Children
with Severe and Multiple Disabilities
346 -
Psychology of the Exceptional Child
(4-22-13)
IDEA does not include the category of "severe" disability, but does include "multiple disability" and "deaf-blind"
Multiple Disabilities are defined by IDEA as concomitant impairments that may combine to cause such severe educational problems that accommodation cannot be achieved in educational programs solely for one of the impairmentsuse of the term: "dual diagnosis" is problematic because this expression has multiple meanings in the professional literatures:
"dual diagnosis" may refer to the occurrence of emotional/behavioral problems in an individual with mental retardation
However--in other contexts "dual diagnosis" refers to comorbid substance abuse and psychiatric disorder; or to mental retardation and another mental disorderDeaf-Blindness is a dual sensory impairment, intellectual functioning may range from gifted to severe mental retardation
Helen Keller
TASH The Association for Persons with Severe Handicaps
The TASH definition of Severe Disabilities focuses on 3 factors in their definition of severe disabilities:
1. adaptive fit: the relationship of the individual with the environment--requiring the individual to cope with the demands of various environments as well as requiring environments to accommodate the need of the individual
2. the need to include people of all ages
3. "extensive ongoing support" in life activities
Prevalence of severe and multiple disabilities
Very small percentage of general population: estimates vary from 0.1 to 1%
Small percentage of children receiving special education: approximately 2%
Etiology: numerous factors may be involved
neurological factors are common
Characteristics:
Life needs often cannot be met without substantial assistance from others.
Degree of participation in life may require substantial assistance from others.
For some, life long institutial care may be a reality.
Mental retardation is often a primary condition.
Academic learning may be a reduced priority.
Adaptive skills are critical to success in personal independence and social interaction: taking care of oneself and communicating basic needs are essential life skills.direct training efforts focused on adaptive behavior has been very successful
enhancing executive functioning has been less successful
adaptive communication is useful in overcoming speech problems, less effective with language and/or comorbid profound intellectual deficit
Significant deficits in and delays in speech and language skills are common; these tend to positively correlate with severity of mental retardation (but not always--severe cerebral palsy may compromise speech, manual, and electronic communication in individuals with good language ability and intelligence).
Significant physical and health needs are common.
Sensory and motor deficits are common.
Technological advances have made a significant impact on the quality of life of some individuals with severe and multiple disabilities.
assistive devices
inhanced independence and safe self-sufficiency
vocational opportunities
opportunities for social communication and interaction
Balancing the good of the individual and the good of society is a major challenge
paying for services
providing accessable venues
Am I my brother's keeper?
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