Chapter Six Individuals With Intellectual Disabilities

The AAIDD, founded in 1876, has amended its definition of mental retardation several times over the decades. In 1987, the American Association of Mental Deficiency (AAMD) changed its name to the American Association on Mental Retardation (AAMR). In 2007, the Association changed its name to the American Association on Intellectual and Developmental Disabilities (AAIDD) which is consistent with European and Canadian terminology. The U.S. Department of Education uses the term mental retardation and both are used interchangeably in this textbook

Defining Intellectual Disability: An Evolving Process 1961 AAIDD Definition 1973 AAIDD Definition 1983 AAIDD Definition 1992 AAIDD Definition 2002 AAIDD Definition 2010 AAIDD Definition 4

5

Defining Intellectual Disability 1961 AAIDD definition “Subaverage general intellectual functioning which originates during the developmental period and is associated with impairments in adaptive behavior.” 1973 AAIDD definition “Significantly subaverage general intellectual functioning existing concurrently with deficits in adaptive behavior, and manifested during the developmental period AAIDD definition “Significantly subaverage general intellectual functioning resulting in or associated with concurrent impairment in adaptive behavior and manifested during the developmental period.” 6

Defining Intellectual Disability 1992 AAIDD definition “Significantly subaverage intellectual functioning, existing concurrently with related limitations in two or more of the following applicable adaptive skill areas: communication, self- care, home living, social skills, community use, self-direction, health and safety, functional academics, leisure, and work. Mental retardation manifests before age 18.” ‒It portrays intellectual disability as a relationship among three key elements: the individual, the environment, and the type of support required for maximum functioning in various settings. ‒It stresses functioning in one’s community rather than just focusing on the clinical aspect of the individual such as IQ score or adaptive behavior. 7

8

Defining Intellectual Disability 2002 AAIDD definition “Mental retardation is a disability characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills. This disability originates before age 18.” 9

Defining Intellectual Disability 2002 AAIDD definition continued Limitations in present functioning must be considered within the context of community environments typical of the individual’s age, peers, and culture. With appropriate personalized supports over a sustained period, the life functioning of the person with an intellectual disability will generally improve.

Defining Intellectual Disability 2010 AAIDD definition The term mental retardation is replaced by the more contemporary label, intellectual disabilities. Developed by a committee of eighteen medical and legal scholars as well as policymakers, educators, and other professionals, the 2010 definition emphasizes the abilities and assets of individuals with intellectual disabilities rather than their deficits or limitations. Intellectual disabilities are viewed as a state of functioning rather than an inherent trait. As in earlier definitions, one of the goals of the 2010 definition is to maximize support services so as to allow persons with intellectual disabilities to participate fully in all aspects of daily life. 11

Assessing Intellectual Ability Assessment tools: Wechsler Intelligence Scale for Children (4th ed., WISC-IV) Stanford-Binet Intelligence Scale (5 th ed.) Potential problems: Potential for cultural bias Flexibility of IQ scores Overemphasis on IQ score 13

Assessing Adaptive Behavior Adaptive behavior is seen as “the degree to which, and the efficiency with which, the individual meets the standards of maturation, learning, personal independence, and/or social responsibility that are expected for his or her age level and cultural group.” (Grossman, 1983, p. 11) 14

Assessing Adaptive Behavior Considers the context of the individual’s environment and cultural influences. Skill areas in which most people participate: communication, self-care, home living, social skills, community use, self-direction, health and safety, functional academics, leisure, and work Assessment Tools: AAMR Adaptive Behavior Scale-School AAMR Adaptive Behavior Scale-Residential and Community AAIDD Diagnostic Adaptive Behavior Scale being developed

Classification of Individuals With Intellectual Disabilities Etiological perspective- consequence of disease processes or biological defects Intellectual deficits- classification based on IQ score Educational perspective- use of outdated terms to distinguish a children’s level of ability to learn academic or employment skills Levels of supports- definitions have shifted to an emphasis on the level of supports that an individual needs rather than IQ score 16

17

18

Brief History of the Field – Early Civilizations Early civilizations such as the Greek and Roman empires valued physical and mental strength and were reported to practice infanticide with children thought to be defective. – The Middle Ages The social force of religion brought a more charitable view of disability into vogue and churches established asylums for the “children of God.” Fear and superstition were rampant and people with intellectual disabilities were often thought to possess demonic powers from Satan. 19

Early optimism (early nineteenth century) Itard and Seguin (educators mid 1800’s ) brought European ideas to America regarding the education of people with intellectual disabilities. In 1876, the Association of Medical Officers of American Institutions for Idiotic and Feeble- minded Persons was established

– Protection and pessimism (late nineteenth and early twentieth centuries) This era witnessed the American development of large, isolated institutions designed to segregate people with intellectual disabilities. The understaffed institutions focused on custodial care rather than education and training. The deinstitutionalization movement began in the 1970s to move people with intellectual disabilities into the community. – Emergence of public education for students with intellectual disability In the early part of the twentieth century, schools were developed for students with intellectual disability although they were often isolated and segregated. Classes were generally available to students who were considered higher functioning and did not provide services for students with severe intellectual disability. Legislation and professional opinion has shifted toward less restrictive and more integrated educational placements for students with intellectual disability.

Prevalence of Intellectual Disabilities Over 431,000 students between the ages of 6-21 were identified as having intellectual disabilities during the school year. These students represent approximately 7% of all pupils with disabilities and less than 1% of the total school age population. The number of students identified as having intellectual disabilities has decreased over the years. Majority of those identified have mild intellectual disability 22

Etiology of Intellectual Disabilities Prenatal (before birth) – Chromosomal, metabolic and nutritional disorders, maternal infections, environmental factors, unknown influences Perinatal (during birth) – Gestational disorders, neonatal complications Postnatal (after birth) – Infections and intoxicants, environmental factors 23

24

Prevention of Intellectual Disabilities Prevention Levels: – Primary (before onset or occurrence) Prenatal care, genetic testing, ultrasound – Secondary (reduce risk factors) Newborn screening – Tertiary (interventions) Aimed at maximizing the quality of life for a person with a disability 25

Characteristics of Individuals With Intellectual Disabilities Learning Characteristics -attention -memory -academic performance -motivation -generalization -language development Social and Behavioral Characteristics -poor interpersonal skills -socially appropriate interactions -difficulty establishing and maintaining friendships 26

27

28

Educational Considerations Functional academics/functional curriculum Community-based instruction Standards-based instruction IEP teams must consider: student and family preferences, student’s age and years left in school, rate of learning, current and future settings, other skill needs 29

Effective Instructional Techniques – High expectations – Task analysis: A complex behavior or task is broken down and sequenced into steps – Cooperative learning: An instructional methods that places small groups of students together in order to jointly accomplish a common goal – Scaffolding: Support is given to a student learning a new task and the support is withdrawn as the student becomes more independent and no longer needs the support. – Inclusion strategies: Modify instruction, materials, and assessments, teach organizational skills, monitor progress of all students, collaborate with families 31

Services for Young Children With Intellectual Disabilities Early intervention can be defined as the services and supports rendered to children with disabilities or those who evidence risk factors, younger than age 3, and their families. Early intervention represents a consortium of services—not just educational assistance but also health care, social services, family supports, and other benefits. 32

Transition Into Adulthood Transition planning Independent living Employment – Sheltered workshop – Supported competitive employment – Job coach 33

Adults With Intellectual Disabilities Integration in all aspects of daily life with nondisabled peers Self-determination: decision-making capacity must be fostered Self-advocacy: encourage people with intellectual disabilities to advocate for their own wants and needs 34

Family Issues Families with a child with intellectual disabilities may experience a wide range of concerns and often rely on a support network made up of friends and family members in addition to parent organizations and professional groups. 35

Issues of Diversity Overrepresentation of minority students in special education programs Culturally biased assessment tools and practices Teacher expectations 36

Technology and Individuals With Intellectual Disabilities Computers Augmentative and alternative communication (AAC) systems Self-operated prompting devices for daily activities and life skills Content-area support  37

Trends, Issues, and Controversies Genetic testing Quality of life Attitudinal changes Technology and medical advances Inclusive education Increased self-advocacy and self-determination 38