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Michael Cotten

Sarah Detraz

Hunter Stamps

Michael Cotten

No single definition covers all the conditions associated with multiple disabilities.

Schools sometimes use the terms multiple disabilities and severe disabilities.

These terms are used to describe students who need intensive support to address their intellectual, adaptive, motor, sensory, or communication needs.

Whenever children have multiple, coexisting abilities and disabilities, it

presents a challenge:

How should an educator classify such as student? What type of

disability do they have?

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IDEA states that multiple disabilities are defined by

concomitant impairments (such as intellectual disability and blindness; emotional/behavioral disorder and orthopedic impairment) the combination of which causes such severe

educational needs that they cannot be accommodated by solely addressing one of the impairments.

Unpacking that:

Concomitant = a phenomenon that naturally accompanies or follows something. (i.e. delays and turbulence are a concomitant of flying)

Thus, the impairments the student has naturally occur with one another so you cannot accommodate the student by treating only one impairment.

Due to the individualistic nature of multiple disabilities, you cannot accurately describe the entire group with catch all phrases.

You can, however, group students within this heterogeneous mix into specific characteristics involving:

Intellectual Functioning

Adaptive Skills

Motor Development

Sensory Functioning

Communication Skills

Remembers the list as IAMS Cat.

Intellectual Functioning

Adaptive Skills

Motor Development

Sensory Functioning

Communication Skills

IAMS motto is “Life’s Better” and we are trying to improve these students’ lives. Why remember? Nearly all disabilities fall within one of these 5 categories.

Cognitively impaired students often have intellectual functioning that is typically two standard deviations below mean (70 and below)

Some students may have average or above average intellect and have impairments within the realm of adaptive, motor, sensory, or communication impairments.

Traditional IQ tests are often inappropriate for students with multiple disabilities.

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Why are IQ tests not suitable? Four reasons. 1. Multiple Disabilities students are not included in normative samples of

standardized intelligence tests.

2. Information from these tests has limited utility when designing appropriate educational programs.

3. These students have often not been exposed to academic content used on the tests.

4. These tests rely primarily on verbal abilities and many students with multiple disabilities have communication impairments.

Remember, some students can overcome impairments and graduate with a general curriculum diploma. Others will work on how to increase alertness, or interact with others and environmental peers.

This includes practical competency and self-care skills.

It is especially important these skills generalize to home and community settings.

Most students with Multiple Disabilities attain some level of independence.

Teachers need to communicate with parents and caregivers about school-based training, including how to carry it out at home and where to get support to do so.

Students with Multiple Disabilities usually have significant motor and physical challenges. This often produces abnormal muscle tone.

Undeveloped muscle tone can lead to difficulty sitting and moving; over development can lead to spasticity.

Both of these can lead to difficulty functional tasks – tasks such as eating, dressing, playing, etc…

Hearing and Vision impairments are common.

IDEA recognizes deaf-blindness as its own category.

“ Deaf-blindness” means concomitant hearing and visual impairments, the combination of which causes such a severe communication and other developmental and educational needs that they cannot be accommodated in special education programs solely for children with deafness or blindness. “

Note: over 90% of students in this classification have various combinations of the two. The impairments are sever enough that they need their own special designed instruction.

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Almost all students with multiple disabilities, not just those who are deaf-blind, have communication impairments.

Teachers often report these students are not sufficiently engaged in communicative interactions during school, and this lack of interaction is associated with multiple barriers, including lack of teacher preparations, school contextual factors, lack of speech-lnguage pathologists, and complexity of students’ communication needs.

Many students use augmentative and alternative communication (AAC) systems.

This can sometimes be unknown and sometimes quite easy to pinpoint.

In ¾ of all children who have severe intellectual impairments, there is a biological cause. This is typically prenatal biomedical factors.

A common genetic cause is fragile X syndrome, this is the most common genetic disorder that is associated with intellectual disabilities.

Fragile X is an absence of protein in the chromosome that manifests itself as a multiple disability including intellectual disability and autism. Males are typically afflicted at a more significant level and on rare occasions an individual will have no intellectual disability.

https://www.youtube.com/watch?v=xKqN21OdsLQ

Determining the Presence of Multiple Disabilities

Apgar test – screens health of newborns and can be the first sign of impairment in newborns.

The test gives a score in one of 5 physical tests (skin color, heart rate, respiratory effort, muscle tone, and reflex irritability when stimulated.) at one minute and five minutes after birth. Newborns receive a 0-2 for each test. When the overall Apgar test is less than 4, a more thorough evaluation is indicated.

Students with multiple disabilities are typically identified at birth or in their early years, thus, physicians and not educators or psychologists, usually make the initial diagnosis.

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Students often use assistive technology, but only if the needs and ability to use technology are fairly determined by a close technology-related evaluation.

Assistive technology evaluations are multidisciplinary: technology specialists, speech-language pathologists, orientation and mobility specialists, and occupational and physical therapists.

Together the professionals and family evaluate how the assistive technology can enhance communication, seating/positioning, and fine-motor skills.

SETT – (Student, Environment, Task, Tools) This is the

framework for the assistive technology evaluation. Needs to be considered are:

Student’s needs, interests, and abilities

Environment in which the technology will be used

Tasks for which the technology will be needed

Tools that might be needed t o meet the student’s needs.

This determines if and how the assistive technology will be used.

Sarah Detraz

Key Terms: Person-centered planning approach

MAPs process

Supplementary aids & devices

AAC devices

1.0 Designing an appropriate IEP 1.1 Partnering for Special Ed. and Related Services

1.2 Determining Supplementary Aids and Services

1.3 Planning for Universal Design for Learning

1.4 Planning for Other Educational Needs

2.0 Using Effective Learning Strategies 2.1 Early Childhood Students: Children’s School Success

2.2 Elementary and Middle School Students: The Partial Participation Principle

2.3 Secondary Transition Students: Student-Directed Learning Strategies

1.0 CSS The Partial Participation Principle Student-directed learning

strategies Self-instructional strategies Self-monitoring strategies

2.0

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1.1 Partnership for Special Education

Person-centered planning approach

AAC (Augmentative and Alternative Communication)

and Related Services

Person-centered planning approach A way to design an IEP and plan transitions. • MAPs (McGill Action Planning Process)

• Customizes students’ education programs to their specific visions, strengths, and needs. • A creative way to plan for transitions from school to post-school life and activities.

Can be incorporated into IEP meeting or independently

Requires time

Work with experienced facilitator

Overarching questions: What makes the student tick?

How do we build off of their strengths to facilitate their learning experience?

How does this relate to/affect their inclusion within the home/school/community?

What are the obstacles?

How do we move past these obstacles?

Who is involved? Student, family/friends, facilitator, & teacher (specific service providers)

What is MAPs? What is your history/story? What about your dreams? What are your nightmares? Who are you? What are your strengths, gifts, talents? What do you need? What is the plan of action? References:

http://origin.library.constantcontact.com/download/get/file/1102498830321-84/Using+the+MAPS+Proc+to+Plan...+(Lockwood),+Doc+5..pdf

http://pcp.sonoranucedd.fcm.arizona.edu/resources/person-centered-planning-tools/map

https://www.youtube.com/results?search_query=assisstive+tech+for+students+w+multiple+disabilities

What is a supplementary aid/service?

Peer Tutoring

One on one

Small groups

Benefits?

Things to keep in mind as you implement peer tutoring:

Clarify roles

Match students appropriately

Provide support to all students

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Use of technology to enhance inclusion of students with multiple disabilities

Technology can include (but is not limited to):

Smartphones

iPads

Tablets

https://www.youtube.com/watch?v=IzSNdxsfk0Q

AAC (Augmentative and Alternative Communication)

Provides alternate forms of communication

Devices/strategies used by students with communication difficulties

Promotes:

Literacy learning

Access to general education curriculum

Autonomy

Self-sufficiency

Self-determination

Questions for the IEP team: What AAC devices are appropriate for the

student? What does the student need?

Symbols? How is meaning represented? How does the device display information?

Fixed vs dynamic https://allaboutaac.wordpress.com/consider

ations/type-of-display/

What will the selection options be? Scanning vs direct https://www.youtube.com/watch?v=Bhj5vs

9P5cw (1:20)

What is the method for output?

• Things to Consider: • Speech pathologist • Challenges:

• Limited functionality • Training & support availability • Focus remains on

communication • Reference:

• www.asha.org (American-Speech-Language-Hearing Association)

2.1 Early Childhood Strategies

2.2 Elementary and Middle School Students

2.3 Secondary and Transition Students

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CSS Children’s School Success Model designed by researchers

Goals?

Crucial points: Interaction b/w peers

5 key assumptions:

Active learners

Practice

Participation

Choice

Integration & problem-solving

4 main steps

CSS model’s 4 main steps in problem-solving process Reflect and act Plan and predict Act and observe Report and reflect

Gains/connections Academic & social Relates to previously discussed topics

Universal design Self-determination Involvement Inclusion/integration High expectations Science-based strategies

Principals that govern the education of students with multiple disabilities: Maximal participation Maximizes participation

The Partial Participation Principal No student denied access to general education classroom Rejects all-or-none approach Implementing this principal: Ask yourself questions What noninstructional supports does the student need for meaningful participation? How much does the student wish to participate? How can you enhance independence/partial independence?

Observe the student Plan accordingly What can the student do? What do they need to learn? Conduct task analysis Series of steps/observations and is recorded Can they perform the task independently, will they learn to perform the task, or do they need assistance?

Goal

Student-directed learning strategies Universal strategy

Particularly beneficial for students with multiple disabilities Picture prompts/antecedent cue regulation Reduces reliance

Helps those who have issues with memory

Temporary support that promotes learning

Self-instruction Teach verbal/communication skills to direct their learning

Self-monitoring Tangible way to track their own progress

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Types Traditional problem-solving Verbally instruct themselves

Task sequencing (“did-next-now”) Learn self-instruction statements related to a sequence of steps Ex. “I placed the silverware on the napkin,” next step, “I need to roll the silverware in

the napkin.

“What-where” Learn statements about what they need to do

Ex. “I need to roll the silverware in the napkin,” and, “I roll the silverware in the napkin at my workstation in the restaurant.”

Interactive (“did-next-ask”) Instruct themselves to ask for next step after completing previous

Traditional Charting or checklists

Tangible/creative Physical representations of “addition/subtraction” Ex. Marble added when tasks is complete.

Ex. Moving objects from one place to another. Promotes self-monitoring

Conditions: Must know how to complete task

Must know/understand measuring strategy

Build in check system

There Is convincing evidence that students with multiple disabilities can be successful in not only the regular classroom, but with extracurricular activities as well (sports, clubs, etc.)

46% of students with multiple disabilities spend LESS than 40% of their day spent in a regular classroom (usually in a special setting or even at home)

Parents believe that the primary benefit for their children to be included in a regular classroom setting is they have a greater chance of general education and functional skills because their expectations are higher in those classes.

Video start- 4:12

https://www.youtube.com/watch?v=qkfhsr3gX90

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Portfolio-based assessment- permanent products that show a students work. (graphs, life space analysis, students progress with other students)

The only way to measure a students progress towards a social goal, you have to watch and observe the students behavior and then record data to compare with.

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Day 1 Day 3 Day 7 Day 10

Working alone Working w/ Sally Working w/ multiple students Column1

Field observations- observing and recording a students behavior

Time sampling- an observer records the occurrence or nonoccurrence of specific behaviors during short, predetermined intervals