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Introduction

This Resource Note book is about characteristics of students with disabilities. According to the Disability Discrimination Act, a disabled individual is anyone who has a mental or physical impairment that has a long-term and substantial adverse effect on that individuals potential or ability to undertake normal day-to-day activities (Disabled People, 2008). The Individuals with Disabilities Education Act (IDEA) (P.L. 101-476) and the Education for All Handicapped Children Act (P.L. 94-142) came up with particular categories of disabilities through which children may qualify for special education and related services.

IDEA identified a child with disability as a child with speech or language impairments, mental retardation, visual impairments (including blindness), traumatic brain injury, hearing impairments (including deafness), serious emotional disturbance, autism, orthopedic impairments, other health impairments, specific learning disabilities, or other health impairments: and who by any virtue of the above mentioned disabilities, needs specialized education and other related services (Disabled People, 2008). Such types of disabilities may actively hinder students to dependably and easily process various types of information if not well taken care of. These disabilities will be addressed in depth in this Resource book. The main aspects of these disabilities that will be looked into include the definition of the disability, causation, prevention, characteristics, current trends and instructional strategies for each disability. The Note book will also look into aspects of Early Childhood Education (ECD).

Students with Learning Disabilities

According to Lyon (1996), over 5 percent of all students in public schools have a learning disability. Most students are taught at an early age how to develop an organized strategy or plan when confronted with a problem, and how to process information. But other students find such cognitive tasks as learning basic skills quite challenging. These and many other children having diverse disabilities that limit their educational performance in relation to other normal children are referred to as children with Learning Disabilities (Smith, 1997). The learning disabilities fall on a continuum, ranging in severity from mild to critical impairment. The U.S. congress passed an educational bill in 1975 named the Education for All Handicapped Children Act (PL 94-142), assuring children with learning disabilities an appropriate, quality, and free education in the least restrictive environment (Bernadette & Barbara, 1998).

Mental Retardation

Definition

According to IDEA, mental retardation is a significantly sub average general intellectual functioning existing concurrently with deficits in adaptive behavior (Bernadette & Barbara, 1998). It is often noticeable during the childs development period, thereby unfavorably affecting his or her educational performance.

Causes of mental Retardation

There are many causes of mental retardation as it can be caused by many condition that damage the proper development of the brain either before birth, during the birth process, or during childhood years. Indeed, there are several hundred causes of mental retardation (Heward, 2005) and (Link et.al. 1999). These causes can be categorized into the following broad categories.

Genetic conditions

• Abnormal genes inherited from parents
• Errors in genes combinations
• Gene disorders caused by infections during pregnancy
• Overexposure to X-rays
• Inborn errors of metabolism, such as the deadly Phenylketonuria (PKU)
• Chromosomal abnormalities bringing diseases such as Fragile X syndrome and Down syndrome

Problems during Pregnancy

• Alcohol abuse by pregnant mothers
• Pregnancy illnesses such as granular disorders, rubella, cytomegalovirus, and diabetes
• Malnutrition
• HIV infection originating from prenatal life

Problems at Birth

• Injury to the infants brain during the birth process, resulting to physical malfunctions
• Prematurely born infants
• Low birth weight

Problems after birth

• Child illnesses such as chicken pox, Hib disease, measles, and whooping cough can lead to encephalitis and meningitis that can in turn damage the brain
• Man-made and natural disasters and accidents
• Dangerous substances such as lead mercury and lead

Poverty and Cultural Deprivation

• Malnutrition due to poverty
• Inadequate medical care
• Environmental health hazards
• Deprivation of many day-to-day and cultural experiences leading to brain under stimulation

Prevention of mental retardation

Mental retardation can be prevented through various prevention strategies. However, due to the fact that that most mental retardation cases occurs during pregnancy and the subsequent upbringing of the child, it is imperative that the prevention strategies are subdivided into two  Prenatal and Post natal (Heward, 2005; Link et.al. 1999; Simpson, 2008).

Prenatal Prevention Strategies

• Avoid using drugs such as cocaine and heroine, alcohol, and smoking
• Obtain quality medical care when sick
• Keep away from habits that can expose you to sexually transmitted diseases
• Maintenance of good healthcare and nutrition during pregnancy
• Obtain all the necessary prenatal and genetic tests
• Treat infections immediately
• Administer folic acid tablets to avert the occurrence of neural tube disorders

Postnatal Prevention Strategies

• Proper Medicare and nutrition
• Obtain appropriate immunizations such as DPT, BCG, and MMR
• Avoid intake of dangerous chemicals such as lead
• Avoid child neglect and abuse
• Eliminate dilapidating conditions of poverty and associated problems
• Employ toddler and infant seat belts and car seats
• Universal iodization of salt to curtail iodine insufficiency
• Adequate pregnancy spacing to allow the body replenish lost nutrients

Characteristics of Mental Retardation

The characteristics of mentally handicapped individuals may be divided into four broad categories namely intellectual functioning, social skills, motor skills, and communication skills.

Intellectual functioning

• Failure to demonstrate learned skills spontaneously
• Slow learners and failure to notice relevant features of what the teacher is teaching
• Difficulty in applying the learned knowledge and skills to new situations
• Difficulty in contemplating complex skills and abstract concepts

Social Skills

• Difficulty in developing interpersonal relationships
• Not interested in individuals and events around them
• Rarely makes any eye contact to those around them
• Engagement in inappropriate or isolated behaviors

Motor skills

• May exhibit signs of delays in motor and sensory development
• May exhibit signs of physical disabilities such as visual impairments, speech impairments, epilepsy, and hearing defects.
• In cases of severe mental retardation, seizure disorders, cerebral palsy, hydrocephalus and other cardiovascular disorders may be witnessed.

Communication skills

• Speech problems like delayed speech is widespread among students with relentless disabilities
• The development of language skills may be significantly delayed or inhibited
• The quality and content of language may be significantly affected as people with mental retardation usually construct less complex, shorter sentences

Current Trends

• 1 to 2 percent of the worldwide population is mentally retarded
• Slightly over 1 percent of the school going population is requiring special education due to mental retardation
• Almost 90 percent of all individuals requiring special education have symptoms of mild mental retardation (WHO Fact sheet, 2004)

Instructional Strategy

• Functional Assessment  this strategy is good in these circumstances as it looks beyond the behavior of the mentally retarded students to identifying particular pupil-specific, affective, social, cognitive, and environmental factors associated with the mental retardation. A broader perspective of the problems will help the instructor understand the mentally retarded (CECP, 2001).

Emotional Disturbance

According to IDEA, a child is deemed to have emotional disturbance when he or she exhibits one or more of the following characteristics:

• An active inability to concentrate in learning that cannot be explained by sensory, intellectual, or health factors.
• An active inability to either build or maintain a sustainable interpersonal relationship with teachers and peers.
• Inappropriate or questionable types of feelings and behaviors under normal situations
• A general passive mood of depression and unhappiness.
• A general tendency of developing physically manifested symptoms or fears associated with school or personal problems.

According to IDEA, serious emotional disturbance may develop into Schizophrenia and psychosis (Bernadette & Barbara, 1998).

Causes

Heward (2005) and Dharitri (1996) argue that the causes of emotional disturbances among students are often varied and hard to determine. However, the causes can be grouped into the following broad categories.

Biological Factors

• Genetics and brain chemistry
• Biochemical factors
• Neurological factors

Environmental factors

• Social rejection by friends
• A belligerent pattern of behavior exhibited on entering school
• An unfavorable early rearing environment

Family

• Relationship and interaction between parent and child
• Child abuse and neglect

School

• Peers at school
• Teacher actions and expectations on the student

Society

• Impoverished environment and poor nutrition
• Sense of frustration and hopelessness
• A Disrupted family

Prevention

Due to an unclear understanding on the causes of emotional disturbance among students, it is often hard to pinpoint an exact preventive strategy (Heward, 2005; The Lead Center, 2008; Mauro, 2009). However, some of common strategies used include:

• Positive behavioral interventions, strategies, and supports  Effective for a student whose personal behavior impedes his or her own learning and that of other students.
• Psychological and counseling services  Effective on emotionally disturbed students
• Career education (both academic and vocational)  Should be offered to all adolescents

Characteristics

• Psychiatric disorders  includes anxiety disorders, mood disorders, and conduct disorders
• Hyperactivity  includes impulsiveness and short attention span
• Withdrawal  includes retreating from social interaction conversations and failure to initiate social interaction with others.
• Aggression/ Self-injurious behavior  always involved in fights and acting out
• Learning difficulties  always performing below grade level academically
• Immaturity  includes temper tantrums, inappropriate crying, and poor life coping skills

Current trends

• One in every five children has in one time or another developed a diagnosable emotional, mental, or behavioral disorders.
• Up to ten percent of all children may develop a serious emotional disturbance later on in their adult life.
• Worldwide, up to 70 percent of all children who have developed emotional disturbance do not in anyway receive mental health treatment (WHO Fact sheet, 2004).

Instructional Strategies for Emotional disturbance

• Presentation of materials at independent level, not frustration at level
• Providing short and manageable class assignments
• Provision of mini-breaks between lessons

Autism

Definition

IDEA defines autism as a developmental disability that significantly affects the social interaction and verbal and nonverbal communication of children before they attain the age of three years, thereby adversely affecting their educational performance. Other characteristics associated with the condition include resistance to change in daily routines or to environmental change, engagement in repetitive activities, unusual responses to sensory experiences, and stereotyped movements. It was added as a distinct class of disability in 1990 under P.L. 101-476 (Bernadette & Barbara, 1998).

Causes

According to Heward (2005) and ASA (2008), no research has been able to unearth the causes of Autism. But possible causes put forth by researchers can be grouped into two broad categories that entail:

Genetic Vulnerability

• Abnormalities in brain function and structure
• Link between genetics, heredity, and medical problems
• Metabolic imbalances
• Genetic illnesses such as tuberous sclerosis, Fragile X syndrome, untreated phenylketonuria (PKU), and congenital rubella syndrome.

Environmental factors

• Medical conditions such as acute viral infections
• Exposure to dangerous environmental chemicals and metals such as mercury
• Problems during pregnancy

Prevention

• No known prevention strategy to reduce incidences or severity of the disorder at this time

Characteristics

According to Heward (2005), the characteristics of the Autistic disorder can be divided into the following major categories:

Social interactions and language development

• Signs of rejection, lack of general interest in people and physical contacts.
• Evade making eye-to-eye contact with other people, including parents
• Experience difficulty in communication
• Failure to interact with other children or develop interpersonal relationship
• Delay or total lack of language development
• Failure to use language to develop with others effectively
• Repetition of words and phrases (Echolalia)
• Using idiosyncratic or stereotypical language

Behavioral and cognitive development

• Presence of stereotyped or repetitive patterns of behavior
• Preoccupied usually with moving objects, parts of objects, and lights
• Repetitive motor movements such as finger or hand flapping and rocking
• Noticeable hypersensitivity to certain types of noises
• Perform rituals
• Maintains routines that are excessively rigid or nonfunctional
• Undertakes highly restricted patterns of interests or preoccupations

Current Trends

• Autism occurs in approximately 1 per 2,000 children
• Improved media coverage has led to public allure with autism
• There exists astonishing claims about the efficacy of some treatment approaches but no empirical evidence has been able to substantiate the claims

Instructional Strategies

• Printed schedules
• Printed directions
• 3-D rewards such as small toys
• Visual prompts such as overlays to put on the page that the student should focus on (Disability Resources, 2007).

Other Health Impairment

Definition

According to IDEA, Other health impairment is a condition attributable to individuals who have limited vitality, strength, or alertness as a result of acute or chronic health conditions such as rheumatic fever, heart condition, leukemia, hemophilia, and asthma, which unfavorably affect the educational performance of that individual (Bernadette & Barbara, 1998).

Causes

According to Heward (2005) a multiplicity of factors is believed to play a pivotal role in causing other health impairments. However, the most common causes are:

• Genetic impairments
• Disease
• Environmental factors such as pollen, animal dander and chemical irritants

Prevention

Although some Other Health Impairments are hard to prevent, the following preventive strategies have been found useful.

• Physiotherapy
• Being physically active and maintaining a healthy body weight
• Reducing alcohol intake and fat in food
• Avoiding prolonged exposure to the UVA/UVB sources such prolonged sun tanning

Characteristics

• Lack of alertness or strength to keep up with class work among the students with OHIs, thereby affecting the students ability to perform successfully
• Long periods of absence due to acute or chronic health problems
• Observed inability to perform tasks at the same pace and length of time as peers due to acute or chronic health problem
• Inability to attend to tasks due to the medication being taken
• An acute inability to attend to school duties for more than a few hours a day due to limited vitality and strength
• Developmentally inappropriate degrees of impulsivity, inattention, and over activity

Current Trends

The number of students diagnosed with OHIs worldwide is less than 5 percent. However, the number is rising than in the past decades because students with attention deficit hyperactivity disorder and ADD are now integrated in this category.

Instructional Strategy

Be flexible with deadlines. Due to the students lack of strength and vitality as a result of the OHIs, they may require more time to complete a task or assignment. Other students with medicated or chronic pain may need an extension of time or additional explanations of the materials that have already been covered in class (Disability Resources, 2007).

Traumatic Brain Injury

According to IDEA definition, Traumatic Brain Injury (TBI) is an acquired injury to the brain occasioned by an external physical force, thereby causing partial or total psychosocial impairment or partial functional disability, or both, that unfavorably affects a students educational performance. The definition applies to closed or open injuries to the head, resulting in actual impairments in one or more areas, such as language, memory, cognition, abstract thinking, attention, judgment, perceptual, problem-solving, and motor abilities. The injuries may also result in impairments in physical functions, psychosocial behavior speech, and information processing. TBI was added as a distinct category of disability in 990 under P.L. 101-476 (Bernadette & Barbara, 1998).

Causes

TBI can be can be caused by a multiplicity of causes like the ones indicated below (Adams et.al. 2008).

• Motor Vehicle  traffic crashes
• Assaults/ Firearms
• Falls
• Struck by/ against situations
• Harmful chemicals such as solvents, insecticides, lead poisoning, and carbon monoxide poisoning
• Lack of adequate oxygen (Hypoxia)
• Disease

Prevention

There are numerous ways to prevent the chances of TBI happening. Some of them are:

• Fastening of seat belts while driving and buckling your children too
• Never drive under the influence of alcohol
• Wear a helmet when riding a motorbike, playing contact sport, riding a horse, etc.
• Making living areas safer by removing clutter in walkways, installing grab bars next to a toilet, improving the lighting systems throughout the home, etc.
• Putting lethal chemicals out of reach of children

Characteristics

According to Kimes (2005), there are many characteristics of TBI students. Below are the most basic ones

• A deep sense of frustration and denial occasioned by the fact that the student was previously living a normal life prior to the acquired brain injury. The student physical, social, emotional and academic life drastically changes due to the injury bringing about the deep sense of frustration.
• Greater degree of disorientation, confusion, and emotional outbursts during the initial stages of recovery from the injury.
• Unusual discrepancies in ability levels such as inconsistent patterns of performance and uneven cognitive deficits.
• Significant problems in integrating, generalizing, and structuring information
• Behavioral problems such as being more distractible, impulsive, hyperactive, and perceptions of being socially inappropriate.

Current trends

Approximately 1.5 individuals in the U.S. suffer from TBI every year. Out of that number, 50, 000 succumb to the injuries, and another 85, 000 suffer long term disabilities. More than 5.3 million individuals in the U.S. live permanently with disabilities occasioned by TBI. Among the children aged 0 to 14 years, 2,685 die out of TBIs, 37,000 are hospitalized, and 435,000 receive emergency department visits each year (Centre for Disease Control, 2008).

Instructional Strategy

Compensatory strategy  Due to heightened levels of frustration, stress, and self denial occasioned by the acquired disability, the students concentration levels in class is substantially affected. As such, what the student hear does not stick, a situation known as slowed acquisition. As such, the instructor must use a lot of repetition to compensate for what the student lacks to grasp (Disability Resources, 2007).

Multiple/ Severe disabilities

Definition

IDEA defines multiple/ severe disabilities as a combination of impairments (such as mental retardation-physical disabilities, or mental retardation-physical disabilities) that has the capacity to cause extreme educational problems that the child cannot find any accommodation whatsoever in a special education program sorely for one of the multiple impairments. However, the term does not cover deaf-blindness situations (Bernadette & Barbara, 1998).

Causes

In 40 percent of all cases of multiple disabilities, no identifiable cause has been forthcoming. But according to Heward (2005) and a fact sheet on multiple disabilities published in 2006, the most likely causes of multiple disabilities includes metabolic disorders, prenatal biomedical factors, brain malfunctions, possible dysfunction in production of enzymes causing a large buildup of toxic chemicals substances in the brain, problems during pregnancy, problems at birth, low birth weight, incidents after birth, and heredity problems..

Prevention

A good prevention strategy for multiple disabilities should include:

• Good prenatal care
• Pre-Pregnancy determination of risk causing factors
• Access to quality healthcare
• Public awareness of prevention strategies

Characteristics

According to Heward (2005), Allyn and Bacon (2004), the characteristic of multiple disabilities are varied. They can be subdivided into the following sub-categories.

Cognitive

These includes Motor delays, abnormal muscle tone, Balance problems, Muscle atrophy, Memory loss, and Contractures

Medical

These characteristics include Seizure disorders, Problems in hearing and vision, Heart disease, and Cerebral palsy.

Language

Characteristics include having trouble generalizing information and communication problems

Social

Trouble communicating in community activities without supports

Current Trends

• In the U.S., only 0.18 percent of students have multiple-severe disabilities
• The requirements for this type of disability are different in various states. For instance, some states exclude hearing problems and learning disabilities from this category. However, the unique needs of all the students having this disability are met.
• Currently, children with multiple-severe disabilities are being placed in classrooms and other community-based activities with their counterparts who are not disabled. However, this trend has been courted with controversy

Instructional Strategy

Note taker services  due to the severity of the multiple disabilities, such students can be assisted by finding effective note takers to help them take notes in the class. The note takers should be pooled from the class (Disability Resources, 2007).

Communication Disorders

Definition

According to IDEA, a communication disorder is a language or speech impairment such as impaired articulation, voice impairment, communication disorder or a language impairment that unfavorably affects a childs educational performance (Bernadette & Barbara, 1998).

Causes

According to Heward (2005), the causes of communication disorders are varied, and are related to the functioning of the brains. They can be classified under the following categories.

• Hearing impairment  Either full or partial hearing impairment may cause difficulty in language and speech development
• Physical disabilities  Causes includes palate, cleft lip, Cerebral palsy, malformations of the nose or the mouth, and vocal cord injury.
• Developmental disability like the Down syndrome, Autism
• Learning disabilities
• Diseases such as the Austin spectrum disorders and Pervasive Development Disorders
• Behavior and emotional problems like deficiencies in social skills
• Alcohol intoxication

Prevention

There are many strategies that can be used to prevent communication disorders (Heward, 2005) and (Khan, 2007). However, these strategies can be grouped into three distinct groups  primary, secondary, and tertiary preventive measures.

Primary

These include genetic counseling, health education, hearing conservation, environmental change, vocal hygiene, immunization, prenatal care, and prevention of secondary communication disorders.

Secondary

Secondary prevention measures for communication disorders include:

• Screenings for speech-language disorders
• Screenings for hearing/ balance disorders
• Early intervention for hearing/ balance disorders
• Early intervention for language-swallowing disorders

Tertiary

• Tertiary prevention measures include:
• Patient counseling
• Family/ caregiver education programs
• Treatment of identified disabilities
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