Definition
Speech and language disorders refer to problems in communication and related areas such as oral motor function. These delays and disorders range from simple sound substitutions to the inability to understand or use language or use the oral-motor mechanism for functional speech and feeding. Some causes of speech and language disorders include hearing loss, neurological disorders, brain injury, mental retardation, drug abuse, physical impairments such as cleft lip or palate, and vocal abuse or misuse. Frequently, however, the cause is unknown.
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Incidence
More than one million of the students served in the public schools’ special education programs in the 2000-2001 school year were categorized as having a speech or language impairment. This estimate does not include children who have speech/language problems secondary to other conditions such as deafness. Language disorders may be related to other disabilities such as mental retardation, autism, or cerebral palsy. It is estimated that communication disorders (including speech, language, and hearing disorders) affect one of every 10 people in the United States.
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Characteristics
A child's communication is considered delayed when the child is noticeably behind his or her peers in the acquisition of speech and/or language skills. Sometimes a child will have greater receptive (understanding) than expressive (speaking) language skills, but this is not always the case.
Speech disorders refer to difficulties producing speech sounds or problems with voice quality. They might be characterized by an interruption in the flow or rhythm of speech, such as stuttering, which is called dysfluency. Speech disorders may be problems with the way sounds are formed, called articulation or phonological disorders, or they may be difficulties with the pitch, volume or quality of the voice. There may be a combination of several problems. People with speech disorders have trouble using some speech sounds, which can also be a symptom of a delay. They may say "see" when they mean "ski" or they may have trouble using other sounds like "l" or "r." Listeners may have trouble understanding what someone with a speech disorder is trying to say. People with voice disorders may have trouble with the way their voices sound.
A language disorder is an impairment in the ability to understand and/or use words in context, both verbally and nonverbally. Some characteristics of language disorders include improper use of words and their meanings, inability to express ideas, inappropriate grammatical patterns, reduced vocabulary and inability to follow directions. One or a combination of these characteristics may occur in children who are affected by language learning disabilities or developmental language delay. Children may hear or see a word but not be able to understand its meaning. They may have trouble getting others to understand what they are trying to communicate.
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Educational Implications
Because all communication disorders carry the potential to isolate individuals from their social and educational surroundings, it is essential to find appropriate timely intervention. While many speech and language patterns can be called "baby talk" and are part of a young child's normal development, they can become problems if they are not outgrown as expected. In this way an initial delay in speech and language or an initial speech pattern can become a disorder which can cause difficulties in learning. Because of the way the brain develops, it is easier to learn language and communication skills before the age of 5. When children have muscular disorders, hearing problems or developmental delays, their acquisition of speech, language and related skills is often affected.
Speech-language pathologists assist children who have communication disorders in various ways. They provide individual therapy for the child; consult with the child’s teacher about the most effective ways to facilitate the child’s communication in the class setting; and work closely with the family to develop goals and techniques for effective therapy in class and at home. The speech-language pathologist may assist vocational teachers and counselors in establishing communication goals related to the work experiences of students and suggest strategies that are effective for the important transition from school to employment and adult life.
Technology can help children whose physical conditions make communication difficult. The use of electronic communication systems allow nonspeaking people and people with severe physical disabilities to engage in the give and take of shared thought.
Vocabulary and concept growth continues during the years children are in school. Reading and writing are taught and, as students get older, the understanding and use of language becomes more complex. Communication skills are at the heart of the education experience. Speech and/or language therapy may continue throughout a student’s school years either in the form of direct therapy or on a consultant basis.
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Resources
Charkins, H. (1996). Children with facial differences: A parents' guide. Bethesda, MD: Woodbine House. (Telephone: 800.843.7323. Web: www.woodbinehouse.com)
Cleft Palate Foundation. (1997). For parents of newborn babies with cleft lip/cleft palate. Chapel Hill, NC: Author. (Telephone: 800.242.5338. Also available online at: www.cleftline.org)
Gruman-Trinker, C. (2001). Your cleft-affected child: The complete book of information, resources and hope. Alameda, CA: Hunter House. (Web: www.hunterhouse.com)
Hamaguchi, P. M. (2001). Childhood speech, language, & listening problems: What every parent should know (2nd ed.). New York: John Wiley & Sons, Inc. (Telephone: 800.225.5945. Web: www.wiley.com)
http://www.nichcy.org/pubs/factshe/fs11txt.htm
Tuesday, August 12, 2008
MOTOR/ORTHOPEDIC IMPAIRMENTS
Introduction
Motor impaired/orthopedic disabilities includes a heterogeneous grouping of conditions with a wide range of causes. Examples of some of the more common causes are: Nervous system disorders Traumatic spinal cord injury Stroke Muscular Dystrophy Cerebral Palsy Epilepsy Muscular-skeletal disorders Rheumatoid arthritis Cardiovascular disease Coronary heart disease Respiratory Disorders Emphysema Asthma Endocrine-metabolic Diabetes Amputation of all types.
One of the first considerations in the effective science education of individuals with motor/orthopedic impairments is a brief understanding of his/her impairment and the degree of educational limitation it causes. With such information, a set of mitigative strategies can be derived that are fully appropriate to that particular student, however, some of the strategies may not work for every student. (After "Mainstream Teaching of Science: A Source Book", Keller et al.)
General Courtesy
* Accept the fact that a disability exists. Not acknowledging this fact is not acknowledging the person.
* Ask the student to tell you when he/she anticipates a need for assistance.
* Don't lean on a student's wheelchair. The chair is a part of the body space of the student who uses it.
* Don't patronize students who use wheelchairs by patting them on the head. This is a sign of affection that should be reserved only for small children, and most of them do not like it either.
* Encourage students who use crutches or canes to keep them within easy reach and make such a space available.
* Only push a wheelchair when asked.
* Have custodians use non-skid floor polish for students who use crutches and wheelchairs.
* If spills occur, keep floors clear of liquids.
* If writing is difficult, use a tape recorder.
* Speak directly to the student with a disability, confidentially, as you would other students.
* Students should be encouraged to talk confidentially with their instructors during the first week of classes to discuss their functional difficulties and needs, and to talk about ways to accommodate.
* Using a wheelchair when the person can walk with the aid of cane(s), brace(s), crutch(es), or a walker does not mean a student is "feigning" the degree of disability. It may be a means to conserve energy or move about more quickly.
* When it appears that a student needs help, ask if you can help. Accept a "no thank you" graciously.
* When talking to a student who uses a wheelchair for more than a few minutes, or so, sit down or kneel to place yourself at that student's eye level.
* Reserve parking space that is accessible and close to the building.
* Allow course waiver or course substitution for certain students.
* Always plan any field trip in advance to ensure accessibility.
* Words like "walking" or "running" are appropriate. Sensitivity to these words is not necessary. Students who use wheelchairs use the same words.
General Strategies
* Bring to the student's attention Science Role Models with Disabilities with a similar disability to that of the student. Point out that this individual got ahead by a combination of effort and by asking for help when needed.
* If the functional limitation involves the lack of arm use then the use of Dragon-Dictate may be extremely useful. It may be used for such things as computer aided drafting and design(CADD) and other computer applications.
* Arrange for library personnel to assist access to card catalouges, bookshelves, and microfiche and other equipments.
* Consider accessibility factor to classroom so that student is able to get to class on time.
* Be familiar with the building's emergency evacuation plan to assure that it is manageable for the students.
Teacher Presentation
* If breaks between classes are short (10 minutes or less), the student who has a mobility impairment may frequently be a few minutes late. Students and instructors may want to plan for these occasions, so students don't miss important material.
* Observe potential obstacles so you can be aware of what is accessible and what is not accessible to students in wheelchairs.
* Students may need to tape lectures (difficulty with writing or unable to write).
* Table-type desks, with adequate leg space, which have enough clearance for wheelchairs can be moved into classrooms.
Laboratory
Adaptations such as: latching devices, keylocks, headmaster, and light talkers that simplify access to computers can greatly help the motor/orthopedic science student.
1. Consider alternate activities/exercises that can be utilized with less difficulty for the student, but has the same or similar learning objectives.
2. Allow more time for the student to complete the lab activities.
3. Alter the height of tables to "fit" the students (e.g., a small ramp to a flat platform for high desks).
4. Anticipate areas of difficulty in access and involve the student with disability in doing the same. Together, work out alternate procedures while trying not to disengage the student from the activity.
5. Assign a lab partner who can help to reach or manipulate objects as needed.
6. Be aware of, and prevent the possible overheating of students who have poor heat regulation.
7. Have students in wheelchairs participate in activities as fully as possible.
8. Built-in lab tables (or small ramp/platforms) may need to be modified to accommodate wheelchairs.
9. For students who cannot fully use a computer because of physical limitations in their hands or arms, explore avenues for obtaining adaptive access software, altered keyboards (including Unicorn keyboards), special switches (latching devices, keylocks), and Power Pads, eye-controlled input systems, or touch-screens in conjunction with a light talker, trackballs, footmice, and other special equipment.
10. If appropriate, provide assistance, but also provide positive reinforcement when the student shows the ability to do something unaided.
11. If breaks between classes are short (10 minutes or less), the student who has a mobility impairment may frequently be a few minutes late. Students and instructors may want to plan for these occasions, so students don't miss important aspects of the activity.
12. In the laboratory, place water, gas, and electric facilities in accessible locations.
13. Increase size of wheels, dials, handles, and buttons on lab equipment.
14. Lower supplies and equipment for easier access, or simply give them to the student as needed.
15. Perhaps a change in aisles (by relocating desks and/or chairs) is needed for wheelchair access.
16. For hoods in laboratories, have operating knobs and switches within easy access.
17. Provide an accessible means for the recording of data, charts, or graphs.
18. Select non-manual types of laboratory teaching techniques (e.g., electronic probes vs. pipette bulbs).
19. Table-type desks, which are high enough for wheelchairs can be moved into labs.
20. Use a peer-buddy system.
21. Use electric hot plates instead of Bunsen burners as heat sources.
22. Use laboratory sinks that are accessible from 3 sides for those with one side or those who are paralyzed.
23. Use low-force electric micro switches for lights and equipment.
24. Use modified lids on the tops of containers (wider and bigger).
25. Use a portable eye wash.
26. When information gathering involves a physical action that the student cannot perform, try using a different type of experience that will yield the same information.
Group Interaction and Discussion
* Include student in open discussions.
* Allow more time for the student to complete activities.
* Use ramps and raised platforms for student's access.
* Lower chalkboard and/or corkboard.
Reading
* Acknowledge understanding by blinking, nodding, or a pointer.
* Use a tape recorder.
* Use small sections of large text or readings.
* Use easels, portable reading racks, a standing table, and adjustable seats and desks.
* Allow more time for the student to complete the activities.
Field Experiences
* Anticipate areas of difficulty and involve the student with a disability in doing the same. Together, and in the planning stage, work out alternate procedures while trying not to disengage the student from the activity.
* Consider alternate activities/exercises that can be utilized with less difficulty for the student, but has the same or similar learning objectives.
* Be sure students in wheelchairs can fully participate in activities.
* When the activity involves field work or field trips, many of the students using a wheelchair will probably need other travel arrangements because they often need to rely on attendants, ramp adapted vans for transportation, or power lift vans for transportation to and from field activities.
* In the field, provide assistance, but also provide positive reinforcement when the student shows the ability to do something unaided.
* Increase size of wheels, dials, handles, and buttons on field equipment.
* Use a peer-buddy system.
* Use modified lids on the tops of containers (wide, bigger, and easier to open).
* When information gathering involves a physical action that the physically impaired student cannot perform, try a different experience yielding the same information.
* Make special advance arrangements with curators during passive visiting field trips.
* Make sure that field activity sites are accessible. Check the following:
o Are there nearby parking spaces reserved for persons with disabilities?
o Is there a ramp or a step-free entrance?
o Are there accessible rest rooms?
o If the site is not on the ground floor, does the building have an elevator?
o Are water fountains and telephones low enough for a student in a wheelchair?
o Arrange with curators of museums, science centers, etc. for alternate activities if it is not possible to have the student in a wheelchair do the activities.
o Discuss any needs, problems, or alternatives with the student.
Research
* Review and discuss with the student the steps involved in a research activity. Think about which step(s) may be difficult for the specific functional limitations of the student and jointly devise accommodations for that student.
* Depending on the site of the research check the previous two sections.
* Use appropriate laboratory and field strategies.
Testing
* Allow more time for the student to complete the activities.
* Provide a seperate place for the test if necessary.
* Give completely oral tests or completely written tests, whichever is more appropriate to the students needs.
* Allow students to tape record answers to tests or type answers, as needed.
* Writers should be provided for test-taking if the student is unable to write (or give oral tests out of the earshot of other students).
* Students may write slowly and need extended time for tests.
* Develop a portfolio of the student's work, both singly and as part of a cooperating group. Orally quiz him/her to establish the extent to which the student contributed to the group-based accomplishments.
http://www.as.wvu.edu/~scidis/motor.html#sect0
Motor impaired/orthopedic disabilities includes a heterogeneous grouping of conditions with a wide range of causes. Examples of some of the more common causes are: Nervous system disorders Traumatic spinal cord injury Stroke Muscular Dystrophy Cerebral Palsy Epilepsy Muscular-skeletal disorders Rheumatoid arthritis Cardiovascular disease Coronary heart disease Respiratory Disorders Emphysema Asthma Endocrine-metabolic Diabetes Amputation of all types.
One of the first considerations in the effective science education of individuals with motor/orthopedic impairments is a brief understanding of his/her impairment and the degree of educational limitation it causes. With such information, a set of mitigative strategies can be derived that are fully appropriate to that particular student, however, some of the strategies may not work for every student. (After "Mainstream Teaching of Science: A Source Book", Keller et al.)
General Courtesy
* Accept the fact that a disability exists. Not acknowledging this fact is not acknowledging the person.
* Ask the student to tell you when he/she anticipates a need for assistance.
* Don't lean on a student's wheelchair. The chair is a part of the body space of the student who uses it.
* Don't patronize students who use wheelchairs by patting them on the head. This is a sign of affection that should be reserved only for small children, and most of them do not like it either.
* Encourage students who use crutches or canes to keep them within easy reach and make such a space available.
* Only push a wheelchair when asked.
* Have custodians use non-skid floor polish for students who use crutches and wheelchairs.
* If spills occur, keep floors clear of liquids.
* If writing is difficult, use a tape recorder.
* Speak directly to the student with a disability, confidentially, as you would other students.
* Students should be encouraged to talk confidentially with their instructors during the first week of classes to discuss their functional difficulties and needs, and to talk about ways to accommodate.
* Using a wheelchair when the person can walk with the aid of cane(s), brace(s), crutch(es), or a walker does not mean a student is "feigning" the degree of disability. It may be a means to conserve energy or move about more quickly.
* When it appears that a student needs help, ask if you can help. Accept a "no thank you" graciously.
* When talking to a student who uses a wheelchair for more than a few minutes, or so, sit down or kneel to place yourself at that student's eye level.
* Reserve parking space that is accessible and close to the building.
* Allow course waiver or course substitution for certain students.
* Always plan any field trip in advance to ensure accessibility.
* Words like "walking" or "running" are appropriate. Sensitivity to these words is not necessary. Students who use wheelchairs use the same words.
General Strategies
* Bring to the student's attention Science Role Models with Disabilities with a similar disability to that of the student. Point out that this individual got ahead by a combination of effort and by asking for help when needed.
* If the functional limitation involves the lack of arm use then the use of Dragon-Dictate may be extremely useful. It may be used for such things as computer aided drafting and design(CADD) and other computer applications.
* Arrange for library personnel to assist access to card catalouges, bookshelves, and microfiche and other equipments.
* Consider accessibility factor to classroom so that student is able to get to class on time.
* Be familiar with the building's emergency evacuation plan to assure that it is manageable for the students.
Teacher Presentation
* If breaks between classes are short (10 minutes or less), the student who has a mobility impairment may frequently be a few minutes late. Students and instructors may want to plan for these occasions, so students don't miss important material.
* Observe potential obstacles so you can be aware of what is accessible and what is not accessible to students in wheelchairs.
* Students may need to tape lectures (difficulty with writing or unable to write).
* Table-type desks, with adequate leg space, which have enough clearance for wheelchairs can be moved into classrooms.
Laboratory
Adaptations such as: latching devices, keylocks, headmaster, and light talkers that simplify access to computers can greatly help the motor/orthopedic science student.
1. Consider alternate activities/exercises that can be utilized with less difficulty for the student, but has the same or similar learning objectives.
2. Allow more time for the student to complete the lab activities.
3. Alter the height of tables to "fit" the students (e.g., a small ramp to a flat platform for high desks).
4. Anticipate areas of difficulty in access and involve the student with disability in doing the same. Together, work out alternate procedures while trying not to disengage the student from the activity.
5. Assign a lab partner who can help to reach or manipulate objects as needed.
6. Be aware of, and prevent the possible overheating of students who have poor heat regulation.
7. Have students in wheelchairs participate in activities as fully as possible.
8. Built-in lab tables (or small ramp/platforms) may need to be modified to accommodate wheelchairs.
9. For students who cannot fully use a computer because of physical limitations in their hands or arms, explore avenues for obtaining adaptive access software, altered keyboards (including Unicorn keyboards), special switches (latching devices, keylocks), and Power Pads, eye-controlled input systems, or touch-screens in conjunction with a light talker, trackballs, footmice, and other special equipment.
10. If appropriate, provide assistance, but also provide positive reinforcement when the student shows the ability to do something unaided.
11. If breaks between classes are short (10 minutes or less), the student who has a mobility impairment may frequently be a few minutes late. Students and instructors may want to plan for these occasions, so students don't miss important aspects of the activity.
12. In the laboratory, place water, gas, and electric facilities in accessible locations.
13. Increase size of wheels, dials, handles, and buttons on lab equipment.
14. Lower supplies and equipment for easier access, or simply give them to the student as needed.
15. Perhaps a change in aisles (by relocating desks and/or chairs) is needed for wheelchair access.
16. For hoods in laboratories, have operating knobs and switches within easy access.
17. Provide an accessible means for the recording of data, charts, or graphs.
18. Select non-manual types of laboratory teaching techniques (e.g., electronic probes vs. pipette bulbs).
19. Table-type desks, which are high enough for wheelchairs can be moved into labs.
20. Use a peer-buddy system.
21. Use electric hot plates instead of Bunsen burners as heat sources.
22. Use laboratory sinks that are accessible from 3 sides for those with one side or those who are paralyzed.
23. Use low-force electric micro switches for lights and equipment.
24. Use modified lids on the tops of containers (wider and bigger).
25. Use a portable eye wash.
26. When information gathering involves a physical action that the student cannot perform, try using a different type of experience that will yield the same information.
Group Interaction and Discussion
* Include student in open discussions.
* Allow more time for the student to complete activities.
* Use ramps and raised platforms for student's access.
* Lower chalkboard and/or corkboard.
Reading
* Acknowledge understanding by blinking, nodding, or a pointer.
* Use a tape recorder.
* Use small sections of large text or readings.
* Use easels, portable reading racks, a standing table, and adjustable seats and desks.
* Allow more time for the student to complete the activities.
Field Experiences
* Anticipate areas of difficulty and involve the student with a disability in doing the same. Together, and in the planning stage, work out alternate procedures while trying not to disengage the student from the activity.
* Consider alternate activities/exercises that can be utilized with less difficulty for the student, but has the same or similar learning objectives.
* Be sure students in wheelchairs can fully participate in activities.
* When the activity involves field work or field trips, many of the students using a wheelchair will probably need other travel arrangements because they often need to rely on attendants, ramp adapted vans for transportation, or power lift vans for transportation to and from field activities.
* In the field, provide assistance, but also provide positive reinforcement when the student shows the ability to do something unaided.
* Increase size of wheels, dials, handles, and buttons on field equipment.
* Use a peer-buddy system.
* Use modified lids on the tops of containers (wide, bigger, and easier to open).
* When information gathering involves a physical action that the physically impaired student cannot perform, try a different experience yielding the same information.
* Make special advance arrangements with curators during passive visiting field trips.
* Make sure that field activity sites are accessible. Check the following:
o Are there nearby parking spaces reserved for persons with disabilities?
o Is there a ramp or a step-free entrance?
o Are there accessible rest rooms?
o If the site is not on the ground floor, does the building have an elevator?
o Are water fountains and telephones low enough for a student in a wheelchair?
o Arrange with curators of museums, science centers, etc. for alternate activities if it is not possible to have the student in a wheelchair do the activities.
o Discuss any needs, problems, or alternatives with the student.
Research
* Review and discuss with the student the steps involved in a research activity. Think about which step(s) may be difficult for the specific functional limitations of the student and jointly devise accommodations for that student.
* Depending on the site of the research check the previous two sections.
* Use appropriate laboratory and field strategies.
Testing
* Allow more time for the student to complete the activities.
* Provide a seperate place for the test if necessary.
* Give completely oral tests or completely written tests, whichever is more appropriate to the students needs.
* Allow students to tape record answers to tests or type answers, as needed.
* Writers should be provided for test-taking if the student is unable to write (or give oral tests out of the earshot of other students).
* Students may write slowly and need extended time for tests.
* Develop a portfolio of the student's work, both singly and as part of a cooperating group. Orally quiz him/her to establish the extent to which the student contributed to the group-based accomplishments.
http://www.as.wvu.edu/~scidis/motor.html#sect0
Monday, August 11, 2008
Emotional Disturbance
Definition
Many terms are used to describe emotional, behavioral or mental disorders. Currently, students with such disorders are categorized as having an emotional disturbance, which is defined under the Individuals with Disabilities Education Act as follows:
"...a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child's educational performance--
(A) An inability to learn that cannot be explained by intellectual, sensory, or health factors.
(B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.
(C) Inappropriate types of behavior or feelings under normal circumstances.
(D) A general pervasive mood of unhappiness or depression.
(E) A tendency to develop physical symptoms or fears associated with personal or school problems." [Code of Federal Regulations, Title 34, Section 300.7(c)(4)(i)]
As defined by the IDEA, emotional disturbance includes schizophrenia but does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance. [Code of Federal Regulation, Title 34, Section 300.7(c)(4)(ii)]
Incidence
In the 2000-2001 school year, 473,663 children and youth with an emotional disturbance were provided special education and related services in the public schools (Twenty-fourth Annual Report to Congress, U.S. Department of Education, 2002).
Characteristics
The causes of emotional disturbance have not been adequately determined. Although various factors such as heredity, brain disorder, diet, stress, and family functioning have been suggested as possible causes, research has not shown any of these factors to be the direct cause of behavior or emotional problems. Some of the characteristics and behaviors seen in children who have emotional disturbances include:
• Hyperactivity (short attention span, impulsiveness)
• Aggression/self-injurious behavior (acting out, fighting)
• Withdrawal (failure to initiate interaction with others; retreat from exchanges of social interaction, excessive fear or anxiety)
• Immaturity (inappropriate crying, temper tantrums, poor coping skills)
• Learning difficulties (academically performing below grade level).
Children with the most serious emotional disturbances may exhibit distorted thinking, excessive anxiety, bizarre motor acts, and abnormal mood swings. Some are identified as children who have a severe psychosis or schizophrenia.
Many children who do not have emotional disturbances may display some of these same behaviors at various times during their development. However, when children have an emotional disturbance, these behaviors continue over long periods of time. Their behavior thus signals that they are not coping with their environment or peers.
Educational Implications
The educational programs for children with an emotional disturbance need to include attention to providing emotional and behavioral support as well as helping them to master academics, develop social skills, and increase self-awareness, self-control, and self-esteem. A large body of research exists regarding methods of providing students with positive behavioral support (PBS) in the school environment, so that problem behaviors are minimized and positive, appropriate behaviors are fostered. (See the resource list at the end of this publication for more information on PBS.) It is also important to know that, within the school setting:
• For a child whose behavior impedes learning (including the learning of others), the team developing the child’s Individualized Education Program (IEP) needs to consider, if appropriate, strategies to address that behavior, including positive behavioral interventions, strategies, and supports.
• Students eligible for special education services under the category of emotional disturbance may have IEPs that include psychological or counseling services. These are important related services which are available under law and are to be provided by a qualified social worker, psychologist, guidance counselor, or other qualified personnel.
• Career education (both vocational and academic) is also a major part of secondary education and should be a part of the transition plan included in every adolescent’s IEP.
There is growing recognition that families, as well as their children, need support, respite care, intensive case management, and a collaborative, multi-agency approach to services. Many communities are working toward providing these wrap-around services. There are a growing number of agencies and organizations actively involved in establishing support services in the community.
http://specialchildren.about.com/od/mentalhealthissues/a/ED.htm
Many terms are used to describe emotional, behavioral or mental disorders. Currently, students with such disorders are categorized as having an emotional disturbance, which is defined under the Individuals with Disabilities Education Act as follows:
"...a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child's educational performance--
(A) An inability to learn that cannot be explained by intellectual, sensory, or health factors.
(B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.
(C) Inappropriate types of behavior or feelings under normal circumstances.
(D) A general pervasive mood of unhappiness or depression.
(E) A tendency to develop physical symptoms or fears associated with personal or school problems." [Code of Federal Regulations, Title 34, Section 300.7(c)(4)(i)]
As defined by the IDEA, emotional disturbance includes schizophrenia but does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance. [Code of Federal Regulation, Title 34, Section 300.7(c)(4)(ii)]
Incidence
In the 2000-2001 school year, 473,663 children and youth with an emotional disturbance were provided special education and related services in the public schools (Twenty-fourth Annual Report to Congress, U.S. Department of Education, 2002).
Characteristics
The causes of emotional disturbance have not been adequately determined. Although various factors such as heredity, brain disorder, diet, stress, and family functioning have been suggested as possible causes, research has not shown any of these factors to be the direct cause of behavior or emotional problems. Some of the characteristics and behaviors seen in children who have emotional disturbances include:
• Hyperactivity (short attention span, impulsiveness)
• Aggression/self-injurious behavior (acting out, fighting)
• Withdrawal (failure to initiate interaction with others; retreat from exchanges of social interaction, excessive fear or anxiety)
• Immaturity (inappropriate crying, temper tantrums, poor coping skills)
• Learning difficulties (academically performing below grade level).
Children with the most serious emotional disturbances may exhibit distorted thinking, excessive anxiety, bizarre motor acts, and abnormal mood swings. Some are identified as children who have a severe psychosis or schizophrenia.
Many children who do not have emotional disturbances may display some of these same behaviors at various times during their development. However, when children have an emotional disturbance, these behaviors continue over long periods of time. Their behavior thus signals that they are not coping with their environment or peers.
Educational Implications
The educational programs for children with an emotional disturbance need to include attention to providing emotional and behavioral support as well as helping them to master academics, develop social skills, and increase self-awareness, self-control, and self-esteem. A large body of research exists regarding methods of providing students with positive behavioral support (PBS) in the school environment, so that problem behaviors are minimized and positive, appropriate behaviors are fostered. (See the resource list at the end of this publication for more information on PBS.) It is also important to know that, within the school setting:
• For a child whose behavior impedes learning (including the learning of others), the team developing the child’s Individualized Education Program (IEP) needs to consider, if appropriate, strategies to address that behavior, including positive behavioral interventions, strategies, and supports.
• Students eligible for special education services under the category of emotional disturbance may have IEPs that include psychological or counseling services. These are important related services which are available under law and are to be provided by a qualified social worker, psychologist, guidance counselor, or other qualified personnel.
• Career education (both vocational and academic) is also a major part of secondary education and should be a part of the transition plan included in every adolescent’s IEP.
There is growing recognition that families, as well as their children, need support, respite care, intensive case management, and a collaborative, multi-agency approach to services. Many communities are working toward providing these wrap-around services. There are a growing number of agencies and organizations actively involved in establishing support services in the community.
http://specialchildren.about.com/od/mentalhealthissues/a/ED.htm
Developmental Delay
What is developmental delay?
Developmental Delay is when your child does not reach their developmental milestones at the expected times. It is an ongoing, major delay in the process of development. If your child is slightly or only temporarily lagging behind, that is not called developmental delay. Delay can occur in one or many areas—for example, motor, language, social, or thinking skills.
Developmental Delay is usually a diagnosis made by a doctor based on strict guidelines. Usually, though, the parent is the first to notice that their child is not progressing at the same rate as other children the same age. If you think your child may be “slow,” or “seems behind,” talk with your child's doctor about it. In some cases, your general pediatrician might pick up a delay during an office visit. It will probably take several visits and possibly a referral to a developmental specialist to be sure that the delay is not just a temporary lag. Special testing can also help gauge your child's developmental level.
The first three years of a child's life are an amazing time of development...and what happens during those years stays with a child for a lifetime. That's why it's so important to watch for signs of delays in development, and to get help if you suspect problems. The sooner a delayed child gets early intervention, the better their progress will be.
What causes developmental delay?
Developmental delay can have many different causes, such as genetic causes (like Down syndrome), or complications of pregnancy and birth (like prematurity or infections). Often, however, the specific cause is unknown. Some causes can be easily reversed if caught early enough, such as hearing loss from chronic ear infections, or lead poisoning.
What should I do if I suspect my child has developmental delay?
If you think your child may be delayed, you should take them to their primary care provider, or to a developmental and behavioral pediatrician or pediatric neurologist. An alternative to seeing a specialist is to work through your local school system (see below). If your child seems to be losing ground—in other words, starts to not be able to do things they could do in the past—you should have them seen right away. If your child is developmentally delayed, the sooner you get a diagnosis, the sooner you can begin appropriate treatment and the better the progress your child can make.
If you are concerned about your child's development, check out First Signs, a website with information and resources for early identification and intervention for children with developmental delays and disorders. Explore the many resources for parents available on the site.
What can the school system do for my child?
Ask your school system in writing for an evaluation of your child, even if your child is a baby, toddler or preschooler. They are required to provide it, at no cost to you. The purpose of an evaluation is to find out why your child is not meeting their developmental milestones or not doing well in school. A team of professionals will work with you to evaluate your child. If they do not find a problem, you can ask the school system to pay for an Independent Educational Evaluation (IEE). There are strict rules about this, so you may not get it. You can also have your child tested again privately, and pay for it yourself. But check with your school district first to make sure they will accept the private test results. By law, the school system must consider the results of the second evaluation when deciding if your child can get special services.
* Tips for your child's developmental assessment, from Zero to Three, is a guide for parents who are concerned about their baby's, toddler's or preschooler's development and learning. It will help you prepare for an evaluation, and know what to expect.
* Basics for Parents: Your Child's Evaluation explains what parents of school-aged kids need to know about the evaluation process.
If testing shows your child has developmental delay, the school system will start your child in either an early intervention or a special education program, depending on your child's age.
What is early intervention?
Every state has an early intervention program that you will want to get your child into right away. If you live in Michigan, your doctor may refer you to the Early On Program in your local school district. (Outside Michigan, you can find your state's early intervention services through the NICHCY website.) Early On (and all states' early intervention programs) offer many different services and will help set up an individualized program for your family. It is called an Individual Family Service Plan (IFSB).
* Find out all about finding help for babies, toddlers, and preschoolers. ["Finding Help for Young Children with Disabilities (Birth-5)"]. You can get this information in plain text, PDF, or in Spanish.
It is most important to start treatment as early as possible, and make sure it involves lots of one-on-one interaction with your child.
What is special education?
Special education means “educational programming designed specifically for the individual.” It can really help your child do better in school. If your school-aged child qualifies for special education, they will have an Individualized Education Program ( IEP) designed just for them.
* Here is a helpful overview of the special education process.
* Find out all about the process on this comprehensive page from the US Department of Education. You can also download the information in Word or PDF format.
* Find out how to help create a useful IEP for your child.
* Help your child take part in making their own IEP with these two resources from NICHCY: A Student’s Guide to the IEP and Helping Students Develop Their IEP.
What happens as my child grows up and eventually becomes an adult?
Transition planning is planning to get your child ready to lead a rewarding life as an adult. As your child gets closer to adulthood, they will need an IEP transition plan. Transition planning begins at age 14. It is part of the IEP every year after that. At age 16, planning will begin for how your child will transition from school into the community. The goal is for your child to become as independent as possible. Your child should take part in the planning, because their input will help make the plan more successful. For a thorough discussion (37 pages when printed) of the transition plan, see Transition Services in the IEP, from NICHCY.
* The National Center on Secondary Education and Transition (NCSET) coordinates national resources, offers technical assistance, and provides information on secondary education and transition for youth with disabilities. Their website provides a wealth of further information.
What do I need to know about the laws that have to do with early intervention and special education? What are our rights?
* Know your rights, as a parent, in the special education process.
* Questions and Answers about IDEA (the Individuals with Disabilities Education Act). This is also available in PDF, and Spanish.
* Internet Legal Resources about Special Education and Disabilities –from the University of Virginia.
http://www.med.umich.edu/1Libr/yourchild/devdel.htm
Developmental Delay is when your child does not reach their developmental milestones at the expected times. It is an ongoing, major delay in the process of development. If your child is slightly or only temporarily lagging behind, that is not called developmental delay. Delay can occur in one or many areas—for example, motor, language, social, or thinking skills.
Developmental Delay is usually a diagnosis made by a doctor based on strict guidelines. Usually, though, the parent is the first to notice that their child is not progressing at the same rate as other children the same age. If you think your child may be “slow,” or “seems behind,” talk with your child's doctor about it. In some cases, your general pediatrician might pick up a delay during an office visit. It will probably take several visits and possibly a referral to a developmental specialist to be sure that the delay is not just a temporary lag. Special testing can also help gauge your child's developmental level.
The first three years of a child's life are an amazing time of development...and what happens during those years stays with a child for a lifetime. That's why it's so important to watch for signs of delays in development, and to get help if you suspect problems. The sooner a delayed child gets early intervention, the better their progress will be.
What causes developmental delay?
Developmental delay can have many different causes, such as genetic causes (like Down syndrome), or complications of pregnancy and birth (like prematurity or infections). Often, however, the specific cause is unknown. Some causes can be easily reversed if caught early enough, such as hearing loss from chronic ear infections, or lead poisoning.
What should I do if I suspect my child has developmental delay?
If you think your child may be delayed, you should take them to their primary care provider, or to a developmental and behavioral pediatrician or pediatric neurologist. An alternative to seeing a specialist is to work through your local school system (see below). If your child seems to be losing ground—in other words, starts to not be able to do things they could do in the past—you should have them seen right away. If your child is developmentally delayed, the sooner you get a diagnosis, the sooner you can begin appropriate treatment and the better the progress your child can make.
If you are concerned about your child's development, check out First Signs, a website with information and resources for early identification and intervention for children with developmental delays and disorders. Explore the many resources for parents available on the site.
What can the school system do for my child?
Ask your school system in writing for an evaluation of your child, even if your child is a baby, toddler or preschooler. They are required to provide it, at no cost to you. The purpose of an evaluation is to find out why your child is not meeting their developmental milestones or not doing well in school. A team of professionals will work with you to evaluate your child. If they do not find a problem, you can ask the school system to pay for an Independent Educational Evaluation (IEE). There are strict rules about this, so you may not get it. You can also have your child tested again privately, and pay for it yourself. But check with your school district first to make sure they will accept the private test results. By law, the school system must consider the results of the second evaluation when deciding if your child can get special services.
* Tips for your child's developmental assessment, from Zero to Three, is a guide for parents who are concerned about their baby's, toddler's or preschooler's development and learning. It will help you prepare for an evaluation, and know what to expect.
* Basics for Parents: Your Child's Evaluation explains what parents of school-aged kids need to know about the evaluation process.
If testing shows your child has developmental delay, the school system will start your child in either an early intervention or a special education program, depending on your child's age.
What is early intervention?
Every state has an early intervention program that you will want to get your child into right away. If you live in Michigan, your doctor may refer you to the Early On Program in your local school district. (Outside Michigan, you can find your state's early intervention services through the NICHCY website.) Early On (and all states' early intervention programs) offer many different services and will help set up an individualized program for your family. It is called an Individual Family Service Plan (IFSB).
* Find out all about finding help for babies, toddlers, and preschoolers. ["Finding Help for Young Children with Disabilities (Birth-5)"]. You can get this information in plain text, PDF, or in Spanish.
It is most important to start treatment as early as possible, and make sure it involves lots of one-on-one interaction with your child.
What is special education?
Special education means “educational programming designed specifically for the individual.” It can really help your child do better in school. If your school-aged child qualifies for special education, they will have an Individualized Education Program ( IEP) designed just for them.
* Here is a helpful overview of the special education process.
* Find out all about the process on this comprehensive page from the US Department of Education. You can also download the information in Word or PDF format.
* Find out how to help create a useful IEP for your child.
* Help your child take part in making their own IEP with these two resources from NICHCY: A Student’s Guide to the IEP and Helping Students Develop Their IEP.
What happens as my child grows up and eventually becomes an adult?
Transition planning is planning to get your child ready to lead a rewarding life as an adult. As your child gets closer to adulthood, they will need an IEP transition plan. Transition planning begins at age 14. It is part of the IEP every year after that. At age 16, planning will begin for how your child will transition from school into the community. The goal is for your child to become as independent as possible. Your child should take part in the planning, because their input will help make the plan more successful. For a thorough discussion (37 pages when printed) of the transition plan, see Transition Services in the IEP, from NICHCY.
* The National Center on Secondary Education and Transition (NCSET) coordinates national resources, offers technical assistance, and provides information on secondary education and transition for youth with disabilities. Their website provides a wealth of further information.
What do I need to know about the laws that have to do with early intervention and special education? What are our rights?
* Know your rights, as a parent, in the special education process.
* Questions and Answers about IDEA (the Individuals with Disabilities Education Act). This is also available in PDF, and Spanish.
* Internet Legal Resources about Special Education and Disabilities –from the University of Virginia.
http://www.med.umich.edu/1Libr/yourchild/devdel.htm
Mild Intellectual Disability, MID/ Mild Mental Retardation
What Is Mild Intellectual Disability (MID) also Referred to as Mild Mental Retardation?
Many of the characteristics of MID correspond to those of Learning Disabilities. The intellectual development will be slow, however, MID students have the potential to learn within the regular classroom given appropriate modifications and/or accommodations. Some MID students will require greater support and/or withdrawal than others will. MID students, like all students demonstrate their own strengths and weaknesses. Depending on the educational jurisdiction, criteria for MID will often state that the child is functioning approximately 2-4 years behind or 2-3 standard deviations below the norm or have an IQ under 70-75. The intellectual disability may vary from mild to profound.
How are MID Students Identified?
Depending on the education jurisdiction, testing for MID will vary. Generally, a combination of assessment methods are used to identify mild intellectual disabilities. Methods may or may not include IQ scores or percentiles, adaptive skills cognitive tests in various areas, skills-based assessments, and levels of academic achievement. Some jurisdictions will not use the term MID but will use mild mental retardation.
Academic Implications
Students with MID may demonstrate some, all or a combination of the following characteristics:
* 2-4 years behind in cognitive development which could include math, language, short attention spans, memory difficulties and delays in speech development.
* Social Relationships are often impacted. The MID child may exhibit behavior problems, be immature, display some obsessive/compulsive behaviors and lack the understanding of verbal/non verbal clues and will often have difficulty following rules and routines.
* Adaptive Skill Implications. (Everyday skills for functioning) requiredThese children may be clumsy, use simple language with short sentences, have minimal organization skills and will need reminder about hygiene - washing hands, brushing teeth etc.
* Weak Confidence is often demonstrated by MID students. These students are easily frustrated and require opportunities to improve self esteem. Lots of support will be needed to ensure they try new things and take risks in learning.
* Concrete to Abstract thought is often missing or significantly delayed. This includes the lacking ability to understand the difference between figurative and literal language.
Best Practices
* Use simple, short, uncomplicated sentences to ensure maximum understanding.
* Repeat instructions or directions and ask the student if further clarification is necessary.
* Keep distractions and transitions to a minimum.
* Teach specific skills whenever necessary.
* Provide an encouraging, supportive learning environment that will capitalize on student success and self esteem.
* Use appropropriate program interventions in all areas where necessary to maximize success.
* Use alternative instructional strategies and alternative assessment methods.
* Help the MID student develop appropriate social skills to support friend and peer relationships.
* Teach organizational skills.
* Use behavior contracts and reinforce positive behavior if necessary.
* Ensure that your routines and rules are consistent. Keep conversations as normal as possible to maximize inclusion with peers. Teach the difference between literal/figurative language.
*
Be patient! Assist with coping strategies.
http://specialed.about.com/od/handlingallbehaviortypes/a/MID.htm
Many of the characteristics of MID correspond to those of Learning Disabilities. The intellectual development will be slow, however, MID students have the potential to learn within the regular classroom given appropriate modifications and/or accommodations. Some MID students will require greater support and/or withdrawal than others will. MID students, like all students demonstrate their own strengths and weaknesses. Depending on the educational jurisdiction, criteria for MID will often state that the child is functioning approximately 2-4 years behind or 2-3 standard deviations below the norm or have an IQ under 70-75. The intellectual disability may vary from mild to profound.
How are MID Students Identified?
Depending on the education jurisdiction, testing for MID will vary. Generally, a combination of assessment methods are used to identify mild intellectual disabilities. Methods may or may not include IQ scores or percentiles, adaptive skills cognitive tests in various areas, skills-based assessments, and levels of academic achievement. Some jurisdictions will not use the term MID but will use mild mental retardation.
Academic Implications
Students with MID may demonstrate some, all or a combination of the following characteristics:
* 2-4 years behind in cognitive development which could include math, language, short attention spans, memory difficulties and delays in speech development.
* Social Relationships are often impacted. The MID child may exhibit behavior problems, be immature, display some obsessive/compulsive behaviors and lack the understanding of verbal/non verbal clues and will often have difficulty following rules and routines.
* Adaptive Skill Implications. (Everyday skills for functioning) requiredThese children may be clumsy, use simple language with short sentences, have minimal organization skills and will need reminder about hygiene - washing hands, brushing teeth etc.
* Weak Confidence is often demonstrated by MID students. These students are easily frustrated and require opportunities to improve self esteem. Lots of support will be needed to ensure they try new things and take risks in learning.
* Concrete to Abstract thought is often missing or significantly delayed. This includes the lacking ability to understand the difference between figurative and literal language.
Best Practices
* Use simple, short, uncomplicated sentences to ensure maximum understanding.
* Repeat instructions or directions and ask the student if further clarification is necessary.
* Keep distractions and transitions to a minimum.
* Teach specific skills whenever necessary.
* Provide an encouraging, supportive learning environment that will capitalize on student success and self esteem.
* Use appropropriate program interventions in all areas where necessary to maximize success.
* Use alternative instructional strategies and alternative assessment methods.
* Help the MID student develop appropriate social skills to support friend and peer relationships.
* Teach organizational skills.
* Use behavior contracts and reinforce positive behavior if necessary.
* Ensure that your routines and rules are consistent. Keep conversations as normal as possible to maximize inclusion with peers. Teach the difference between literal/figurative language.
*
Be patient! Assist with coping strategies.
http://specialed.about.com/od/handlingallbehaviortypes/a/MID.htm
Deafness and Hearing Loss
A student/child with deafness or hard-of-hearing disabilities has deficitis in language and speech development because due to a diminished or lack of auditory response to sound. Students will demonstrate varying degrees of hearing loss which often results in difficulty acquiring spoken language. When you have a child with hearing loss/deafness in your classroom, you need to be careful not to assume that this student has other developmental or intellectual, delays. Typically, many of these students have average or better than average intelligence.
Characteristics Found in the Classroom:
* Difficulty following verbal directions
* Difficulty with oral expression
* Some difficulties with social/emotional or interpersonal skills
* Will often have a degree of language delay
* Often follows and rarely leads
* Will usually exhibit some form of articulation difficulty
* Can become easily frustrated if their needs are not met which will lead to some behavioral difficulties
* Sometimes the use of hearing aids leads to embarassment and fear of rejection from peers
What Can You Do?
* Many students with hearing disabilities will have some form of specialized equipment recommended by the audiologist - help the child to feel comfortable with his/her device and promote understanding and acceptance with other children in the class
* Remember that devices DO NOT return the child's hearing to normal
* Noisy enviroments will cause grief to the child with a hearing device and noise around the child should be kept to a minimum
* Check the device often to ensure it is working
* When using videos - make sure you get the 'closed captioned' type
* Shut classroom doors/windows to help eliminate noise
* Cushion chair bottoms
* Use visual approaches whenever possible
* Establish predictable routines for this child
* Provide older students with visual outlines/graphic organizers and clarification
* Use a home/school communication book
* Enunciate words clearly using lip movement to assist the child to lip read
* Keep close proximity to the student
* Provide small group work when possible
* Make assessment accommodations to enable a clear picture of demonstrated academic growth
* Provide visual materials and demos whenever possible.
Language will be the priority area for students who are deaf or hard of hearing. It is the basic requirement for success in all subject areas and will influence the student’s comprehension in your classroom. Language development and its impact on the learning of students who are deaf or hard of hearing can be complex and difficult to attain. You may find that students will need interpreters, note-takers, or educational assistants to facilitate communication. This process will usually require external personnel involement.
http://specialed.about.com/od/disabilities/a/deaf.htm
Characteristics Found in the Classroom:
* Difficulty following verbal directions
* Difficulty with oral expression
* Some difficulties with social/emotional or interpersonal skills
* Will often have a degree of language delay
* Often follows and rarely leads
* Will usually exhibit some form of articulation difficulty
* Can become easily frustrated if their needs are not met which will lead to some behavioral difficulties
* Sometimes the use of hearing aids leads to embarassment and fear of rejection from peers
What Can You Do?
* Many students with hearing disabilities will have some form of specialized equipment recommended by the audiologist - help the child to feel comfortable with his/her device and promote understanding and acceptance with other children in the class
* Remember that devices DO NOT return the child's hearing to normal
* Noisy enviroments will cause grief to the child with a hearing device and noise around the child should be kept to a minimum
* Check the device often to ensure it is working
* When using videos - make sure you get the 'closed captioned' type
* Shut classroom doors/windows to help eliminate noise
* Cushion chair bottoms
* Use visual approaches whenever possible
* Establish predictable routines for this child
* Provide older students with visual outlines/graphic organizers and clarification
* Use a home/school communication book
* Enunciate words clearly using lip movement to assist the child to lip read
* Keep close proximity to the student
* Provide small group work when possible
* Make assessment accommodations to enable a clear picture of demonstrated academic growth
* Provide visual materials and demos whenever possible.
Language will be the priority area for students who are deaf or hard of hearing. It is the basic requirement for success in all subject areas and will influence the student’s comprehension in your classroom. Language development and its impact on the learning of students who are deaf or hard of hearing can be complex and difficult to attain. You may find that students will need interpreters, note-takers, or educational assistants to facilitate communication. This process will usually require external personnel involement.
http://specialed.about.com/od/disabilities/a/deaf.htm
Autism
Autism is a developmental disorder that appears in the first 3 years of life, and affects the brain's normal development of social and communication skills.
Causes
Autism is a physical condition linked to abnormal biology and chemistry in the brain. The exact causes of these abnormalities remain unknown, but this is a very active area of research. There are probably a combination of factors that lead to autism.
Genetic factors seem to be important. For example, identical twins are much more likely than fraternal twins or siblings to both have autism. Similarly, language abnormalities are more common in relatives of autistic children. Chromosomal abnormalities and other nervous system (neurological) problems are also more common in families with autism.
A number of other possible causes have been suspected, but not proven. They involve:
* Diet
* Digestive tract changes
* Mercury poisoning
* The body's inability to properly use vitamins and minerals
* Vaccine sensitivity
The exact number of children with autism is not known. A report released by the U.S. Centers for Disease Control and Prevention (CDC) suggests that autism and related disorders are more common than previously thought, although it is unclear if this is due to an increasing rate of the illness or an increased ability to diagnose the illness.
Autism affects boys 3 - 4 times more often than girls. Family income, education, and lifestyle do not seem to affect the risk of autism.
Some parents have heard that the MMR vaccine that children receive may cause autism. This theory was based, in part, on two facts. First, the incidence of autism has increased steadily since around the same time the MMR vaccine was introduced. Second, children with the regressive form of autism (a type of autism that develops after a period of normal development) tend to start to show symptoms around the time the MMR vaccine is given. This is likely a coincidence due to the age of children at the time they receive this vaccine.
Several major studies have found NO connection between the vaccine and autism. The American Academy of Pediatrics and the Center for Disease Control and Prevention report that there is no proven link between autism and the MMR vaccine, or any other vaccine.
Some doctors believe the increased incidence in autism is due to newer definitions of autism. The term "autism" now includes a wider spectrum of children. For example, a child who is diagnosed with high-functioning autism today may have been thought to simply be odd or strange 30 years ago.
Other pervasive developmental disorders include:
* Asperger syndrome (like autism, but with normal language development)
* Rett syndrome (very different from autism, and only occurs in females)
* Childhood disintegrative disorder (rare condition where a child learns skills, then loses them by age 10)
* Pervasive developmental disorder - not otherwise specified (PDD-NOS), also called atypical autism.
Back to TopSymptoms
Most parents of autistic children suspect that something is wrong by the time the child is 18 months old and seek help by the time the child is 2. Children with autism typically have difficulties in:
* Pretend play
* Social interactions
* Verbal and nonverbal communication
Some children with autism appear normal before age 1 or 2 and then suddenly "regress" and lose language or social skills they had previously gained. This is called the regressive type of autism.
People with autism may:
* Be overly sensitive in sight, hearing, touch, smell, or taste (for example, they may refuse to wear "itchy" clothes and become distressed if they are forced to wear the clothes)
* Have unusual distress when routines are changed
* Perform repeated body movements
* Show unusual attachments to objects
The symptoms may vary from moderate to severe.
Communication:
* Cannot start or maintain a social conversation
* Communicates with gestures instead of words
* Develops language slowly or not at all
* Does not adjust gaze to look at objects that others are looking at
* Does not refer to self correctly (for example, says "you want water" when the child means "I want water")
* Does not point to direct others' attention to objects (occurs in the first 14 months of life)
* Repeats words or memorized passages, such as commercials
* Uses nonsense rhyming
Social interaction:
* Does not make friends
* Does not play interactive games
* Is withdrawn
* May not respond to eye contact or smiles, or may avoid eye contact
* May treat others as if they are objects
* Prefers to spend time alone, rather than with others
* Shows a lack of empathy
Response to sensory information:
* Does not startle at loud noises
* Has heightened or low senses of sight, hearing, touch, smell, or taste
* May find normal noises painful and hold hands over ears
* May withdraw from physical contact because it is overstimulating or overwhelming
* Rubs surfaces, mouths or licks objects
* Seems to have a heightened or low response to pain
Play:
* Doesn't imitate the actions of others
* Prefers solitary or ritualistic play
* Shows little pretend or imaginative play
Behaviors:
* "Acts up" with intense tantrums
* Gets stuck on a single topic or task (perseveration)
* Has a short attention span
* Has very narrow interests
* Is overactive or very passive
* Shows aggression to others or self
* Shows a strong need for sameness
* Uses repetitive body movements
Back to TopExams and Tests
All children should have routine developmental exams by their pediatrician. Further testing may be needed if there is concern on the part of the doctor or parents. This is particularly true whenever a child fails to meet any of the following language milestones:
* Babbling by 12 months
* Gesturing (pointing, waving bye-bye) by 12 months
* Single words by 16 months
* Two-word spontaneous phrases by 24 months (not just echoing)
* Loss of any language or social skills at any age.
These children might receive a hearing evaluation, a blood lead test, and a screening test for autism (such as the Checklist for Autism in Toddlers (CHAT) or the Autism Screening Questionnaire).
A health care provider experienced in the diagnosis and treatment of autism is usually necessary for the actual diagnosis. Because there is no biological test for autism, the diagnosis will often be based on very specific criteria laid out in a book called the Diagnostic and Statistical Manual IV.
An evaluation of autism will often include a complete physical and nervous system (neurologic) examination. It may also include a specific screening tool, such as:
* Autism Diagnostic Interview - Revised (ADI-R)
* Autism Diagnostic Observation Schedule (ADOS)
* Childhood Autism rating Scale (CARS)
* Gilliam Autism Rating Scale
* Pervasive Developmental Disorders Screening Test - Stage 3
Children with known or suspected autism will often have genetic testing (looking for chromosome abnormalities) and perhaps metabolic testing.
Autism encompasses a broad spectrum of symptoms. Therefore, a single, brief evaluation cannot predict a child's true abilities. Ideally, a team of different specialists will evaluate the child. They might evaluate:
* Communication
* Language
* Motor skills
* Speech
* Success at school
* Thinking abilities
Sometimes people are reluctant to have a child diagnosed because of concerns about labeling the child. However, failure to get a diagnosis can lead to failure to get the treatment and services the child needs.
Back to TopTreatment
An early, intensive, appropriate treatment program will greatly improve the outlook for most young children with autism. Most programs will build on the interests of the child in a highly structured schedule of constructive activities. Visual aids are often helpful.
Treatment is most successful when geared toward the child's particular needs. An experienced specialist or team should design the program for the individual child. A variety of therapies are available, including:
* Applied behavior analysis (ABA)
* Medications
* Occupational therapy
* Physical therapy
* Speech-language therapy
Sensory integration and vision therapy are also common, but there is little research supporting their effectiveness. The best treatment plan may use a combination of techniques.
APPLIED BEHAVIORAL ANALYSIS (ABA)
This program is for younger children with an autism spectrum disorder. It can be effective in some cases. ABA uses a one-on-one teaching approach that reinforces the practice of various skills. The goal is to get the child close to normal developmental functioning.
ABA programs are usually conducted within a child's home, under the supervision of a behavioral psychologist. Unfortunately, these programs can be very expensive and have not been widely adopted by school systems. Parents often must seek funding and staffing from other sources, which can be hard to find in many communities.
TEACCH
Another program is called the Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH). TEACCH, developed as a statewide program in North Carolina, uses picture schedules and other visual cues. These help the child work independently and organize and structure their environments.
Though TEACCH tries to improve a child's adaptation and skills, it also accepts the problems associated with autism spectrum disorders. Unlike ABA programs, TEACCH programs do not expect children to achieve typical development with treatment.
MEDICINE
Medicines are often used to treat behavior or emotional problems that people with autism may have, including:
* Aggression
* Anxiety
* Attention problems
* Extreme compulsions that the child find impossible to stop
* Hyperactivity
* Impulsiveness
* Irritability
* Mood swings
* Outbursts
* Sleep difficulty
* Tantrums
Currently, only risperidone is approved for the treatment of children ages 5 - 16 with irritability and aggression associated with autism. There is no medicine that treats the underlying problem of autism.
DIET
Some children with autism appear to respond to a gluten-free or casein-free diet. Gluten is found in foods containing wheat, rye, and barley. Casein is found in milk, cheese, and other dairy products. Not all experts agree that dietary changes will make a difference, and not all reports studying this method have shown positive results.
If you are considering these or other dietary changes, talk to both a doctor who specializes in the digestive system (gastroenterologist) and a registered dietitian. You want to be sure that the child is still receiving enough calories, nutrients, and a balanced diet.
OTHER APPROACHES
Beware that there are widely publicized treatments for autism that do not have scientific support, and reports of "miracle cures" that do not live up to expectations. If your child has autism, it may be helpful to talk with other parents of children with autism and autism specialists, and follow the progress of research in this area, which is rapidly developing.
At one time, there was enormous excitement about using secretin infusions. Now, after many studies have been conducted in many laboratories, it's possible that secretin is not effective after all, but research is ongoing.
Back to TopSupport Groups
For organizations that can provide additional information and help on autism, see autism resources.
Back to TopOutlook (Prognosis)
Autism remains a challenging condition for children and their families, but the outlook today is much better than it was a generation ago. At that time, most people with autism were placed in institutions.
Today, with the right therapy, many of the symptoms of autism can be improved, though most people will have some symptoms throughout their lives. Most people with autism are able to live with their families or in the community.
The outlook depends on the severity of the autism and the level of therapy the person receives.
Back to TopPossible Complications
Autism can be associated with other disorders that affect the brain, such as:
* Fragile X syndrome
* Mental retardation
* Tuberous sclerosis
Some people with autism will develop seizures.
The stresses of dealing with autism can lead to social and emotional complications for family and caregivers, as well as the person with autism.
Back to TopWhen to Contact a Medical Professional
Parents usually suspect that there is a developmental problem long before a diagnosis is made. Call your health care provider with any concerns about autism or if you think that your child is not developing normally.
http://health.nytimes.com/health/guides/disease/autism/overview.html
Causes
Autism is a physical condition linked to abnormal biology and chemistry in the brain. The exact causes of these abnormalities remain unknown, but this is a very active area of research. There are probably a combination of factors that lead to autism.
Genetic factors seem to be important. For example, identical twins are much more likely than fraternal twins or siblings to both have autism. Similarly, language abnormalities are more common in relatives of autistic children. Chromosomal abnormalities and other nervous system (neurological) problems are also more common in families with autism.
A number of other possible causes have been suspected, but not proven. They involve:
* Diet
* Digestive tract changes
* Mercury poisoning
* The body's inability to properly use vitamins and minerals
* Vaccine sensitivity
The exact number of children with autism is not known. A report released by the U.S. Centers for Disease Control and Prevention (CDC) suggests that autism and related disorders are more common than previously thought, although it is unclear if this is due to an increasing rate of the illness or an increased ability to diagnose the illness.
Autism affects boys 3 - 4 times more often than girls. Family income, education, and lifestyle do not seem to affect the risk of autism.
Some parents have heard that the MMR vaccine that children receive may cause autism. This theory was based, in part, on two facts. First, the incidence of autism has increased steadily since around the same time the MMR vaccine was introduced. Second, children with the regressive form of autism (a type of autism that develops after a period of normal development) tend to start to show symptoms around the time the MMR vaccine is given. This is likely a coincidence due to the age of children at the time they receive this vaccine.
Several major studies have found NO connection between the vaccine and autism. The American Academy of Pediatrics and the Center for Disease Control and Prevention report that there is no proven link between autism and the MMR vaccine, or any other vaccine.
Some doctors believe the increased incidence in autism is due to newer definitions of autism. The term "autism" now includes a wider spectrum of children. For example, a child who is diagnosed with high-functioning autism today may have been thought to simply be odd or strange 30 years ago.
Other pervasive developmental disorders include:
* Asperger syndrome (like autism, but with normal language development)
* Rett syndrome (very different from autism, and only occurs in females)
* Childhood disintegrative disorder (rare condition where a child learns skills, then loses them by age 10)
* Pervasive developmental disorder - not otherwise specified (PDD-NOS), also called atypical autism.
Back to TopSymptoms
Most parents of autistic children suspect that something is wrong by the time the child is 18 months old and seek help by the time the child is 2. Children with autism typically have difficulties in:
* Pretend play
* Social interactions
* Verbal and nonverbal communication
Some children with autism appear normal before age 1 or 2 and then suddenly "regress" and lose language or social skills they had previously gained. This is called the regressive type of autism.
People with autism may:
* Be overly sensitive in sight, hearing, touch, smell, or taste (for example, they may refuse to wear "itchy" clothes and become distressed if they are forced to wear the clothes)
* Have unusual distress when routines are changed
* Perform repeated body movements
* Show unusual attachments to objects
The symptoms may vary from moderate to severe.
Communication:
* Cannot start or maintain a social conversation
* Communicates with gestures instead of words
* Develops language slowly or not at all
* Does not adjust gaze to look at objects that others are looking at
* Does not refer to self correctly (for example, says "you want water" when the child means "I want water")
* Does not point to direct others' attention to objects (occurs in the first 14 months of life)
* Repeats words or memorized passages, such as commercials
* Uses nonsense rhyming
Social interaction:
* Does not make friends
* Does not play interactive games
* Is withdrawn
* May not respond to eye contact or smiles, or may avoid eye contact
* May treat others as if they are objects
* Prefers to spend time alone, rather than with others
* Shows a lack of empathy
Response to sensory information:
* Does not startle at loud noises
* Has heightened or low senses of sight, hearing, touch, smell, or taste
* May find normal noises painful and hold hands over ears
* May withdraw from physical contact because it is overstimulating or overwhelming
* Rubs surfaces, mouths or licks objects
* Seems to have a heightened or low response to pain
Play:
* Doesn't imitate the actions of others
* Prefers solitary or ritualistic play
* Shows little pretend or imaginative play
Behaviors:
* "Acts up" with intense tantrums
* Gets stuck on a single topic or task (perseveration)
* Has a short attention span
* Has very narrow interests
* Is overactive or very passive
* Shows aggression to others or self
* Shows a strong need for sameness
* Uses repetitive body movements
Back to TopExams and Tests
All children should have routine developmental exams by their pediatrician. Further testing may be needed if there is concern on the part of the doctor or parents. This is particularly true whenever a child fails to meet any of the following language milestones:
* Babbling by 12 months
* Gesturing (pointing, waving bye-bye) by 12 months
* Single words by 16 months
* Two-word spontaneous phrases by 24 months (not just echoing)
* Loss of any language or social skills at any age.
These children might receive a hearing evaluation, a blood lead test, and a screening test for autism (such as the Checklist for Autism in Toddlers (CHAT) or the Autism Screening Questionnaire).
A health care provider experienced in the diagnosis and treatment of autism is usually necessary for the actual diagnosis. Because there is no biological test for autism, the diagnosis will often be based on very specific criteria laid out in a book called the Diagnostic and Statistical Manual IV.
An evaluation of autism will often include a complete physical and nervous system (neurologic) examination. It may also include a specific screening tool, such as:
* Autism Diagnostic Interview - Revised (ADI-R)
* Autism Diagnostic Observation Schedule (ADOS)
* Childhood Autism rating Scale (CARS)
* Gilliam Autism Rating Scale
* Pervasive Developmental Disorders Screening Test - Stage 3
Children with known or suspected autism will often have genetic testing (looking for chromosome abnormalities) and perhaps metabolic testing.
Autism encompasses a broad spectrum of symptoms. Therefore, a single, brief evaluation cannot predict a child's true abilities. Ideally, a team of different specialists will evaluate the child. They might evaluate:
* Communication
* Language
* Motor skills
* Speech
* Success at school
* Thinking abilities
Sometimes people are reluctant to have a child diagnosed because of concerns about labeling the child. However, failure to get a diagnosis can lead to failure to get the treatment and services the child needs.
Back to TopTreatment
An early, intensive, appropriate treatment program will greatly improve the outlook for most young children with autism. Most programs will build on the interests of the child in a highly structured schedule of constructive activities. Visual aids are often helpful.
Treatment is most successful when geared toward the child's particular needs. An experienced specialist or team should design the program for the individual child. A variety of therapies are available, including:
* Applied behavior analysis (ABA)
* Medications
* Occupational therapy
* Physical therapy
* Speech-language therapy
Sensory integration and vision therapy are also common, but there is little research supporting their effectiveness. The best treatment plan may use a combination of techniques.
APPLIED BEHAVIORAL ANALYSIS (ABA)
This program is for younger children with an autism spectrum disorder. It can be effective in some cases. ABA uses a one-on-one teaching approach that reinforces the practice of various skills. The goal is to get the child close to normal developmental functioning.
ABA programs are usually conducted within a child's home, under the supervision of a behavioral psychologist. Unfortunately, these programs can be very expensive and have not been widely adopted by school systems. Parents often must seek funding and staffing from other sources, which can be hard to find in many communities.
TEACCH
Another program is called the Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH). TEACCH, developed as a statewide program in North Carolina, uses picture schedules and other visual cues. These help the child work independently and organize and structure their environments.
Though TEACCH tries to improve a child's adaptation and skills, it also accepts the problems associated with autism spectrum disorders. Unlike ABA programs, TEACCH programs do not expect children to achieve typical development with treatment.
MEDICINE
Medicines are often used to treat behavior or emotional problems that people with autism may have, including:
* Aggression
* Anxiety
* Attention problems
* Extreme compulsions that the child find impossible to stop
* Hyperactivity
* Impulsiveness
* Irritability
* Mood swings
* Outbursts
* Sleep difficulty
* Tantrums
Currently, only risperidone is approved for the treatment of children ages 5 - 16 with irritability and aggression associated with autism. There is no medicine that treats the underlying problem of autism.
DIET
Some children with autism appear to respond to a gluten-free or casein-free diet. Gluten is found in foods containing wheat, rye, and barley. Casein is found in milk, cheese, and other dairy products. Not all experts agree that dietary changes will make a difference, and not all reports studying this method have shown positive results.
If you are considering these or other dietary changes, talk to both a doctor who specializes in the digestive system (gastroenterologist) and a registered dietitian. You want to be sure that the child is still receiving enough calories, nutrients, and a balanced diet.
OTHER APPROACHES
Beware that there are widely publicized treatments for autism that do not have scientific support, and reports of "miracle cures" that do not live up to expectations. If your child has autism, it may be helpful to talk with other parents of children with autism and autism specialists, and follow the progress of research in this area, which is rapidly developing.
At one time, there was enormous excitement about using secretin infusions. Now, after many studies have been conducted in many laboratories, it's possible that secretin is not effective after all, but research is ongoing.
Back to TopSupport Groups
For organizations that can provide additional information and help on autism, see autism resources.
Back to TopOutlook (Prognosis)
Autism remains a challenging condition for children and their families, but the outlook today is much better than it was a generation ago. At that time, most people with autism were placed in institutions.
Today, with the right therapy, many of the symptoms of autism can be improved, though most people will have some symptoms throughout their lives. Most people with autism are able to live with their families or in the community.
The outlook depends on the severity of the autism and the level of therapy the person receives.
Back to TopPossible Complications
Autism can be associated with other disorders that affect the brain, such as:
* Fragile X syndrome
* Mental retardation
* Tuberous sclerosis
Some people with autism will develop seizures.
The stresses of dealing with autism can lead to social and emotional complications for family and caregivers, as well as the person with autism.
Back to TopWhen to Contact a Medical Professional
Parents usually suspect that there is a developmental problem long before a diagnosis is made. Call your health care provider with any concerns about autism or if you think that your child is not developing normally.
http://health.nytimes.com/health/guides/disease/autism/overview.html
What Is Special About Special Education?
What Is Special About Special Education?
Special education is governed by federal law in most educational jurisdictions. Under Indviduals with Disabilities Education Act (IDEA), Special Education is defined as:
"Specially designed instruction, at no cost to parents, to meet the unique needs of a child with a disability."
Special education is in place to provide additional services, support, programs, specialized placements or environments to ensure that all students' educational needs are provided for. Special education is provided to qualifying students at no cost to the parents. There are many students who have special learning needs and these needs are addressed through special education. The range of special education support will vary based on need and educational jurisdictions. Each country, state or educational jurisdiction will have different policies, rules, regulations and legislation that governs what special education is. In the US, the governing law is:
Individuals with Disabilities Education Act (IDEA)
Typically, the types of exceptionalities/disabilities will be clearly identified in the jurisdiction's law surrounding special education. Students qualifying for special education support have needs that will often require support that goes beyond what is normally offered or received in the regular school/classroom setting.
The 13 categories under IDEA include:
* Autism
* Deaf or Blindness
* Developmental Delays
* Emotional Disturbance
* Hearing Impairments
* Mental Retardation
* Multiple Disabilities
* Orthapedic Impairments
* Other Health Impairments
* Specific Learning Disabilities
* Speech and Language Impairments
* Traumatic Brain Injury
* Visual Impairments.
Gifted and talented are viewed as exceptional under IDEA, however, other jurisdictions may also included Gifted in part of their legislation. Some of the needs in the above categories cannot always be met through regular instructional and assessment practices. The goal of special education is to ensure that these students can take part in education and access the curriculum whenever possible. Ideally, all students need to have equitable access to education in order to reach their potential.
A child suspected of needing special education support will usually be referred to the special education committee at the school. Parents, teachers or both can make referrals for special education. Parents should have any necessary information/documentation from community professionals, doctors, external agencies etc. and inform the school of the child's disabilities if they are known prior to attending school. Otherwise, typically the teacher will being to notice anomalies and will relay any concerns to the parent which can lead to a special needs committee meeting at the school level. The child who is being considered for special education services will often receive assessment(s), evaluations or psycho testing (again this depends on the educational jurisdiction) to determine if they qualify to receive special education programming/supports. However, prior to conducting any type of assessment/testing, the parent will need to sign consent forms.
Once the child qualifies for additional support, an Individual Education Plan/Program (IEP)is then developed for the child. IEPs will include goals, objectives, activities and any additional supports needed to ensure the child reaches his/her maximum educational potential. More on IEPS. The IEP is then reviewed and revised regularly with input from the stakeholders.
To find out more about Special Education, check with your school's special education teacher or search online for your jurisdiction's policies surrounding special education.
rujukan:http://specialed.about.com/od/idea/a/Special101.htm
Special education is governed by federal law in most educational jurisdictions. Under Indviduals with Disabilities Education Act (IDEA), Special Education is defined as:
"Specially designed instruction, at no cost to parents, to meet the unique needs of a child with a disability."
Special education is in place to provide additional services, support, programs, specialized placements or environments to ensure that all students' educational needs are provided for. Special education is provided to qualifying students at no cost to the parents. There are many students who have special learning needs and these needs are addressed through special education. The range of special education support will vary based on need and educational jurisdictions. Each country, state or educational jurisdiction will have different policies, rules, regulations and legislation that governs what special education is. In the US, the governing law is:
Individuals with Disabilities Education Act (IDEA)
Typically, the types of exceptionalities/disabilities will be clearly identified in the jurisdiction's law surrounding special education. Students qualifying for special education support have needs that will often require support that goes beyond what is normally offered or received in the regular school/classroom setting.
The 13 categories under IDEA include:
* Autism
* Deaf or Blindness
* Developmental Delays
* Emotional Disturbance
* Hearing Impairments
* Mental Retardation
* Multiple Disabilities
* Orthapedic Impairments
* Other Health Impairments
* Specific Learning Disabilities
* Speech and Language Impairments
* Traumatic Brain Injury
* Visual Impairments.
Gifted and talented are viewed as exceptional under IDEA, however, other jurisdictions may also included Gifted in part of their legislation. Some of the needs in the above categories cannot always be met through regular instructional and assessment practices. The goal of special education is to ensure that these students can take part in education and access the curriculum whenever possible. Ideally, all students need to have equitable access to education in order to reach their potential.
A child suspected of needing special education support will usually be referred to the special education committee at the school. Parents, teachers or both can make referrals for special education. Parents should have any necessary information/documentation from community professionals, doctors, external agencies etc. and inform the school of the child's disabilities if they are known prior to attending school. Otherwise, typically the teacher will being to notice anomalies and will relay any concerns to the parent which can lead to a special needs committee meeting at the school level. The child who is being considered for special education services will often receive assessment(s), evaluations or psycho testing (again this depends on the educational jurisdiction) to determine if they qualify to receive special education programming/supports. However, prior to conducting any type of assessment/testing, the parent will need to sign consent forms.
Once the child qualifies for additional support, an Individual Education Plan/Program (IEP)is then developed for the child. IEPs will include goals, objectives, activities and any additional supports needed to ensure the child reaches his/her maximum educational potential. More on IEPS. The IEP is then reviewed and revised regularly with input from the stakeholders.
To find out more about Special Education, check with your school's special education teacher or search online for your jurisdiction's policies surrounding special education.
rujukan:http://specialed.about.com/od/idea/a/Special101.htm
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