ECE 28 WEEK 4 DEVELOPMENTAL DISABILITIES: CAUSES & CLASSIFICATIONS The Exceptional Child, Inclusion in Early Childhood Education, Fifth

Edition, Thomson-Delmar Chapter 5 OBJECTIVES: After discussion you should be able to: Specify several possible causes of developmental disabilities & give examples. Discuss the correlation between poverty & developmental disabilities. Argue both for & against labeling young children as having a particular disability, supporting each argument with examples. Explain why it is especially inappropriate to use terms like mentally retarded, emotionally disturbed, or learning disabled in reference to young children. List at least seven of the major categories of disabling conditions, in order of the most to the least number of children & youth being served. KEY TERMS acute amino acid anoxia asymptomatic auditory biological insult autosomal dominant gene disorder behavior geneticist breech autosomal recessive gene disorder Braille categorical funding chronic congenital congenital anomaly enzyme Fragile X syndrome genetic disorder metabolic disorder metabolize neurological orthopedic impairments reflexive remission residual vision sex-linked gene disorder syndrome tactile toxemia visual acuity CAUSES OF DEVELOPMENT DIFFERENCES, Two questions: What causes developmental problems? Should we assign a disability category to young children with atypical developmental patterns? Answer: Research, discussion, lack of agreement continues because of varying professional & legal viewpoints. Responses: Developmental differences appear to be a combination of interacting events; heredity, biology (physical makeup), temperament (personality), environmental factors, including poverty. Whatever the cause of developmental disabilities, the damage can occur at any stage of development. Congenital - a condition present at the time of birth. These problems may or may not be genetically related. Indisputable evidence that biology & environment act together to produce both atypical & typical development. BIOLOGICAL FACTORS Biological insult refers to interference with or damage to an individuals physical structure or functioning. Insult may occur at the same time as conception, with resulting genetic disorders. It may occur during pregnancy, often within the first trimester (first 12 weeks of pregnancy) & be related to health problems in the mother. Insults can also happen at the time of birth, or anytime during childhood. GENETIC DISORDERS The fertilized egg has 46 chromosomes: 22 pairs of autosomes (non-sex chromosomes). 2 chromosomes that determine the sex of the child (XX in a girl, & XY in a boy). Abnormal biological development may be caused by deviations in chromosomal structure or by abnormal single genes. Single gene defects are hereditary & often show racial variations. (Autosomal dominant gene i.e. like a web between the second & third toe). SYNDROMES Syndromes are a major class of genetic abnormalities. Refers to a grouping of physical characteristics called stigmata. When several stigmata are found together in a recognizable pattern the child is said to have a syndrome. Down syndrome; most widely recognized. Also known as Trisomy 21, and the individual has 47 rather than 46

chromosomes. On chromosome 21, there is an extra chromosome Occurs in approximately 1 in 700 births. Risk is higher in teenage mothers & woman over 45 years old. Name the physical stigmata that makes Down syndrome readily recognizable. About 50% of children with Down syndrome have congenital defects, some examples are: Heart abnormalities, often life threatening. Hearing impairments. Cognitive delays, ranging from mild to severe. Fragile X syndrome described as a structural abnormality on the X chromosome of some males with a developmental disability. Fragile X can cause some disability in both sexes, but boys seem to be more seriously impaired. Second leading cause for mental retardation. METABOLIC DISORDERS Metabolic disorders cause a breakdown in the complex chemical activities needed to metabolize food. The breakdown can destroy, damage, or alter cells. Single-gene defects (such as PKU). PKU (phenylketonuria) occurs one in 10,000 births cause by a autosomal recessive gene common to people of Northern European ancestry & uncommon to African Americans. Infant born lacks an enzyme that breaks down amino acid phenylanine, present in milk, wheat, eggs, fish & meat. First time infant drinks milk, brain damage occurs. A restricted diet must be followed through developmental years. Affected females are recommended to stay on the diet during childbearing years. - If not, baby she carries will be severely brain damaged. The control of PKU demonstrates how environmental manipulations can modify genetic disorders successfully. INCLASS ASSIGNMENT: Work in pairs to present the following information Weed Tay Sachs Cystic fibrosis Sickle-cell anemia Duchenne muscular dystrophy McCloud Alcohol and other drugs Lead poisoning Yreka Prenatal infections & intoxicants Rubella AIDS Diabetes Toxemia Tulelake Birth Complications Complications following birth Happy Camp Meningitis Encephalitis POVERTY Families living in poverty experience higher rates of infant death, failure to thrive, & birth defects than any other segment in society. The Children's Defense Fund (CDF) describes poverty as a persistent & pervasive social problem in the United States. Devastating link between poverty & developmental disabilities. Nutritional deficiency is associated with poverty. Special Supplemental Food Program for Women, Infants, & Children (WIC) established in 1970's. Inadequate health care & education. About 25% of pregnant women do not receive adequate prenatal care. These women often bear infants at high risk for developmental problems. Homelessness & substandard of living.

 Estimated that 100,000 children may be without a home, half are less than 6 years old. Single-parent families. Child care. Combating poverty. CLASSIFICATION OF DEVELOPMENTAL DISABILITIES Categorical funding has been discontinued in the birth to 6 component of the law. Replaced with a more flexible concept developmental delay. Categorical Systems do exist and are used to allocate federal funding in twelve categories: TWELVE CATEGORICAL SYSTEMS Specific Learning Disorder (SLD) Speech & Language Impairments Mental Retardation Emotional Disturbance Multiple Disabilities Hearing Impairment Orthopedic Impairment Other Health Impaired Visual Impairments Autism Deaf-blindness Traumatic Brain Injury A CLOSER LOOK AT SPECIAL EDUCATION DISABILITY CATEGORIES While some states may break some of these disabilities into separate categories the federal government lists these 11 categories in IDEA. The brief description is meant to be a general guide and should not be considered specific criteria for eligibility. The disabilities are based on what is sometimes referred to as educational diagnosis as opposed to a medical diagnosis. This means that the criteria for special education may be different than diagnostic criteria for the medical or mental health profession. This is often confusing to parents and doctors, psychologists and others not familiar with the criteria necessary for special education. Developmental Delay: this is when a child between the ages of 3 and 9, exhibits developmental delays in one or more of the following areas: physical development, cognitive development, communication development, social or emotional development, or adaptive development. There are specific criteria for determining whether or not the delay is significant, this usually has to do with how far behind the student is from peers developmentally. There are also specific rules around using this category, in California it is primarily used in children birth to 3 years old. Mental Retardation (MR): this usually refers to those students who have both a significantly lower IQ - (100 is average MR is 69 or below) AND has significant delays in adaptive skills as indicated through an evaluation. Students are generally given some kind of an IQ test and a test that assesses their living skills, the Vineland is one test used, the Achenbach is also used. There are many different tests for adaptive skills these range from questionnaires to checklists to actual performance of the student. A school psychologist can explain this to you in detail. Hearing Impairments (including deafness): this is fairly straight forward and describes those impairments that affect the students ability to hear the spoken word and other sounds. Speech or Language Impairment: this actually addresses two very distinct problems. First, speech impairments generally refer to impairments in the ability to produce language or sound required for language. This is often referred to articulation or artic. Other speech issues may include the movement of the tongue and mouth and throat muscles oral motor skills. Speech and language pathologists are specialists in working with speech problems. A CLOSER LOOK AT SPECIAL EDUCATION DISABILITY CATEGORIES The other area, language, refers to both expressive language (how students use language) and receptive language (how students understand language). These problems can impact students in many ways; from reading and writing to social and behavior skills. It is important to look at language when we have a student who is exhibiting social and behavior problems as well as problems in the academic areas. Speech and language pathologists are specialists in language (although students can have an oral expression or listening comprehension learning disability which is generally considered the same as language impairments). Visual Impairments (including blindness): this category refers to those students who have impairments that limit their ability to see. Visual perception, visual tracking and other perception problems are not typically included under his category. Serious Emotional Disturbance (hereinafter referred to as Emotional Disturbance'): Students

who qualify for special education under this category must meet specific educational criteria outlined in state law. An educational diagnosis is different than a medical diagnosis; and on some occasions may not be in agreement. The symptoms for an educational diagnosis must be present for a period of time and are significantly impacting social, behavioral or emotional functioning in the school environment. Social maladjustment and some mental health diagnoses may exclude the use of this category. Autism: this disability includes all the Autism Spectrum Disorder (ASD) categories; Autism, Aspergers, Pervasive Developmental Delays Not Otherwise Specified (PDD-NOS) and Pervasive Developmental Delays (PDD). This diagnosis may be an educational or medical diagnosis and it is important to consider who has made the diagnosis. Autism generally affects communication, social interaction and behavioral (routines, specific and/or unusual interests, abnormal behavior such as flapping, spinning or swinging). Traumatic Brain Injury (TBI): refers to injuries to the brain that occur after birth, usually caused by an accident, incident or sometimes by medical interventions for tumors, cancers or other illnesses. Orthopedic Impairments (Physical Impairments): this refers to physical disabilities that may affect the students ability to be mobile, use arms, legs or hands. Many of these students require physical or occupational therapy in order to either benefit from their special education or to be involved in the general education environment. Cerebral Palsy and Muscular Dystrophy are just two disorders that are found under this category. Other Health Impairments: this includes those health issues that significantly impact student functioning such as ADHD, swallowing difficulties, use of respirator or other medical equipment etc. Specific Learning Disabilities (SLD): there are currently seven areas of learning disabilities: basic reading, reading comprehension, math calculation, math reasoning, written expression, oral expression and listening comprehension. Eligibility for learning disabilities is changing with IDEIA. For more information, look at Response to Intervention (RTI) or Problem Solving Model for determining eligibility for special education. SPECIFIC LEARNING DISORDER LEARNING DISABILITIES: TYPES, SYMPTOMS, AND INTERVENTIONS A learning disability is not a problem with intelligence, often the individual's IQ falls within the normal range. The source of the difficulty is in the brain. Children and adults with a learning disorder have trouble processing sensory information which interferes in their daily activities at school and work. They see, hear and understand things differently. If left untreated, the challenges of a learning disability can create a severe affect for a child's school experience and self-esteem. However, treatment is available and can be successful even if the disability is identified in late childhood or adulthood. Scientists are currently studying the brain's potential for change which may hold the answer to innovative treatments for learning disabilities and may one day reduce the need for prescription medications. SPECIFIC LEARNING DISORDER, WHAT IS A LEARNING DISABILITY? These are common statements made from uneducated people about children with learning disabilities. "If she would just pay attention, she would get it." "After I give the instructions, he sits there and stares at his paper. He is not motivated." "He has the ability, if he just tried harder, he could do it. He chooses not to do the work." SPECIFIC LEARNING DISORDER A child with a learning disability cannot try harder, pay closer attention, or improve motivation on their own; they need help to learn how to do those things. A learning disability is caused by a problem in the nervous system that affects how information is received, processed or communicated. There are a variety of disorders that affect the way verbal and non-verbal information is acquired, understood, organized, remembered and expressed. SPECIFIC LEARNING DISORDER TYPES OF LEARNING DISABILITES There are a variety of skills impacted by learning disabilities. They cover the gamut from language and reasoning to calculation and motor skills. Learning disorders cause havoc in a childs life on a daily basis. If left untreated, the frustration and difficulties caused by the learning problems, both at home and in school, creates stress and hardship resulting in the child feeling bad about themselves. SPECIFIC LEARNING DISORDER LIST OF THE DIFFERENT TYPES OF LEARNING DISABILITIES FREQUENTLY IDENTIFIED: Language: Reading Disorder, Disorder of Written Expression Calculation: Mathematics Disorder

 Problems with Motor Skills: Developmental Coordination Disorder Communication Disorders: Expressive Language Disorder, Mixed Receptive-Expressive Language Disorder, Phonological Disorder, Stuttering SPECIFIC LEARNING DISORDER SKILLS IMPACTED BY LEARNING DISABILITIES Oral Language: listening, speaking, and understanding Reading: decoding and comprehension Written Language: spelling and written expression Mathematics: computation and problem solving SPECIFIC LEARNING DISORDER SIGNS AND SYMPTOMS OF LEARNING DISABILITIES Some signs of learning disabilities present themselves in early childhood which is beneficial because the earlier a problem is recognized, the sooner an intervention can be made, allowing for a better prognosis. Often a developmental lag is not considered a symptom of a learning disability until the child is much older and attending school, which wastes precious treatment time. By noticing if a toddler or preschooler is not meeting normal developmental milestones you can get ahead of the game by having a child evaluated further. When the learning disability is not diagnosed early-on, parents are often surprised to find out that their bright and imaginative child is struggling in school. They are shocked when their child receives a low score on a standardized test or a progress report comes home indicating their child is "underachieving" or "not working up to their full potential." SPECIFIC LEARNING DISORDER FREQUENT SIGNALS OF LEARNING DISABILITIES *Signs that appear in preschool: Delay in understanding or using spoken language Difficulty understanding simple instructions Lengthy pause before naming objects and colors Limited awareness or interest in books Difficulty coloring or drawing Problems with motor coordination Short attention span (won't sit through one storybook) *Symptoms in school-age children: Difficulty understanding and following instructions Trouble remembering what someone just told them Failing to master reading, spelling, writing, and/or math skills and therefore fails schoolwork Difficulty telling the difference between "right" and "left," problems identifying words or a tendency to reverse letters, numbers or words (e.g., confusing "b" with "d," 18 with 81, or "on" with "no.") Lacking motor coordination when walking, playing sports, holding a pencil or trying to tie a shoelace Frequently loses or misplaces homework, schoolbooks or other items Unable to understand the concept of time, confused by the difference between "yesterday," "today," and "tomorrow." SPECIFIC LEARNING DISORDER NEUROLOGICAL CONDITIONS THAT MAKE LEARNING DIFFICULT * Conditions affecting concentration: Anxiety, depression, stressful events, emotional trauma, and other conditions affecting concentration make learning more of a challenge. Difficulty in mastering certain academic skills can also stem purely from a neurological basis. Here is a list of neurological conditions that can affect a childs ability to learn. * Other conditions impacting ability to learn: Visual processing disorder Auditory processing disorder Attention-Deficit/Hyperactivity Disorder Pervasive Developmental Disorders (Autism and Aspergers) Sensory Integration Dysfunction ADD and ADHD are other learning disorders that impact the ability to learn. SPECIFIC LEARNING DISORDER LEARNING DISABILITY TESTING IN PUBLIC SCHOOLS Determining whether a child has a learning disability involves testing, history taking and observation by a trained specialist. Referrals in Siskiyou County Public Schools are managed through Siskiyou

County Office of Education through the Special Education Department. Specialists trained to do testing and interpretation of results: Special education teacher School psychologist Speech and language therapist School nurse Vision/Hearing specialist Occupational therapist Physical therapist Sometimes several professionals coordinate services as a team to obtain an accurate diagnosis, including input from your child's teachers. Recommendations can then be made for special education services or speech-language therapy within the public school system. SPECIFIC LEARNING DISORDER TIPS FOR TEACHING STUDENTS WITH LEARNING DISABILITIES Here are a few common interventions and accommodations that can be used with children in their regular classrooms. If you are a parent of a child with a learning disability, talk to your child's teacher about creative ways to make learning more fun. Visual problems For problems with reading - try enlarged print for books, papers, worksheets or other materials which makes tasks more manageable. Improving tracking and focus - using colored construction paper, cut a window out of a rectangle to create a frame that is placed on top of the worksheet, it helps keep the relevant numbers, words, or sentences, in clear focus while blocking out much of the peripheral material which can be distracting. As the child's tracking improves, the prompt can be reduced. For example, after a period of time, you can replace the "window" with a ruler which still provides additional structure. This can be reduced further by having the child point to the word they are reading with their finger or pencil For problems with writing - adding more structure to the lined paper they write on can be helpful. For example, lines can be made darker and more distinct; paper with raised lines provides kinesthetic feedback; worksheets can be simplified and less material can be placed on each worksheet; using paper which is divided into large and distinct sections can help to improve penmanship when doing math problems. Auditory problems When giving verbal instructions - try to supplement with written materials or other visual cues Simplify verbal directions - give two commands instead of three, slow the rate of speech, and minimize distractions Help build auditory processing skills - rhyming games build phonics awareness and improve discrimination skills between similar and different sounds; sorting games involving verbal commands help to improve memory