Teaching Strategies for Individuals with Multiple Disabilities

 

Evidence based practices for students with severe disabilities 

Instructional strategies for students with multiple disabilities

Multiple disabilities in your classroom: 10 tips for teachers

Severe and education of individuals with multiple disabilities

Strategies for inclusion of children with multiple disabilities including deaf-blindness

Students who are blind or visually impaired with multiple disabilities

Students with multiple disabilities

Supporting young children with multiple disabilities: What do we know and what do we still need to learn?

Teaching students with multiple disabilities

Teaching students with severe or multiple disabilities

What is Childhood Disintegrative Disorder?

Did you know that Childhood Disintegrative Disorder is  considered part of Autism Spectrum?

Childhood Disintegrative Disorder (CDD) is a condition where a child develops normally and achieves appropriate milestones up to the age of 4 and then begins to regress in both developmental and behavioral milestones and lose the skills they already learned. with a loss o skills plateauing around the age of 10.

Childhood Disintegrative Disorder is rare. It affects 1.7 in 100,000 and affects males at a higher rate than females. It is also known as Heller’s Syndrome and Disintegrative psychosis. The causes are unknown but may be linked to issues with the brain and nervous systems with some researchers suggesting it is some form of childhood dementia.

First discovered by Dr. Theodor Heller in 1908, Dr. Heller began publishing articles on his observation of children’s medical history in which he reported that in certain cases, children who were developing normally began to reverse at a certain age.

Signs and Symptoms

Children begin to show significant losses of earlier acquired skills in at least two of the following areas:

  • Lack of play
  • Loss of language or communication skills
  • Loss of social skills
  • Loss of bladder control
  • Lack of motor skills

The following characteristics also appear:

  • Social interaction
  • Communication
  • Repetitive interests or behaviors

Due to the small number of reported cases, it is included in the broad grouping of autism spectrum disorder in DSM-V under pervasive developmental disorder (PDD).  Although grouped with the autism spectrum disorder diagnosis, there are distinct differences. For example, children with CDD were more likely to be diagnosed with severe intellectual disability, epilepsy and long term impairment of behavior and cognitive functioning.

Resources

NCBI

Summit Medical Group

Teaching Strategies for Dysgraphia

Dysgraphia is  learning disability that affects handwritng, spelling and the ability to put thoughts on paper. It affects fine motors skills leading to illegible handwriting, inconsistent spacing between letters and poor spelling ability. It is possible for dysgraphia to be part of the diagnosis of ADHD, autism, and dyslexia. Signs often include an awkward pencil grip, becoming quickly tired from writing and lack of punctuation and capitalization. The following links provide teaching strategies which will help to improve writing skills.

5 helpful strategies for dysgraphia

9 strategies for dysgraphia

Creating a dysgraphia- friendly classroom

Dyslexia and dysgraphia: Teaching strategies to help your students

How can teachers and schools help kids with dysgraphia?

Intervention for dysgraphia

Strategies for Dealing with Dysgraphia

Strategies for students with dysgraphia

What is dysgraphia? Support and strategies for your classroom

What teachers need to know about dysgraphia

Teaching Visually Impaired Students

According to IDEA’s definition, visually impairment is defined as including blindness means an impairment in vision that, even with correction, adversely affects a child’s educational performance. The term includes both partial sight and blindness. There are 3 types of blindness including The types of vision impairments are low visual acuity, blindness, and legal blindness (which varies for each country): Low visual acuity, also known as moderate visual impairment, is a visual acuity between 20/70 and 20/400 with your best corrected vision, or a visual field of no more than 20 degrees.

The following articles and links provide resources on teaching students with visual impairments.

Teaching Strategies

The following are articles that provide tips and resources on teaching students with visual impairments.

10 tips for teaching blind or visually impaired students

Classroom strategies for regular education teachers who have students with visual impairments

General tips for teaching visually impaired students

How to teach a blind or visually impaired student

Inclusion teaching: Vision impairment and blindness

Teaching languages to blind and visually impaired students

Teaching strategies for vision impaired students

Teaching the blind and visually impaired

Strategies for helping children with visual impairments to develop listening skills

Visual impairment in the classroom

Teaching Activities

The following links provide activities that can used to teach students with visual impairments.

Adapting materials for visually impaired students

Create a restaurant book with tactile symbols

Durable braille flashcards

Tips and tools for teaching beginning braille skills

 

Attention Skills Strategies

Attention is defined as the ability to keep the mind on something and the ability to concentrate. Skills often include careful observation or listening. The ability for a student to sustain attention, motivation, language, and sensory intervention. Children with autism, ADHD, intellectual disabilities, executive functioning disorders, and Cri du Chat have difficulty sustaining attention over a long period of time.

Strategies they may provide to be useful include:

  • Eye Contact
  • Repeat instructions
  • Provide frequent breaks
  • Use in a leadership role.
  • Provide choices in test-taking
  • Ongoing prompting.

The following are articles on ways to improve concentration and attention:

4 concentration activities for students – Getting Smart

7 in-class activities to improve concentration in children-TEACH

10 Games to boost attention and focus– Heart-Mind Online

Attention Activities– The OT Toolbox

Activities that help develop attention skills– Boise Speech and Hearing Clinic

Attention and Concentration– Kidsense

Brain training activities– Our Journey Westward

Pay attention: Ten steps to improving attention and concentration- ADHD Center

The attention games: Catching focus through fun– Additude

Using play to increase attention– Miss Jaime OT

Fragile X Syndrome Teaching Strategies Resources

Fragile X Syndrome is a genetic disorder and is the most common form of inherited intellectual and developmental disability. It is estimated to affect 1 in 4,000 males and 1 in 8,000 females. Characteristics include learning disorders, sensory issues, speech and language and attention disorders.

Learning challenges include, difficulty in processing information, understanding concepts, poor abstract thinking and cognitive delays. The following sites provide information on teaching students with Fragile X Syndrome.

Best Practice in Educational, Strategies and Curricula (National Fragile X Foundation)

Education Planning for Fragile X Syndrome for Patients (UPMC Children’s Hospital of Pittsburg)

Fragile X in the Classroom (TeAchnology)

Fragile X Syndrome Teaching Strategies and Resources (Teacher’s Gateway to Special Education)

General Educational Guidelines for Students with Fragile X Syndrome (National Fragile X Foundation)

Student Teaching Tips: Helping your students with Fragile X (Magoosh)

Strategies for Learning and Teaching (National Council for Special Education)

Down Syndrome and Heart Disease

Down Syndrome  is a chromosomal disorder caused by an extra cell division that results in an extra 21st chromosome. This causes developmental delays both intellectually and physically. The disorder is named after John Langdon Down, a British physician who was the first to describe the syndrome in 1866. The disorder was later identified by Jerome LeJeune in 1959 as a condition associated by the chromosome structure. Down syndrome is the most common chromosome disorder. Each year, about 6,000 babies are born with Down syndrome.

An estimate of 1 in 700 babies born. The life expectancy of people with Down syndrome increased between 1960 and 2007. In 1960, an average person with Down syndrome lived to be 10 years old compared to 2007 with people with Down syndrome living to 47 years of age. Often, people born with Down syndrome may develop health issues and a cognitive development ranging from mild to severe. There is often a speech delay and children may lag behind with fine and gross motor skills. Physical characteristics may include a flat nasal bridge, single, deep creases across the center of the palm, protruding tongue, large space between the large and second toe, low muscle tone, almond shape to the eyes.

 

The causes of Down syndrome is due to an extra copy of chromosome 21 in every cell. This is the most common form of Down syndrome. It represents 94% of all cases of Down syndrome. Congenital  heart failure affects 300,000 or 40% of individuals with Down syndrome. There are 3 types:

  • atrioventricular septal defect (AV Canal)- a condition caused by the Septum failure to close properly. This occurs during the embryonic stage and results in a large opening at the center of the heart.
  • Persistent Ductus Arteriosus- when a tube that continues to exists after a baby is born. It is a persistent opening between the two major blood vessels leading from the heart.
  • Tetralogy of Fallot- a heart condition composed of four abnormalities: 1) Ventricular Septal Defect 2) a narrowing of the passage from the right ventricular to the lungs 3) an over enlarged right ventricle due to blood back up 4) an over enlarged aorta, which carries blood from the left ventricle to the body.

Congenital Heart Disease can range from severe to mild. Typically, students do not require special care. For those with more severe heart issues, be aware of the signs and symptoms of a student heart disease is getting worse. This include:

  1. Arrhythmia, an abnormal heart rhythm that can cause the heart to beat fast or too slow
  2. Congenital heart failure- when the heart cannot pump enough blood and oxygen to meet the needs of the body.
  3. Pulmonary hypertension- a type of high blood pressure that affects the arteries in the lungs and the right side of the heart.

Signs and symptoms include:

  • shortness of breath
  • fatigue and weakness
  • swelling
  • rapid or irregular heartbeat
  • persistent cough

Things to be aware of in students with Heart Issues:

Tires easily or becomes short of breath after exercise

May have exercise restrictions

May need extra time to go and from classes

 

Resources

Related articles

It’s hard to imagine a time when children with disabilities did not have access or the rights to an equal education as those students without disabilities. Prior to 1975, many children with disabilities were living in large institutions or went to private schools.

President Gerald Ford signed into the Education For All Handicapped Children Act (Pubic Law-94-142) now knowns as the Individuals with Disabilities Education Act (IDEA). The purpose of IDEA is to protect the rights of infants, toddlers, children and youth with disabilities and to provide equal access to children for children with disabilities. The following list describes the 13 categories of IDEA eligibility including the definition below:

A child with a disability is defined as a child evaluated as having an intellectual disability, hearing impairment (including deafness), a speech or language impairment, visual impairment (including blindness), a serious emotional disturbance, an orthopedic impairment, autism, traumatic brain injury, an other health impairment, a specific learning disability, deaf-blindness, or multiple disabilities who need special education and related services.

  1. Autism means developmental disability significantly affecting verbal and nonverbal communication and social integration, generally evident before age 3, that adversely affect a child’s educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences.
  2. Deaf-blindness- defined as having both visual and hearing impairments. The combination of which causes such severe communication and other developmental and education needs that they cannot be accommodated in special education programs.
  3. Deafness- a hearing impairment that is so severe that the child is impaired in processing linguistic information through hearing, or with or without amplification, that adversely affects a child educational performance.
  4. Emotional disturbance- a condition exhibiting one or more of the following characteristics over a long period of time
  5. Hearing impairment- an impairment in hearing, whether permanent or fluctuating that adversely affects a child’s performance but that is not included under the definition of deafness.
  6. Intellectual disability- significantly lower general intellectual functioning, existing concurrently with deficits in adaptive behavior and manifested during the developmental period, that adversely affect a child’s educational performance.
  7. Multiple disabilities- A combination of impairments (such as intellectual disability-blindness or intellectual disability-orthopedic impairment). The combination causes severe educational needs that they cannot be accomplished in special education program solely for one of the impairments.
  8. Orthopedic impairment- a severe orthopedic impairment that adversely affects a child’s educational performance. The term includes impairments caused by a congenital anomaly, impairments caused by diseases (e.g. Poliomyelitis) and impairment causes (e.g. cerebral palsy, amputations, and fractures or burns that cause contractures)
  9. Other health impairments- having limited strength, vitality, or alertness including a heightened alertness to environmental stimuli that results in limited alertness with respect to the educational environment that is due to chronic or acute health problems such as asthma, ADHD, diabetes, epilepsy, heart condition, sickle cell anemia and Tourette syndrome which adversely affects a child’s education performance.
  10. Specific learning  disability- a disorder in  one or more of the basic psychological processes involved in understanding or in using language spoken or written that may manifest itself in the imperfect ability to listen, think, speak, read, write, spell or to do mathematical calculations including conditions such as perceptual disabilities, brain injury, dyslexia and developmental aphasia.
  11. Speech or language impairment- a communication disorder such as stuttering impaired articulation, a language impairment, or a voice impairment that adversely affects a child’s educational performance.
  12. Traumatic brain injury- An acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment or both. Traumatic brain injury applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition, language, memory, attention, reasoning, abstract thinking, judgement, problem-solving, sensory, perceptual motor abilities and information processing and speech.
  13. Visual impairment including blindness- an impairment in vision that, even with correction, adversely affects a child’s educational performance. The term includes both partial sight and blindness.

Early Signs of Rett Syndrome

Rett syndrome is a neurodevelopmental disorder occurring mostly in females in which the child exhibits reduced muscle tone, autistic-like behaviors, stereotyped hand movements consisting of wringing and waving. It is a rare disorder that affects about 1 out of 10,000 children and is the most genetic causes of severe intellectual disability in females. Due to similarities to autism and cerebral palsy, it is often misdiagnosed.

Signs similar to autism include outburst, eye contact avoidance, lack of social reciprocity, sensory issues and loss of speech. Signs of Rett syndrome similar to cerebral palsy include short stature, difficulty with walking, gait movement difficulties and delayed ability to walk.

Typically, children born with Rett syndrome develop normally until the age of 6 and 18 months and reach typical development milestones including eye contact, rolling over and grasping objects. As children grow, motor development begins to slow such as walking and muscle movement. The first signs is usually the loss of muscle tone where the child’s arms and legs appear “floppy.”

Other early signs include:

  • Loss of communication abilities
  • Unusual eye movement
  • Breathing problems
  • Irritable and crying often
  • Intellectual disability
  • Seizures
  • Scoliosis
  • Sleep disturbance
  • Irregular heartbeat
More Resources on Rett Syndrome

Over 30 Online Resources on Rett Syndrome

 

Dysgraphia and Workplace Accommodations

Some might be surprised to learn that there are several types of learning disabilities. Dysgraphia is describes as a learning disability that affects writing, spelling and fine motor skills. Dysgraphia is a neurodevelopmental disorder that can occur as a stand alone disorder or part of a co-occurring disorder with other disabilities such as ADHD, Autism, and Dyslexia. Typically it is diagnosed or discovered in the early years when children are beginning to learn how to write. Most adults often remain undiagnosed.

Early Signs of Dysgraphia

Signs and symptoms of dysgraphia generally begin to show up when children began to lean how to write. Early signs of Dysgraphia include:

  • Inconsistent spacing between letters
  • Poor spatial planning
  • Poor spelling
  • Unable to read own handwriting
  • Poor fine motor skills
  • Omitted words
  • Writes slow
  • Pain in hand from writing
  • Messy unorganized papers
  • Difficulty organizing thoughts on paper
  • Illegible printing and cursive letter formation
  • Slopping handwriting
  • Tight, cramped pencil grip
  • Tires quickly when writing
  • mixes upper and lower case or irregular sizes and shapes of letters.

Download a free dysgraphia checklist

Signs and Symptoms in the Workplace

A early signs that rarely disappears is having a “sloppy” handwriting. The person when writing leaves out letters at the end of a sentence, difficulty reading own handwriting after meetings, trouble with filling out routine forms, displays unorganized papers on the desk, difficulty thinking and writing at the same time and tends to mixes upper and lower case letters when writing. The person will also avoid writing when possible and show a preference to using a computer or texting neatness, line spacing, staying inside margins and capitalization rules.

Strategies to Use in the Workplace
  1. If you have a smart phone, you can use the device to record meetings, interviews or instructions that are given to you.
  2. Assitive technology such as tablets, computers and Apps are also useful in transcribing information
  3. Take the time to organize your desk before you leave work in the evening. Prioritize your workflow and create a plan for the next day.
  4. Pre-write. Before you take on the task of writing, create an outline on paper.