Introduction to Special Education: Making a Difference Seventh Edition

1. Chapter 13 Very Low Incidence Disabilities: Multiple-Severe Disabilities, Deaf-Blindness, and Traumatic Brain Injury Introduction to Special Education: Making a DifferenceSeventh Edition

2. Chapter Objectives • Explain the major characteristics of students with multiple-severe disabilities. • Describe the impact of deaf-blindness. • Discuss how cases of traumatic brain injury (TBI) can be prevented. • Explain alternate assessments and what they mean for students with low-incidence disabilities. • Provide a rationale for the community to be some students’ LRE and for the curriculum to be functional.

3. Historical Context • Helen Keller: probably the most famous person with deaf-blindness. • She was a woman of many accomplishments. • None would have been possible without teacher Anne Sullivan, a person with low vision who used Braille for reading. • Today many students with multiple disabilities receive FAPE in the most LRE available, learning in real-life settings.

4. Characteristics of Multiple-Severe Disabilities • Problems transferring or generalizing from one situation to another • Limited communication abilities • Difficulties with memory • Need for supports for many of life’s activities • Need for services from many related service providers

5. Prevalence • Only 0.20% of American students ages 6-21 have multiple disabilities. • Requirements for each state are different. • Some states do not include learning disabilities or hearing problems in this category. • All students are served in ways that meet their unique needs.

6. Causes Heredity Problems during pregnancy Problems at birth Incidents after birth Low birth weight Unknown factors Prevention Pre-pregnancy determination of risk factors Good prenatal care Access to health care Public awareness of prevention strategies Causes and Prevention

7. Multiple-Severe Disabilities Defined • IDEA ‘04 defines multiple-severe disabilities as a separate special education category. • The term developmental disabilities (used by the Centers for Disease Control) is often used interchangeably with multiple-severe disabilities. • Multiple-severe disabilities is defined as severe disabilities that combine intellectual and physical problems.

8. Deaf-Blindness Defined • Deaf-Blindness has been a separate special education category since 1969. • Many of these students have other disabilities besides their visual and hearing problems. • 21% have low vision. • 24% are legally blind. • The majority have some residual hearing and/or vision. • Almost half have enough residual vision to allow them to read enlarged print. • 7% of students attend general education classes. • Almost 30% receive their education in separate special education classes.

9. Characteristics of Deaf-Blindness • Students have restricted vision and hearing. • The degree and amount of vision and hearing loss is not uniform. • Each individual is affected differently. • At least 60% of students have physical disabilities in addition to this one. • Cognitive disabilities are a common problem. • Common problem areas include: • Feelings of isolation. • Communication. • Mobility.

10. Prevalence: The National Deaf-Blind Census reports 7,985 ages 6-21 identified (NCDB, 2008a). The U.S. Department of Education reported 1,413 the same year. The discrepancy is due to the reporting criterion. Causes Associated with the following factors: Pre-maturity. Heredity causes. Risk factors, including poverty and access to health care. Prevention Risk factors can be reduced with systematic national prevention programs. Prevalence, Causes, and Prevention

11. Before 1975, these students were served under the learning-disabilities category. In 1990, Congress added TBI to the special education list. It is estimated that every teacher will come into contact with a student with TBI. Medical advances since the 1960s are saving more children, but some end up needing special education. One million children annually experience head injury; over 30,000 result in lifelong disabilities. TBI: Is an acquired injury to the brain. Adversely affects educational performance. Refers to either open- or closed-head injuries. Does not include brain injuries at birth. Ranges from mild to severe. Can result in lifelong problems. Is not immediately recognized or diagnosed. Traumatic Brain Injury (TBI) Defined

12. Characteristics of TBI • TBI often includes these characteristics: • Seizures • Headaches • Hearing losses • Reduced stamina • Vision problems • Uneven abilities • Behavior problems and reduced self esteem • Sometimes, but not always, long-term disability

13. Prevalence: 23,864 students ages 6-21 were served for TBI (OSEP, 2008a). Causes: Car accidents Bicycle accidents Sports accidents Falls on the playground Child abuse (for children under 2) High-risk behaviors often cause TBI. Common sense prevention measures include: Wearing helmets. Not driving when intoxicated. Avoiding high-risk behaviors. Getting prompt medical attention and rehabilitation. Prevention education. Prevalence, Causesand Prevention

14. Educational Considerations for Students with Low Incidence Disabilities • Assessment • Most are identified before they reach kindergarten or first grade. • Participation in school’s accountability system: • Many have accommodations or modifications. • Others take alternate assessments. • Early Identification • Individuals have IFSPs. • Families receive assistance in helping to interact with child. • Pre-Referral • For students with TBI who are identified later, school personnel can play critical role to bringing important services. • Identification • Infant screening • TBI often goes unseen; school professionals can assist with identification.

15. Evaluation: Alternate Assessments - The “1-Percent Kids” • IDEA ‘04 requires that all students be included in the national accountability system. • A limited number of students with multiple disabilities may participate in alternate assessments based on alternate achievement standards. • The government allows states to receive credit for proficient scores on alternate assessments as long as the number included “does not exceed 1.0 percent of all students in the grades assessed (approximately 9 percent of students with disabilities)” (Briggs, 2005, p. 28). • Alternate Assessments may differ from standard assessments. • Format • Narrower range of topics or fewer objectives • Less complex questions, stated more simply

16. Early Intervention • High quality early intervention and preschool education can make an enormously positive outcome in terms of: • Number and intensity of supports needed as an adult. • Attainment of independence. • Level of community presence. • Quality of life. • Five outcomes for families participating in services: • Understand their child’s strengths, abilities, and special needs. • Know their rights and advocate effectively for their children. • Help their child develop and learn. • Have support systems. • Access desired services, programs, and activities in their community. (Bailey et al., 2008)

17. Teaching Students with Low Incidence Disabilities • Access to the General Education Curriculum • Many with very low incidence do not have access to the general education curriculum. • Students with TBI have highest access. • Reasons for low participation rates: • Students require more intensive, individualized instruction. • IEP goals focus on achieving adult independence. • Students participate in a functional curriculum. • Instructional Accommodations • Each student requires different forms of assistance. • Simple adjustments and modifications can allow students access. • Example: Students with TBI who spend only half a day at school benefit when the teacher structures the day so that important academic tasks happen during the morning.

18. Teaching Students with Low Incidence Disabilities • Data-based Practices • Functional curriculum • Instruction in natural settings • Has direct relationship to person’s daily needs • Not appropriate for every student with low incidence disabilities • Vocational and life skills instruction • Labor laws allow students to work after age 14.

19. Technology • Technology helps students: • Communicate more effectively. • Increase levels of independence. • Have greater mobility. • Control their environments. • Gain access to information. • Augmentative and alternative communication devices (AAC) • Communication boards • Speech synthesizers • Communication books • Sign language

20. Transition Through Adulthood • Students with low incidence disabilities leave school at age 21 instead of 18. • After school, many receive supported living arrangements and employment services. • As students get older, they receive more community-based instruction to foster learning from one setting to another. • A transition plan begins for students by the age of 16.

21. Collaboration • Students with low incidence disabilities and their families interface with many professionals from many disciplines. • Multidisciplinary teams should be brought together to orchestrate the needs of each student. • When this happens, overall results are more positive. • Intervener • Paraprofessionals that provide instruction and facilitate all aspects of learning for students with deaf-blindness

22. Families • Educators must focus on the family’s concerns, needs, capacity, and potential for providing support. • Key concepts in creating family support include having the family: • Be the primary unit of concern. • Remain active in the community. • Be assisted in gaining access to support systems. • Empowered to deal with the complexity of social service agencies. • Receive services which are sensitive to their cultural diversity.

23. What comprises an appropriate education? What comprises the least restrictive environment for students with low incidence disabilities? Challenge Questions