1. Chapter 4 Children with Intellectual and Developmental Disabilities (IDD) © 2015. Cengage Learning. All rights reserved.

2. Brief History of IDD Early Pioneers: Itard, Seguin, Montessori What’s in a Name?? For many years, the term “mental retardation” was used. In 2007, the key organization in the field changed its name to the American Association on Intellectual and Developmental Disabilities to reflect the move to the use of “Intellectual and Developmental Disabilities” over “mental retardation” © 2015. Cengage Learning. All rights reserved.

3. Defining IDD Current definition of IDD (from AAIDD): “Intellectual disability is a disability characterized by significant limitations both in intellectual functioning and in adaptive behavior, which covers many everyday social and adaptive skills. This disability originates before the age of 18.” © 2015. Cengage Learning. All rights reserved.

4. Defining IDD 2 domains are assessed to diagnose IDD: Cognitive ability (as defined by significantly below average intelligence); typically measured by IQ tests such as the Wechler Adaptive Skills (limitations in the 3 adaptive skills groups: conceptual, social, and practical); instruments such as the Vineland Scales can be used to measure The emphasis on adaptive skills in defining IDD allows that some individuals of below average intelligence will not be classified if they function well in world. It also captures the lack of Theory of Mind that characterizes many with IDD. © 2015. Cengage Learning. All rights reserved.

5. Levels of IDD/Intensity of Support Old Model: based solely on IQ scores Mild, Moderate, Severe, and Profound © 2015. Cengage Learning. All rights reserved.

6. Levels of IDD/Intensity of Support New classification, based on the intensity of support a child needs (takes into account both cognitive abilities and adaptive skills): Intermittent refers to support as needed, but not necessarily present at all times. Limited refers to support provided on a regular basis for a short period of time. Extensive support indicates ongoing and regular involvement. The pervasive level of support describes constant high- intensity help provided across environments and involving more staff members than the other categories. © 2015. Cengage Learning. All rights reserved.

7. Prevalence of IDD In recent decades, the number of children classified as IDD has dropped from about 3% to about 1%. This is likely due to children once classified as IDD being defined as having other conditions. Minority children are disproportionately classified as having IDD. One possible explanation is that minority students are also more likely to live in poverty. We know that poverty is a risk factor for IDD. Therefore, an increase in early intervention and early childhood education programs could offset this disparity. © 2015. Cengage Learning. All rights reserved.

8. Genetic Factors and IDD Certain genetic mutations are linked to intellectual and developmental disorders. Some examples: Down Syndrome: Caused by an extra copy of chromosome 21. Causes mild to moderate cognitive impairment and certain physical features. Phenylketonura (PKU): a metabolic condition in which the liver doesn’t produce an important enzyme. Special diets can limit the loss of cognitive ability Fragile X Syndrome: caused by a mutation in the X chromosome; leads to cognitive impairments as well as social-emotional delays. © 2015. Cengage Learning. All rights reserved.

9. Toxic Agents and IDD Teratogens: substances that adversely affect fetal development; drugs, tobacco, and alcohol are well known examples Fetal Alcohol Syndrome (FAS) is one of the leading causes of IDD; children with FAS often suffer from hyperactivity, inattention, and impaired cognitive function Heavy metals such as lead can cause cognitive impairment if they build up to high levels in the body. Illness such as Rubella during pregnancy can harm the developing fetus and cause IDD. High fevers in children and adults can also result in damage to cognitive ability. © 2015. Cengage Learning. All rights reserved.

10. Environment and Experiences and IDD Advances in our understanding of the function of the brain have allowed us to understand that environment and experiences matter – “good” experiences can rewire the brain in positive ways, mitigating the effects of certain conditions. The earlier and more intense positive environmental factors are, the greater the impact they will have on outcomes for individuals with IDD. The right environment and experiences can improve both cognitive abilities and adaptive behaviors. Educators have an important role to play! © 2015. Cengage Learning. All rights reserved.

11. Information Processing Model © 2015. Cengage Learning. All rights reserved.

12. Characteristics of Children with IDD Children with IDD develop in similar patterns as typically- developing children, but at a slower pace. Language and cognition are closely linked making support for language development crucial to improved cognitive function. Support for the development of emotional and social skills is also key; children with IDD often struggle with understanding social cues or interacting in social situations. Explicit instruction in these skills and role-playing activities can help strengthen adaptive behaviors. © 2015. Cengage Learning. All rights reserved.

13. Identification of Children with IDD Students may be referred by anyone with concerns although often referrals for special education happen when the student is struggling academically or socially in school. A prereferral team works with the classroom teacher to develop strategies to address a struggling student’s needs in the general classroom; Tier II services may also be a part of the prereferral team’s recommendations. © 2015. Cengage Learning. All rights reserved.

14. Identification of Children with IDD If the student continues to struggle after these recommendations are implemented, he/she will be referred for testing. Eligible students will have an IEP created by a multidisciplinary team that outlines a more intense plan of support and intervention. © 2015. Cengage Learning. All rights reserved.

15. Educational Settings for Students with IDD Students at all levels of IDD benefit from the right environment and interventions. Most students with IDD will need supplements to the general education program to help them achieve their potential. About half of students with IDD spend 80% or more of their school day in a general education classroom. As students enter secondary school, the percentage of time students with IDD spend outside the general education classroom tends to increase. © 2015. Cengage Learning. All rights reserved.

16. Educational Settings for Students with IDD Note: The educational responses discussed in this chapter are aimed primarily at those students needing mild or moderate intensity support. Those needing the most intense supports are discussed in Chapter 13. All students have potential! © 2015. Cengage Learning. All rights reserved.

17. RtI Approaches for Students with IDD: Universal Tier I RtI Universal Tier I includes adaptations to the general classroom curriculum or environment to meet the needs of students with special needs. Universal Design for Learning (UDL) is one approach to modifying instruction in the general education classroom. © 2015. Cengage Learning. All rights reserved.

18. RtI Approaches for Students with IDD: Universal Tier I Inclusion is the practice of incorporating students with special needs into the general classroom environment. A team approach helps the general classroom teacher be successful in meeting the needs of all of her students in the inclusive classroom. IDEA 2004 expresses a preference for the use of inclusive classrooms for students with special needs. © 2015. Cengage Learning. All rights reserved.

19. RtI Approaches for Students with IDD: Targeted Tier II RtI Targeted Tier II interventions pull students from the regular classroom for short periods of time for special, intensive instruction in a variety of academic and adaptive skills areas. Learning environment alone is not an effective intervention. What happens in that learning environment matters! © 2015. Cengage Learning. All rights reserved.

20. RtI Approaches for Students with IDD: Targeted Tier II Students with IDD typically need more time and more direct instruction to make gains in academics and in adaptive skills than do their typically-developing peers. Tier II interventions can provide this direct, intense instruction. © 2015. Cengage Learning. All rights reserved.

21. RtI Approaches for Students with IDD: Intensive Tier III RtI Intensive Tier III provides more intensive interventions in a separate environment. Students receiving Tier III interventions may focus on skills different from those in general education classrooms. The current approach is to focus on a student’s relative strengths to develop more effective interventions. Some students with IDD may be unable to master the general education curriculum, particularly at the secondary level, but can still learn and build skills that will help them transition to adulthood. © 2015. Cengage Learning. All rights reserved.

22. What Curriculum for Students with IDD? What curriculum should a student with IDD be expected to master? The answer depends on the goals for that student and reasonable, immediate objectives towards those goals. Some students with IDD may receive a modified curriculum from the elementary years; others may be expected to master the general education curriculum up to a point with appropriate modifications and support. © 2015. Cengage Learning. All rights reserved.

23. What Curriculum for Students with IDD? CCSS and NCLB create a dilemma for educators – How best to master the conflicting directives to hold all students to the same rigorous standard while still meeting the particular needs of individual students? © 2015. Cengage Learning. All rights reserved.

24. Differentiation Differentiation (or tiered assignments) is the practice of adjusting the level of difficulty of a task to challenge all students appropriately. It is important that a teacher consider the strengths of all students in determining the type of task that is appropriate for each. Differentiated assignments should still allow all students to participate in the class in meaningful ways. Approaches such as UDL can be helpful in creating differentiated assignments. © 2015. Cengage Learning. All rights reserved.

25. Communication and Social Skills Communication skills often require direct instruction; learning to listen, discuss, and share experiences are all adaptive skills that students with IDD may struggle with. Social skills are another area in which direct instruction benefits students with IDD. Taking turns, sharing, and working cooperatively can also be taught through daily classroom activities. © 2015. Cengage Learning. All rights reserved.

26. Communication and Social Skills Role-playing is a valuable teaching tool for social skills. Peer-buddy systems, peer support networks, and circles of friends are all strategies that help students with IDD build positive relationships with peers and others in the community. © 2015. Cengage Learning. All rights reserved.

27. Instructional Strategies for Students with IDD Positive behavior interventions and supports (PBIS) addresses the motivations behind disruptive behavior and seeks to change a student’s environment in a way that prevents the negative behavior. Scaffolding is a teaching technique that uses modeling and gradually stepped down support to facilitate independence with a task. © 2015. Cengage Learning. All rights reserved.

28. Instructional Strategies for Students with IDD Reciprocal teaching is a strategy that asks students to take an active role in teaching material based on a teacher’s modeling. Cooperative learning emphasizes group instruction and peer interactions to facilitate learning instead of relying solely on one-on-one instruction. © 2015. Cengage Learning. All rights reserved.

29. Motivation and Self-Determination Students with IDD may struggle with motivation, perhaps from having met with failure in the past. Learned- helplessness can also cause a lack of motivation. Self-determination is the ability to set personal goals and to take appropriate action to achieve those goals. Making choices and problem solving are skills that improve self-determination and the ability of students to self- manage. Improved self-management skills lead to enhanced self- confidence, higher motivation, and improved adaptive skills. © 2015. Cengage Learning. All rights reserved.

30. Effectiveness of Interventions Duration and intensity of interventions are key!! Students often lose the gains made during an intervention if the special treatment is stopped. Research suggests that many students are not receiving adequate support through their IEP – most notably that IEPs are frequently “stock” instead of being crafted with the student’s individual needs and goals in mind. © 2015. Cengage Learning. All rights reserved.

31. Assistive Technology for Students with IDD Assistive technology helps students with disabilities gain access to the information needed for learning. Instructional technology is used to help the student learn that information. Technology is only useful if teachers and other educators have proper training in how to use it effectively to meet students’ needs. © 2015. Cengage Learning. All rights reserved.

32. Transition to Work and Community The ultimate goal of transition from school to community is for students with IDD to achieve independence as much as possible. This requires: Systematic planning over several years Careful attention to the development of essential skills Assistance in the transition process Ongoing support in adulthood © 2015. Cengage Learning. All rights reserved.

33. Transition to Work and Community Research suggests that individuals with IDD have lower rates of employment and independent living than do individuals with other disabilities. The right support throughout adulthood is crucial for individuals with IDD to achieve a good quality of life. © 2015. Cengage Learning. All rights reserved.