Studies show that both children and adults with developmental disabilities are vulnerable to incidents of abuse and injuries. Personal safety includes learning about being safe and dangerous environments. The following articles focus on teaching tips in both the community and in the home.
Feeding problems are common in people with an intellectual/developmental disability. For example, it is reported that 37% of individuals with diplegia or hemiplegia and 86% of individuals with quadriplegia experience GERD. It is very common in people with cerebral palsy and can show up as anemia, failure to thrive and reoccurring infections.
It is usually missed by people who have been feeding and serving food to individuals with disability due to its subtle signs.
What is Gastroesophageal Reflux? (GERD)
GERD occurs when the muscle connecting to the esophagus is weak and opens under pressure, allowing the stomach contents to flow back into the esophagus. It is the acid from the stomach to the esophagus. this will irritate the lining of the esophagus and causes heartburn. Without treatment, GERD can cause complications.
What causes GERD?
GERD is usually caused by inflammation from the exposure of the esophagus to the stomach acid. The following can cause GERD:
- diet such as fatty foods, coffee, peppermint and chocolate
- decreased muscle tone
- backup in blockage of the intestinal tract.
There are many reasons for the high incidence of GERD in individuals with intellectual disability including immobility and positioning, abnormal postures, medication use and excessive drooling.
What is a developmental disability?
A developmental disability is described as an assortment of chronic conditions that are due to mental or physical impairments or both. For example, you may have a child or an adult with an intellectual disability or perhaps a person diagnosed with cerebral palsy and an intellectual disability. It is also considered a severe and chronic disability that can occur up to the age of 22, hence the word developmental. A developmental disability can occur before birth such as genetic disorders (i.e. cri du chat, fragile x syndrome,) or chromosomes ( i.e. Down syndrome, Edwards syndrome); during birth (lack of oxygen) or after birth up to the age of 22 (i.e. head injuries, child abuse or accidents).
For people with limited communication, the following are possible signs of gastroesophageal reflux:
If you suspect GERD, make arrangements for the person to be evaluated by a physician.
Publisher: Yahoo News
Written by:Rachel DeSantis
A day at the Dollywood Family Amusement Park is filled with enough sights, sounds and colors to overstimulate anyone — especially those with autism.
That’s why Dollywood safety manager Judy Toth, who noticed an influx of families with children on the spectrum at the Tennessee park, decided to take action to help make their trip all the more memorable.
The result? A first-of-its-kind calming room that serves as a refuge of sorts for families seeking a break from the non-stop hustle and bustle of the 150-acre theme park.
“[It’s] sensory overload when you come to a theme park,” Toth tells PEOPLE. “And I couldn’t quite grasp at the beginning, you know, why are they coming? Knowing that something could potentially trigger their child. But realistically, it was just that they want their child to do what any other child does.”
The calming room first opened in the spring of 2016 after Toth observed that families with children on the spectrum were having to either end their trip early or slip someplace quieter, like a bathroom or a first-aid tent. Click here to read the rest of the story
Learn to identify coins is one of the first steps in learning to count and understanding money management skills. The following worksheets will help to reinforce the ability to recognize the various denominations of coins.
The lesson plan below is a helpful tool to reinforce recognizing coins. Children with intellectual disabilities and special needs learn best through visual demonstrations and pictures. Remember to allow extra time to complete the task and use simple directions.
Lesson Plan: Identify Coins
Objective: the Student will successfully identify coins
Performance Criteria: The student will identify the correct coin, 3 out of 5 trials
- coin worksheets
- actual penny, nickle, dime and quarter
- the instructor will use real coins and identify the coin to the student
- the instructor will use one coin at a time, starting with the smallest demoninator
- The instructor will pick up the penny and state, “this is a penny.”
- The instructor will then ask the student to pick up the penny
- The instructor will aske the student to describe the penny
- The instructor will ask the student the value of the penny.
- Once completed, the instructor will have the student complete the worksheet
- The insstructor will continue with the rest of the coins.
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)
Strategies for Learning and Teaching (National Council for Special Education)
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:
- Arrhythmia, an abnormal heart rhythm that can cause the heart to beat fast or too slow
- Congenital heart failure- when the heart cannot pump enough blood and oxygen to meet the needs of the body.
- 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
- 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
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.
- 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.
- 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.
- 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.
- Emotional disturbance- a condition exhibiting one or more of the following characteristics over a long period of time
- 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.
- 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.
- 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.
- 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)
- 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.
- 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.
- 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.
- 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.
- 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.
Obesity is a major health concern and is more common in individuals with Down syndrome than the general population. Obesity is defined as excessive fact accumulation that increases health risk. It is an abnormal accumulation of body fact usually 20% of a person’s ideal body weight.
Medical complications of obesity includes sleep apnea, lung disease, pancreatitis, heart disease, cancer, arthritis, inflamed veins and gout. When the body mass increases, so does the risk of having a heart attack or heart failure.
In a study published by the American Association Intellectual and Developmental Disabilities found a difference between studies on children versus adults with Down syndrome. Children with Down syndrome have consistently been found to exhibit a reduced resting metabolic rate meaning children with Down syndrome are at a great risk for weight gain since they will burn fewer calories. at rest during activities.
Children with Down syndrome also tend to have a condition known as hypothyroidism. Approximately 10 percent of children with Down syndrome have hypothyroidism. As children with Down syndrome get older, eating behaviors change leading to obesity (Approximately 30%). These changes may be due to low muscle tone or inactivity due to thyroid problems or heart conditions.
Exercise and recreation are crucial to the well-being of individuals with Down syndrome. The following are strategies for helping to maintain weight control and to live longer and healthier lives:
- Develop a regular exercise program. According to Drs. Chicoine and McGuire, authors of The Guide to Good Health for Teens and Adults with Down syndrome, Exercise should be free of risk. Push ups and weightlifting are not appropriate due to many people with Down syndrome who have issues with the upper 2 vertebrates.
- Swimming is an effective exercise. Many pool have walking exercises in the pool as well.
- Exercise should be fun, socially and realistic.
- For older adults with Down syndrome, look for teachable moments to teach portion control, drinking enough fluids, and eating a well-balanced meal.
Chicoine, B. and McGuire, B. (2010). The Guide to Good Health for Teen and Adults with Down Syndrome. Bethesda, MD
Obsessive- Compulsive Disorder (OCD) is defined as a disorder that includes two core symptoms- obsessions and compulsions. According to the Census for Disease Control and Prevention (CDC), obsessions are defined by:
- Thoughts, impulses, or images that occur over and over again. These thoughts, impulses or images are unwanted. They cause a lot of anxiety and stress.
- The person who has these thoughts, impulses or images tries to ignore them or tries to make them go away.
Compulsions are defined as:
- Repeated behaviors or thoughts over and over again or according to certain rules that must be followed exactly in order to make an obsession go away.
- The person feels that the purpose of the behaviors or thoughts is to prevent or reduce distress or prevent some feared event or situation.
The following are facts and statistics on Obsessive Compulsive Disorder:
- 1.2% of U.S. adults had OCD in the past year.
- OCD was higher for females (1.8%) than males (0.5%).
- Among adults with OCD, approximately one half (50.6%) had serious impairment
- 34.8% of adults with OCD had moderate impairment
- 14.6% had mild impairment.
- OCD affects 2.2 million adults
- The average onset is 19 with 25% of cases occurring by age 14
- One-third of affected adults first experience symptoms in childhood
- 17% of autistic people may specifically have OCD
- Because of similar characteristics, it is often overlooked
- It affects people of all races, ethnicities, and socioeconomic backgrounds
- OCD is one of the top 20 causes of illness-related disability worldwide for individuals between 15 and 44 years of age
- 1 in 40 adults are affected.
- 1 in 100 children are affected
- Other conditions may co-exist with OCD including anxiety, bipolar, ADHD, autism spectrum, Tourette syndrome, and major depressive disorder.
- Worldwide, OCD is approximately 2% of the general population
- OCD ranks 10th place among all diseases
- 1 in every 200 children has the disorder 60 to 70% of OCD children improve significantly with therapy.
- Many people still hide their OCD behaviors.
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
- Sleep disturbance
- Irregular heartbeat
More Resources on Rett Syndrome