Intellectual Disabilities/Mental Retardation

1. Intellectual Disabilities/Mental Retardation In-service Presented by: Lyndsey Carlson, Nicole Fagg, Angela Reich, Kendra Heyer, and Monica Hernandez

2. Basic Concepts • Mental retardation (MR) 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. It is also defined as a level of functioning significantly below what is considered to be “average.” “The U.S. Department of Education (2006) reported that the percentage of children between the ages of six and seventeen served under the category of MR was 1.04percent” (Smith 212). Lyndsey

3. Basic Concepts Cont. • In 2006, the U.S. Department of Education reported the percentage of children between the ages 6 and 17 served under the category of MR was 1.04%. The range was significant across individual states, from 3.1% (West Virginia) to 0.37% (New Jersey). • The prevalence of MR in individuals of school-age tends to be higher than in adults. This is because of the challenges of formal education for school-age individuals, as well as, the relative lack of identification in adulthood. • The estimated prevalence of MR in the general population is 0.78% (Smith p.21).

4. Terminology • Intellectual disabilities (ID)- conveys a broad-based concept that places under it deficits in varied cognitive and adaptive ability areas. In turn, this term has received little acceptance internationally so the American Association on Mental Retardation has changed its name to reflect this newer and broader term… • Developmental disabilities- The term has become more popular mainly for reference to programs for adults and professional organizations, although it is used far less frequently in the schools. The problem is the mere rendering of the term, Developmental disabilities, which would exclude 40% of those people who might otherwise have been identified as mildly mentally retarded. • Mental Retardation (MR)- Professionals and parents have been hesitant to use the term MR to refer to young children for many years. The term is rarely used during the preschool years and in many states the term is deferred until children reach the age of nine.

5. Terminology • Developmental Delay (DD)- is recognized by the federal government as the preferred term for younger children through the age of 8. • Mild Retardation- A newer, broader term for developmental disabilities. However, the term presents as an oxymoron in that it may convey mild as insignificant. For instance, “a mild cold”. Many people avoid term Mild Retardation in fear of judging or labeling. • High-incidence disability- is the encouraged term to use, rather than, mild retardation. However, no term is without criticism.

6. History of Mental Retardation • Many positive changes have occurred in the treatment of individuals with mental retardation in the late twentieth century. • Movement away from restricted, sometimes abusive settings. • Positive shifts in public attitudes • Improved services and supports

7. Court Cases • Penry v. Lynaugh (1989) • Said that the death penalty for people with MR was not “cruel and unusual punishment”. • Used a competency evaluation during trial to diagnose Penry with MR. • Was overturned by Atkins v Virginia ruling • Atkins v. Virginia (2002) • Said that the death penalty was “cruel and unusual punishment” • Saved many people with MR from the death penalty. Monica

8. Basis for Diagnosis • AAIDD’s definitions are generally considered as the basis for diagnosis. • Three concepts are central to the AAIDD’s recent definitions: • Intellectual Functioning • Cognitive abilities • Operationally, performance of an IQ test • IQ alone is not a sufficient for a diagnosis • Adaptive Behavior or Skills • “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) • Developmental Period • Time period between conception and 18 years of age • Below-average intellectual functioning and disabilities in adaptive behavior must appear during this period Lyndsey

9. Contemporary 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 skills. (Luckasson et al., 2002) • This disability originates before age 18.

10. Classifications Deficit System Alternative Systems Mild Moderate Severe Profound retardation Summative judgments based on intelligence and adaptive behavior assessments • Educable and trainable • Educable Mentally Retarded (EMR) • Trainable Mentally Retarded (TMR) • Mild or Severe with NO IQ scores • AAIDD classification system of Luckasson and colleagues (1992,2002) - classification based on levels of support needed • “Supports are resources and strategies that aim to promote the development, education, interests, and personal well-being of a person and that enhance individual functioning” Kendra

11. AAIDD(American Association on Intellectual and Developmental Disabilities) 4 General Levels of Support Intermittent – support on an “as needed basis” by episodic or short-term nature; high or low intensity Limited – Consistent support over time; time-limited Extensive – Support that includes regular involvement in at least some environments and not time-limited Pervasive – Support that is constant, high intensity, life sustaining nature; involves more staff

12. Approximately 1% of school population is identified with Mental Retardation 50% had mild retardation 56% were male Race and Ethnicity 1.1% - Native Americans/Alaskans 1.8 % - Asian/Pacific Islanders 34.5% - African Americans 12.5 % - Hispanic 50.6% - European Americans Prevalence

13. Causes Down Syndrome – Trisomy 21 (3 pairs rather than 2) Environmental or Psychological Disadvantages Fetal Alcohol Syndrome – Caused by drinking during the pregnancy Fragile X Syndrome – Genetic disorder related to gene or X chromosome

14. Causes Cont. Hydrocephalus – Disruption in appropriate flow of cerebrospinal fluid on the brain Phenylketonuria – Autosomal recessive genetic disorder Prader-Willi Syndrome – Chromosomal error of the autosomal type Tay-Sachs – Autosomal recessive genetic disorder

15. Characteristics • Problems in attention are common • 10% of students with ADHD have a primary diagnosis of MR • student’s achievement is proportional to the expectations set by the teachers Monica

16. attention Span focus strategy production short term Memory applying knowledge to new tasks external locus of control outer directedness, symbolic though, delayed acquisition of vocabulary, social adjustment, self-esteem peer acceptance Problem Areas with MR

17. Identification, Assessment and Placement • Intellectual functioning and adaptive behavior are two key prongs for the eligibility and assessment process • 1950’s-1970’s students with MR were taught in a self-contained classroom • Inclusion was increased, however students with MR are less likely to be included in the classroom for most or all of the school day

18. Transition Considerations • Fewer than half of students with MR complete the designated academic curriculum • 25% graduated with a diploma • 17.6 received a certificate • “Floundering” is the transition period after leaving high school Nicole

19. Challenges of Adulthood • Employment/Education • General job skills • General education • Employment settings • Home and Family • Home management • Financial management • Leisure Pursuits • Indoor/outdoor activities

20. Essential Features for Transition • Transition efforts must start early • Decisions must balance what is ideal and possible • Active and meaningful student participation and family involvement • Supports are beneficial • Community-based instructional experiences • Transition planning is needed by all students

21. Strategies for Curriculum and Instruction • Four Primary Goals • Productive Employment • Build students career awareness and help them see how academic content relates to applied situations • Independence and Self-Sufficiency • Young adults need to become responsible for themselves. • One essential element of empowerment is self determination!

22. Strategies for Curriculum and Instruction • Four Primary Goals Cont. • Life Skills Competence • Focus on the importance of competence in everyday activities. • Use of community resources, home and family activities, social and interpersonal skills, health and safety skills, use of leisure time, and participation the community as a citizen. • Successful School and Community Involvement • Requires that students experience inclusive environments.

23. Classroom Adaptations • Inclusion is the program of choice for more students with MR • Adaptations for MR students: instructional delivery systems and response modes • EX: Testing adaptations for extended time • Specialized curriculum is less common in students with MR Angela

24. Classroom Adaptations • Focus on teaching and learning adaptations that: • Ensure attention • Teach ways to learn content while teaching content itself • Focus on meaningful content to the students that promote learning/application • Provide training that includes multiple learning and environmental contents • Opportunities for active involvement

25. Classroom Adaptations • Teachers need to focus on the learning process (not content alone.) • Strategy Training (acquire, retain and master relevant curriculum skills) • Curricular adaptations: focus on relevant and meaningful content that students can master and apply to their current and future lives • Learning, working, and residing • Assistive Technology: improve learning environments for each of the 4 stages of respective learning: • The acquisition of new skills • Development of fluency and proficiency • Maintenance of skills overtime • Generalization of skills (learned to other settings beyond school)

26. Promoting Inclusive Practices • Create a sense of community in the classroom as well as the school • For students to succeed, they should be welcomed, encourages, and involved • Key friendships create a “belonging place” in the general education classroom • Teachers can promote an environment in which the benefits of friendships can be realized.

27. Final Thoughts • Students with mental retardation require a comprehensive, broad-based curriculum. • Most effective programs will: • Provide appropriate academic instruction • Address social skills, life skills, and transition skills • Incorporate a “life” inclusion philosophy

28. Journal Articles • 1.  Mental Health Disorders among Individuals with Mental Retardation: Challenges to Accurate Prevalence Estimates • 2.  Public Conceptions of Mental Illness in 1950 and 1996: What Is Mental Illness and Is It to be Feared? • 3. Spinal Cord Compromise: An Important but Under diagnosed Condition in People with Mental Retardation

29. Resources • Cornell University Law School. Retrieved March 23, 2009, from Supreme Court Collection Web site: www.law.cornell.edu/supct/html/00-8452.ZS.html • the International Justice Project. Retrieved March 23, 2009, from Current Court Cases- Mental Retardation Web site: www.internationaljusticeproject.org/retardationCurCases.cfm • Smith, Tom Teaching Students with Special Needs in Inclusive Settings. • Journal Article 1: Kerker, B (2004).Mental Health Disorders among Individuals with Mental Retardation: Challenges to Accurate Prevalence Estimates . Public Health Reports . 119, 409-417. • Journal Article 2: Phelan, Jo C. (2000).Public Conceptions of Mental Illness in 1950 and 1996: What is Mental Illness an Is It to be Feared?. Journel of Health and Social Behavior. 41, 188-207. • Journal Article 3: Curtis, Rod (2004).Spinal Cord Compromise: An Important but Underdiagnosed Condition in People with Mental Retardation. Public Health Reports. 119, 396-400.