and worksheets into student mailboxes at the end of day. This job is great for kids who are readers

- Recycling chief: makes sure that all recycled goods are in the recycling bin instead of the trash can. They also collect recycling bins from other classrooms once a week with our facilities workers

- Veterinarian: gives our class gerbils food and water. Help to clean the cage once a week.

- Meteorologist: gives the weather each morning during circle time. This is another job that is great for kids with limited mobility or who are non verbal because they can eye gaze or point at picture symbols to tell the weather

- Line leader: leads the classroom to lunch, specials, and recess. This is also a good job for kiddos who use wheelchairs.

- Electrician:Turns the lights on and off when we enter and leave the classroom. Another great job for kiddos with mobility issues

To make the job display, I glued clothes pins onto a piece of wood and spray painted it. I glued picture symbols at the top to indicate jobs. Students' pictures can be easily moved with the clothes pins.

Students keep jobs for a week and are paid $0.10 for each day they complete their job. On Friday, students have the option to buy a Popsicle or ice cream for $0.50 if they have enough money. Students who are non-eaters can buy something else, options include: silly bands, stickers, small books, and toys. Some students need more support with jobs than others and that's okay. Students have some say in choosing their jobs each week, but be mindful that they aren't choosing a job that is too easy or too difficult.

These are what I use to help the students count their money and determine if they have enough money ($0.50) to buy a treat.

Do you have any other classroom jobs that are great options for kiddos with intellectual and physical disabilities? How do you reward students for completing classroom jobs? I'm always looking for new and fun ways to motivate students.

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Special Education Classroom Job & Money Math

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As a teacher who teaches kids with severe disabilities, one of my biggest goals is to teach kiddos skills that will help them succeed in the...

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As many of you know, my family and I are expecting baby number three in just a few short weeks. As I take some time off from work and blogging to spend time with my family both before and after my new son's birth, I am thrilled to share with you some amazing posts written by some very talented bloggers. So please sit back, relax and enjoy this guest post and leave a comment letting us know what you think! Today we have Shannon from Speechy Musings sharing some activities for children with intellectual disabilities.
First, I'd like to begin by thanking Katie for inviting me to post! If you don't know me, I'm Shannon from over at Speechy Musings. I am currently in my second semester of graduate school for speech-language pathology. On my blog, you'll find a ton of my materials, reviews, resources, and ideas for speech therapy! Today, I'm going to share three ideas for age appropriate materials for children with intellectual disabilities! Hopefully, this information will be helpful for both parents and professionals! You can definitely use ALL of these materials for children who don't have ID as well.

As everybody who works with children with disabilities knows, it can be a real challenge to find materials for children with intellectual disabilities! Oftentimes, I worked with children who had very narrow interests, many of which were not age appropriate. Other times, it was just difficult to find materials that looked mature, but that were still simple enough that my clients weren't getting frustrated! I didn't want to do simple cut and glue activities for everything, but I didn't want them feeling defeated either! Below are some ideas I've come up with in the past couple years. Please feel free to share your own!

1) LEGO Club Magazine

For kids who are older and have trouble reading, it can be an incredible challenge to find reading material that isn't insulting while being fun and interesting!! There are only so many 'early reader' type books, and those can start to get really expensive! A year or so ago I signed up for the LEGO Club Magazine.

It's free and contains many pages of great, easy material for beginner readers! Below is an example of two magazines that have "The Yoda Chronicles": a series of child friendly comics.

It is especially great for boys who are unmotivated by other types of books. Sign up at the link below:
https://club.lego.com/en-us/join/magazinesubscription/

Can target:
-Reading
-Vocabulary
-Anything (if used as a reinforcer by itself or in a craft!)
-Articulation Carryover
-Fluency Practice
-Basic Concepts including Prepositions (describe the pictures!)

2) American Girl Creative Card Making Pad:

I LOVE this booklet of materials that can be used to make cards and envelopes. It's great to use for following direction activities (e.g.: "Put the sticker on the X" or "Fold the paper in half"). It's also great as a reward. Have the child earn pieces of their card throughout other exercises. For older kids, it can be used a life skills activity. Have them address the envelopes and fill out a return label (to practice writing their address!). Your students can practice a variety of skills while writing letters on the cards or to put in their envelopes!

Overall, I've found this packet to be much more age appropriate and motivating for many of my clients when compared to construction paper crafts and cards! Many of my clients love making cards for birthdays and other special events at school, which gives them opportunities to talk to their classmates and practice their social skills!

Can target:
-Receptive Language (i.e.: following directions)
-Anything (if used as a reinforcer)
-Social Skill Development (e.g.: "What card should we make for Maggie? Why? What should we write?" AND giving the card to the student!)

3) Store Catalogues

Start collecting catalogues from various stores that might be of interest to the child! That might be and outdoor/hunting catalogue, a clothing catalogue, or a toy catalogue! Anything! You can use these to make a collage of your child's favorite things. In speech therapy, you can work on sorting with so many of these pictures! Cut out things and sort things that have wheels and things that have wings. Sort the pants from the shirts. Sort the fishing supplies from the hunting supplies. Get creative!

You can cut out a child from a magazine and have your student dress them. Target basic concepts through this! Have your student find a purple shirt or have them put a hat on top of the boy's head.

Note: Keep travel brochures for a similar activity!

Can target:
-Categories & Sorting
-Vocabulary
-Basic Concepts (colors, prepositions)
-Life Skills

What do you all love using with your children with intellectual disabilities? I'd LOVE to hear!

Thanks for reading! I'd love to see you over in my neck of the woods sometime! Feel free to like me on Facebook or follow me on Twitter and Pinterest!

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Three Fun Materials for Children with Intellectual Disabilities - Playing With Words 365

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As many of you know, my family and I are expecting baby number three in just a few short weeks. As I take some time off from work and blogging to spend time with my family both before and after my new son's birth, I am thrilled to share with you some amazing posts written [...]