Disability Characteristics

Understanding Differences

Assignment
Get into groups of 3 Group 1 Learning Disabilities / Mental Retardation Group 2 Cerebral Palsy / Spinal Cord Injury Group 3 Autism / Sensory Impairments (VI/HI) Each group has the responsibility of putting together a review of disability characteristics for each disability in their group to discuss with class Take 20 minutes for this assignment

Learning Disabilities

Definition, Causes, and Characteristics

Learning Disabilities

Learning disabilities include: (P.L. 101-476)

perceptual disabilities brain injury minimal brain dysfunction dyslexia, dyscalculia, dysgraphia aphasia, amnesia

Learning Disabilities

Learning Disabilities do not include:

learning problems resulting from visual, hearing, or motor disabilities, mental retardation, emotional disturbance, or cultural or economic disadvantage

Causes Specific causes are difficult to pinpoint Commonly accepted as neurologically derived

Learning Disabilities Causes

Breakdown somewhere within the CNS processing mechanism Sensory processing issue When functioning effectively, Sensory Information Processing leads to normal learning

Example:

Sensory Information Processing

Input Sensory Input Decision Making Integration Assimilation

Sensory Input into Perceptual Patterns Decision Making

Message to Muscles:

Response
Output

Learning Disability Characteristics

Top ten frequently cited characteristics: 1. Hyperactivity 2. Perceptual-motor impairments 3. Emotional instability 4. Coordination deficits 5. Attention disorders 6. Impulsivity

Learning Disability Characteristics

7. Disorders of memory and thinking 8. Specific academic learning disabilities 9. Disorders of language 10. Neurological signs (soft/hard)

Prevalence
Approximately 2million students in U.S. w/ LD (47% spec ed.) Growing 1 to 2% per/year 3x as many boys than girls Other disabilities (CP / SHI) typically have LD Educational Placement - 60% resource rooms / 20% regular ed / 20% self-contained

Attention Deficit Hyperactivity Disorder (ADHD)

ADHD characteristics: Inattention Impulsive Hyperactive Perseveration

transition difficulties ball bouncing laughing repeating phrase or topic of conversation

Mental Retardation

Definition, Causes, and Characteristics

Mental Retardation
AAMR definition: Four criteria 1) Substantial limitations in personal capabilities 2) Subaverage intellectual functioning (I.Q.) 3) Disability in 2 or more adaptive skill areas Communication, home living, community use, work, health/safety, social skills, self-care, self-direction, functional academics, leisure 4) Begins before age 18

MR Definition
School personnel: Definition within the Rules for implementing IDEA IDEA Definition (Three Parts)

Significantly subaverage general intellectual functioning Existing together with deficits in adaptive behavior Originating during the developmental period

Levels of MR associated with IQ

Levels of Severity of MR: IQ Based

Depends on scale that your using M=100 SD=15, then 70-55 Mild 54-40 Moderate 39-25 Severe 25 and below Profound New definition 2 levels

New Classification MR
Mild and Severe Not based on IQ, rather level of functioning IQ is one of 3 or 4 dimensions used to determine level of severity of disability Issue: Severe / Profound

Etiology (Causes)
30 to 40 percent: No know cause Other causes include two factors: Biological and Environmental Most common cause of MR in the United States: Fetal Alcohol Syndrome (FAS) Oldest known cause of developmental disabilities

How Old?

Fetal Alcohol Syndrome

Bible (Judges 13:3-4) Behold now, thou art barren and barest not; but thou shalt conceive and bear son. Now therefore beware, I pray thee, and drink not wine nor strong drink

Fetal Alcohol Syndrome

Characteristics

born to term, but small, childhood thin and short, adolescent may be normal ht and wt microcephalic (small head) strabismus (cross or wall eyed) increased incidence of heart defects I.Q. b/w 60-70 ADHD, autistic tendencies

Causes of MR linked to time periods

MR Causes: Time Related

Prenatal Chromosomal Anomaly Hydrocephalus, Microcephalus Metabolic Disorders Maternal Disease Parental Blood Incompatibility Maternal Self Abuse

MR Causes: Time Related

Perinatal Premature birth, post mature birth Low birth weight Difficult labor delivery Elevated Billy Ruben (Treatment?)

MR Causes: Time Related

Postnatal Head trauma Disease Environmental Deprivation Poisoning Late Onset Metabolic Disorders Malnutrition Seizure Disorders

MR Causes: Time Related

Combined Occurrence (before, during, or after birth Accident Cerebral Anoxia Tumors Syphilis Idiopathic Conditions

Scope
By definition (using IQ only), 3% of population is Mentally Retarded (i.e. 7.5 million people) About every five or six minutes, a child is born with MR (9,000 a month) 90% mild 6 % moderate 5% severe/profound SES major factor in MR prevalence

Physical Disabilities
Cerebral Palsy Paralysis and Spinal Cord Injury Amputations Other Physical Conditions

Cerebral Palsy

Definition, Causes, and Characteristics

Cerebral Palsy
Medical term that refers to one of a series of motor disorders that stem from brain malfunction *Damage to the immature brain Damage to motor centers (motor cortex, basal ganglia, brain stem, or cerebellum) Damage is commonly associated with retention of primitive reflexes 4 Diagnostic Criteria for Reflex Problems

Cerebral Palsy: Causes and Characteristics

Non-hereditary, non-contagious, and nonprogressive Disease, injury, and malformation of brain cells can all produce effects identical to those of cerebral palsy Exact cause is not known Typically, causes are associated by time of onset. For example:

Cerebral Palsy: Causes and Characteristics

Prenatal Functional disturbances of the mother (may produce hemorrhages in fetal brain) Rh incompatibility Infection Diseases

Cerebral Palsy: Causes and Characteristics

Natal Prolonged or difficult labor Anoxic conditions Premature birth Postnatal Brain infections Poisoning Head trauma

Cerebral Palsy: Causes and Characteristics

Specific common prenatal (90%) causes include: AIDS, rubella, herpes, cytomegalovirus Alcohol, tobacco, street drugs Trauma to mother that effects fetal brain development Maternal age (under 20 over 34) Oxygen deprivation deliveries (anoxia, hypoxia, asphyxia)

Cerebral Palsy: Causes and Characteristics

Specific common acquired (10%) causes include: Must be damage to immature brain Encephalitis, meningitis, pertusis Accidents Child abuse Cerebral stroke Gunshot wounds Gas, lead, radon poisoning

Types of Cerebral Palsy

Mild to severe Based on muscle tone and limbs involved 7 distinct types of CP 5 anatomical classifications of limbs involved Three Main Types Spastic Athetoid Ataxic

Spastic Cerebral Palsy

Occurs in over 1/2 of all cases (i.e. most common Damage to cortical tracts Characterized by high muscle tone (hypertonus) Hyperactive reflexes and contracted flexor muscles Contractures Often associated with mental retardation

Athetoid Cerebral Palsy

Occurs in about 1/4 of all cases Damage to basal ganglia Characterized by puposeless, involuntary movement Varying degrees of muscle tone (hyper to hypotonic) Constant squirming and wriggling

Ataxic Cerebral Palsy

Less common type of cerebral palsy (10%) Usually acquired postnatally Characterized by deficient sense of balance, coordination, and kinesthesis Voluntary movements are usually uncoordinated and clumsy Swagger Gait similar to an intoxicated person Typically poor muscle tone

Anatomical Classification for Limbs Involved

Monoplegia Diplegia Hemiplegia Triplegia Quadriplegia Other associated characteristics include; speech disorders, seizures, visual/hearing deficits, and perceptual motor difficulties

Paralysis and Spinal Cord Injury

Definition, Causes, and Characteristics

Spinal Cord
Spinal cord: 31 pairs of spinal nerves Protected by vertebral column 24 movable

7 cervical 12 thoracic 5 lumbar

Spinal cord injuries = result form some type of trauma

Most common ? Most common sport? Gender?

Spinal Cord Injury Classification

Five-point grading system for extent of injury (lesion to spinal cord) 1. Complete 2. Incomplete with sensation only 3. Incomplete with nonfunctional motor ability 4. Incomplete with motor function 5. Complete recovery

Paralysis and Spinal Cord Injury

Two categories of paralysis

paraplegia quadriplegia

Higher lesions = less function C1 or C2 most devastating (Iron Lungs) Other associated complications

Amputations

Causes, Incidence, and Characteristics

Amputations Classifications
4 classifications of causes Limb Deficiencies 1. Congenital Acquired Amputations 2. Tumor 3. Trauma 4. Disease

Amputations
Incidence Approximately 400,000 people in U.S. 2 other categories of differences in amputations

dysmelia phocmelia

Prosthetics

Other Physical Conditions

Muscular Dystrophy Multiple Sclerosis Spina Bifida

Muscular Dystrophy
Degenerative muscular condition Weakening of respiratory muscles and immunosuppressed Three main types

Duchenne Facio-scapular-humeral Limb girdle

Duchenne Muscular Dystrophy

Most severe and most common Fatal, inherited form of MD Sex linked disorder (mostly males affected) Muscle fibers degenerate in gluteals, abs, erector spinae, and anterior tibialis Frequent falls, contractures, body imbalance Gradual reduction in motor ability, wheelchair use, and then ultimately death

Facio-Scapular-Humeral MD
Most common in adults Equal gender affliction Progressive weakness of face, shoulder, and arm muscles (hence the name) Usually, non-fatal

Limb Girdle MD
Slow muscle degeneration of shoulder girdle and hip and thigh muscles Equal gender affliction usually after 10 years old Least common form of MD

Multiple Sclerosis
Inflammatory disease of the CNS Demyelination bouts that last 1 to 3 months Leaves some degree of disability Followed by periods of remission More common in women Age of onset 20 to 40

Spina Bifida
Second in prevalence to cerebral palsy for orthopedic defects in school-aged children Congenital anomaly resulting in, Failure of of one or more vertebral arches to properly develop and close Usually occurs in the lumbar region Three types (levels of severity) of Spina Bifida

Spina Bifida
Spina Bifida Occulta Least severe Defect in the fusion of the posterior neural arch Usually asymptomatic, does not cause paralysis or muscle weakness

Spina Bifida
Meningocele More severe, requires surgery Characterized by a sac containing (meninges or spinal cord covering) protruding out of the open neural arch Spinal fluid leaks into sac. Rupture can lead to meningitis Otherwise, usually no neurological defects

Spina Bifida
Myelomeningocele Most severe and most common Always associated with some degree of neurological deficit Both the meninges and part of the spinal cord itself protrude into a sac Location of spinal cord lesion determines involvement and associated disabilities 90% of cases have hydrocephalus

Deafness and Hearing Impairment

Definition, Causes, and Characteristics

Deafness and Hearing Impairment

P.L. 101-476 defines: Hearing Impairment an impairment in hearing, whether permanent or fluctuating, that adversely affects a childs educational performance but that is not included under deafness in this section P.L. 101-476 defines: Deafness

Deafness and Hearing Impairment

Deafness is defined as: hearing impairment that is so severe that the child is impaired in processing linguistic information through hearing, ...that adversely affects a childs educational performance Very few students are deaf; most are hearing impaired

Sound Characteristics

Two primary characteristics of sound

loudness / intensity frequency / pitch

Loudness is measured by decibels (dB) Ex. Normal speech at 10ft away is 45 to 65 dB loud. A freight train 10ft away is 90 to 120 dB loud 5 classifications for hearing loss in (dB)

Classifications for Hearing Loss

Slight = 25-40 dB loss Mild = 41-55 dB loss Marked = 56-70 dB loss Severe = 71-90 dB loss Profound = 91 dB or greater loss A 70 dB loss is the cut-off between hard of hearing and deaf Frequency is measured in hertz (Hz) or cycles per second

Frequency (Hz)
Frequency is basically high and low pitch Piano example: lowest key is 30 Hz and highest key is 4,000 Hz Normal range = 20 Hz and 20,000 Hz Daily communication is between 100 and 10,000 Hz Two main types of hearing loss

conductive sensorineural

Types of Hearing Loss

Conductive hearing loss - originates in outer or middle ear Sound traveling through air passages is obstructed

ex. Put finger in ear canal (25 dB loss)

Conductive loss results in hard of hearing condition, NOT deafness

Types of Hearing Loss

Sensorineural hearing losses are more serious, occurring in the inner ear Damage to auditory nerve, nerve fibers, or one of the structures of the inner ear Causes disruption in conversion of sound waves into neural impulses for translation Balance problems typically associated Generally irreversible loss Incidence: over 16 million (2 million deaf)

Visual Impairments

Definition, Causes, and Characteristics

Visual Impairments
Legal Blindness Definition: Less than 20/200 vision with best correction, or Less than 20 degree visual field with best correction Incidence - 1 in 3,000

25% total blindness 25% partial blindness 50% can read enlarged type

Structure of the Eye

LIGHT CORNEA and LENS

Retina

Optic Nerve

Brain

Blindness

Causes:

anoxia intrauterine infections head trauma retinoblastoma nutrition disorders (vitamin A deficiency)
cortical - problem along visual pathway retinal - eye structure itself

Two types: