Chapter 12 Low Incidence Disabilities: Severe/Multiple Disabilities, Deaf-Blindness, and Traumatic Brain Injury William L. Heward Exceptional Children: An Introduction to Special Education, 8e Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Severe and Multiple Disabilities Severe disability Significant disabilities in intellectual, physical, and/or social functioning Multiple disabilities Multiple disabilities means concomitant impairments, that causes such severe educational problems that they cannot be accommodated in special education programs solely for one impairment William L. Heward Exceptional Children: An Introduction to Special Education, 8e Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Characteristics and Prevalence Slow acquisition rates for learning new skills Poor generalization and maintenance of newly learned skills Limited communication skills Impaired physical and motor development Deficits in self-help skills Stereotypic and challenging behavior Prevalence Estimates range from 0.1% to 1% of the population William L. Heward Exceptional Children: An Introduction to Special Education, 8e Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Causes In almost every case of severe disabilities, a brain disorder is involved Chromosomal disorders Genetic or metabolic disorders that can cause serious problems in physical or intellectual development Severe disabilities may develop later in life from head trauma In about one-sixth of all cases, the cause cannot be clearly determined William L. Heward Exceptional Children: An Introduction to Special Education, 8e Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Traumatic Brain Injury (TBI) Definition an acquired injury to the brain Resulting in total or partial functional disability Adversely affects a child’s educational performance TBI is the most common acquired disability in childhood William L. Heward Exceptional Children: An Introduction to Special Education, 8e Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Curriculum: What Should Be Taught? 1. Functional skills - activities of daily living skills (ADLs) 2. Age-appropriate skills 3. Making choices skills 4. Communication skills 5. Recreation and leisure skills William L. Heward Exceptional Children: An Introduction to Special Education, 8e Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Instructional Methods: How Should Students Be Taught? Instruction must be carefully planned, systematically executed, continuously monitored The student’s current level of performance must be assessed The skill to be taught must be defined clearly The skill may need to be broken down into smaller component steps The teacher must provide a clear prompt to cue the child The student must receive feedback and reinforcement Strategies that promote generalization and maintenance must be used The student’s performance must be directly and frequently assessed William L. Heward Exceptional Children: An Introduction to Special Education, 8e Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Partial Participation, Positive Behavioral Support, and Small Group Instruction Students can be taught to perform selected components or an adapted version of the task Positive behavioral support Use of functional assessment methodologies to support student’s placement Advantages of small group instruction Skills learned in small groups may be more likely to generalize Provides opportunities for social interaction Provides opportunities for incidental or observation learning from other students May be a more cost-effective use of teacher’s time William L. Heward Exceptional Children: An Introduction to Special Education, 8e Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Where Should Students with Severe and Multiple Disabilities Be Taught? Benefits of the neighborhood school and inclusion More likely to function responsibly as adults in a pluralistic society Integrated schools are more meaningful instructional environments Parents and families have greater access Helps develop range of relationships with nondisabled peers Students with severe disabilities are more likely to develop social relationships with students without disabilities if they are included at least part of the time in the regular classroom William L. Heward Exceptional Children: An Introduction to Special Education, 8e Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

The Challenge and Rewards of Teaching Students with Severe and Multiple Disabilities Teachers must be sensitive to small changes in behavior The effective teacher is consistent and persistent in evaluating and changing instruction to improve learning and behavior Working with students who require instruction at its very best can be highly rewarding to teachers William L. Heward Exceptional Children: An Introduction to Special Education, 8e Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.