“This multimedia product and its contents are protected under copyright law. The following are prohibited by law: any public performance or display, including transmission over a network: preparation of any derivative work, including the extraction, in whole or part, of any images; any rental, lease, or lending of the program.” Mental Retardation (Intellectual Disabilities) Chapter Ten

“Copyright© Allyn & Bacon 2006” Introduction Some commonalities associated with mild to severe mental retardation: Children with mild retardation do not exhibit readily identifiable physical problems during the early childhood years. The difficulties of children with moderate to severe mental retardation transcend the classroom. Many individuals with severe and profound retardation are dependent on others to maintain basic life functions. With proper education and support - develop skills that allow some degree of independence.

“Copyright© Allyn & Bacon 2006” IDEA Definition “…significantly sub-average general intellectual functioning, existing concurrently with deficits in adaptive behavior and manifested during the developmental period, that adversely affects a child’s educational performance.”

Definitions American Association on Mental Retardation (AAMR) Significant limitations both in intellectual functioning and adaptive behavior as expressed in conceptual, social, and practical adaptive skills. The age of onset must occur prior to 18 years of age. Six major dimensions: Intellectual abilities – reasoning, planning, problem solving, abstract thought, processing speed. Adaptive behavior - communication, daily living skills, socialization. Participation, Interaction, and Social Roles Principle of normalization. Physical and mental health. Environmental context. Age of Onset.

“Copyright© Allyn & Bacon 2006” AAMR Definition (1992, 2002) 6. Age of onset Levels of Support Intermittent, limited, extensive, or pervasive; natural or formal

“Copyright© Allyn & Bacon 2006” Classification Based on Needed Support Intermittent supports are provided on an “as-needed basis.” Limited supports are characterized by consistency; time required may be limited but not intermittent. Extensive supports are characterized by regular involvement (e.g., daily). Pervasive supports - constancy and high intensity and provided across environments that may be life sustaining in nature. Supports: Formal supports include government programs or advocacy organizations. Natural supports include family members, friends, or neighbors.

“Copyright© Allyn & Bacon 2006” Definitions The AAMR cites five criteria for putting the definition into practice: Limitations within the context of typical community environments. Valid assessment considers diversity and differences due to culture, language, communication, sensory factors, and behavior. Limitations often coexist with strengths. Purpose of describing limitations is to develop a profile of needed supports. With sustained and appropriate personalized supports, the life functioning will improve.

“Copyright© Allyn & Bacon 2006” Classification Severity Mild, moderate, severe, or profound retardation. Determined in two ways (both are necessary): Assistive Technology – computers, PDAs, hearing aids, wheelchairs. Indicators of adaptive behavior.Use of scores on intelligence tests.

“Copyright© Allyn & Bacon 2006” Normal Distribution

“Copyright© Allyn & Bacon 2006” Bell Curve

“Copyright© Allyn & Bacon 2006” The Dynamics of Intelligence

“Copyright© Allyn & Bacon 2006” Classification Educability expectations Educable (IQ 55 to about 70). Second to fifth grade achievement in academic areas. Social adjustment will permit some degree of independence in the community. Occupational sufficiency will permit partial or total self-support. Trainable (IQ 40 to 55). Learning is primarily in the area of self-help skills; some achievement occurs in academic areas. Social adjustment is often limited to the home and nearby area. Employment opportunities often include supported work in a community job. Symptom-severity classifications.

“Copyright© Allyn & Bacon 2006” Classification Medical descriptors. Fetal alcohol syndrome. Chromosomal abnormalities – Down syndrome. Metabolic disorders - PKU. Infections.

“Copyright© Allyn & Bacon 2006” Prevalence

“Copyright© Allyn & Bacon 2006” Characteristics Learning and Memory Intellectual deficit that translates to a difference in the rate and efficiency in which people acquire, remember, and use knowledge. Abstract concepts. Generalization. Memory problems. Difficulty focusing on relevant stimuli.

“Copyright© Allyn & Bacon 2006” Characteristics Self Regulation The ability to rehearse a task is related to self- regulation or the ability to regulate one's own behavior. Efficient learning strategies. Information processing theories - processing information from sensory stimuli into motoric output. Underdevelopment of metacognitive processes.

“Copyright© Allyn & Bacon 2006” Characteristics Adaptive Skills The ability to adapt to the demands of the environment, relate to others, and take care of personal needs. Ability to apply skills learned in classrooms to daily activities. Higher rates of distractibility and inattentiveness. Poor interpersonal skills. Working cooperatively with peers. Social perceptions. Failure to read social cues. Use of socially acceptable language. Acceptable responses to teacher direction and cues. Lower self-image greater expectancy for academic and social failure.

“Copyright© Allyn & Bacon 2006” Characteristics Academic Achievement Significant delays in the area of literacy. Reading comprehension. Decoding words then comprehending their meaning. Significant delays in the area mathematics. Perform poorly in mathematical computations. Unable to apply concepts. Children with moderate and severe mental retardation can be taught functional academics.

“Copyright© Allyn & Bacon 2006” Characteristics Motivation History of failure and fear of taking risks. Learned helplessness. Experiences should have a high probability of success. Physical Development There is a relationship between the severity of the mental retardation and the extent of physical problems for the individual.

“Copyright© Allyn & Bacon 2006” Characteristics Speech and Language Delayed speech and language development. Articulation, voice, and stuttering problems. Functional communication. Severity of speech and language problems is positively correlated with the severity of the mental retardation. Mental retardation may cause speech problems, but some speech difficulties, such as echolalia, may also contribute directly to the severity of mental retardation.

“Copyright© Allyn & Bacon 2006” Causation Sociocultural Influences Low-level socioeconomic status and culturally diverse backgrounds. Living in adverse economic conditions. Receiving poor nutritional and medical care. Few opportunities for learning. The nature-versus-nurture controversy = how much of a person’s ability is related to sociocultural influences and how much to genetic factors? Cultural familial retardation- retardation that may be attributable to both sociocultural and genetic factors.

“This multimedia product and its contents are protected under copyright law. The following are prohibited by law: any public performance or display, including transmission over a network: preparation of any derivative work, including the extraction, in whole or part, of any images; any rental, lease, or lending of the program.” Fetal Alcohol Syndrome

“Copyright© Allyn & Bacon 2006” Sign and Symptoms of Fetal Alcohol Syndrome. Low birth weight Small head circumference Failure to thrive Developmental delay Organ dysfunction Epilepsy Poor coordination / fine motor skills Behavioral problems, including hyperactivity, inability to concentrate, social withdrawal, stubbornness, impulsiveness, and anxiety.

“Copyright© Allyn & Bacon 2006” Down Syndrome (Trisomy 21)

“Copyright© Allyn & Bacon 2006” 1:733 births, and more than 350,000 people in the U.S.

“Copyright© Allyn & Bacon 2006” Down Syndrome (Trisomy 21) Physical Deformities flattening of the back of the head slanting of the eyelids short stubby limbs thick tongues heart problems overly flexible joints shorter than normal height

FRAGILE X SYNDROME Sex-linked: affects mostly males eye & vision impairmentsHyper-extensible joints (double jointed) elongated face Large testicles (evident after puberty) Flat feet Low muscle tone High arched palateAutism and autistic-like behavior Prominent ears hand biting and hand-flapping Mental RetardationHyperactivity and short attention span

“Copyright© Allyn & Bacon 2006” William’s Syndrome absence of genetic materials on the seventh pair of chromosomes. “elfish” face “Mental retardation and associated medical problems. Highly personable Relatively good language skills Musical ability Behavior problems Cardiovascular problems “miss the forest for the trees.”

“Copyright© Allyn & Bacon 2006” Phenylketonuria (PKU) 1:15,000 births microcephaly Seizures hyperactivity Excessive phenylalanine in the blood saturates the large neutral amino acid transporter (LNAAT), which carries LNAAs across the BBB. Thus, excessive levels of phenylalanine significantly decrease the levels of other LNAAs in the brain needed for brain development.large neutral amino acid transporter Phenylalanine in meat, dairy products, fish, grains and legumes

“Copyright© Allyn & Bacon 2006” Causation Metabolic disorders- the body’s inability to process certain substances that can become poisonous and damage tissue in the central nervous system. Phenylketonuria (PKU). Galactosemia. Postnatal brain disease Neurofibromatosis. Tuberous sclerosis.

“Copyright© Allyn & Bacon 2006” Galactosemia Inability to properly process lactose - cataracts - infections - MR - kidney failure - enlarged liver - poor growth

“Copyright© Allyn & Bacon 2006” Tuberous sclerosis The disease is caused by the proliferation of small benign tumors in the brain, as well as on the face and eyes, and in the kidneys, lungs, and other organs benign tumors Seizures MR Small benign facial skin tumors

“Copyright© Allyn & Bacon 2006” Neurofibromatosis 1:3000 an autosomal dominant genetic disorder. Genetic disorders that cause tumors to grow along types of nerves. The tumors can grow anywhere on or in the body.autosomal dominant genetic disorder - headaches - seizures - MR - macrocephaly

“Copyright© Allyn & Bacon 2006” Infection Congenital rubella pregnant woman who has contracted rubella during her first trimesterrubella - microcephaly - heart defects - MR Toxoplasmosis - The parasite Toxoplasma gondii multiplies in the intestine of the cat and is shed in cat feces, mainly into litter boxes and garden soil. - encephalitis - heart - liver - eyes - MR

“Copyright© Allyn & Bacon 2006” Causation Traumas or Physical Agents Traumas or physical agents may occur either prior to birth, during delivery, or after the baby is born. Anoxia. Several conditions associated with unknown prenatal influences can result in severe disorders. Hydrocephalus.

“Copyright© Allyn & Bacon 2006” Educational supports and services The Early Childhood Years Head Start. Federally funded preschool program for disadvantaged students.

“Copyright© Allyn & Bacon 2006” Supports and services

“Copyright© Allyn & Bacon 2006” Task Analysis Breaking of a complex task or behavior into its’ component parts Select goals Identify prerequisite skills and materials needed to perform the task Identify specific components of the task and sequence component parts Evaluate instruction and task mastery level Seek to generalize skill to other settings

Educational supports and services The Elementary School Years Decreasing dependence on others while teaching adaptation to the environment. Motor skills. Gross motor. Fine motor. Self-Help skills. Social skills. Communication skills. Verbal language. Augmentative communication. Combination. Assistive technology. Academic skills.

Educational supports and services Transition from School to Adult Life Personal independence. Participation in the community. Employment Preparation. Primary opportunities for social interaction. A basis for personal identity and status. Chance to contribute to the community. Guidelines for supporting employment: Job coach Opportunity to make informed choices. Training in community settings. Training which focuses on work opportunities present in the local area. Specific employment training. Collaborative effort between school and adult service agencies.

“Copyright© Allyn & Bacon 2006” Figure 5.5 Figure Represents Percentage of Enrollment of Students with Mental Retardation During the School Year

“Copyright© Allyn & Bacon 2006” Inclusive education Placement of students with mental retardation in general education classrooms with peers without disabilities. Individualized educational program. Full inclusion. Partial inclusion. Almost 94% of student between the ages of 6 and 21 with mental retardation attend general education schools for the entire day. About 4% of students with mental retardation attend public special schools and less than 10% attend private special schools.