Developmental Disabilities: A Public Health School Issue

1. Developmental Disabilities: A Public Health School Issue

2. What are Developmental Disabilities (DD)? • Severe and chronic interference of a persons functionality which is attributable to a mental or physical impairment or a combination of mental and physical impairment. • Manifested before the person attains age 22 is likely to continue indefinitely

3. What are Developmental Disabilities (DD)? (Continued) • Results in substantial functional limitations in three or more of the following areas (self-care, receptive and expressive language, learning, mobility, self-direction, capacity for independent living, economic self-sufficiency) • Reflects the person's need for a combination and sequence of special, interdisciplinary, or generic care, treatment, or other services which are lifelong or extended duration and individually planned and coordinated. (Haring & McCormick, 1986)

4. How Prevalent are Developmental Disabilities? • About 17% of U.S. children under 18 years of age have a developmental disability. • Approximately 2% of school-aged children in the U.S. have a serious developmental disability

5. What are the Major Developmental Disabilities? • Autism • Mental Retardation • Cerebral Palsy • Seizure Disorder

6. Let’s Look at these Disabilities

7. What Characterizes Autism? • Autism is diagnosed if the person exhibits symptoms listed within each of three domains. These are • (1) Qualitative impairments in social interaction, • (2) Qualitative impairment in communication, and • (3) Restricted, repetitive, and stereotyped patterns of behaviors, activities, and interests

8. Is There an Autistic Gene? Duke University Margaret Pericak-Vance and her collaborators have found evidence of chromosomal defects that may be linked to autistic spectrum disorder

9. What is Mental Retardation? • Characterized both by a significantly below-average score on a test of mental ability or intelligence, and • By limitations in the ability to function in areas of daily life, such as communication, self-care, and getting along in social situations and school activities. • Mental retardation is sometimes referred to as a cognitive or intellectual disability. 

10. How Common is Mental Retardation? • Mental retardation is the most common developmental disorder • About 1% of children ages 3-10 years had mental retardation • 1.2 of every 100 10-year-old children had mental retardation. • Mild mental retardation was 3 times more common than severe mental retardation.

11. What Causes Mental Retardation? • Mental retardation can occur at anytime in the course of human development • It can be caused by a genetic abnormality, injury, disease, or deprivation • These causes can happen while in the whom, during the birthing process, or during childhood

12. Can Mental Retardation be Prevented? • We do not know how to prevent most conditions that cause mental retardation • There are some causes that can be prevented • Fetal alcohol syndrome (FAS) is one such cause • Some metabolic conditions, such as phenylketonuria (PKU).

13. How Can We Respond to PKU?

14. What is the Cost of Mental Retardation? During the 1995-1996 school year, about 600,000 U.S. 6- to 21-year-old children with mental retardation received special educational services, at a cost of about $3.3 billion. 

15. What is Cerebral Palsy? • Cerebral palsy is a disorder of movement or coordination caused by an abnormality of the brain • Almost 70% have other disabilities, primarily mental retardation

16. How Does the Law Protect School Age-Children?

17. What is the Lanterman Act? • Guarantees the right to services andsupports to help individuals diagnosed with developmental disabilities live an independent and productivelife.

18. What are the Rights Guaranteed Under the Lanterman Act? • Treatment and habilitation; • Dignity, privacy and humane care; • Participation in an appropriate program • Prompt medical care and treatment; • Religious freedom;

19. Lanterman Rights (Continued) • Social interaction and participation in community activities; • Physical exercise and recreation; • Freedom from harm; • Choices in your own life; • The opportunity to make decisions. § 4502.1

20. What are Regional Centers? • Non-profit corporate community agencies that provide services to people with developmental disabilities; • There are 21 regional centers in California; and • The main point of contact in your community between service management and the end-user.

21. Who is Eligible for Regional Center Services? • People with developmental disabilities; • People who are at high risk of giving birth to a child with a developmental disability; and • Infants who have a high risk of becoming developmentally disabled.

22. What is a "substantial disability?” • A condition that is severe enough to be a major impairment of cognitive and/or social functioning. • A condition that requires Interdisciplinary planning • A condition that requires Coordination of Services

23. What are the responsibilities of the regional center? • Search out and identify; • Provide intake and assessment; • Supply preventive services; and • Develop an Individual Program Plan (IPP).

24. What Happens After Becoming Eligible? • Within 60 days after the intake and assessment a written Individual Program Plan (IPP) must be developed: • It should focus on you and your family, where appropriate. • It should promote community integration; an independent, productive, and normal life; and • A stable and healthy environment.

25. Why is the IPP So Important? • It is a contract or agreement between the family of the consumer and the regional center; • It establishes what will be provided and what will not be provided; • It indicates who will provide the services; and • Who will pay for the services

26. How is the IPP Developed? • Gathering information and conducting assessments; and • Assessments may be formal or informal

27. What Must the Regional Center do to Make the IPP Work? • Getting the services and supports; • Providing advocacy; • Identifying and building circles of support; • Ensuring quality of services; and • Developing new services

28. What are the Entitlement Services and Supports? • Assessment services • Habilitation and training • Treatment and therapy • Preventive services • An array of different living arrangements • Community integration • Employment/Day programs

29. Entitlement Services and Supports (Continued) • Family support services • Relationship services and supports • Emergency and crisis intervention services • Specialized equipment • Transportation services • Facilitation/Self-Advocacy • Interpreter/translator services • Advocacy

30. The History of Special Needs Children • Prior 1975, approximately 1 million children with disabilities were shut out of schools • Hundreds of thousands more were denied appropriate services • Ninety percent of children with developmental disabilities were housed in state institutions.

31. Current Status of Special Needs Children • Three times the number of young people with disabilities are enrolled in colleges or universities as compared to prior to 1975, and • Twice as many of today's 20 year olds with disabilities are working.

32. The Unfulfilled Promises to Special Needs Children • Twice as many children with disabilities drop out of school. • Drop outs do not return to school, have difficulty finding jobs and often end up in the criminal justice system. • Girls who drop out often become young  unwed mothers—at a much higher rate than their non-disabled peers. • Many children with disabilities are excluded from the curriculum and assessments  

33. PL94-142 Education for All Handicapped Children (1975) • Assures that all handicapped children have available to them a free appropriate public education (FAPE) regardless of how, or how seriously, he may be handicapped • Mandates an individualized education program (IEP) for every student with a disability

34. PL 98-199 Education of the Handicapped Act Amendments (1983) • Allows for federal funding to create parent training and information centers (PIC) • Expands services for children from birth to age 3 and the initiatives for transition services from school to adult living for students with disabilities

35. PL 99-372 Handicapped Children's Protection Act (1986) • Allows parents or guardians to be reimbursed for reasonable legal costs if they WIN a hearing or court action. • Requires that the case and the costs of the legal proceedings should be discussed with the lawyer prior to any legal action

36. What IDEA Attempted To Do • Raise expectations for children with disabilities; • Increase parental involvement in the education of their children; • Ensure that regular education teachers are involved; • Include children with disabilities; • Support quality professional development.

37. IDEA Accomplishments • Full-inclusion has become the standard • Increased graduation rates • Increased employment • Greater college and University attendance • More support programs for education • Improved technology for all of us

38. IDEA’s Areas of Weakness • Eligibility and over representation of racial and ethnic minorities; • Funding of IDEA; • Monitoring and enforcement; and • Discipline

39. Overrepresentation of Minorities Under IDEA • Prevent special education placement • Intervene in general education • Increase regular educational staffing • Improve family centered services • Improved school support services • Increased funding for regular education

40. Monitoring and enforcement • Significant weaknesses exist in the current systems of monitoring and enforcement • More timely system focused on solid outcomes for students • More classroom time for teachers