Session 4

Print as an outline uses as a jigsaw activity

Autism Spectrum Disorder Deaf-blindness Deafness Developmental Delay Emotional Disturbance*** Speech and Language

Impairment*** Traumatic Brain Injury

Hearing Impairment Mental Retardation*** Multiple Disabilities Orthopedic Impairment Other Health Impairment Specific Learning

Disabilities*** Visual Impairment

including blindness

Disabilities( *** High Incidence Disabilities)

– Group Report– Brief definition-

– Normal intelligence– Learning disabilities are problems that affect the brain's ability

to receive, process, analyze, or store information. These problems can make it difficult for a student to learn as quickly as someone who isn't affected by learning disabilities.

– There are many kinds of learning disabilities. Most students affected by learning disabilities have more than one kind. Certain kinds of learning disabilities can interfere with a person's ability to concentrate or focus and can cause someone's mind to wander too much. Other learning disabilities can make it difficult for a student to read, write, spell, or solve math problems

Learning Disabilities

• No specific cause has been identified- some theories suggest:– It is neurological and that there is some type of

brain damage, but most can not be identified- Lack of oxygen before, during or after birth is one suggestion

Etiology

• Heredity- many people with LD report they have relatives who had it- but it may be the same environmental factors that both have experienced

• Turner’s syndrome has been directly associated with mathematics disabilities

Etiology

• SES-• Living with limited health care,• Living around dangerous toxins– Lead

– Since we do not know what the causes are, we can not say what the prevention is.

Etiology

Difficult to say because LD is such a large and encompassing term

About 4 to 7 % ( 5.5 % is 2005 from dept of ed) Nearly Half of all students identified for special education have Learning disabilities

Adults 15 to 23%Next closest group by half is Speech and

LanguageSome feel it is a dumping ground for all students

that do not learn

Prevalence

• Some students with severe LD will need services their entire academic life even into adulthood- They will need to learn strategies to adapt to their needs

• Some student ended up leaving special education once they have learned the foundational skills

Prognosis

* Slow to learn the connection between letters and sounds

* Confuses basic words (run, eat, want)

* Makes consistent reading and spelling errors including letter reversals (b/d), inversions (m/w), transpositions (felt/left), and substitutions (house/home)

* Transposes number sequences and confuses arithmetic signs (+, -, x, /, =)

* Slow to remember facts * Slow to learn new skills,

relies heavily on memorization * Impulsive, difficulty planning * Unstable pencil grip * Trouble learning about time * Poor coordination, unaware

of physical surroundings, prone to accidents

Common Signs/ Physical characteristics

• * Reverses letter sequences (soiled/solid, left/fe

• Avoids reading aloud• * Difficulty with handwriting• * Avoids writing assignment• * Difficulty making friends• * Trouble understanding body

language and facial expressions, =)

Common Signs/ Physical characteristics

• Early intervention is essential However these is in conflict with the discrepancy model

• Two approaches were taken- – Process- one approach tried to teach students

to process information better. Retrain perceptual skills- very little success with this- Hamel research

– Product approach is to focus on teaching the academic skills ( reading)

Types of Interventions

• Small group direct instruction ( on level)

• Chunking• Perceptual motor

correction• visualization

• Fluency training• Most with reading, but

certainly can be math• Need to deal with social

skills as well

Types of intervention

• A font to help with dyslexia- unique letters- b (s) are different than d (s)

• So are all of the letters

Classroom Practices and accommodations

• Provide information at the start of the lesson to help children remember information

Advanced organizers

• Different memory techniques• Every good boy does fine

Mnemonics

• Dyslexia is a specific learning disability that is neurological in origin. It is characterized by difficulties with accurate and / or fluent word recognition and by poor spelling and decoding abilities. These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction. Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth of vocabulary and background knowledge.

OtherTypes of LD

Dyslexia is one type of learning disability. Others include...

• Dyscalculia - a mathematical disability in which a person has unusual difficulty solving arithmetic problems and grasping math concepts.

• Dysgraphia - a neurological-based writing disability in which a person finds it hard to form letters or write within a defined space.

• Almost 50 % of children with learning disabilities, have problems with math.

• Some students have problems with the multistep such as borrowing or visualizing the abstract.

Math Issues

• Many LD students do not approach learning in an organized and efficient manner and need support with this area

• Some of these skills include• Classifying, chunking, associating, sequencing

Non Strategic Learners

• Classifying is the skills where students can groups things together in terms of what characteristics they have in common

When students can group things together, they need to learn less- similar to chunking.

Non Strategic Learners

ADHD

• APA defines it as a persistent pattern of inattention and /or hyperactivity-impulsivity that is more frequent and severe than typically observed in individuals at a comparable level of development

ADHD

• One confusing issue is their inattention

– Often caused because they have a heightened sense of alertness, as a result they are tuned into everything and not able to tune out things

– This lead to an inability to focus on one thing , thus considered in attentive.

ADHD

• As a condition included under other health impairments- having limited strength, vitality or alertness, including heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment… adversely affects a child’s educational performance.

• Symptoms have to persist for six months to a degree that is maladaptive and inconsistent with developmental levels

ADHD Defined

• Very Little is known for sure, there are some theories that feel it is neurologically based-– Specifically the frontal lobes ( know for executive

function- the ability to self regulate, inhibit inappropriate behaviors and engage in goal directed activities

• Genetics may also play a role in ADHD as well

Etiology

Some estimates include between 4 % others say between 3 -7 % and still others say 3-55

BECAUSE ADHD CO-EXIST WITH OTHER DISABILITIES ND IS OFTEN NOT THE PRIMARY DISABILITY is one reason that there is not a clear number of how many children have ADHD

BOYS HAVE IT MORE THAN GIRLS- AS MUCH AS 4 TO 9 TIMES AS MUCH.

PREVALENCE

• ADHD is not as prevalent in other countries. Other countries have a much tighter criteria for having ADHD

• Some feel it will eliminate placing children as a result of cultural factors.

PREVALENCE

• There is no "cure" for ADHD. Children with the disorder seldom outgrow it; however, some may find adaptive ways to accommodate the ADHD as they mature.... Even though most people don't outgrow ADHD, people do learn to adapt and live fulfilling lives.

• Research shows Hyper activity sometimes decreases with age. Adolescents and adults still continue to have trouble with daydreaming and distractions

• Medications can help

Prognosis

• Ritalin, Adderal, Dexadrine or Concerta

• Are actually stimulants- it is believed that these medications increase blood flow to the frontal lobe and help it function better

• Increases attention level• Delays response time and allows a child to

think something through and not be so impulsive

Medications

• Medication improves behaviors related to ADHD, but not necessarily academic performance

• Some controversy surrounds these medications– Over prescribed– Has side affects

• Loss of appetite• Sleeplessness• Jitteriness• Dizziness

Medications

• Can be given too strong a dose,• Need to monitor and work with family• Can have an incredibly positive affect in school• Once was against but have seen to many

positive cases• Brad, Andrew

Medications

• In attention• Hyperactivity• Impulsivity

Common Physical Signs /Characteristics

• In attention• Noticed by parents and teachers• The inability to pay attention has serious consequences– Can’t follow directions– Difficulty play along with others, lose their spot– Can’t focus on a task– Difficulty changing activities ( transitions

Common Physical Signs /Characteristics

• Hyperactivity– Difficult to determine when an activity level

becomes “Hyper” or to high.

Common Physical Signs /Characteristics

• Impulsivity• A very common trait with children with ADHD.• Butt-in to conversations• Call out comments across a classroom• Change topic of conversation• Talk out of turn• One of the biggest reason ADHD children get into trouble-

often make poor decisions because they did not think something through

Common Physical Signs /Characteristics

• First step-– behavioral techniques– Systematic instruction– Highly motivating materials***

• Medication- More than any other disability, Students with ADHD are prescribed medication– Ritalin, Adderal, Dexadrine or Concerta

– *** too motivating and it is distracting

Types of Interventions

• Teachers can give advanced notice of change in activities. _ “in five minutes I need you to finish reading so we can get ready for lunch”

• Give clear concise directions- lose you after too many steps

• Try and keep routines and maintain a structured schedule and environment

Types of Interventions

• Teach social skills – direct instruction on how to interact with others and behave in socially appropriate ways

• Behavior plans and FBA’s help• Teach self management with rewards

Types of Interventions

Keep loud noises and distraction to a minimum ( sound Fields) Arrange desks for efficient flow Dismiss students in Small Groups ( when Possible) Have a behavior management plan Remind student of classroom rules Provide frequent feedback Deliver positive consequence immediately and frequently Introduce new activities and schedules incrementally Teach and support management skills Teach self regulation Warn of transitions Stand close to a student ( proximity)

Types of Interventions

• Avoid drawing attention to a student's behavior

• Conceal your frustration and redirect behavior• Explain clearly why the behavior is

inappropriate• Provide alternatives ( e.g. Teach students to

count to five before raising their hand)

Types of Interventions

• Time-on-task has been proven to have a direct correlation to academic performance

• Time studying also has a direct correlation• ADHD children have trouble with both of

these areas and not surprisingly their grades and performance in school suffers

• Handwriting messy, can’t find work/homework

Other Academic Performance

• As a result of the impulsivity, hyperactive and inattentive behaviors, positive social interactions decrease

• ADHD children become more introspective- and judge themselves as failures

• Creates a increasing cycle of alienation

Other/Social Behaviors

• Often ADHD is not identified till school age for several reasons– Before school the ADHD is not as serious a

problem and can be accommodated for in different settings

– Professionals do not want to identify someone wrongly

– Many of the characteristics of ADHD are common among preschoolers

Other/ADHD

• The major problem of students with ADHD is the vast amount of information they miss when they have episodes of non-attention

• Some strategies might include:– Reduce distracting Stimuli• Keep it quiet• Reduce wall distractions• Hallway distractions, fish tanks, doors, water fountains,

pencil sharpeners, high traffic areas

Other/ADHD

• Place near teacher• Give a behavior chart with rewards• Pointer to track words• Timers, so he completes task on time• Visual cues to indicate inappropriate

behavior- sad faces, yellow cards• Give reading and math early in the day• Have teacher monitor progress carefully• Uses student offices• Teach self-management/ self regulation

• ADHD is not an approved qualifying disability under IDEA 04, instead a child must qualify under “Other Health Impairments”

Other/ADHD

• Some people argue that ADHD is not a real disability and feel it is used and a excuse to justify bad behavior

• ADHD rates are increasing• ADD is sometimes used, but the medically

correct term is ADHD

ADHDOther

• Many times children with ADHD receive accommodations through a 504 plan.

Other/ADHD

This is when ADHD exist with another disabilityADHD often overlaps with other disabilitiesSome studies have shown, that as much as 70 %

of children with ADHD also have Learning Disabilities

Comorbidity students can receive support on an LS room or a ES room depending on what other disability overlaps with ADHD

Other/ADHDComorbidity

Emotional Disturbance

Historically

• For thousands of years, individuals with Emotional or behavioral disorders have been mistreated by society

• At times believed to be possessed by devil• Treatment included, imprisonment, beating,

chaining, straitjackets and starving• First institution was called St Mary of

Bethlehem also know as Bedlam, now this refers to a place that is out of control

Historically

• Most children with an emotional disturbance were not allowed in school

• Some felt it was contagious• When Socially and Emotionally Disturbed

students finally were provided education, it was in a residential setting

ED Students

• Ed students present some of the greatest challenges to Teachers

• When compared with other special education students, ED students have the most negative outcomes

• They lag behind academically in areas such as reading and math

• Do poorly on standardized tests

ED Students

• They miss more school• Are suspended more• Earn lower grades• And continue to struggle when they leave

school

IDEA

• Now called ED use to be SED for seriously Emotionally Disturbed

• Socially Maladjusted no longer included in the definition

Defined

• A condition exhibiting one or more of the following conditions over a long period of time and to a marked degree affects a child's educational placement– An inability to learn tat cannot be explained by

health, intellectual or sensory factors– An inability to build or maintain satisfactory

interpersonal relationships with peers and teachers

• Inappropriate types of feelings under normal circumstances

• A general pervasive mood or feeling of unhappiness or depression

• A tendency to develop physical symptoms related to fears associated with personal or school problems

Three types

• Emotional or behavioral disorders can be divided into three groups– Externalizing behaviors– Internalizing Behaviors– Low incidence disorders

Externalizing Behaviors

• Behaviors that you can see. Acting out behaviors, can be described as aggressive, impulsive coercive and no compliant

• Identify three behaviors that fit this category

Causes

• Biological• Home and Community• School

Biology

• There is a link between prenatal drug exposure and childhood emotional and behavioral problems

• Mood disorders such as schizophrenia and depression can be genetic

Home and Community

• Home and community shape everyone’s behavior

• Rarely does one specific experience result in an emotional disturbance. Most often it is repeated exposure to negative treatment, stress, rule confusion, low expectation and turmoil over a period of time

School

• Is key at dealing with growing emotional disturbance

• Unskilled teachers that allow bullying, continued harassment, disengagement can foster ED.

• Skilled teacher have a positive affect and can help reduce its onset.

Prevention

• Early identification• Maintain healthy environments school and at

home

Overcoming Challenges

• Medical Management– Correct medicine– Good prenatal care

• Reduce overrepresentation– Reduce suspensions

• School Based Interventions– Positive Support Plan

• Three-tiered- School wide, small group, individual- create a school where positive behavior is the norm

• FBA when needed

Mental Retardation

History

• Varies from culture to culture– Some cultures more accepting– Others and most not

• Sam Howe, the first director of the Perkins institute, predicted that hazards of residential institutions in 1848

• The use of institutions grew and by 1914, all but four states had residential institutions

• In 1877 a New York prison guard started rumors about how dangerous Mentally Retarded People are

• Blamed them for a great deal of crime, poverty and other social ills

• Almost a Hitler like philosophy, cleansing society from the imperfect

• Family members should be cast away• Encourage removing them from society

Basic Definition

• Mental retardation is a developmental disability that first appears in children under the age of 18. It is defined as an intellectual functioning level (as measured by standard tests for intelligence quotient) that is well below average and significant limitations in daily living skills (adaptive functioning).

Normalization

• People with retardation should have available to them patterns of life and conditions which are as close as possible to the regular circumstances and ways of life of society- from this came the philosophy of Dignity of risk

• Dignity of risk is a practice in which people with mental retardation should experience life’s challenges and adventures but not be overprotected

Normalization

• Shortly after this new philosophy became known, a young reporter named Geraldo Rivera exposed the terrible conditions in a Mental institution in New York, he snuck into Willowbrook State School and exposed the terrible conditions.

• This awareness lead to a dismantling of many similar institutions, Embreeville, Haverford , Pennhurst.

New Definitions of MR

• Seek to not use the deficit model and focus on the positive Orientation

• Mental Retardation means significant subaverage intellectual functioning, existing concurrently with deficits in adaptive behavior and manifested during the developmental period, that adversely affects a child’s educational performance

Intellectual Functioning

• This level of function is usually determined by a test on a Intelligence test or by a clinical judgment

• I Q is usually determined by the where they fall on normal curve need to fall two standard deviations below the mean

Levels of Mental Retardation

• Mild Mental Retardation• Moderate Mental Retardation• Severe Mental Retardation• Profound Mental Retardation

Mild mental retardation

Approximately 85% of the mentally retarded population is in the mildly retarded category. Their IQ score ranges from 50-75, and they can often acquire academic skills up to the 6th grade level. They can become fairly self-sufficient and in some cases live independently, with community and social support.

Moderate Mental Retardation

• About 10% of the mentally retarded population is considered moderately retarded. Moderately retarded individuals have IQ scores ranging from 35-55. They can carry out work and self-care tasks with moderate supervision. They typically acquire communication skills in childhood and are able to live and function successfully within the community in a supervised environment such as a group home.

Severe Mental Retardation

• About 3-4% of the mentally retarded population is severely retarded. Severely retarded individuals have IQ scores of 20-40. They may master very basic self-care skills and some communication skills. Many severely retarded individuals are able to live in a group home.

Profound Mental Retardation

• Only 1-2% of the mentally retarded population is classified as profoundly retarded. Profoundly retarded individuals have IQ scores under 20-25. They may be able to develop basic self-care and communication skills with appropriate support and training. Their retardation is often caused by an accompanying neurological disorder. The profoundly retarded need a high level of structure and supervision.

Another System

• The education system does not use this yet, but I case you encounter someone that does, it is good to know

• The American Association on Mental Retardation (AAMR) has developed another widely accepted diagnostic classification system for mental retardation. The AAMR classification system focuses on the capabilities of the retarded individual rather than on the limitations. The categories describe the level of support required.

AAMR system of classification

• They are: – intermittent support, – limited support, – extensive support– pervasive support.

AAMR system of classification• To some extent, the AAMR classification mirrors

the DSM-IV classification. • Intermittent support, (mild) for example, is

support needed only occasionally, perhaps during times of stress or crisis. It is the type of support typically required for most mildly retarded individuals.

• At the other end of the spectrum, pervasive support,( profound) or life-long, daily support for most adaptive areas, would be required for profoundly retarded individuals.

Mental Age

• The mental development of a child to the child's chronological age the IQ was invented. IQ = (MA/CA) * 100. The intelligence quotient was equal to 100 times the Mental Age divided by the Chronological Age.

• A child age ten with a 70 IQ would be functioning at a seven year old developmental level

Mental Age

• Take that same child• Is he overachieving or underachieving in the

following situations based on his MA? Based on it being September)– READING AT A FOURH GRADE LEVEL– DOING FOURTH GRADE MATH– SPELLING SECOND GRADE WORDS– Likes to watch Barney

Adaptive Behaviors

• Adaptive behaviors are the practical skills that people develop in order to function in everyday life.

• Some of these include:– Feeding– Toileting– Dressing

Adaptive BehaviorsCategories

• Conceptual– Money skills– Self-Direction– Reading and writing– language

• Social– Interpersonal– Avoids victimization– Obeys laws– Follow rules– Self esteem

responsibility

Adaptive skillsCategories

• Practical– Life skills– Safety– Self help– occupational

Characteristics of Mental Retardation

• Although individuals with MR are individual and their needs vary, the needs fall into three categories– Problems with cognition– Problems with adaptive behavior– Need for support to sustain behavior

Problems with Cognition

• Probably the most defining feature• It compounds all tasks- language learning,

memory• Teachers need to teach transfer, • provided direct instruction, discovery and

incidental learning is not affective

Supports

• With your partner, develop a list of some supports that you could provide for some of these areas

• Social– Interpersonal– Avoids victimization– Obeys laws– Follow rules– Self esteem responsibility

• Practical– Life skills– Safety– Self help– Occupational

• Conceptual– Money skills– Self-Direction– Reading and writing– language

Prevalence

• By definition, it is designed to be about two out of every one hundred people meet the criteria for mental retardation. The definition of mental retardation is set so that on average, about 2.3 percent of the entire population will fit into it. This much of the condition is politically defined and arbitrary. ( based on the bell curve, Normal Curve)

Prevalence

• About less than 1% of the school aged children are MR

• WHY IS IT LOWER THAN THE CURVE SUGGEST- Often, district label children differently

Causes• There are about 100 causes for Mental

retardation. The three main reasons are:• Down Syndrome• Fragile X Syndrome• Fetal Alcohol Syndrome• The causes are organized into three categories• Prenatal• Perinatal• Postnatal

Prenatal• The effects of before birth,• This includes genetic, toxins taken by the mother

during pregnancy, disease and neural tube defects

• i.e. Fragile X, Down syndrome, PKU• Prenatal toxins include tobacco, drug exposure,

HIV/AIDS• Neural Tube- Spina Bifida, ( incomplete closure of

spinal column, And anencephaly- most of the brain is missing at birth

Prenatal

Fragile X is the most common inherited cause of mental impairment and the most common known cause of autism.

It is caused by a mutation of the x chromosomeAlso display limited attention span,

hyperactivity, inability to relate to others

Down Syndrome

• Resemble each other rather than their family• Some characteristics include- extra flap of skin

by eye• Have a high incidence of medical issues such

as heart problems, less active, higher obesity,

PKUPhenylketonuria

• Is when a person is unable to metabolize phenylalnine, which builds up in the body to a toxic level that damages the brain

• Diet needs to be radically changed• Can be treated with medication

Toxins

• Fetal alcohol Syndrome- mothers that smoke or drink during pregnancy place their unborn child at serious risk

Perinatal

• The effects caused by the birth processor Birth injuries such as– Deprivation of oxygen– Umbilical cord accidents– Obstetrical Trauma and head trauma– Low birth weight- associated with poverty– Medical advanced allow children born as little as

two pounds to survive, but are at great risk for disabilities

Postnatal

• These are causes that occur after birth• They include • Environmental factors• Child abuse• Neglect• Environmental toxins and accidents

Physical and Health Disabilities

History

• As with many of the other disabilities we have discussed, individuals with physical and health disabilities were often denied access to school

• Many feared it was contagious or did not like looking at these people

• As a country we have made great strides with physical disabilities, yet more can be done ADA

History

• Physical and health disabilities may often occur with a intellectual disability (Multiple disabilities), but often does not

• There fore students can function in he regular education

• Two major types of Physical disabilities– Neuromotor- are conditions caused by damage to

the central Nervous System, The brain and the spinal Cord)• Cerebral Palsy• epilepsy

– Muscular Skeletal conditions- are impairments that effect limbs and muscles- These problems are with using or controlling limbs that are unrelated to the neurological system

– Often these students use assistive devices

Epilepsy

• Epilepsy is a neurological condition that from time to time produces brief disturbances in the normal electrical functions of the brain. Normal brain function is made possible by millions of tiny electrical charges passing between nerve cells in the brain and to all parts of the body. When someone has epilepsy, this normal pattern may be interrupted by intermittent bursts of electrical energy that are much more intense than usual. They may affect a person's consciousness, bodily movements or sensations for a short time.

Epilepsy• These physical changes are called epileptic seizures.

That is why epilepsy is sometimes called a seizure disorder. The unusual bursts of energy may occur in just one area of the brain (partial seizures), or may affect nerve cells throughout the brain (generalized seizures). Normal brain function cannot return until the electrical bursts subside. Conditions in the brain that produce these episodes may have been present since birth, or they may develop later in life due to injury, infections, structural abnormalities in the brain, exposure to toxic agents, or for reasons that are still not well understood.

Epilepsy

• Many illnesses or severe injuries can affect the brain enough to produce a single seizure. When seizures continue to occur for unknown reasons or because of an underlying problem that cannot be corrected, the condition is known as epilepsy. Epilepsy affects people of all ages, all nations, and all races. Epilepsy can also occur in animals, including dogs, cats, rabbits, and mice.

Cerebral Palsy• The term cerebral palsy refers to any one of a number

of neurological disorders that appear in infancy or early childhood and permanently affect body movement and muscle coordination but don’t worsen over time. Even though cerebral palsy affects muscle movement, it isn’t caused by problems in the muscles or nerves. It is caused by abnormalities in parts of the brain that control muscle movements. The majority of children with cerebral palsy are born with it, although it may not be detected until months or years later. The early signs of cerebral palsy usually appear before a child reaches 3 years of age.

Cerebral Palsy• The most common are a lack of muscle coordination

when performing voluntary movements (ataxia); stiff or tight muscles and exaggerated reflexes (spasticity); walking with one foot or leg dragging; walking on the toes, a crouched gait, or a “scissored” gait; and muscle tone that is either too stiff or too floppy. A small number of children have cerebral palsy as the result of brain damage in the first few months or years of life, brain infections such as bacterial meningitis or viral encephalitis, or head injury from a motor vehicle accident, a fall, or child abuse.

Cerebral Palsy

• Cerebral palsy doesn’t always cause profound disabilities. While one child with severe cerebral palsy might be unable to walk and need extensive, lifelong care, another with mild cerebral palsy might be only slightly awkward and require no special assistance. Supportive treatments, medications, and surgery can help many individuals improve their motor skills and ability to communicate with the world.

Limb Deficiencies

• Is a missing of nonfunctioning limb such as an arm or a leg either acquired through and accident or through birth

• Although the disability is physical, it obviously has many psychological affects as well

• Now great assistance is provided through robotics and prosthesis

Juvenile Arthritis

• Very common, 300000 students have it• 255 receive special education and most of the

others have 504 plans• Many different forms of the disease, it is

typically chronic and painful• Children are frequently absent and need help

keeping caught –up with work• Affects ability to move

Health Disabilities

• Two types of disabilities– Chronic illnesses- last for years or even a lifetimes• Some are medically fragile

– Infectious diseases

Chronic Illnesses

• Asthma- Asthma affects people of all ages, but it most often starts in childhood. In the United States, more than 22 million people are known to have asthma. Nearly 6 million of these people are children.

• The airways are tubes that carry air into and out of your lungs. People who have asthma have inflamed airways. This makes the airways swollen and very sensitive. They tend to react strongly to certain substances that are breathed in.

• When the airways react, the muscles around them tighten. This causes the airways to narrow, and less air flows to your lungs. The swelling also can worsen, making the airways even narrower. Cells in the airways may make more mucus than normal. Mucus is a sticky, thick liquid that can further narrow your airways.

• This chain reaction can result in asthma symptoms. Symptoms can happen each time the airways are irritated.

• Sometimes symptoms are mild and go away on their own or after minimal treatment with an asthma medicine.

• At other times, symptoms continue to get worse. When symptoms get more intense and/or additional symptoms appear, this is an asthma attack. Asthma attacks also are called flareups or exacerbations.

• It's important to treat symptoms when you first notice them. This will help prevent the symptoms from worsening and causing a severe asthma attack. Severe asthma attacks may require emergency care, and they can cause death.

Infectious Diseases

• Rare, but public reaction is irrational– HIV Human immunodeficiency Virus- a potentially

fatal disease- transmitted through bodily fluids– AIDS is acquired immunodeficiency syndrome-is

caused by HIV it destroys the immune system

Autism Spectrum Disorders

ASDAutism Spectrum Disorders

• ASD is a broad term that includes five conditions characterized by limitations in three developmental areas– Communications– Social interaction– Repetitive behaviors or interests

Autism Spectrum Disorders

• The five conditions under ASD umbrella are• Autism• Asperser's syndrome• Rett syndrome• Childhood disintegrative disorder• Pervasive developmental disorder – not other

wise specified

HISTORY

• UNTIL RECENTLY ASD WAS NARROWLY DEFINED, NOW IT IS recognized that it has a range from mild to severe

• Has been around for ever, but first labeled simultaneously by Leo Kanner and Hans Asperger around 1943

• Originally called early infantile

Autism Spectrum Disorders

• Originally people blamed the mother for not being affectionate enough and referred to them as the refrigerator mothers

• In the 1960 the realized this was not the case, developed some intervention strategies, and parent groups were formed

• It is now in the spotlight gaining national attention

Autism

• Autism is one of the specific diagnosis under ASD, Often the two are used interchangeably. They are not the same

• Children with autism do not communicate with other people in typical ways.

• 50 % of these children do not talk as a way to communicate

• The other 50 % speak, but often use repetitive language

Autism

• Repetitive language is called echolalia• Sometimes children wit autism speak and

misuse the pronouns• They might say- you are hungry, meaning I

am hungry• They also sometimes do not understand the

concept of communication, they do not understand that it is between two people

Autism

• They have problem with social interaction• Autistic children often exhibit repetitive

behaviors some times called sterotypies• Some times they have a tremors strength in

one area like ( not to the degree of being a savant savant)– The weather– Movies– dates

Savant• A very rare occurrence, less than one percent of

people with autism have this• The autistic savant is one of the most fascinating

cognitive phenomena in psychology. "Autistic savant" refers to individuals with autism who have extraordinary skills not exhibited by most persons. Historically, individuals with these exceptional skills were called 'idiot savants,' a French term meaning unlearned (idiot) skill (savant). In a 1978 article in Psychology Today, Dr. Bernard Rimland introduced a more appropriate term 'autistic savant,' which is the current label.

Savant• The estimated prevalence of savant abilities in autism is 10%,

whereas the prevalence in the non-autistic population, including those with mental retardation, is less than 1%.

• There are many forms of savant abilities. The most common forms involve mathematical calculations, memory feats, artistic abilities, and musical abilities. A mathematical ability which many autistic individuals display is calendar memory. They could be asked a question like: 'What day of the week was May 22, 1961? and they can determine the answer within seconds--Monday. Others can multiply and divide large numbers in their head and can also calculate square roots and prime numbers without much hesitation.

• Other examples are gifted skills in music, art, sculpture• Although they are gifted in one area, they cannot take care of

themselves and are dependent in almost all other areas

Autism

• Many children with Autism like to follow the same routine and enjoy repetitive activities

Autism and Sensory Integration

• Extreme sensory issues are very common in autism. Some autistic children cannot tolerate sounds or hugs, while another is oblivious to sounds and craves hugs. One autistic child may have an explosive and exaggerated reaction to loud noises, while another may not react at all. Autistic children with sensory issues have difficulty filtering sensory input. Their nervous systems do not know what to block out and what to amplify.

Autism and Sensory Integration• Children and adults with autism, as well as those with

other developmental disabilities, may have a dysfunctional sensory system. Sometimes one or more senses are either over- or under-reactive to stimulation. Such sensory problems may be the underlying reason for such behaviors as rocking, spinning, and hand-flapping. Although the receptors for the senses are located in the peripheral nervous system (which includes everything but the brain and spinal cord), it is believed that the problem stems from neurological dysfunction in the central nervous system--the brain.

Autism and Sensory Integration

• Sensory processing disorder (SPD), sometimes called Sensory Integration Dysfunction (SID), is extremely common among individuals on the autism spectrum. Therapy, provided by an occupational therapist trained in sensory integration, can be extremely beneficial for a person with autism. Regulating one's sensory system is integral to growth and development.

• Often this therapy can be provided by a PCA or a TSS- It helps keep the child on on an Even level.

• Also need to help train the child to monitor themselves

Autism and Sensory Integration

• In the field of sensory integration, the sensory system is broken up into three main areas: tactile, vestibular, and proprioceptive.

• The tactile system is your sense of touch.• The vestibular system is responsible for

movement and the body’s position in space.• The proprioceptive system deals with muscles

and joints. There are other sensory systems but they are not as commonly associated with sensory dysfunction.

Autism and Sensory Integration

• To the inexperienced eye, sensory integration therapy can look like a normal afternoon of play. However, all of the activities that the therapist and the individual participate in actually serve a specific purpose. Some of the types of activities you might see in a sensory-based occupational therapy session include: the following slides

Autism and Sensory Integration• • Swinging in a net swing –

a net swing cocoons the child/student providing them with proprioceptive input. At the same time, the spinning gives vestibular input; combining two types of sensory input is common in occupational therapy. To the client this may just be fun, but to the therapist, this is giving the two sensory systems input in an organized fashion.

Autism and Sensory Integration

• Balancing on a bosu ball while playing catch – this activity works all three of the main sensory systems as well. A weighted ball is often used providing proprioceptive input when the ball is caught. The ball should also be textured which allows for a different tactile sensation. The act of balancing on the bosu ball works the vestibular system.

Autism and Sensory Integration

• • Jumping onto a mat – sometimes called crashing, jumping onto a mat is a great way to provide proprioceptive input; the freefall period provides vestibular input and rolling around on the mat gives tactile input. All three of the main sensory systems are stimulated with one very fun activity.

Autism and Sensory Integration

• Autistic child with hyperactive sensory systems may avoid engaging in activities that involve motion. They may get motion sickness very easily. They may resist activities like climbing or descending stairs. They may seek assistance with seemingly simple tasks like walking, or want to be carried instead of walking.

Autism and Sensory Integration

• In contrast, autistic children with hypoactive sensory systems actively seek activities that involve motion. They may enjoy swinging or other activities involving motion. They may not become dizzy after spinning around in circles. They may need to be restrained from excessive motion, rather than needing encouragement to simply engage in motion (as may be the case with children with hyperactive sensory systems).

Autism and Sensory Integration

• Sensory integration activities address autistic children's sensory needs by either lessening or amplifying the intensity of various forms of sensory stimulation that children receive. Most sensory integration activities work with children's vestibular, proprioceptive and tactile sensory systems.

Autism

• 25% of children with autism have typical intelligence

• 75% have mental retardation• As a result, some people refer to autistic

students as being high functioning or low functioning

Asperger’s Syndrome

Asperger’s Syndrome

• One of the autism spectrum disorders (ASD) wherein usually in the average or above average range

• A collection of behavioral characteristics that are associated with problems developing adequate social characteristics that are associated with problems developing adequate social skills and with restricted or unusual interest

Asperger’s Syndrome

• Although the have difficulty wit communication, they develop speech normally

• Some have language skills, cannot understand jokes, or interpret behaviors of others

• They often take everything literally

Asperger’s Syndrome

• Many consider high functioning autistic children and asperger’s syndrome the same thing. The differences are small and not worth arguing over.

• The treatment is the same.

Asperger’s in the classroom• * Provide a predictable and safe environment;

• * Minimize transitions;

• * Offer consistent daily routine: The child with AS must understand each day's routine and know what to expect in order to be able to concentrate on the task at hand;

• * Avoid surprises: Prepare the child thoroughly and in advance for special activities, altered schedules, or any other change in routine, regardless of how minimal;

Asperger’s in the classroom

• Allay fears of the unknown by exposing the child to the new activity, teacher, class, school, camp and so forth beforehand, and as soon as possible after he or she is informed of the change, to prevent obsessive worrying. (For instance, when the child with AS must change schools, he or she should meet the new teacher, tour the new school and be apprised of his or her routine in advance of actual attendance. School assignments from the old school might be provided the first few days so that the routine is familiar to the child in the new environment. The receiving teacher might find out the child's special areas of interest and have related books or activities available on the child's first day.)

PDD-NOS

• Children on the ASD spectrum usually always exhibit problem in three areas, communication, social skills, and range of interest.

• When these characteristics show up in a child, but the child does not exhibit all three, they are considered PDD-NOS

Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS)

• PDD-NOS is often incorrectly referred to as simply "PDD." The term PDD refers to the class of conditions to which autism belongs. PDD is NOT itself a diagnosis, while PDD-NOS IS a diagnosis. The term Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS; also referred to as "atypical personality development," "atypical PDD," or "atypical autism")

PDD-NOS

• is a 'subthreshold' condition in which some - but not all - features of autism or another explicitly identified Pervasive Developmental Disorder are identified.

• is included in DSM-IV to encompass cases where there is marked impairment of social interaction, communication, and/or stereotyped behavior patterns or interest, but when full features for autism or another explicitly defined PDD are not met

PDD-NOS

• It should be emphasized that this ''subthreshold'' category is thus defined implicitly, that is, no specific guidelines for diagnosis are provided. While deficits in peer relations and unusual sensitivities are typically noted, social skills are less impaired than in classical autism. The lack of definition(s) for this relatively heterogeneous group of children presents problems for research on this condition.

ASDSummary of characteristics

• Children on the ASD spectrum usually always exhibit problem in three areas, communication, social skills, and range of interest.

• Is lifelong disorder• Sensory input issues (noises, lights, activity)• May exhibit self-injury or aggressive behaviors

ASDSummary of characteristics

• 75 % have concurrent diagnosis with Mental retardation

• 50 % never develop functional speech• 17 % engage in self injury or aggression• 4 out of five are male• 33% have epilepsy

Prevalence

• Despite national attention, and the number of incidences identified growing and four other disabilities added to ASD, it still is a low incidence disorder

• Only about 2.7% of children in special education are identified with ASD

Prevalence

• there are several reason why the numbers have increased

• Improved diagnostic procedures• The use of the broader term ASD instead of

the narrow term autism• An actual increase in the condition

Causes

• Most agree it is unrelated to parenting• It is a neurobiological disorder that has a

genetic base• It is related to many other disabilities,• But, no cause has yet to been identified