PSCL 379 Exam 1

What is an Intellectual Disability?

What is an Intellectual Disability?

• a heterogeneous group of disorders that have significant deficits in reasoning that impairs the individual's ability to function in day to day life 

  • Must demonstrate adaptive deficits that impair in comparison to peers of a similar age or culture

  • Impairments limit or restrict an individuals participation and performance in one or more aspects of daily life → communication, social participation, function at school or work, personal independence

  • Adaptive behavior is measured with tests

What is Rosa’s Law?

changed the term used in federal legislation from mental retardation to intellectual disability

What are three domains of of adaptive behavior?

• Conceptual → language and literacy, money, time, number concepts and self direction

• Practical → activities of daily living, occupational skills, health care, travel/transportation, schedules/routines, safety, money use, telephone use

• Socialization → interpersonal skills, social responsibility, self esteem, gullibility, naivete, social problem solving, ability to follow rules and obey laws to avoid being victimized

What is needed for Intellectual disability to be diagnosed?

For ID to be diagnosed there has to be deficits in one of the three domains of adaptive behavior

What are the methods of classification for Intellectual Disability?

• Methods for classification: 

  • 1. Degree of intellectual impairment

  • 2. Adaptive behavior 

  • 3. Required supports 

  • 4. Domain of disability

  • 5. Etiology

What are the two populations of intellectual disability?

• Mild intellectual disability 

  • More likely to be associated with social disadvantage and familial factors 

• Severe Intellectual Disability 

  • More typically linked to biological/genetic origin

How does the postnatal environmental influence expression of neurodevelopment dysfunction?

• Postnatal environmental influences mediate biological process through mechanisms that may be indirect → might also affect the expression of neurodevelopmental dysfunction

  • For example, a child may have an initial biological insult (e.g., intrauterine growth restriction [IUGR]) that can be compounded by postnatal environmental variables, such as poor nutrition, social disadvantage, or physical abuse).

True/False: Men are more likely to manifest ID

true

What is neurodevelopmental disability?

●  Disorder that impairs neural development and organization
●  Usually present at birth and affect the trajectory of development and functioning

•  Cognition (e.g., intellectual disability)

•  Social functioning (e.g. autism)

•  Physical ability (e.g. hyperphagia in prader willi)

What is global developmental delay?

• Temporary diagnosis in young children at risk for developmental disabilities, especially intellectual disability

Significant delay in achieving age-appropriate neurodevelopmental milestones in language, motor, and social-adaptive development

Why is early identification of developmental delay crucial?

The sooner you have a diagnosis, the sooner you can start working

What does intellectual disability include?

• Includes:

  • Current intellectual impairment

  • Onset during developmental period

  • Adaptive behavior deficits → how the child is functioning. 

  • What can the child do?

    • Count to 10, make a phone call, dress themselves, etc (daily living skills)

What are disagreements and concerns regarding intellectual functioning?

• Intellectual functioning: disagreements and concerns include

  • Assessment of intellectual functioning

  • Underlying value of IQ score → how useful is it? For best treatment and supports

  • Predictive validity and cultural bias → will IQ test at age 8 predict functioning as
    an adult?

What are adaptive impairments?

• Adaptive impairments: impaired ability to adapt or function in daily life

  • What are the domains of adaptive behavior? Conceptual, practical, social

  • How is adaptive behavior measured? Surveys by parents, teachers, observing child

How is degree of intellectual impairment determined? What are the attitudes around this?

• Degree of intellectual impairment

  • Based on IQ levels: mild, moderate, severe, profound

    • Accepted widely in medical community, but controversial

    • Classification solely on basis of IQ not sufficient

  • Required supports (AAIDD)

    • Based on patterns and intensity of needed support

    • Focuses on abilities of individuals to function in inclusive environment

    • Controversial

What are the 5 domains of disability?

1. pathophysiology

2. impairment

3. functional limitation

4. disability

5. societal limitation

Ex: pathophysiology is deletion in chromosome 15. Impairment is prader-willi
syndrome. Functional limitation is intellectual disability/feeding disorder. Disability is learning and adaptive skills below age level and obesity. Societal limitation is noninclusive school settings, stereotyping, and underestimating abilities

What is the prevalence of intellectual disability?

• Prevalence of intellectual disability

  • Based on definition, method of ascertainment, and population studies

  • 6.7-10.37 of 1000

  • Diagnosis peaks at 10-14 years of age

  • Mild impairments identified later than severe

Why might mild impairments be identified later than severe impairments?

• may not struggle with early milestones, harder to pinpoint cause of impairment, may not come with physical disability

What is the etiology of mild intellectual disability?

• Mild intellectual disability

  • Often associated with racial, social, and familial factors

  • Identifiable in less than half of affected individuals

  • Common biological causes are genetic/chromosomal syndromes, perinatal complications, and prenatal alcohol/drug exposure

  • Familial clustering common

What is the etiology of severe intellectual disability?

•  Linked to biological/genetic origin

• Identifiable in 75% of cases

• Common causes: down syndrome, fragile x syndrome, fetal alcohol spectrum disorders

• Biological origins: the earlier the problem, the more severe its consequences → pregnancy

What are common associated impairments?

• Cerebral palsy, seizure disorders, communication disorders, sensory impairments, psychological/behavioral disorder

• Important to identify comorbid conditions: for treatment, cognition Psychological testing and interpretation

Explain psychological testing and interpretation for intellectual disabilities

• A variety of tests are used to evaluate individual intelligence and adaptive skills

• Poor predictive validity until about 10 years old

• Tests can help differentiate in young children with severe intellectual disability, but not
  with mild

• Often there is a correlation between scores on intelligence and adaptive scales

What are treatment approaches for intellectual disabilities?

•  Most useful treatments are multimodal

• Educational services - most important discipline involved in intervention

  • Must be relevant to child’s needs, addressing strengths and challenges (IFSP, IEP)

• Leisure and recreational needs - peer socialization influences social-emotional development

  • Socialization competencies and experiences affect school readiness, participation, and future success in adult life

  • Sports or exercise regimens offer short and long term benefits activities can increase independence

• Behavior therapy - problems may result from organic problems, unrealistic parental expectations, family difficulties, or school-related adjustment difficulties

  • Consider “cognitive” vs “Chronological” age

  • Environmental changes may improve behavior

  •  Behavior management techniques

• Most useful treatments are multimodal

  • Use of medication - not useful in treating core symptoms but can help with comorbid behavioral or emotional disorders 

Discuss the history of intellectual and developmental disabilities in Greece

• Ancient Greece

  • The importance of intelligence, physical strength and beauty were really valued 

  • Their society exemplified the ideal society and their people were superior to all others

  • Physical differences were seen as inferior 

  • Early writing show distinction for people who are other in reference to their abilities 

    • Homer

    • Plato felt that the mentally retarded had little place in society 

      • Selective breeding 

      • Idea: How to maintain society robust and remove those who are different 

      • We need to separate those with impairments from society 

    • Aristotle → “to prevent the rearing of deformed children let there be a law that no deformed child shall live”

      • Children with invisible disabilities were protected from this

Discuss the history of intellectual and developmental disabilities in Sparta

• Practiced eugenics 

• Valued strength and intellectual ability 

• If a baby was found to be defective they were thrown from a cliff or left outside to die

• There was little wiggle room is the child has visible physical disabilities

Discuss the history of intellectual and developmental disabilities in Athens

• Early on there is evidence that infanticide occurred but only to the very weak and deformed 

• Those who were not greatly defective were left out and abandoned and were sold into slavery

• Unwanted newborns placed into a jar at the temple doors for adoption → eventually sold as slaves 

• Plato wrote that children with disabilities has unsoundness of mind

Discuss the history of intellectual and developmental disabilities in Rome

• In the first week of life parents had the right to do whatever they wanted if they did not want to carry on with their babies → withhold nourishment or sell 

  • Fathers had the right to kill, mutilate, or sell them 

• The state provided wet nurses to feed unwanted babies placed at the base of columna lactaria 

• Children mutilated to heighten their value as future beggars 

  • More deformed more money 

• Cornelius celsus (1AD)

  • Thinks of the distinction of those who are “other” 

    • Imbecillus: general weakness or any form of debility 

    • Idios: private person (did not associate with ID until much later)

    • Fatuity: someone who was witless

• 4th century rise of christianity 

  • Practices for compassion and forgiveness 

  • We see more movement towards compassion and decreases on infanticide

Discuss how the 1800s were a sign of early optimism for ID and DD

• Prior to 1800s there was no differentiation between ID and insanity 

• First major change came with Dr. Esquirol who was a famous psychiatrist in france 

  • We set to scientifically delineate intellectual disability and insanity 

  • Imbeciles: generally well formed, and their organization is nearly normal

    • Mildly affected maybe not physical 

  • Idiocy is not a disease but a condition in which the intellectual facilities are never manifested or have never been developed sufficiently…intellectual faculties are almost null.

    • Distinction that idiocy occurs in childhood 

  • Anticipate future developments in the study of ID/DD

  • Believed that individuals would not benefit from training

Explain the significance of the wild boy

• Young boy who was found living in the forest nonverbal, not clothed, struggled w daily living skills 

  • First wild child 

• Dr. Itard decided that this boy who today we would say is severely impaired, he decided he was going to train this child of daily living, communication, and functioning 

• He was the first physician to state that an enriched environment could compensate for ID/DD caused by hereditary or deprived environment

• He thought that he could train him into being a typical teenager → did not work he gained some skill but not back to normalcy → showed that intervention can help

• Influenced Dr. Seguin who influenced maria montessori

Who was Dr. Seguin and what did he do?

• Dr. Seguin 

  • One of the first great teachers in the field of disabilities 

  • Continued to distinguish and define the categories of impairment 

  • Divided into 4 broad categories

    • Idiocy: probably included moderately, severely, and profound ID)

    • Imbecility: mild ID showing severe deficits in moral (social) development 

    • Backwardness and feeblemindedness 

    • Simpleness or superficial retardation evidenced by slowing down of development 

Who was Langdon Down? What did he do?

• First to identify a behavioral phenotype → identified that some individuals had similar characteristics → shared some overlap in physical and behavioral characteristics → coined the term mongoloid → down syndrome 

• Idiocy in 3 categories 

  • Identified that there are some impairments that may be hereditary or accidental (during birth that resulted in deficits in functioning) or developmental (things that effect a baby when in utero → disturbed mothers, inebriation at conception, overexcitement during babyhood (stress))

What are the three categories of idiocy?

Identified that there are some impairments that may be hereditary or accidental (during birth that resulted in deficits in functioning) or developmental (things that effect a baby when in utero → disturbed mothers, inebriation at conception, overexcitement during babyhood (stress))

How was the 19th century a turning point for those with ID and DD?

• United States 19th Century 

  • Until the 1840s individuals severely or profoundly affected were not educated and any education occurring was at the community level there was no state mandate → formal services were not a part of everyday life 

  • Start to be some chatter for the need of services for these people 

Who was Samuel Gridley Howe? What did he do?

• Promoted reintegration and rehabilitation

  • Goal was to train (training schools) to help individuals live in society better → most individuals did not believe that children could be taught or have intervention 

  • Paved the way offering some hope for people with disabilities

Who was Dorothea Dix? What did she do/advocate for?

• Dorothea Dix

  • Went along w the momentum of training and education nd was a fighter for those who were not being taken care of in society 

    • The poor, criminals, and the mentally ill 

    • Felt that there needed to be more overarching structure so that these decisions were not made at community level 

      • Uniform across states 

    • She lobbied for getting intervention in place and it led to the first generation of american institutions

    • Advocated for hospitals to sever mentally ill, epilepsy, and ID/DD but not separately 

    • Did not advocate for education or return to community 

    • She wanted everyone to be served → no framework for how each group needs to be helped

What were the terms used in 1910 to classify severity of ID and DD?

• 1910 Definition (AAMD)

  • Idiots → severe

    • Said to be “so deeply defective” that their mental development does not exceed that of 2 yrs old 

  • Imbeciles → Moderate

    • Mental development does not exceed 7 years of age 

  • Morons → Mild

    • Mental development does not exceed 12 yrs of age

• Expectation that development is limited and it is limited by mental age 

• First estimate for what a neurotypical individual should perform like at a certain age

Discuss Institutionalization

• Institutionalization 

  • During the 1st half of the 20th century we had a big problem with institutionalization 

    • Those with down syndrome were routinely institutionalized

      • Largest cohort

      • One of the most common IDs

      • At this time there was no genetic testing → DS was very prevalent → other disorders has not been identified uniquely yet 

  • Movement toward segregation → moving people to institutions and moving them out of their homes 

  • Problem: institutions become permanent residencies often with deplorable living conditions

    • Not enough resources, overcrowding → lead to neglect 

    • There are various types of disorders and the leaders may not have the expertise needed

  • 1966 an expose was done by taking photos of the institutions 

    • Went in to document the conditions 

    • Did a lot but didn't do as much as willowbrook

  • Institutions intended to care for these people but the needs were too much

Discuss Eugenics in the United States

• United States 

  • Eugenics movement based on the myth that ID contributed to societies social ills and could be eliminated by physical segregations and sterilization 

    • Making sure people who have impairment are not procreating 

    • Sterilization 

      • Because institutions were so overcrowded 

      • Before moving them out to the community we will sterilize fist 

      • Prevent transmission of the defect → the person would pass it on to their child and they would not be able to care for their children 

    • 1927 US Supreme Court Ruling 

      • Carrie buck is pregnant 

      • The court upheld sterilization and deemed it necessary to sterilize her → for the protection of the state and society

      • Was largely seen as negative eugenics → improve human race by eliminating defectives from the gene pool 

Discuss public eduction for those with ID and DD in the 19th and mid 20th centuries

Public Education
• 1896: Rhode Island had the 1st public SPED class
• By 1930, sixteen states offered special classes for children
with mental retardation
• By 1952, forty-six states
• Until late 1950’s children with severe and profound
mental retardation were excluded from public
education

• First formal stirrings of a formal education process 

• RI first to have a SPED class 

  • Those who were severely and profoundly affected did not get the choice to be in these programs → only for those who were high functioning

How did the 1960s and 70s change the attitudes towards those with ID and DD

• 1960s and 70s

  • More community outrange and shift in attitude towards how we have been treating these individuals

  • Presidents panel on mental retardation

  • Introduces an era of national concern for the rights of individuals 

  • Eventual increase in federal aid to education 

  • Establishment of comprehensive community based programs 

  • Educational rights 

  • Movement towards less restrive and more integrated educational placements 

  • Institutions failing to meet the needs of individuals

  • Public condemnation of dehumanizing conditions

• deinstitutionalization

The 1960’s & 70’s: A shifting emphasis
• Deinstitutionalization
• 60’s: Concept gained recognition
• Establish smaller, specialized residential centers
• 70’s: acquired greater support
• Emphasis on closing large institutions
• 80’s: became a national political, professional, and parental goal
• Started with releasing the mentally ill
• By 1984 over 75% were returned to the community to often cruel
and inhumane results

How did ARC define dehumanization? Why was this important?

• ARC definition of dehumanization

  • Being treated as a prisoner instead of resident 

  • Having only certain days for bathing 

  • Being behind locked doors 

  • Being subjected to standards set for the least capable resident 

  • Not being able to obtain dentures, glasses, or hearing aids 

  • Having to ask for personal items 

  • Privacy in dressing and bathing 

  • Having 40  roommates

  • Being expected to participate in childish games, regardless of your feelings on the matter 

    • Some people who are in their 40s with DD like to play duck duck goose 

• ARC set the stage for “we can't do this anymore”

Discuss deinstitutionalization

• Deinstitutionalization 

  • Establish smaller specialized residential centers → more catered to the individual needs 

  • Emphasis on closing large institutions → took some time because where are all these people going to go?

  • By 1984 over 75% of people were deinstitutionalized and returned to the community to often cruel inhumane results 

    • Large homelessness population followed 

  • Most people with IDD were sent to nursing homes, some were returned to families, and some were sent to smaller more targeted facilities

What is a developmental milestone?

• DM: a developmental milestone is a behavior, ability, or skill that emerges at a particular age in most children that can easily be observed and described 

  • Milestones are characterized as belonging to specific funtions domains that can be dividen and described in different ways for different purposes

clinically most useful milestones:

• Emerge within a reasonably narrow and predictable range of ages 

• Are easy to observe and describe 

• Do not vary tremendously from person to person 

• Are functionally relevant

What is development?

• Development refers to anything that changes over time 

  • Changes in human thought, behavior and function 

• We have both a unique developmental history and a common developmental blueprint that happens aside from our individual life histories and cultures 

• Development refers to the characteristic, predictable ways in which behavior changes during the human life cycle 

  • Behavior: any action that a person can perform and another can observe 

  • Observing and interpreting behavior is the primary focus of developmental assessment

Why do we use typical and atypical when referring to human development?

• Normal and abnormal carry good and bad connotations when referring to human development

  • Behavior is not only different from what is expected but it is also bad 

• Preferable to use the term typical (express the idea of usual, expected, or average) and atypical (convey that which is unusual, unexpected or significantly different from average)

What is plasticity?

• Plasticity: the ability of the nervous system to change or adapt 

  • Changes over the lifespan this is why children are more able to attain fluency in multiple languages than adults 

True/False: Learning is unabated throughout the lifespan

true

What is Sigmund Freud’s theory of psychosexual development?

Views the conflict between inborn biological drives and external societal restrictions as being the engine of developmental and behavioral change

What is Erik Erikson's Psychosocial Stage Theory?

A model for development through the lifespan that describes a series of existential crises that must each be successfully overcome

What is Attachment Theory?

Emphasizes the critical importance of the infant-caregiver bond and describes early infancy as a critical period within which such bonds must form

What is Piaget’s cognitive development stage theory?

• Our interactions with the environment are governed by the construction of cognitive processes during childhood, which he called schemas

  • Schemas arise through assimilation (adaptation to the environment) and accommodation (creating new schemas to process new types of information)

• Stages 

  • Sensorimotor, Pre-operational, concrete operational, formal operational

What is B.F. Skinner's Operant Conditioning?

Considers a child a blank slate whos behavioral responses are entirely governed by these environmental contingencies

What is social learning theory?

Emphasizes the importance of social modeling and imitation in learning

What is Vygotsky’s Sociocultural Theory

• Emphasizes the importance of family, teachers, and peers in facilitating hands on learning 

• Zone of proximal development: represents the space between what learners can do on their own and what they are not ready to do at all → place where students are able to learn new, difficult things with help and support of others

What is Bronfenbrenner’s ecology theory

Emphasizes the cultural context and the roles, activities, and relationships engendered by that context that determine individual behavior to a greater or lesser degree

What are the 7 specific functional domains/streams Milestones are characterized as belonging to?

• Gross motor skills

• Fine motor skills

• Language and communication

• Cognitive and problem solving skills

• Self care 

• Play 

• Social

True/False: Domains cannot be split or lumped together

FALSE

• These domains can be split or lumped depending on why they are being used 

  • Ex: when looking for ASD language and communication and social domains are lumped together into a larger communication/socialization domain to emphasize the broad range of skills important to social interactions

  • Language milestones may be split into expressive (spoken) and receptive (comprehension) skills

Why are developmental milestones necessary?

Developmental milestones are necessary for the assessment and management of children with potential developmental challenges

What are the 4 characteristics a useful milestone should have?

• The most useful milestones have the following characteristics: 

  • 1. They emerge in most children within a reasonably narrow and predictable range of ages.

  • 2. They are easy to observe and describe.

  • 3. They don’t vary tremendously in appearance from person to person.

  • 4. They are functionally relevant.

What are limitations to milestones?

• Limitations 

  • Milestones vary considerably in their level of precision 

  • Milestones for language, social-emotional, and cognitive development are less precisely defines and have less support than those for motor milestones

What are primitive reflexes?

Primitive reflexes: programmed motor responses that are present at birth such as the ability to orient toward and suckle a nipple → gradually fade within first year and are replaced by voluntary motor responses

What are automatic movement reactions?

protective responses

What are adaptive skills?

• Adaptive skills

  • Refer to the broad range of abilities that allow human beings to manipulate their environment

    • Pincer grasp: the ability to pick up a small object between the tips of the thumb and index finger

    • Palmar grasp reflex → radial palmar grasp

What is object permanence?

• Object permanence: the early ability to create and sustain a stable mental image of objects 

  • Fundamental to memory and is necessary to the development of all subsequent cognitive skills

What is stranger anxiety?

Unease in the presence of strangers

What is separation anxiety?

Fear at losing sight of a caregiver

What is theory of mind?

•  the ability to understand something about the thoughts and intentions of others – to perceive the world from their perspective

  • Fundamental to social cognition and human social interactions → lacking can lead to ASD

What is pretend play?

Pretend play: like having a tea party → ideas of intentionality and agency → acting to produce a particular result

What is parallel play?

Parallel play: playing in the company of other children

what is cooperative play?

Cooperative play: involving sharing, turn taking, and common goals

What is imaginative play?

Imaginative play: the ability to imagine that a thing is something other than itself ( a stick is a magic wand)

what is a developmental delay?

• Developmental Delays: refer to the late emergence of a particular skill or milestone or the general slowing of development within or across broader domains of development

• a significant lag in the attainment of milestones in one or more areas of development

What is a dissociated pattern of delay?

development that is more delayed in some domains than others

What is global developmental delay?

Global developmental delay: development that is significantly delayed across all domains

what is developmental surveillance?

• Developmental surveillance: the process of review of developmental progress over time 

• Developmental surveillance

  • General processes of monitoring development progress 

  • Employed especially by primary care providers, such as pediatricians

  • Methods vary widely 

    • Depends on what that practice or doctor does → no formalized structure → because surveillance differs between providers things can be missed

What are screening tests used for?

Screening tests: are primarily designed to distinguish children who are at risk for developmental problems from those who are not → pass or fail

• Developmental screening 

  • Use of specific standardized screening tools 

  • Recommended at 9,18, and 24 or 30 months for all children 

  • Designed to identify children at risk for ongoing developmental problems 

  • THIS DOES NOT DIAGNOSE 

  • This screener would send up an alert that maybe a child needs to be looked at more 

• Next steps after failed screening

  • Early intervention (provision of services to ameliorate and promote developmental progress) 

    • Can even get rid of the problem → ex: challenges w language

  • Developmental diagnosis

what is early intervention?

refers to a specific federally mandated program for children from birth to 3 years of age

What are the 4 fundamental questions that most parents have when they seek evaluation?

• Four Fundamental Questions that most parents have when they seek evaluation:

  • 1. What is wrong with my child? (Diagnosis)

  • 2. What is going to happen to my child over time? 

  • 3. What can be done to improve my child’s condition? (Treatment 

  • 4. What caused my child’s condition? (Etiology) 

What are the three streams of development?

• Streams of Development 

  • Motor 

    • Gross, fine, and oral motor 

  • Cognitive (central processing)

    • Language 

    • Receptive 

    • Expressive 

    • Nonverbal problem solving/perceptual reasoning 

  • Neurobehavioral

    • Social behavior 

    • Adaptive emotional behavior, self regulation, and metal status 

What is a developmental quotient?

• a useful means of quantifying development within a stream as a percentage of normal

  • Ratio that is childs developmental age (DA) in a particular area od development / their chronological age (CA) multiplied by 100  → DQ=DA/CA x 100

  • If DQ is 60 then they are experiencing a 40% delay

What is developmental dissociation?

Developmental Dissociation: significant difference in developmental rates between two of the major areas of development

What is developmental deviance?

refers to non sequential unevenness in the achievement of milestones within one or more streams of development

True/False: All children with Global Developmental Delay will have ID

FALSE

Not all children with GDD will ultimately have ID because developmental trajectories may change but the greater the degree of GDD the higher the predictive validity

What is developmental regression?

• Developmental Regression: the loss of previously attained milestones

  • 20% of children with ASD lose previously established language and or social interaction skills at 21-24 months

What is the spectrum of developmental disabilities?

The various developmental disorders that result from neurologically based abnormalities in cognitive, motor, and neurobehavioral function have been referred to as the spectrum of developmental disabilities

How is severity determined?

Severity is determined by the degree of developmental delay, dissociation, and/or deviance, and, as with most other pathologies, the milder forms are more common than the most severe forms.

Why is diagnostic classification important?

Diagnostic classification is important for treatment planning, prognostication, and other aspects of clinical care for specific individuals as well as for etiologic and outcomes research and societal allocation of resources

What are the 5 elements a diagnostic evaluation should include?

• The Diagnostic Evaluation should incorporate the following elements

  • Caregiver interview 

  • Review of pertinent medical and educational records 

  • Direct clinical assessment 

  • Integration of information and determination of categorical diagnoses 

  • Consideration of etiologic possibilities

PLUSSS

• In addition to assessing each stream of development by history, the diagnostician evaluates each child by direct observation and elicitation

• Formal testing is either completed by the clinician or the results of current testing done by professionals in other disciplines are reviewed or both.

Describe developmental milestones in early childhood

• Developmental milestones: Early childhood

  • Milestone attainment tends to follow a particular sequence 

    • Provides for early identification of possible problems 

  • Four major areas of development

    • Language skills 

      • Vocabulary explosion by 24 months 

    • Social adaptive skills 

      • Responsive smiling around 2 months/separation anxiety at 8-10 months 

    • Gross motor skills 

      • 1st steps around 1 year of age 

    • Fine motor development 

      • Uses pincer grasp around 11 months 

What are milestone charts?

• Milestones charts are approximate ages that skills will be attained–things differ from child to child for many reasons 

  • Lack of opportunity to develop those muscles 

  • Environment 

  • Parenting

What kinds of atypical development can be seen in the first 2 years of life?

• Early identification

  • Early infancy 

    • Typically more severe impairments – tend to be obvious upon physical exam 

      • Lack of responsiveness

      • Unusual muscle tone 

      • Poor suck reflex/feeding difficulties 

  • Between 6-18 months 

    • Delay of motor milestones 

  • After 18 months 

    • Language concerns and atypical behavior 

      • Social behaviors are not progressing as expected 

  • The early detection the better 

What is atypical development?

• Atypical development represents a departure from expected development

  • Delays: may be global )across multiple domains) or dissociated (predominantly occurring in specific domains)

  • Deviance/divergence: development that is off track

What is special education?

• Special Education: specially designed instruction, at no cost to parents, to meet the unique needs of a child with a disability

  • All SE services are individualized to provide the instruction necessary to reach each students goals

What does IDEA guarantee?

IDEA guarantees a free appropriate public education (FAPE) for all students with disabilities ages 3-21 no matter of severity

• Special education legislation offers services through this age for students with disabilities who 1) have not earned all of their credits toward graduation, 2) need additional transition services, or 3) are earning an alternative certificate rather than gen-ed diploma

• For a student to receive special education services, he or she must have a physical, cognitive, or behavioral impairment that interferes with the ability to benefit from instruction in the general classroom curriculum 

  • Students who qualify are provided services through an IEP

What are some disabilities recognized by IDEA?

• Disabilities recognized by IDEA:

  • Intellectual disability

  • Hearing impairments (including deafness)

  • Speech or language impairments

  • Visual impairments (including blindness)

  • Emotional disturbances

  • Orthopedic impairments

  • Autism

  • Traumatic brain injury

  • Other health impairments (including chronic diseases and attention deficit/hyperactivity disorder [ADHD] if they impair educational performance)

  • Specific learning disabilities

  • Deaf-blindness

  • Multiple disabilities

  • Young child with a developmental delay (ages 3–9)

What are related services?

• Related services: transportation and such developmental, corrective, and other supportive services… as may be required to assist a student with a disability to benefit from special education

  • Speech-­ language pathology and audiology services

  • Psychological services

  • Physical and occupational therapy

  • Recreation, including therapeutic recreation

  • Social work services

  • Counseling services, including rehabilitation counseling

  • Orientation and mobility services, including therapeutic recreation

  • Medical services

  • Nurse services

What does the ADA do?

• The ADA creates access to physical barriers 

  • Mandating an elevator or lift in a school building if needed for a student with a physical disability

What does Section 504 do?

• Section 504 creates access to programmatic needs

  • Requiring a place to rest and shortened assignments if needed for a student with cancer who is receiving chemotherapy 

  • Protects people who have a physical or mental impairment that substantially limits one or more major life activities, have a record of such impairment, or are regarded as having such an impairment

    • Ex: major life activities: caring for oneself, walking, seeing, speaking, breathing etc..

  • Mitigating measures such as medication cannot be considered when determining disability for a 504

What students are covered by 504 but not IDEA?

• Students covered by 504 but not IDEA

  • Students with communicable diseases (e.g., HIV)

  • Students with food allergies

  • Students with asthma

  • Students with attention disorders without significant academic deficiencies

  • Students with Tourette syndrome, epilepsy, diabetes, or cancer

  • Students with impairments as a result of emotional illness or former misclassification of intellectual disability (Office of Civil Rights, 1995)