(Down Syndrome, 2018)

(Down Syndrome, 2018) & (Data And Statistics On Down Syndrome, 2020)

(Down Syndrome Research And Medical Care Timeline, 2015)

(Down Syndrome Research And Medical Care Timeline, 2015) & (Data And Statistics On Down Syndrome, 2020)

(Down Syndrome Research And Medical Care Timeline, 2015)

Schools are adopting processes and resources to help students with Down Syndrome-

(Down Syndrome And Civil Rights Timeline, 2015) & (Programs & Resources, 2022) & (Students With Down Syndrome In The Classroom, 2019)

The New Brunswick Human Rights Commission (2011) provides a more comprehensive description of physical disabilities stating that it includes any degree of disability, infirmity, malformation or disfigurement of a physical nature caused by bodily injury, illness or birth defect and includes, but is not limited to, a disability resulting from any degree of paralysis or from diabetes mellitus, epilepsy, amputation, lack of physical coordination, blindness or visual impediment, deafness or hearing impediment, muteness or speech impediment, or physical reliance on a guide dog or on a wheelchair, cane, crutch or other remedial device or appliance. (Supporting Students with Disabilities | Physical Disabilities, n.d.)

It is important to note that defining physical disability is not about the physical condition itself but how it impacts daily life, such as the ability to carry out work activities (Types of Physical Disabilities, n.d.) as the effects of physical disability on a persons experience of life and learning varies even for children with the same diagnosis or condition. (Physical Disability – Pdnet, n.d.)

Kids with a diagnosis of deafness fall under this category. These are kids who can’t hear most or all sounds, even with a hearing aid.

3. Hearing impairment
The term “hearing impairment” refers to a hearing loss not covered by the definition of deafness. This type of loss can change over time. Being hard of hearing is not the same thing as having trouble with auditory or language processing.

4. Deaf-blindness

Kids with a diagnosis of deaf-blindness have both severe hearing and vision loss. Their communication and other needs are so unique that programs for just the deaf or blind can’t meet them.

5. Orthopedic impairment

An orthopedic impairment is when kids lack function or ability in their bodies. The most common type is cerebral palsy (CP). 
Many forms of CP are now recognized and it is described either:
in terms of the part of the body affected:

Or

in terms of how the body is affected:

(Cerebral Palsy | National Council for Special Education - CPD and In-School Support, n.d.)

(IDEA Disability Categories, n.d.)

(A Brief Timeline of the History of Disabilities: The Shameful Treatment of People with Disabilities, 2020)

Many other laws impacted the rights of physically disabled students. Please find those on the next post.

(A Brief Timeline of the History of Disabilities: The Shameful Treatment of People with Disabilities, 2020)

To get special education services for a child, you have to follow a legal process.
Lets's deep-dive into three of the above mentioned laws that are crucial regulating the services schools provides for students with physical disabilities.

Individuals with Disabilities Act (IDEA)

It gives rights and protections to kids with disabilities. It covers them from birth through high school graduation or age 21 (whichever comes first).

What are the two big responsibilities on states and their public schools according to IDEA?
School districts must provide a free appropriate public education (FAPE) to kids with disabilities. It can include:

 procedural safeguards

(Individual with Disabilities Education Act (IDEA), n.d.-b)

Educational services are also provided for individuals with physical disabilities under Section 504 of the Rehabilitation Act of 1973.

(Americans with Disabilities Act (ADA) and Educational Accommodation | Stimmel Law, n.d.)

In many alternative schools/private centers and academies, specialized instructions are naturally embedded in all activities throughout the day, targeting not only academic development but also self-management skills and life skills to improve the quality of life of the physically disabled by helping them to be as independent as possible. These educational institutes often have a multidisciplinary team (a group of health care workers who are members of different disciplines and professions, e.g., occupational therapists, psychiatrists, physical therapists, Social Workers, conductive education specialists, etc.), each providing specific services to the students. The team is working closely together to plan the daily activities with appropriate accommodations and modifications for each child and for the group.

In general education classrooms, the options of delivering services can be more limited. The less flexible schedule provides limited time for interventions with professionals, and the quality of implicating those strategies and accommodations are up to the teacher. Also, specialists delivering services as contract workers a couple of hours a week makes collaboration with other professionals more challenging. 

Generally, schools can be a bit more flexible in accommodating students in childcare, preschool, or elementary school due to their young age as the skillset to be developed are built in the mainstream curriculum. They are usually more capable of serving children with intensive needs than high/secondary schools, where the accommodations and the delivered support usually decrease due to structural changes.

(Services for Students with Visual Impairments, n.d.)

Accommodations/strategies:

2.Hearing impairment

Accommodations 101. (2021, May 26). National Deaf Center. https://www.nationaldeafcenter.org/accommodations-101

3. Deaf-blindness

(Deaf-Blindness, n.d.)

(Cerebral Palsy in the Classroom: Providing Support & Promoting Inclusion, n.d.)

(Teaching Students with Physical Disabilities, 2017)


RESOURCE
You can find more information on these two websites:
https://www.adcet.edu.au/inclusive-teaching/specific-disabilities/physical-disability
https://disability.tamu.edu/facultyguide/teaching/

Neural plasticity, also known as neuroplasticity or brain plasticity, can be defined as the ability of the nervous system to change its activity in response to intrinsic or extrinsic stimuli by reorganizing its structure, functions, or connections.

The research of this very exciting area started almost five decades ago. Since then, our view of the mature vertebrate brain has changed significantly. Today it is generally accepted that the adult brain is far from being fixed. A number of factors such as stress, adrenal and gonadal hormones, neurotransmitters, growth factors, certain drugs, environmental stimulation, learning, and aging change neuronal structures and functions. The processes that these factors may induce are morphological alterations in brain areas, changes in neuron morphology, network alterations including changes in neuronal connectivity, the generation of new neurons (neurogenesis), and neurobiochemical changes. (Fuchs, E., & Flügge, G. (2014).

The Petho-method, also known as conductive education, is one of the word wide known educational method that builds on neuroplasticity.
Physician and educator András Pető developed his conductive education system after the Second World War, in 1945. His method opened up a new way for the rehabilitation of motor disordered children and adults whose dysfunction was due to damages to the central nervous system. 

Many of the motor disordered with damage to the central nervous system (those with ataxia, athetosis, hemiplegia, diplegia, etc. ) develop extremely fast with the help of conductive education. The earlier the child receives conductive education, the better chance he or she has for improvement routines!

Find out more about conductive education HERE.


Assistive Technology
Assistive technology has increased in use in recent decades due to accessibility of computers and the digital age. Digital devices such as hand held scanners, online learning environments, and digital resources have changed the educational experiences for students with special needs and disabilities.

(Viner et al., 2020)

Find out more about future trends of technological devices HERE.

Social communication deficits may include¹:

Restricted interests and repetitive behaviors may include¹:

*signs and symptoms from different sources sited below. 

Guidelines for Families and Professionals. UK: Williams Syndrome Foundation http://www.williamssyndrome.org.au/cmsAdmin/uploads/pub14-guidelines-for-familiesprofessionals.pdf 

Uta F. (1999). Williams-Beuren Syndrome: Genes and Mechanisms, Human Molecular Genetics. https://doi.org/10.1093/hmg/8.10.1947

Williams Syndrome. (2022). What is Williams Syndrome? https://williams-syndrome.org/what-is-ws

Yamada, H., Watanabe T. (2011). Two Cases of Diverticulitis in Patients with Williams Syndrome. International College of Surgeons. https://meridian.allenpress.com/international-surgery/article/96/1/64/115852/Two-Cases-of-Diverticulitis-in-Patients-With

https://www.pbs.org/video/women-and-girls-lead-austin-amy-koch/

YouTube

                                        (Turner Syndrome Foundation, 2020)

2.    Originate in childhood

3.    Involves serious impairment in different areas

4.    There are several ways of using the term 

-          Specific disorders of psychological development (in the ik 10)

These disorders comprise of:
language disorders 

learning disorders

motor disorders 
autism spectrum disorders

And ADHD (Broadly speaking) as well as neurodevelopmental disorders. 

Developmental disorders – do present from early life: 

-          Usually improve as child grows older 

-          Contain impairments that are lifetime long. 

-          There’s a strong biological component 

-          More men than women are affected 

(Audiopedia, 2016)

-          results in major functional limitations in three or more areas of major life activity.

The term, "developmental disorder" or "developmental disability" means: 

a severe, chronic disability of an individual that:

(Developmental Disorders, n.d.) 

The DSM-5 places autism symptoms into two categories namely: 

Autism is a neurodevelopmental disorder

Early signs:  

·         likely to appear in infancy/early childhood

·         If people with autism learned to mask their differences, usually a diagnosis is not made until adulthood.

(Grohol, 2021)

· usually involve verbal/spoken communication 

· nonverbal communication - facial expressions and body language. 

These communication-related autism symptoms affect: 

Social skills and interaction

·  May struggle to understand hand gestures/figures of speech in conversation. 

·  Those that need more support may struggle in social cues of introductions and maintaining conversations. 

A lot of autistic people speak in full sentences.

Some may be non-verbal (tend to speak softly)

 Other people might be nonverbal — meaning they tend not to speak out loud — and communicate in other ways.

Nonverbal communication: 

More inclined to: nonverbal communication. 

Might have difficulty with eye contact and making sense of facial expressions or hand gestures or expressing their thoughts/feelings or matching the facial expressions of behaviors of other people. 

Relationships and social connection

Emotional connections may be a challenge for people with autism. 

Balancing speech & behavior to suit conversational mood can be a struggle. 

For children:
May not be keen on friendships
Behavioral patterns:
Usually limited and repetitive and can include: 
A rigid routine - it can bring feelings of instability, feeling lost, or not knowing what to do next.
dislike of change

“Narrowed,” or specific focus - an autistic child might prefer to play with a single toy over all other objects. An autistic adult might have an area of interest in a specific topic that they know a lot about.

Look out for (other repeated) stereotypical behaviors: 

Responses to stimuli in the environment

Over- or under-sensitivity to stimuli in the environment is another common behavioral sign of autism.

Diagnosis

·         Usually done during childhood as parents may notice behavioral differences and speak to a professional. 

·         The professional will make diagnostic assessment to check if criteria is met for Autism. 

·         S/he may refer parents/guardians to a specialist skilled in autism recognition in children. 

The DSM-5 autism diagnosis for communication and behavioral patterns is as follows: 

(Moore, 2021)

·         impacts how one perceives/processes information. 

·         Can likely make learning a skill difficult.

·          Affects how one learns but not the capacity to learn. 

·         Presents in many types of learning disorders.

·         Symptoms can overlap.

·    One could be affected and live with two disorders at the same time.

·         Learning disorders typically manifest in reading, writing, math (for adults too)

·         Learning disorders can manifest as a persistent challenge with varying levels of severity. 

·         Can affect the development of speaking, attention, and movement. 

These learning challenges:

·         Present as below-average academic performance for their group age.

·          Should academic performance reach the said performance average, it would’ve happened after thorough effort & support.

·         Learning disorders require intensive evaluation for a thorough diagnosis. 

·         Can be diagnosed at any point in development, either childhood, adulthood or adolescence. 

A qualified health professional would consider the following: 

·         when symptom began and how long they’ve lasted. 

·         Their impact on one’s daily life/activities, including your performance at work or at school.

·         Often a diagnosis is reached if learning difficulties continue for on average, six months even after special support at home/school has been administered. 

According to the Diagnostic and Statistical Manual of Mental Disorders (5^th ed):

·         Specific learning disorder - is the formal clinical diagnosis used by professionals. 

·         Learning disability - is the terminology used in schools & the legal system to refer to learning disorders.

·         These terms may be used interchangeably.

·          Using “learning disorders” or “learning differences” reduces stigma sometimes associated with the condition. 

·         The term “disability” is what currently permits children to access specific resources in school.

 

The DSM-5 comprises four categories of learning disorders into one named specific learning disorder namely:  

 

1.     reading disorders

It officially recognizes specific learning disorder as a condition and includes these specifiers:

1.     with impairment in reading, also called dyslexia

The abovementioned can be sometimes accompanied by other developmental & motor conditions, like: 

Dyslexia according to the DSM-5, refers to specific difficulties in:

1.     reading words accurately and reading fluently

Signs of dyslexia include: 

1.    trouble associating letters with their sounds

2.     An example would be, one may also have a challenge identifying those sounds in words or keeping pace while reading. 

It’s possible that symptoms of impairment in reading can appear in preschool and go on throughout childhood. 

Herein is a list of examples of challenges experienced: 

1.     matching letters to the sounds

Teenagers and adults can experience the manifestation of dyslexia in the following ways: 

1.     reading comprehension

Learning disorder with impairment in math 

What is Dyscalculia?

·         learning disorder that affects one’s ability to do math related tasks, like, balancing a checkbook or calculating a tip at a restaurant. 

symptoms in young children and children in grade school include:

1.     difficulty learning to count. 

2.     challenges when recognizing patterns, like smallest to largest or tallest to shortest

3.     not recognizing number symbols or connecting them with the amount they represent

In adults and teenagers, it may include challenges in:

1.     comprehending basic math facts and concepts

Dysgraphia affects one’s ability to:

1.     spell accurately. 

NB> These challenges may affect handwriting and typing abilities.

NB>challenges in written expression will also impact your ability to express ideas verbally.

Dysgraphia may, in other instances present as motor skills or larger motor skill disorder.

Dysgraphia across all ages can include:

The following conditions may impact learning although they are technically not considered learning disabilities. 

ADHD (attention deficit hyperactivity disorder) is:

·         a neurodevelopmental disorder that may impact one’s ability to learn new skills.

·         One may experience difficulty focusing, concentrating and/or controlling impulsive behavior.

Dyspraxia: 

1.    Muscle control and motor skills are affected by this disorder. 

2.    Medically, it is called developmental coordination disorder. It affects the planning and execution of movements.

Auditory processing disorder

1.    Sometimes associated with dyslexia 

2.    Symptoms can be confused with ADHD

3.    Traditionally speaking, it is not a hearing problem.

4.    This disorder affects how the brain 

5.    It’s not a hearing problem in the traditional sense, but rather a disorder that affects how your brain interprets sound.

Symptoms include: 

1.     difficulty following conversations in the classroom and between individuals. 

Visual processing disorder:

1.    the brain struggles to read/interpret the signals that the eyes send. 

2.    Not a vision problem

3.    Cannot be remedied by glasses or contacts.

4.    Can affect one’s spatial sense thus causing you to bump into things.
 

Visual processing disorder symptoms include: 

1.     difficulty distinguishing shapes, including letters that look similar (like b and d)

NB> All learning disorders can be managed with professional help.

NB>Individuals can’t grow out of a learning disorder on their own.

NB>Seeking the help of a professional to help you to develop can make coping much easier and may lead to improvement of specific challenges one may be dealing with. 

Some ways to treat learning disorders include:

1.     occupational/behavioral therapy

(Grohol, 2021) 

·         Alcohol may look like a solution to relieve restlessness and anxiety associated with ADHD. 

·         Continued and prolonged heavy alcohol consumption of time can exacerbate symptoms of ADHD and it is associated with difficulties in 

-          Memory

-          decision-making

-          cognition

(Gillette, 2021d) 

2.    side effects for the growing fetus and baby, include: 

 

a.     low body weight

Common types of FASDs include:

a.     fetal alcohol syndrome (FAS)

Language disorders

If your child has challenges related to communication, a language disorder may be the cause and symptoms can include: 

1.     stuttering or stammering

Language disorders include:

Intellectual disorders:

1.    are diagnosed when a child has lower capacity for reasoning, learning, and applying skills. This refers to “IQ”, or intelligence quotient.

2.    Below average IQ can be reflected in daily functioning which the is the main trait of intellectual disorders. 

3.    A child may experience an intellectual disorder as the result of a different and co-occurring developmental disorder like fetal alcohol syndrome.

Childhood developmental disorders frequently present as physical challenges: 

1.    It may be a physical difference that needs the use of a wheelchair.

2.    It may be something less obvious like a change in brain structure.

As for developmental delay: Not EVERY delay is a disorder. 

·         Some children develop skills or attain developmental milestones faster than others. 

·         Some children may take (a little) longer to achieve the abovementioned. 

Example:

·         a child may take longer to learn to walk, say, by three months approximately.  

·         It is not a major cause for concern since it may not develop into a problem in adult life. 

In a nutshell:

Intellectual disability:

1.    Is a condition affecting a child’s IQ negatively. 

Developmental disorders:

2.    Don’t (really) have to do with intelligence. – Developmental disorders may only affect mobility, behavior or other characteristics of children’s development and growth. 

(Gillette, 2021c)

·         A lot of childhood developmental disorders are treatable.

·         They can be managed in and throughout adulthood. 

·         The impact the disorder has on daily functioning will determine the type of therapy; use of daily assistance based on the kind of disorder it is.

·         Early diagnosis & intervention is a good start on route to a good developmental trajectory.

·         Physical assessments & baseline child development models can give a parent clear comparative picture as to how his child’s progress is developing in comparison to his peers. 

·         It is possible & helpful in most cases to apply symptom management. 

(Gillette, 2021b) 

Rational developments 

By the 4th century B. C., new, rational explanations were presented for the physical world including the rational explanations for the causes of disabilities. Up until then, people suffering seizures, or "fits" were often said to be "touched by the finger of God" and were considered sacred. Hippocrates (460-357 B. C.), the "Father of Medicine," challenged this notion. speculated seizures were the result of physical causes and not divine intervention 

Children with disabilities in Rome were ill-treated. Those children who were blind, deaf and/or mentally retarded were reportedly thrown in the Tiber River by their parents. Some children born with disabilities were mutilated to increase their value as beggars or left in the woods to die, with their feet bound together to discourage passersby’s from adopting them. In Sparta it was a legal requirement to abandon "deformed and sickly" infants. 

It was common for the aristocracy in Rome to keep a person with a physical or a mental disability, referred to as a "fool," for their amusement. Later this practice extended to royal courts and treated them as "fools" or "court jesters" or playthings.

The influence of Christianity.

Christianity influenced how people with disabilities were treated. Jesus Christ (6 B.C. - 30 A.D.), called "The Great Physician," showed compassion for people with disabilities. He is often credited with showing kindness and performing miraculous cures of those who were "lame, blind, and otherwise disabled". Similarly, St. Paul instructed Christians to "comfort the feeble-minded."

By the 4^th century A.D., Christianity’s rise paved the way for humane practices toward people with disabilities. Infanticide (the practice of killing children) stopped and helping "the afflicted" became a sign of strength. The Greek physician and scholar Galen (130 -200 A.D.) recognized the brain as the central organ of the nervous system and the seat of intellect. 

This provided more proof of the physical, natural causes of disability. Living conditions for people with disabilities were bad during this period. Some people with disabilities survived by relying on the kindness of relatives or on handouts from strangers for shelter and food. 

Changes in the Middle Ages. 

After the Roman Empire fell in the 5th century, Western Europe simply fell apart and for people with disabilities, this period was marked by indifference, neglect, and fear. They were considered "different"; none were considered normal. The Roman Catholic Church provided refuge to those in need, establishing orphanages, hospitals, and homes for the blind and the aged. In 787 A. D., Datheus, archbishop of Milan, founded the first asylum for abandoned infants. Conditions at such institutions were custodial at best, unfortunately most children did not survive.

Leprosariums as places of shelter. 

When leprosy started declining after the Crusades (1100-1300), the remaining colonies, the leprosariums, were converted to other uses and were filled with all types of people thought to be orphans, vagabonds, madmen, incurables, prostitutes, widows, criminals and deviants. 

These "cities of the damned" had the power of "authority, direction, administration, commerce, police, jurisdiction, correction and punishments," and had at their disposal "stakes, irons, prisons and dungeons." Later in 1657, two French facilities were established: the Salpetriere, which housed 1,416 women and children; and the Bicetre, which held 1,615 men.

In 787 A. D., Datheus, archbishop of Milan, founded the first asylum for abandoned infants. "As soon as the child is exposed at the door of the church," he wrote, "it will be received in the hospital and confined to the care of those who will be paid to look after them." Conditions at such institutions were custodial at best, and most children did not survive.

As time went on, "idiot cages" became the norm in town centers to "keep people with disabilities out of trouble."

 

All aboard the ship of fools.

Some people with disabilities, especially the ones dubbed unproductive dependents, were "shipped off" to other places. Many communities’ paid sailors to take disabled individuals away to stop the strain of supporting their daily needs. 

The practice led to the birth of, "Ships of Fools " that sailed from port to port, charging admission to view their strange human cargo. Later, the ships would abandon their "passengers" at another port to fend for themselves.  

The shrine at Gheel, Belgium founded in 1215 and dedicated to St. Dymphna, patron of the mentally afflicted, is considered the beginning of family care & foster care. People with disabilities were brought here due to the belief that madness could be cured at the shrine. It was likely that people with disabilities were among the poorest citizens with a limited set of choices for their survival. 

While religion remained a powerful influence during the Renaissance period, this period was both an intellectual & cultural movement that hinted toward a revival of classical learning, art & architecture and also the concept of the dignity of man, as demonstrated in the great works of Michelangelo and Raphael. People were, in this era, more interested in the arts and sciences. This led to advancements in health care & a better understanding of disabilities.

Scientific approaches in the17th and 18th centuries.

This period experienced more constructive, scientific approaches to people with disabilities.

Thomas Hobbes (1588-1679) and John Locke (1632-1704) were interested in rationalism and the study of human nature. Locke believed that learning comes through association ("ideas derive from experience"). 

His idea of the mind being a blank slate had a substantial influence on later approaches to mental retardation. It was assumed that people born with any type of mental disability were unable to learn. Not everyone shared Locke's view, but it played a major role in the development of psychology. 

University studies of this time included those of Jacob Rodriguez Pereire (1715-1780) in Portugal, who instructed "deaf mutes" and taught them to hear and speak by touch and vibration through muscles. Scientists were amazed that students could imitate speech perfectly, even dialects. In the 1780s, Valentin Hauy developed embossed print and claimed that blind people could be taught to read. These successful efforts to educate people who were blind and deaf encouraged an interest in educating people with other disabilities.

Philip Pinel (1745-1826), the leading French psychiatrist of his day, was the first to say that the "mentally deranged" were diseased rather than sinful or immoral. In 1793, he removed the chains and restraints from the inmates at the Bicetre asylum, and later from those at Salpetriere. 

Along with the English reformer William Turk, he created the method of "moral management," using gentle treatment and patience instead of physical abuse and chains on hospital patients. 

A wide variety of services given in a humane environment replaced the prison-like treatment of people with disabilities. Pinel classified types of mental illness, pioneered individual case histories and systematic record keeping. He emphasized vocational and work experience. 

The living conditions for people with disabilities in early 19th century were unforgiving. Wealthier parents were prone to keep their children with disabilities at home.

A common practice back then was "warning out" individuals with disabilities and others considered deviant. It functioned as a way to inform an unwanted newcomer that he or she was not welcome in their town. Another practice called, "Passing on". It was quite popular. People were loaded onto a cart and dropped off at the next town. 

The first notable change in the 19th century as to the concept of intellectual deficiency came from Jean-Etienne Dominique Esquirol (1782-1840). He was a student of Pinel's and a famous psychiatrist in France. He divided intellectual deficiency into two levels namely: idiocy and imbecility. He defined "imbeciles" as "generally well formed, and their organization is nearly normal. They enjoy the use of the intellectual and affective faculties, but in less degree than the perfect man, and they can be developed only to a certain extent."

He defined "idiots" as people with little or no intellectual functioning: "Incapable of attention, idiots cannot control their senses. They hear, but do not understand; they see, but do not regard. Having no ideas, and thinking not, they have nothing to desire; therefore, have no need of signs, nor of speech." 

Esquirol's concept gave some consistency to the terminology used to describe people with disabilities. 

Social reformers, by the middle of the 19th century brought society’s attention to the bad living conditions of its many outcasts.

Another influential young doctor was Edouard Seguin (1812-1880), who studied medicine and surgery under Itard (author of "Victor, the Wild Boy of Aveyron"), and psychiatry under Esquirol. Seguin is considered the first great teacher in the field of disabilities. He improved upon Itard's method of sensory training.

As a director at the school for "idiots" in the Salpetriere asylum, Seguin realized the potential benefits of a physiological method in treating mental retardation. He believed mental deficiency was caused by a weakness of the nervous system, and could be cured through a process of motor and sensory training.

By developing the muscles and senses, he believed his pupils would gain more control over their central nervous systems and gain control over their wills. Seguin's methods and positive results served as a foundation for similar efforts throughout Europe and America.

In America, Dr. Samuel Gridley Howe (1801-1876) participated in many social causes. He cared about the conditions of people with mental illness, hearing loss, the blind, slaves, and the politically oppressed throughout Europe. He had heard about developments in Europe, having visited Dr. Guggenbühl's Abendberg school and hearing reports of Seguin's work in France.

In 1848, Dr. Howe, the director of the Perkins School for the Blind, established, The Massachusetts School for Idiotic and Feeble-Minded Youth. It was an experimental boarding school in South Boston for youth with intellectual deficiencies. He firmly believed in the importance of family and community and aimed to prepare children with disabilities to integrate with society. 

A private school similar to Howe's was also started in New York in 1848 under Hervey B. Wilbur’s supervision in his home. He used Seguin's teaching methods and eventually more boarding schools for children with disabilities opened on the East Coast.

During this time, the U.S. Government made its first attempt to determine the number of people with intellectual deficiency. Although these efforts may have been flawed by confusing mental illness with intellectual deficiency, there was a reported increase in the number of people with disabilities during the 19th century:

Seguin's teaching methods led to improvements in physical development, behavior, and social skills. The experimental training schools were a success. Intellectual deficiency was, of course, not "cured".  Many pupils with mild and moderate disabilities profited from their training; they developed the necessary skills to return to their families and communities but during the economic troubles of 1857 on account of the Civil War, there was no employment for returning pupils. 

Historian James W. Trent noted, "In a growing and increasingly industrialized nation, communities did not need idiots, not even educated ones." Pupils who returned to their communities looking for work usually ended up in poorhouses or jails.

There was also an increasing demand for training school placements. Many parents had heard success stories and some believed that intellectual deficiency could even be cured. Existing training schools expanded their facilities and began serving people with all types of disabilities. Although training schools increased, the obligation to training did not. These institutions soon became asylums, giving custodial care for many of the individuals with developmental disabilities, in essence, students were “inmates."

“Higher-functioning inmates” were taught functional skills and used as laborers to reduce costs.

Institution managers asked the states to pay for indigent custodial care. Their argument was that it would be a relief to poorhouses/almshouses. This was the introduction of the, “dehumanizing” process later described by David Vail. Superintendents were more concerned about the cost effectiveness of their facilities rather than working towards supporting the, “inmates”. 

 On June 6, 1876, six superintendents – Eduoard Seguin, Hervey B. Wilbur, G.A. Doran, C.T. Wilbur, H. Knight, and Isaac Kerlin – met in Medina, Pennsylvania and established the Association of Medical Officers of American Institutions for Idiotic and Feeble-Minded People (now known as the American Association for Mental Retardation, or AAMR). Richard Scheerenberger notes in his book, “A History of Mental Retardation”, the Association's main function was to discuss "the causes, conditions, and statistics of idiocy, the management, training and education of idiots and feebleminded people.  

As Institutions became medically oriented, people with disabilities were regarded as patients who were sick and needed to be cured. Many people with disabilities at that time, were seen as burdens due to economic hardship so much so that they were counted in the same categories as other social ills like crime, prostitution, vagrancy; and concluded that many people with "feeblemindedness" were living in the community. 

While parents of people were looking to relieve the strain and financial burden, institutes were looking to expand, take for example, the Rome State Custodial Asylum for Unteachable Idiots at Rome in New York. It opened in 1894 and provided basic care to people with disabilities of all ages both male and female. They tended to the "low-grade" and delinquent cases more especially. It was deemed that they were left there because of the moral failure of their parents. As the 20^th century went on, institutional overcrowding got worse. People could be in the same room for the whole day and sleep on the floor. 

Eugenics influence

In the late 19th and first quarter of the 20th century there was the rise and consequences of the Eugenics Movement which promoted " ... the science of the improvement of the human race by better breeding." So-called "feeblemindedness" was thought to be hereditary, and was eventually blamed for most of society's burdens. 

 

 

The beginning of hope in special education. 

 

 

 

At least one state-supported institution existed in every state. The number of residents increased from 25,000 to 50,000. The ideas of parole and institutional care were promoted. 

At their peak, public institutions housed approximately 4 percent of all people with mental retardation but consumed the vast majority of public funds for services.

 

The importance definitions and perspectives. 

The last half of the 20th Century saw changes in the definitions of and perspectives on disabilities,

These definitions and perspectives have had a profound impact on how services and society see people with disabilities. 

They have both shaped and responded to issues central to community services:

·         who qualifies for services

·         who is seen to be able to benefit from services

·         the focus of services

·         the services funded

 

Some of the fundamental shifts have included:

·         major changes in who is considered "mentally retarded" in terms of age, degree and type of challenge;

·         the emergence of "developmental disabilities" as a focal point for federal policy and funding;

·         a move from an emphasis on deficiency to strengths;

·         a move from seeing patients and clients to seeing people and citizens;

·         the recognition of the role of the social and physical environment (including attitudes, services, and the built environment) in holding people back from realizing their potential and taking their place in the community.

The prevailing definitions of mental retardation and perspectives of service focused almost exclusively on deficits in the individual in the second half of the 20^th century, they combined issues about general intelligence and the individual's ability to cope with the demands of everyday life. 

The principle of normalization) was developing in Scandinavia. This concept would have a profound impact on definitions and perspectives in North America

Edgar Doll's 1941 definition set the standard for many of the more medical definitions of the century. 

He identified six criteria generally considered essential to a sufficient definition and concept of mental retardation:

·         social incompetence

This basic definition soon evolved into determinations of the levels of disability. 

Most are linked to the measurement of I.Q. or Intelligence Quotient. "Subnormality" meant below the normal I.Q. of 100. Over the years, there have been important changes in how far below normal someone's I.Q. score had to be before being considered "mentally retarded".

The challenge for Goddard earlier in the century was to make sure people understood the difference between "feebleminded" and "moron." The challenge for most of the second half of the century was to expand the categories and attempt predictions on what individuals' lives would be like.

In the 1950s, the education system adopted a classification system based on ability to learn (Kirk, Karnes, & Kirk, 1955).

·         "Educable" children could learn simple academic skills but not progress above fourth grade level.

The terms "trainable" and "educable" are still in use today. By 1971, the President's Committee on Mental Retardation indicated that "educable" children could achieve sixth grade level academic skills, instead of only fourth grade, by their late teens.

 

The President's Panel also described "mental retardation" as "a major national health, social, and economic problem". It emphasized the negative consequences to individuals, families and society.

In 1959 Danish law incorporated the principle of normalization. N.E. Bank-Mikkelsen, Director of Mental Retardation Services in Denmark defined normalization as "letting the mentally retarded obtain an existence as close to the normal as possible".

Bengt Nirje, the Secretary General of the Swedish Association for Retarded Children expanded the idea to the quality of life experienced by children and adults. He argued that people had rights.

The principle of normalization had a major impact on our ability to see the tremendous impact attitudes, values and environment have on people with disabilities, and the ways that other citizens understand their roles in the lives of people with disabilities.

The idea that we see people with disabilities having the same needs as all people (that they are "people first") and that the environment can hold people back as much as any condition they might have, grew out of the principle of normalization.

In 1969, the International League of Societies for the Mentally Handicapped recognized that "the Principle of Normalization is a sound basis for programming". The ILSMH also stated that "the great majority of the retarded are ordinary people with an ordinary person's needs."

One of the key concepts that emerged with the principle of normalization was the developmental model – all people have the capacity to grow and learn regardless of the degree of their disability.

The model shifted the focus from medical approaches to teaching approaches. For some, "mental retardation" stopped being an "affliction to be cured". Earlier models emphasized the static nature of the condition and diagnosis. The developmental model stressed supporting people to learn skills that would assist them in their everyday lives.

In the absence of a curriculum model [for students with severe disabilities], professionals adapted preexisting infant and early childhood curriculum for students in Grades K to 12. This approach, known as the developmental model, was based on the assumption that the education needs of students with severe disabilities could best be met by focusing on their mental age as derived from a developmental assessment.

The work of Lou Brown and others in the 1970s challenged that interpretation of the developmental model and suggested teaching functional skills that would be useful to individuals when they took their ultimate place in the community.

From a public policy and community service point of view, the 1970s saw a number of major changes in definition and perspective:

·         The federal government recognized the broader concept of "developmental disabilities" which made funding available to people with a wider range of disabilities.

·         The AAMR, then the federal government restricted the term "mental retardation" to exclude people with higher IQ scores. Among other consequences, this led to a very large number of children being excluded from special educational services.

·         The federal government definition of developmental disability shifted from a categorical or labeling/diagnostic definition to a concern with the severity of functional limitations.

·         The impact of the social and physical environments on the dignity and quality of life of individuals came to be more deeply understood and laid the foundation for understanding the extent to which the social and physical environment holds people back.

·         The clarion call of people with disabilities themselves – "We are People First"

"Developmental Disabilities" Includes More People

In 1970, the Developmental Disabilities Services and Facilities Construction Amendments significantly expanded the scope of federal legislation beyond mental retardation. 

The 1970 Act defined the term developmental disability:

This definition was expanded in 1975 to include autism and dyslexia (so long as those with dyslexia also had another developmental disability). 

As before, the disability also had to be substantial in nature, have originated before the age of 18, and have continued or be expected to continue indefinitely.

The federal definition was intended to apply for planning purposes only. 

It was not intended to define eligibility for services. Over the years, however, state legislatures began to define eligibility for their services in terms of the federal definition. 

it was not until 1985 that the Minnesota Legislature recognized people "with other related conditions" and made them eligible for services

A More Restrictive Definition of "Mental Retardation" Excludes More People

In 1973, the American Association on Mental Deficiency changed its definition of mental retardation as:

The AAMD also decided that the cut off for being labeled “mentally retarded" would be 70 on the IQ test.

As Burton Blatt commented, millions of people were "cured" with this redefinition. Generally, this meant that only 2.25% of the population would be labeled instead of 16%.

Burton Blatt

The main reasons for dropping the borderline category were its racial implications (racial minority groups were over-represented in the borderline group) and a growing uneasiness about the effects of labeling. 

It also meant that fewer students were eligible for special education services. 

The new definition also extended the upper age limit of the developmental period to 18 years of age. 

That change was then reflected in the 1975 amendments to federal legislation.

This focus on adaptive behavior led to the development of scores of adaptive behavior scales that could measure the extent to which individuals' adaptive behaviors were deficient. These scales had their origins in the work of Goddard and Doll at The Vineland Training School in New Jersey. Goddard published his questionable work on The Kallikak Family. Doll developed the concept of adaptive behavior and the Vineland Social Maturity Scale in 1935. The scale was adopted by the U.S. military in 1941. It became the basis for the Vineland Adaptive Behavior Scale still in use today.

Labels, whether medical or cruel, stigmatize and isolate the individual. The change in the federal definition moved the focus away from the label to a concern with specific functional limitations that the individual experiences. This is called the "functional approach".

The 1978 federal definition of developmental disabilities eliminated references to specific disability categories and focused instead on the development of severe functional impairments. 

Over the years, specific functional areas were identified – self-care, language, learning, mobility, self-direction, capacity for independent living, and economic self-sufficiency. 

In the early 1970s, Marc Gold began to shift the understanding of the capacities of people with severe disabilities. Gold was very much aware of how I.Q. testing, assessments, and school curriculum limited people with disabilities. Such tests, Gold insisted, simply tell you the least a person can do; they can never tell you the most.

Marc Gold's strategy was straightforward – "Train, don't test".

In the 1980s, there were four critical developments in the definitions of developmental disabilities:

·         The full legitimization of the view that the social and physical environment (what we do to people) disables them.

 

The Developmental Disabilities Act of 1984 recognized the importance of linking service delivery to individual planning and coordination. P.L. 98-527 stated that "a developmental disability is a severe, chronic disability which reflects the person's need for a combination and sequence of special interdisciplinary or generic care, treatment or other services which are of lifelong or extended duration and are individually planned and coordinated."

This definition was linked to the requirement that each person receiving services under the Act must have an individual habilitation plan.

The Americans with Disabilities Act (P.L. 101-336) was passed in 1990. It extended all civil rights protections to people with disabilities including protection from accommodations, telecommunications, and activities of state and local governments. 

The ADA's definition of disability built on the definition used for developmental disabilities, but applied it more broadly. While the Developmental Disabilities legislation required a functional limitation in three or more areas, the ADA included anyone with a functional limitation in one or more areas. This meant that civil rights protections were extended to 20% of all Americans.

 

The Connecticut Advisory Commission on Services and Supports for People with Developmental Disabilities (2002) surveyed state definitions and identified five rough categories.

Six (6) states use definitions that limit the population served by the principal agency only to individuals with mental retardation. In some of these apparently more restrictive states (for instance, Texas) there are other agencies that provide some service and supports to people with developmental disabilities. 

(Parallels In Time | A History of Developmental Disabilities, n.d.)  

 

Change Classroom Teaching Style 

Most children with FASD are educated in the regular classroom. While these students may receive special education services to supplement regular classroom time, small adaptations to the classroom can ensure that all instructional time is productive for both teacher and child:

Emphasize consistency 

Develop a consistent routine in the classroom and stick to it all year. 

 Minimize transitions and provide clear and specific warnings in advance. 

Use a consistent signal (such as, a soft bell, a pencil tap) as a warning that a transition is occurring. 

Show related visuals to reinforce transitions (such as, a book for reading time). 

Provide a transition buddy for students who must change classes. 

Share the schedule so that parents can be equally consistent at home (see the schedules on pages 47 and 49). 

Manage social skill challenges that impact learning 

Give directions by telling students what they should do, rather than what they should not do. 

Reinforce appropriate behavior. Redirect most poor behavior. 

Use immediate short-term consequences clearly related to the inappropriate behavior. 

Place a student at the head of a line to minimize bumping. 

For a child who cannot stop interrupting other students while they are working, give a routine task that involves getting up and moving around (for example, sharpening pencils, going to the office, feeding fish). 

Provide one-on-one supervision during recess and lunch. 

Ask parents what strategies they use for appropriate behavior at home. 

Teach personal space (for example, stand no closer to someone else than an arm’s length). 

Teach self-talk for self-control. Use very specific short phrases, such as, “Count to 10 first.” 

 Use role-playing or videotaping to help a child see and learn appropriate skills for specific situations.

Use learning accommodations 

Post a copy of the schedule in an obvious place. This is useful even for older students. 

Tape the alphabet or other frequently needed materials (for example, class schedule) to the student’s desk. 

Encourage students to use low-tech assistance like calculators, upright manila folders placed on a desk to create a private workspace, rulers to keep their place on a page, etc. 

Use computers to reinforce the curriculum. Computers give immediate and consistent feedback and can compensate for slow or poor fine motor skills. 

Build in frequent breaks for students and gradually increase time on a task (for example, 15 minutes of work followed by a 5-minute break). 

Tape-record classroom lessons for review at home. 

Provide a duplicate set of textbooks to be kept at home. 

Work with the student to provide a written checklist of daily homework assignments. If possible, send the homework list home by email or, phone home to leave the list on the answering machine or voice mail. Rethink presentation style 

Be concrete and literal at all times. 

Use materials and approaches that might be appropriate for a student two or three years younger. 

Teach in multiple modalities (for example, keep lectures short and include activities and audiovisual materials). 

Use concrete representations of time (for example, kitchen timer, stop watch) and other math concepts. 

Let students choose reading books that are available on tape. 

Repeat everything you say and provide ample time for practice. 

Be patient. 

Give the student extra time to complete work. Mastery is the goal, not speed. 

Design worksheets with fewer problems and lots of white space. Use large-scale graph paper for arithmetic. 

Modify homework assignments so students can complete work within the grade-appropriate amount of time. 

Get the student’s attention before giving directions. Give directions one step at a time, and wait until that step is completed before giving the next step. To check for understanding, have the student re-explain or show you what he or she is supposed to do. If the student simply repeats what you said, try explaining it a different way. 

Allow the student to stand at the back of the room to work if that is more productive. For young children, let them lie on the floor. 

Enlist parents for ideas about what they use to get tasks done at home. 

Remember, there are at least 20 ways to teach everything. The teacher may need to try all 20 to reach the student with an FASD. 

Restructure the Physical Space in the Classroom

Children with FASD often are particularly sensitive to their environments and may be distracted from learning by common features of classrooms:

Simple changes to a classroom can make the environment calmer and less distracting, enabling all students to function better. 

Make seating assignments at the beginning of the year and keep them. 

Make sure the desk and chair fit the child (for example, feet touching the floor to improve focus). 

Keep bulletin boards tidy and uncluttered. Keep papers flush against the wall. Avoid suspending materials from the ceiling. 27 Reading Area Quiet Area Play Area 28 

For maximum attention, stand in front of a blank space when speaking (for example, a clean black or whiteboard, a movie screen, or a hanging sheet). 

If posters are used to designate areas of the room, make sure the poster content reinforces the area’s intended use. 

Cover up materials that are not currently being used. 

Provide a calm or quiet corner (for example, a bean bag or rock[1]ing chair, large pillows on the floor, a large appliance carton with pillows inside, a quiet room) to allow students to refocus. 

Do not use this same area for “time-out” discipline. 

Define students’ physical boundaries (for example, desk and chair space, where to stand in line) with masking tape on the floor or rug squares for seats. 

Keep the door closed to minimize noise from the hall. 

(Reach to Teach; 2007)

Some strategies according to Education & Fetal Alcohol syndrome Disorder Toolkit, FADU, ADAI, UW (n.d) are listed as follows: 

 

 

In research from Global Partnership for Education (n.d.), Inclusion means transforming schools so that they can respond to the diverse needs of all children – ensuring that they are not just in the classroom but safe, participating and learning. 

Denying children with disabilities their right to education has a life long impact on learning, achievement and employment opportunities, hence hindering their potential economic, social and human development. 

Throughout my developmental progression in this Masters program, we are reminded of the importance of early interventions, RTI’s, UDL as well as the role of the referral process. 

While I cannot present every accommodation/modification and teaching strategy the following information aims to be a guiding light to facilitate support and inclusivity in the classroom community. 

In research from Kessler (2021), Program accommodations and modifications are available to children who receive services under IDEA or Section 504 of the Rehabilitation Act. 

The general accommodations are listed as follows: 

Large print textbooks
 Textbooks for at-home use
 Additional time for assignments
 A locker with adapted lock
 Review of directions
 Review sessions
 Use of mnemonics
 Have student restate information
 Provision of notes or outlines
 Concrete examples
 Adaptive writing utensils
 Support auditory presentations with visuals
 Use of a study carrel
 Assistance in maintaining uncluttered space
 Weekly home-school communication tools (notebook, daily log, phone calls or email messages)
 Peer or scribe note-taking
 Space for movement or breaks
 Study sheets and teacher outlines
 Extra visual and verbal cues and prompts
 Lab and math sheets with highlighted instructions
 Graph paper to assist in organizing or lining up math problems
 Use of tape recorder for lectures
 Use of computers and calculators
 Books on tape
 Graphic organizers
 Quiet corner or room to calm down and relax when anxious
 Preferential seating
 Alteration of the classroom arrangement
 Reduction of distractions
 Answers to be dictated
 Hands-on activities
 Use of manipulatives
 No penalty for spelling errors or sloppy handwriting
 Follow a routine/schedule
 Alternate quiet and active time
 Teach time management skills
 Rest breaks
 Verbal and visual cues regarding directions and staying on task
 Agenda book and checklists
 Daily check-in with case manager or special education teacher
 Adjusted assignment timelines
 Visual daily schedule
 Varied reinforcement procedures
 Immediate feedback
 Work-in-progress check
 Personalized examples 

Testing and assessment accommodations:

Answers to be dictated
 Frequent rest breaks
 Additional time
 Oral testing
 Untimed tests
 Choice of test format (multiple-choice, essay, true-false)
 Alternate ways to evaluate (projects or oral presentations instead of written tests)
 Accept short answers
 Open-book or open-note tests
 Read test and directions to student
 Provide study guides prior to tests
 Highlight key directions
 Test in alternative site
 Use of calculator or word processor
 Extra credit option
 Pace long-term projects
 Preview test procedures
 Simplified test wording; rephrased test questions and/or directions

General modifications:

Allow outlining, instead of writing for an essay or major project
 Use of alternative books or materials on the topic being studied
 Computerized spell-check support
 Word bank of choices for answers to test questions
 Provision of calculator and/or number line for math tests
 Film or video supplements in place of reading text
 Reworded questions in simpler language
 Projects instead of written reports
 Highlighting important words or phrases in reading assignments
 Modified workload or length of assignments/tests
 Modified time demands
 Pass/no pass option
 Modified grades based on IEP

Behavior modifications: 

Breaks between tasks
 Cue expected behavior
 Daily feedback to student
 Have contingency plans
 Use de-escalating strategies
 Use positive reinforcement
 Use proximity/touch control
 Use peer supports and mentoring
 Model expected behavior by adults
 Have parent sign homework
 Have parent sign behavior chart
 Set and post class rules
 Chart progress and maintain data 

In research from Kessler (2021), the difference between success and failure for students with LD and ADHD often comes down to how effectively the curriculum is adapted to individual needs. Accommodations and modifications are the tools used by the IEP team to achieve that end. 

Accommodations allow a student to complete the same tasks as their non-LD peers but with some variation in time, format, setting, and/or presentation. The purpose of an accommodation is to provide a student with equal access to learning and an equal opportunity to show what he knows and what he can do.

Accommodations are divided into four categories:

·         Variations in time: adapting the time allotted for learning, task completion, or testing

·         Variation of input: adapting the way instruction is delivered

·         Variation of output: adapting how a student can respond to instruction

·         Variation of size: adapting the number of items the student is expected to complete

Common examples of accommodations include: 

 

1.    extended time to complete assignments

2.    provision of notes or outlines, untimed tests, and reduced number of test questions.

 

Unlike accommodations, which do not change the instructional level, content, or performance criteria, modifications alter one or more of those elements on a given assignment. Modifications are changes in what students are expected to learn, based on their individual abilities.

Examples of modifications include use of alternate books, pass/no pass grading option, reworded questions in simpler language, daily feedback to a student.

 

When deciding what accommodations and modifications are appropriate for your child, ask these questions: 

·         Can your child participate in the activity in the same way as her peers?

·         If not, can she do the same activity with adapted materials?

·         If not, can she do the same activity with adapted expectations and materials?

·         If not, can she accomplish the goals of the lesson by working with a partner or small group?

·         If not, can she do the same activity with intermittent assistance from an adult?

·         If not, can she do the same activity with direct adult assistance?

·         If not, can she do a different, parallel activity?

(Kessler, 2021)

But these schools are not required to provide free appropriate education or develop an individualized educational program for students with disabilities. 

As many parents and students attest, in these days of budget cuts for most aspects of education and States so stressed that they seek every method to save money that can be conceived, “expensive” programs such as ADA are often short changed or simply ignored within the institution. This is not viciousness on the part of most administrators so much as a desperate effort to make ends meet. As so often in history, those with disabilities are the ones most likely to face lack of attention and commitment from those who are able. It is up to the student, the family of the student and the rest of us to assert strongly the protections of the law that apply and to compel the institutions to adopt the programs and procedures necessary to fully comply with the law.

The institutions have no choice in the matter. The law is mandatory. And for those running an institution, it must be noted that federal funding is dependent on strict compliance with the law.

In reality, most educators and administrators are as determined to provide the same educational opportunities to every student as they can. It comes down to priorities. When there is not enough money for critical classes or facilities for all students, many institutions find it hard to spend money to help a small minority of the students. The problem is not with the heart of most institutions but with the pocket book.

But as one teacher explained to this writer over ten years ago, long before the monetary crisis of the states, it is often not just lack of funds as lack of information and lack of will. The law does not allow ignorance to be a defense nor any evasion of the requirements.

Residential Services provide a range of housing to people with intellectual/developmental disabilities. Each home offers support services providing people access to medical, nursing, psychological, nutritional, and employment services. 

Day Habilitation

The Day Habilitation programs reduce the barriers to community inclusion by building each individual’s practical skills. These include communication and self-preservation, community awareness, independent living and pre-vocational skills by volunteering in the community. 

Community Habilitation

Community Habilitation encourages people with intellectual/developmental disabilities who don’t live in S:US homes to engage in their community. Community Habilitation staff assist persons served to strengthen their social skills and aid with independent living activities such as cooking, travel and household upkeep. With this model, SUS assists persons to acquire the necessary life skills to be successful as contributing members of society. Additionally, SUS helps to prepare persons to gain the skills needed for greater independence.

Employment

Employment opportunities allow people with intellectual/developmental disabilities, as assisted by job developers and job coaches, to prepare for, secure, and be successful in their work/volunteer environments. Supported Employment (SEMP) provides support to assist people to obtain and maintain paid competitive jobs in the community. 

Self-Direction

Self-Direction empowers people with intellectual/developmental disabilities and their family to determine, with a great amount of flexibility, the supports and services that best fit their needs. Individuals who self-direct will be assisted by a circle of support, a group of people who advocates for the person’s best interests and supports their success. 

(Developmental Disabilities Services (sus.org); 2022) 

 Besides short stature, girls with TS often have certain physical traits:

Girls with TS do not experience typical sexual development.

Girls with TS may also be more likely to have other health complications.
 
Treatment: There is no cure for TS. Treatment usually includes: 

Outlook : The outlook for girls and women with TS is usually good. Life expectancy for TS might be slightly shorter, but by testing for and treating the conditions that come with TS, women with TS can expect to live essentially normal lives.                                                 
(Cleveland Clinic, n.d.)

Retarded. The term was changed to intellectual disabilities. The IQ OF 70/below was the benchmark for intellectual disabilities. 

 

There are many contributing factors to intellectual/developmental disabilities like postnatal, perinatal and postnatal times of life. 

At least 2.27% of the population suffers from an intellectual/developmental disability and 1% is diagnosed on IQ primarily. 

Educational institutes should make suitable accommodations/modifications, apply the best teaching strategies to give learners/students the best chance at success, this includes applying the abovementioned for IEP candidates. 

The long-term goal being to facilitate independence as far as possible and to be self sufficient enough to get employment in environments that may not be as, “harsh”.  

(Overview of Intellectual and Developmental Disabilities, 2021)

Audiopedia. (2016, October 12). What is DEVELOPMENTAL DISORDER? What does DEVELOPMENTAL DISORDER mean? YouTube. Retrieved April 26, 2022, from https://www.youtube.com/watch?v=moFK4nimOvo 

Conrad, J. (2018, Feb. 26). On intellectual and developmental disabilities in the United States: A historical perspective.[PDF file]. Sage. https://journals.sagepub.com/doi/pdf/10.1177/1744629518767001 

Curtis, L. (2021, August 18). What to Know About ADHD and Alcohol. Psych Central. Retrieved April 27, 2022, from https://psychcentral.com/adhd/adhd-and-alcohol  

Developmental Disabilities Services. (n.d.). Services for the Underserved. Retrieved April 27, 2022, from https://sus.org/our-services/intellectual-developmental-disabilities/  

Developmental Disorders. (n.d.). Kennedy Krieger Institute. Retrieved April 26, 2022, from https://www.kennedykrieger.org/patient-care/conditions/developmental-disorders

Education & Fetal Alcohol Spectrum Disorder Toolkit, FADU, ADAI, UW. (n.d.). Adai.Uw.Edu. Retrieved April 30, 2022, from https://adai.uw.edu/fasdtoolkit/educators.htm

Gillette, H. (2021, November 19). All About Childhood Developmental Disorders. Psych Central. Retrieved April 27, 2022, from https://psychcentral.com/disorders/childhood-developmental-disorders 

Global Partnership for Education. (n.d.). Inclusive education. Retrieved April 30, 2022, from https://www.globalpartnership.org/what-we-do/inclusive-education 

Grohol, J. P. M. (2021, March 3). What Are the Symptoms of Autism Spectrum Disorder? Psych Central. Retrieved April 27, 2022, from https://psychcentral.com/autism/autism-spectrum-disorder-symptoms#support-needs  

Grohol, J. P. M. (2021b, March 3). What Are the Symptoms of Autism Spectrum Disorder? Psych Central. Retrieved April 27, 2022, from https://psychcentral.com/autism/autism-spectrum-disorder-symptoms#support-needs 

Grohol, J. P. M. (2021b, March 3). What Are the Symptoms of Autism Spectrum Disorder? Psych Central. Retrieved April 27, 2022, from https://psychcentral.com/autism/autism-spectrum-disorder-symptoms#support-needs

Kessler, E. (n.d.). IEP Planning: Accommodations & Modifications - Smart Kids. Smart Kids -. Retrieved April 30, 2022, from https://www.smartkidswithld.org/getting-help/the-abcs-of-ieps/iep-planning-accommodations-modifications/

 

Kessler, E. (n.d.-b). IEP Planning: Accommodations & Modifications - Smart Kids. Smart Kids -. Retrieved April 4, 2022, from https://www.smartkidswithld.org/getting-help/the-abcs-of-ieps/iep-planning-accommodations-modifications/ 

Long-term services and supports for people with intellectual and developmental disabilities. (2015, December 16). YouTube. Retrieved April 27, 2022, from https://www.youtube.com/watch?v=hvTy1L_8JRQ 

Moore, L. (2021, June 2). What are Learning Disorders and Disabilities? Psych Central. Retrieved April 27, 2022, from https://psychcentral.com/disorders/types-of-learning-disorders#definition 

Overview of Intellectual and Developmental Disabilities. (2021, February 9). YouTube. Retrieved April 28, 2022, from https://www.youtube.com/watch?v=hs1aUjYQsYE 

Parallels In Time | A History of Developmental Disabilities. (n.d.). Mn.Gov/Mnddc/. Retrieved April 27, 2022, from https://mn.gov/mnddc/parallels/ 

Reach to Teach: Educating Elementary and Middle School Children with Fetal Alcohol Spectrum Disorders, DHHS Pub. No. SMA-4222. Rockville, MD: Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration, 2007 

Differences:

The researchers also discovered that 53 of the genes identified were mostly associated with autism and not other developmental conditions.

Types of services - Applied Behavioral Analysis. ABA encourages desired behaviors and discourages undesired behaviors to improve a variety of skills. Progress is tracked and measured.
Occupational Therapy- The primary goal of occupational therapy is to enable people to participate in the activities of
everyday life.
Speech Therapy- helps treat children with communication challenges, both in how they speak and how they understand communication.
Physical Therapy-

Children's Hospital of Philadelphia. (2014, March 30). Turner Syndrome. Www.chop.edu. https://www.chop.edu/conditions-diseases/turner-syndrome

Cleveland Clinic. (n.d.). Turner Syndrome: Causes, Symptoms, Diagnosis & Treatment. Cleveland Clinic. Retrieved April 30, 2022, from https://my.clevelandclinic.org/health/diseases/15200-turner-syndrome#symptoms-and-causes

HealthSketch. (2015, November 3). What is Turner Syndrome? (HealthSketch). Www.youtube.com. https://www.youtube.com/watch?time_continue=192&v=YQG8o5b4lKg&feature=emb_title&ab_channel=HealthSketch

Kelly, K. (2021, December). Classroom Accommodations for Nonverbal Learning Disabilities. Www.understood.org. https://www.understood.org/en/articles/at-a-glance-classroom-accommodations-for-nonverbal-learning-disabilities?utm_medium=email&utm_source=newsletter-en&utm_campaign=evergreen-fam-dec21&utm_content=send

Mayo Clinic. (2017, November 18). Turner Syndrome - Symptoms and Causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/turner-syndrome/symptoms-causes/syc-20360782

Turner Syndrome Foundation. (2020, December 19). From 1938 to 2020: It’s Time for Change. Turner Syndrome Foundation. https://turnersyndromefoundation.org/2020/12/19/from-1938-to-2020-its-time-for-change/

Turner Syndrome Society of the United States. (n.d.). Turner Syndrome A Guide for Families. https://www.turnersyndrome.org/_files/ugd/8fb9de_a621e471cb6542e492a338ee352b65b6.pdf

Social communication encompasses the following components:

Social communication enables individuals to share experiences, thoughts, and emotions. Social communication skills are needed for language expression and comprehension in nonverbal, spoken, written, and visual–gestural (sign language) modalities.

Social communication skills include the ability to

ASHA n.d

https://dralbertknapp.com/social-skills-disabilities-in-kids/


https://www.youtube.com/watch?v=IhNgxXCFXro

Other learning disabilities may affect the ability to connect and follow conversation and therefore affect the social skills of students, like dyslexia.

Impact of Dyslexia and ADHD on Social Skills

Dyslexia is a learning disability that affects a child’s skills in writing, reading, and spelling. It also has an impact on social skills development. Here are five common social challenges faced by children with Attention Deficit Hyperactivity Disorder ADHD and dyslexia:

1) Unable to understand jokes- A child who is a struggling reader may not read as frequently as other children. As a result, he might not be exposed to different words and how they’re used. This makes understanding puns and idioms very difficult for the child.

2) Difficulty finding suitable words- A child with dyslexia is unable to find the right words about topics they feel strongly about or when a quick response is required.

3) Miss out on social cues- Dyslexic children have a hard decoding body language, social cues, and facial expression.

4) Difficulty messaging friends/peers- A dyslexic child might shy away from sending text messages because they’re unable to spell or understand abbreviations.

5) Remembering things incorrectly- The child is unable to recall specific details or words. It can lead to confusion about what someone said.

LDRFA Org.

1. Trouble picking up on social cues

The ADHD link: People with ADHD might not notice how their behavior affects other people. They may interrupt a lot and even bug people by breaking social rules.

How you can help: Role-play different social situations together. First you play the other person in each scenario. Then switch roles. Finish by talking about what went well and what could be done differently.

2. Trouble keeping friends

The ADHD link: People with ADHD can be intense and demanding without knowing it. They can have trouble taking turns and sharing, and friendships may burn out.

How you can help: Sign up for a sport or another group activity. It may be easier for people with ADHD to learn about “give and take” in a group setting rather than one-on-one.

3. Going off-topic

The ADHD link: People with ADHD sometimes lose track of a conversation or get distracted by unrelated thoughts. They may also misinterpret what others are saying.

How you can help: Record a conversation. Listen to it together and talk about where you both hear someone going off-topic. Talk about how the conversation could have gone better.

4. Being unreliable

The ADHD link: People with ADHD can have trouble with planning and follow-through. That can lead other people to think they can’t be counted on when doing group projects.

How you can help: Encourage people with ADHD to talk with the group members about how they’ll divide up the work. Then help make a checklist or chart to keep track of personal progress.

5. Overreacting

The ADHD link: ADHD can make it hard to manage emotions. People with ADHD may lash out when they’re upset. Or they may have meltdowns at an age when it’s no longer appropriate.

How you can help: Try to pay attention to feelings like anger and irritation. What does it feel like? Being mindful makes it easier to recognize when “emotional temperatures” are rising.

Morin, A n.d

Delgado, D. C. (2019, July 18). Timeline: Special education laws. SpecialEd Advice USA. Retrieved May 1, 2022, from https://www.specialedusa.com/post/timeline-special-education-laws

The impact of learning disabilities on social skills. (2022, March 2). LDRFA. https://www.ldrfa.org/impact-of-learning-disabilities-on-social-skills/

Morin, A. (n.d.). ADHD and social skills. Understood. Retrieved May 1, 2022, from https://www.understood.org/en/articles/5-ways-adhd-can-affect-social-skills?_sp=22dc5b6d-1d5e-4081-90cb-1ead5a869a58.1651376233475

Social communication disorder. (n.d.). ASHA. Retrieved May 1, 2022, from https://www.asha.org/practice-portal/clinical-topics/social-communication-disorder/

Social integration handicap | the encyclopedia of world problems. (n.d.). Encyclopedia UIA. Retrieved May 1, 2022, from http://encyclopedia.uia.org/en/problem/social-integration-handicap

Topal, Z., Demir Samurcu, N., Taskiran, S., Tufan, A. E., & Semerci, B. (2018). Social communication disorder: A narrative review on current insights. Neuropsychiatric Disease and Treatment, Volume 14, 2039–2046. https://doi.org/10.2147/ndt.s121124

Update on dsm eligibility. (2013, August 6). Special Education Today. Retrieved May 1, 2022, from https://kcsspecialeducationlaw.com/2013/08/06/update-on-dsm-5-iep-eligibility-for-shttps:/kcsspecialeducationlaw.com/2013/08/06/update-on-dsm-5-iep-eligibility-for-students-with-autism-or-social-communication-disorders/tudents-with-autism-or-social-communication-disorders/

What is NVLD? (2016, June 24). YouTube. Retrieved May 1, 2022, from https://www.youtube.com/watch?v=IhNgxXCFXro

It is illegal to discriminate against anyone solely do to their disability. It is illegal to deny benefits and participation solely do to a disability as well. Individuals with disabilities have the same legal rights and admission to programs and   services. Individuals with disabilities related to speech, manual, and   sensory skills are legally entitled to supplementary tools and other aids.

(Ysseldyke   & Algozzine, 2006, p.11-15)

 

- Free and appropriate public education (FAPE);

- Least restrictive environment (LRE); and

- Approved and appropriate accommodations and modifications during assessments, and an individualized education plan (IEP). 
- Parents have the right to view their child’s school records. 

- Parents must be informed before any changes are made in the student’s educational placement, classes, or programs. 

- Parents may counter their child’s records and any changes placement. 

(Ysseldyke   & Algozzine, 2006, p.11-24)

 

All legal rights provided under Education of All Handicapped Children Act, including FAPE, LRE, IEP, and parameters of   parental involvement, are equally provided to special needs preschool children. 

(Ysseldyke & Algozzine, 2006,   p.11)

 

The Individuals with Disabilities Education Act (IDEA) of 1990 approves and reinforces all aspects of the Education for All Handicapped Children Act. IDEA expands the disability categories by adding autism and traumatic brain injury. Also, IDEA provides   the legally referred to definition of transition services while making   assistive technology more accessible. 

The following are the 13 disabilities listed under IDEA: 

- autism

- deaf-blindness

- deafness

- emotional disturbance

- hearing impairment

- intellectually disability

- multiple disabilities

- orthopedic impairment

- other health inpairment

- specific learning disability

- speech or language disability

- traumatic brain injury

- visual impairment (including blindness) 

(Ysseldyke & Algozzine, 2006,   p.12-27)

 

American With Disabilities Act of 1990 (ADA) prohibits discrimination of special needs individuals in adulthood. 

- Transportation

- Telecommunication services

- Government agencies, services, and occupation. 

(Ysseldyke   & Algozzine, 2006, p.12)

 

In 1997, amendments were made to the Individuals With Disabilities Education Act (IDEA). This amendment provides greater detail about who needs to be present during Individualized Education Plan (IEP) meetings and different paperwork and procedures which are required for IEP documentation. Also, IDEA’s disciplinary standards and regulations were updated. In addition, states are responsibly for tracking and documenting the performance, growth, and evolution of each special needs student. 

(Ysseldyke   & Algozzine, 2006, p.12-29)

 

No Child Left Behind (NCLB) is a law that applies to not only special needs students, but all students within the United States. NCLB requires that students from 3rd to 8th grade (including an additional year in high school) take an annual government designed assessment in mathematics and reading. The Reading First and Early   Reading First programs allows NCLB to provide tier II and tier III   interventions in all areas under the reading umbrella. Under NCLB, parents   are entitled to flexibility when placement of their child’s school district   and school choice. Finally, NCLB reinforces the Elementary and Secondary   Education Act (ESEA), which provides funds the primary and secondary   education along with other contributions to the American education system. 

(Ysseldyke   & Algozzine, 2006, p.12)

 

It is legally required that students with disabilities be taught by teachers who are highly qualified, have obtained a state teaching license, and certified in special education as well as core subjects. The improvement act of IDEA allows for 15% of special education funds to go to general education, in efforts to assist special   needs children who have not been identified yet. Also, new methods are used   to recognize and classify special needs students. Another improvement is that now discrepancy rates are not required when recognizing and classifying   special needs students. In addition, IEP short term goals are no longer   required, however long term IEP’s are permitted. Transition plans must be thought out and expressed with the end goal in place. Lastly, each school   must identify a parent replacement for disabled students who are homeless or the responsibility of the court of law.

(Ysseldyke   & Algozzine, 2006, p.13-33)

Delgado, D. C. (2019, July 18)

Treatment planning

Treatment typically involves collaboration with a variety of professionals (e.g., classroom teachers, special educators, psychologists, and vocational counselors). See ASHA’s resources on Collaboration and Teaming and Interprofessional Education/Interprofessional Practice (IPP/IPE).

Treatment strategies for SCD focus on increasing active engagement and building independence in natural communication environments. One-on-one, clinician-directed interventions are useful for teaching new skills. Group interventions are used in conjunction with one-on-one services to practice skills in functional communication settings and to promote generalization. In school settings, intervention often includes environmental arrangements, teacher-mediated interventions, and peer-mediated interventions (Timler, 2008).

The treatment modalities described below may be used to implement various treatment options.

Augmentative and alternative communication—an area of clinical practice that supplements or compensates for impairments in speech-language production and/or comprehension, including spoken and written modes of communication. Augmentative and alternative communication falls under the broader umbrella of assistive technology, or the use of any equipment, tool, or strategy to improve functional daily living in individuals with disabilities or limitations. 

Computer-based instruction—use of computer technology and/or computerized programs for teaching language skills, including vocabulary, social skills, social understanding, and social problem solving.

Video-based instruction (also called “video modeling”)—an observational mode of teaching that uses video recordings to provide a model of a target behavior or skill. Video recordings of desired behaviors are observed and then imitated by the individual. The learner’s performance of the desired behavior(s) can be videotaped for later review.

Below are brief descriptions of both general and specific treatments for addressing SCD. This list is not exhaustive, and the inclusion of any specific treatment approach does not imply endorsement from ASHA.

For additional treatment options that address social communication skills in school-age children, see ASHA’s Practice Portal pages on Autism Spectrum Disorder, Spoken Language Disorders, and Pediatric Traumatic Brain Injury. For treatment options in adult populations, see ASHA’s Practice Portal pages on Traumatic Brain Injury in Adults, Aphasia, and Dementia.

Behavioral interventions and techniques can be used to modify existing behaviors or teach new behaviors. These approaches are based on principles of learning that include identifying desired behaviors (e.g., social skills), gradually shaping these behaviors through selective reinforcement, and fading reinforcement as behaviors are learned.

Behavioral approaches can be used to modify or teach social communication behaviors in one-on-one, discrete trial instruction or in naturalistic settings with peers or other communication partners. Positive behavior support is one example of a behavioral intervention approach that can be used to foster appropriate and effective social communication (Carr et al., 2002).

Peer-mediated or peer-implemented interventions are those in which typically developing peers are taught strategies to facilitate play and social interactions with children who have SCD.

The interventions below specifically aim to improve social communication skills.

Comic strip conversations—conversations between two or more people illustrated by simple drawings in a comic strip format. The drawings illustrate what people are saying and doing and what they might be thinking. The process of creating the comic strip slows the conversation down, allowing more time for an individual to understand the information being exchanged. Comic strip conversations can be used for conflict resolution, problem solving, communicating feelings and perspectives, and reflecting on something that happened (Gray, 1994; Hutchins & Prelock, 2006).

SCORE skills strategy—a social skills program that takes place in a cooperative small group and focuses on five social skills: (S) share ideas, (C) compliment others, (O) offer help or encouragement, (R) recommend changes nicely, and (E) exercise self-control (Vernon et al., 1996; Webb et al., 2004).

Social communication intervention—an intervention program that focuses on functional social communication goals and carries out the intervention in a “plan, do, and review” framework. There is a particular emphasis on how those involved in an interaction feel about the interaction and motivations for reaching social goals. The “do” phase may involve the child learning social scripts. The “review” phase encourages the child to reflect on the social encounter they completed and how their activities and those of others contributed to the outcomes (Fujiki & Brinton, 2017).

Social Communication Intervention Project—speech and language therapy for school-age children with pragmatic and social communication needs. The Social Communication Intervention Project focuses on social understanding and social interpretation (e.g., understanding social context cues and emotional cues), pragmatics (e.g., managing conversation, improving turn-taking), and language processing (e.g., improving narrative construction, understanding nonliteral language; Adams et al., 2012).

Social scripts—a prompting strategy to teach children how to use varied language during social interactions. Scripted prompts (visual and/or verbal) are gradually faded as children use them more spontaneously (K. Nelson, 1978).

Social skills groups—an intervention that uses instruction, role play, and feedback to teach ways of interacting appropriately with peers. Groups typically consist of two to eight individuals with SCD and a teacher or an adult facilitator. Social skills groups can be used across a wide range of ages, including school-age children and adults.

Social Stories™—a highly structured intervention that uses stories to explain social situations to children and help them learn socially appropriate behaviors and responses. Initially developed for use with children with autism, it has been shown to benefit children with other disorders (Gray et al., 2002; Schneider & Goldstein, 2009).

Social norms are an intrinsic part of culture and communication. These norms may vary across and within cultures. It is essential that clinicians acquire knowledge of their client’s individual cultural norms to determine what is typical for that client within their environment. There is no universal norm for appropriate social behaviors that exists across all cultures. This can be observed in how we modify our communication rules with our partners, coworkers, peers, and family elders. Once the clinician is able to determine the rules of communication for a client, the clinician can determine if variations in patterns reflect communication differences or a disorder. See ASHA’s Practice Portal page on Cultural Competence. There are, however, some universal elements of pragmatic development that are observed in children across cultures, such as the need to develop joint attention skills and the understanding that others’ thoughts may differ from one’s own (this is known as “theory of mind”).

Treatment is conducted in the language(s) used by the individual. A bilingual service provider or the assistance of a trained interpreter may be necessary to provide treatment. See ASHA’s Practice Portal pages on Bilingual Service Delivery and Collaborating With Interpreters, Transliterators, and Translators. See also ASHA’s resource on Person- and Family-Centered Care.

Social communication skills are crucial for adolescents as they explore peer relationships and learn about friendship, loyalty, and individual differences (Seltzer, 2009). Social communication skills are equally important beyond the high school years—in postsecondary school, on the job, and in social settings.

The expectations for social communication change or evolve as the individual’s social settings or opportunities change. For example, expectations for social communication in a high school classroom are different from social communication expectations in a postsecondary classroom or in a workplace. Adolescents must learn to adapt and evolve their social communication style/skills as they adjust to these new social settings and their roles in these settings. Social communication problems tend to persist as adolescents transition to these new roles (Whitehouse et al., 2009).

School-based SLPs are often involved in transition planning to help mitigate the impact of social communication difficulties and to ease the transition to adulthood. See ASHA’s resource on Transitioning Youth. Social communication assessments with adequate psychometric properties are available for this age range (Poll et al., 2021).

Intervention and supports for adults with social communication needs may be available in various forms (e.g., social skills groups, conversation groups, life skills groups, and workshops) and from a variety of providers (e.g., SLPs, psychologists, college counselors, and vocational counselors). Intervention for these populations often focuses on improving conversational skills, navigating social situations, and encouraging participation in daily activities to the fullest extent possible. See ASHA’s Practice Portal pages on Traumatic Brain Injury in Adults, Aphasia, and Dementia.

Deaf or hard of hearing children are at greater risk for developing social skills difficulties when they experience periods of linguistic/cognitive deprivation and sensory fatigue (Szarkowski et al., 2020; Yoshinaga-Itano et al., 2020). SLPs should be aware of these potential causes of social challenges, which may fall outside the parameters of a true SCD, particularly to avoid possible misdiagnosis.

Many social language skills are learned through exposure to events that are witnessed or overheard (i.e., incidental learning). Some of these avenues for learning are not readily available to individuals who are deaf or hard of hearing, and this can have a negative impact on the development of social competencies (Calderon & Greenberg, 2003).

Programs to help children overcome these challenges begin early by promoting parent–child communication. Parents can help “fill in the gaps” by helping children understand and interpret what they have not directly heard (Calderon & Greenberg, 2003). Parents can also help by modeling healthy ways to interact and by teaching acceptable social behaviors (Schlesinger & Meadow-Orlans, 1972; Yoshinaga-Itano et al., 2020).

It is important for adolescents who are deaf or hard of hearing to feel that they are a part of their social network and to be able to interact effectively within this network (Calderon & Greenberg, 2003).

Interventions during the adolescent years include

https://www.asha.org/practice-portal/clinical-topics/social-communication-disorder/#collapse_6

Behavioral symptoms:

Cognitive symptoms:

Psychosocial symptoms:

Completing group projects, performing in Drama performances or solving a minor disagreement with a classmate are all made difficult with these psychosocial symptoms.  Motivating such a student to complete a task or take part in any activity will also become relatively challenging. 

ODD can occur cormobid with other disorders as the symptoms may be similar.  Some of these include:

The latest update of the DSM 5 contains updates that help to distinguish ODD from conduct behaviour as it groups symptoms into three main categories -  vindictiveness, angry/irritable mood, and argumentative/defiant behavior.  With this updated information, physicians and parents can differentiate between poor, but normal, childhood behaviour and actual symptoms of ODD. Physicians can now also use a severity rating which helps them analyse the severity of the disorder across different settings. 

All this research produced data that has had an impact on our current understanding of ODD. The impact of this research is:

Some issues that were raised by research like sex-specific symptoms are still under investigation and more research needs to be conducted to come up with actionable data. 

TYPE OF INSTITUTION: Preschool/Kindergarten 

AGE RANGE: 4-6 years

TYPE OF SUPPORT: Early detection and treatment in children plays a key role in ODD interventions. For the preschool age group, successful support has been noted from home visitations for parent-management training as well as school readiness programs like Head Start. Parent-management training will be discussed later in this section. 

According to the U.S. Department of Health & Human Services  website, Head Start promotes the school readiness of infants, toddlers, and preschool-aged children from low-income families. Through this program, children's growth is supported in a positive and friendly environment. Health screens are available and children are tested for physical as well as mental issues, with an early diagnosis, treatment can begin even for students as young as 3 years old. 

The Head Start program also offers 1 learning experiences as through helping to facilitate meaningful relationships between children and their teachers and parents. 

IMPLICATIONS AND EXAMPLES: As an educator, programs like Head start can help to test and diagnose a child in my class that exhibits ODD. A 5 year old may be very uncooperative during circle time and always seems angry adn getting into fights with the  other children, blaming them and seeking revenge by hiding their favourite toys. Such a child could possibly be diagnosed and I would receive specific recommendation for this student. 

TYPE OF INSTITUTION: Elementary School

AGE RANGE: 6-11 years

TYPE OF SUPPORT: Parent-management training will be discussed later in this section.

School based interventions are conducted in schools as a means of raising awareness of mental health issues amongst school going children. As a result of these mental health awareness campaigns, the stigma that it is often associated with is dismantled. Another advantage of School based interventions is that they reach a wider population of children who are able to benefit from the recommendations such as talking to a professional. What is more, family support within the school setting is also available as teachers and mental health workers have access to parents who can offer their insights into behaviour deemed to be ODD. With parental consent, medication for ODD can also be taken at school in a timely manner with the assistance of the school nurse for younger children.

IMPLICATIONS AND EXAMPLES: Second only to parents, teachers spend a lot of time with children, as a result, I am more likely to notice ODD symptoms in my students. Having school based interventions can be a catalyst to having a conversation about mental health to a student that is  persistently negative, has low self-esteem and is generally uncooperative. It will also provide for a good base to start a conversation with parents in a meeting regarding mental health and the opportunities available at school to support their child like talking to a mental health worker who can provide recommendations for the family. In the classroom, I can use classroom behaviour techniques like using more praise and make use of strategies that prevent oppositional behaviour from escalating like remaining calm in order to  foster obedience to classroom rules and acceptance of social norms. Peer relationships and problem solving can also be taught successfully through modeling and class discussion with peers.

TYPE OF INSTITUTION: Middle and High School

AGE RANGE: 11-18 years

TYPE OF SUPPORT: School based interventions as discussed above also be beneficial to adolescents with ODD as well as parent-management training.

Individual therapy is a more common treatment for adolescents mainly deals with Cognitive-behavioural therapy (CBT). Cognitive-behavioural therapy aims to help a child identify and impulses and behaviour that are considered unacceptable and then teach the child how to control these. In adolescence especially, problem-solving skills training and perspective-taking can be taught more explicitly. At school this can be done by a school psychologist during weekly sessions. 

IMPLICATIONS AND EXAMPLES: Within the classroom, as I teach I can be aware of the triggers of my student who may be very angry during a group discussion and can redirect them as recommended by the psychologist to identify their anger and cool off by taking a step back or going to a particular station in the classroom with soft toys for them to squeeze. For a student with anxiety and depression, this can take the form of identifying 3 things they are grateful for today and celebrating those. 

TYPE OF INSTITUTION: Homeschool 

AGE RANGE: 4-18

TYPE OF SUPPORT: Homeschools are an emerging school that this author deems deserving of the title institute. A slowly growing population of American students are being homeschooled by their parents. For those parents with children/students with ODD, there are interventions that can be beneficial to them, namely parent-management training.

Parent-management training aims to restore the bonds between a parent and their child by open and honest communication based on the following principles:

IMPLICATIONS AND EXAMPLES: Albeit the parent/child relationship can be tested and boundaries stretched in a homeschool setting, parents ought to realise that there ways they can support their child with ODD. Using the parent-management training as a teacher/parent for my teenage child, I can let them know that their defiance will result in a loss of iPad priviledges. In the case of younger child, as the teacher/parent, I can impose time-out ahead of time for my child/student being uncooperative. Simultaneously, I can have a reward chart in their room that records and rewards them each time they are able to control their anger or frustration. After 10 consecutive rewards, they receive a bigger reward like pizza night or more time on the iPad. 

However ODD can qualify as a disability if the student has another disorder like specific learning disorders,  ADHD which requires some interventions under the special education.  As such, if a student has shown prolonged ODD symptoms, a well rounded evaluation ought to be conducted to determine other cormobid conditions which will enable them to qualify for special education. In the event that they still do not qualify, schools can also consider a Section 504 for that student.   Under Section 504, students with ODD can receive accommodations that can meet some of their needs. Schools are expected to review a students performance regularly even though there are no funds allocated towards it.

Ghosh, A., Ray, A., & Basu, A. (2017). Oppositional defiant disorder: current insight. Psychology research and behavior management, 10, 353–367. https://doi.org/10.2147/PRBM.S120582

Boylan K. (2014). The many faces of oppositional defiant disorder. Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent, 23(1), 8–9.

Sanson, A., & Prior, M. (1999). Temperament and behavioral precursors to oppositional defiant disorder and conduct disorder. In H. C. Quay & A. E. Hogan (Eds.), Handbook of disruptive behavior disorders (pp. 397-417). New York: Kluwer Academic/Plenum Publishers.

 Scarr, S. (1992). Developmental theories for the 1990s: Development and individual differences. Child Development, 63, 1-19.

Speech is the process of producing specific sounds that convey meaning to the listener. A speech disorder refers to any condition that affects a person’s ability to produce sounds that create words.

Speech disorders prevent people from forming correct speech sounds, while language disorders affect a person’s ability to learn words or understand what others say to them.

However, both speech and language disorders can make it more difficult for a person to express their thoughts and feelings to others.

Some types of speech disorder include stuttering, apraxia, and dysarthria. 

Stuttering

Stuttering refers to a speech disorder that interrupts the flow of speech. People who stutter can experience the following types of disruption:

The symptoms of stuttering can vary depending on the situation. Stress, excitement, or frustration can cause stuttering to become more severe. Some people may also find that certain words or sounds can make a stutter more pronounced.

Stuttering can cause both behavioral and physical symptoms that occur at the same time. These can include:

There are two main types of stuttering:

Apraxia

The brain controls every single action that people make, including speaking. Most of the brain’s involvement in speech is unconscious and automatic.

When someone decides to speak, the brain sends signals to the different structures of the body that work together to produce speech. The brain instructs these structures how and when to move to form the appropriate sounds.

For example, these speech signals open or close the vocal cords, move the tongue and shape the lips, and control the movement of air through the throat and mouth.

Apraxia is a general term referring to brain damage that impairs a person’s motor skills, and it can affect any part of the body. Apraxia of speech, or verbal apraxia, refers specifically to the impairment of motor skills that affect an individual’s ability to form the sounds of speech correctly, even when they know which words they want to say.

Dysarthria

Dysarthria occurs when damage to the brain causes muscle weakness in a person’s face, lips, tongue, throat, or chest. Muscle weakness in these parts of the body can make speaking very difficult.

People who have dysarthria may experience the following symptoms:

 

People with one or more speech disorders may experience the following symptoms:

Risk factors that can increase the likelihood of a person developing a speech disorder include;

experiencing problems that affect the ears, nose, or throat 

An SLP will evaluate a person for groups of symptoms that indicate one type of speech disorder. To make an accurate diagnosis, SLPs need to rule out other speech and language disorders and medical conditions.

An SLP will review a person’s medical and family history. They will also examine how a person moves their lips, jaw, and tongue and may inspect the muscles of the mouth and throat.

Other methods of evaluating speech disorders include:

Treatment 

The type of treatment will typically depend on the severity of the speech disorder and its underlying cause.

Treatment options can include:

Target selection
Target selection involves a person practicing specific sounds or words to familiarize themselves with particular speech patterns. Examples of therapy targets may include difficult words or sounds that trigger speech disruptions.

Contextual utilization
For this approach, SLPs teach people to recognize speech sounds in different syllable-based contexts.

Contrast therapy
Contrast therapy involves saying word pairs that contain one or more different speech sounds. An example word pair might be “beat” and “feet” or “dough” and “show.”

Oral-motor therapy
The oral-motor therapy approach focuses on improving muscle strength, motor control, and breath control. These exercises can help people develop fluency, which produces smoother speech that sounds more natural.

Ear device
Ear devices are small electronic aids that fit inside the ear canal. These devices can help improve fluency in people who have a stutter.

Some ear devices replay altered versions of the wearer’s voice to make it seem as though someone else is speaking with them. Other ear devices produce a noise that helps control stuttering.

Medication
Some speech disorders can cause people to develop anxiety disorders. Stressful situations can trigger anxiety, resulting in more pronounced speech disorder symptoms. Anxiety medications may help reduce symptoms of speech disorders in some people.

 

Duchan, J. F. (2002). What Do You Know About Your Profession’s History? ASHA Leader, 7(23), 4. https://doi.org/10.1044/leader.ftr.07232002.4

MedlinePlus. (2018). Speech disorders - children: MedlinePlus Medical Encyclopedia. Medlineplus.gov. https://medlineplus.gov/ency/article/001430.htm

 

 

Means, J., & Chester, W. (n.d.). The impact of IDEA 04 and NCLB on speech and language related services: How do we meet the challenges. https://files.eric.ed.gov/fulltext/EJ1098444.pdf

Speech disorders: Types, symptoms, causes, and treatment. (2019, March 21). Www.medicalnewstoday.com. https://www.medicalnewstoday.com/articles/324764#treatment

 

 

Speech and Language Impairments Defined | Special Education Guide. (2013). Special Education Guide. https://www.specialeducationguide.com/disability-profiles/speech-and-language-impairments/

U.S. Department of Education. (2017). Individuals with Disabilities Education Act. Individuals with Disabilities Education Act. https://sites.ed.gov/idea/regs/b/a/300.8/c/11

 

The History of Speech Language Pathology | SpeechEasy. (2019, February 14). SpeechEasy. https://speecheasy.com/the-history-of-speech-language-pathology/