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Consequences/Importance of ID Definition |
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Eligibility Subjected to Exempt from Included in Entitled to |
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How many people in the US have an ID? |
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How many families in the US are affected by ID? |
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What percentage of the population has ID? (APA) |
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How does one get classified as ID? |
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2 standards deviations below the mean |
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characterized by significant limitations in both intellectual functioning and adaptive behavior expressed in conceptual, social, and practical skills; it presents before age 18 |
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-umbrella term -includes physical and intellectual disablities -DEFINITION-severe, chronic physical and/or cognitive disability that manifests before age 18 and is likely to be lifelong -tends to be more significant than ID |
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-if apparent at birth, it is usually DD -ID individuals can progress out of their classification -DD is life long |
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3 causes of intellectual disability |
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Infections (TORCH) -Toxoplasmosis -Other -Rubella -Cytomeglovirus -Herpes Simplex Virus Brain Damage Genetics |
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Parisite found everywhere in warm-blooded animals frequent in cats in the US can be infected by eating undercooked meat, ingesting dirt |
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-measles -contracted during pregnancy |
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mononucleosis contracted during pregnancy 5% of embryo's develop mono |
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Can remain dormant if there is an outbreak during birth, can result in brain damage or death |
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1) Traumatic Brain Injury-occurs from exterior physical force (e.g. shaking baby syndrome) 2)Congenitcal Brain Damage-Hereditary or Environmental -Fetal Alcohol Syndrome-distinct facial features, poor coordination, heart deficits, anxiety, malformed joints, good days/bad days 3) Progressive brain damage-manifests after birth-e.g. Battens disease-inherited metabolic disorder |
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down syndrome fragile x angelman syndrome williams syndrome bardet-biedle syndrome ..... |
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-most common genetic ID -not specific to any race/gender -1/800 births -trisomy 21 -chances increase with mother's age -smaller brain volume, shorter diameter -distinct slant from front of head to back -slanted eyes -flat face -profound crease in hand -blood test is only way of ID'ing it -susceptible to alzheimer's -Mosaic Down Syndrome-mutation occured later in gestation, so not every cell has trisomy 21 |
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-second leading cause of genetic ID -leading cause of genetic ID in males -FMR1 mutation-mutation of gene on X chromosome, excessive copy of gene -1/4000 males, 1/6000 females -recessive -one study suggests slightly higher risk in caucasian than black -lower ears -longer face -broad forehead -pronounced jaw -hyperflexive joints -flat-footed -enlarged testicles at adolescence -poor social development |
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-mutation of chromosome 7, portion of chromosome is missing -random, not inherited -1/8000 -equal opportunity -sunken nasal bridge, upturned nose, small chine, wide full mouth, puffy skin around eyes, light eyes with starburst design, abnormally long neck, sloping shoulders -susceptible to cardiovascular disease and hearing loss -varying degrees of cognitive impairment (motor skill deficincies seen first) -good expressive skills -attention may improve with age -concrete thinkers, spatial deficits -easily stressed -a lot of potential with support |
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-absence of certain group of genes that control ubiquitin production -chromosome 15 -inherited or random -1/12-20,000 -equal opportunity -1,000-5,000 cases in N.A. -protruding toungue, smaller head -feeding issues -developmental delays apparent at 2-12 months -may experience seizures by age 3 -100% have developmental delay, speech problems, movement and balance problems, frequent laughter, short attention span |
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-Mutation on chromosome 3 -polydactyl limbs -Intellectual Disability -development of reproduction system affected -renal failure--> death -obesity common (do not register fullness) -impaired speech -poor coordination -1/140,000 (1/13,500 in Kuwait and 1/17,000 in newfoundland) |
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-rare autosomal recessive gene disorder -mutation on chromosome 2 -ID -deformation of reproductive organs -maturity, behavior, coordination problems |
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-Mutation in cell repair genes on chromosome 5 -1/100,000 -Fast aging process -exposure to light increases aging -not related to cancer -eyes sunken, ears deformed, disproportionate -cannot completely close eyelids -progressive in nature -Type I-not seen at birth, may live through adolescence -Type II-seen at birth, short lifespan |
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-Chromosome 5-missing piece of short arm -1/20-50,000 -More common in females -random mutation, not inherited -feeding problems, poor growth, severe ID, agression small head/jaw, eyes spread apart and have downward slant, webbing between fingers and toes, flat nasal bridge -apparent at birth -ID becomes more severe with age |
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Cornelia du Lang Syndrome |
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Definition
-Nipped gene on chromosome 5 -1/10-30,000 births -excessive body hair -long eye lashes -tip of nose pointed -significant developmental delays -cup-shaped mouth -hearing/vision loss |
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Rubinstein-Taybi Syndrome |
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Definition
-1/300,000 -No known cause -thick and low-lying hair -thick thumbs and first toes -ADD |
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-Absence in Hex-A-responsible for metabolizing fatty acids in cells -not apparent at birth -loss of peripheral vision -innappropriate response to stimuli -lose skills they have learned -seizures common -1/27 Ashkenzi Jews are carriers -1/250 general population |
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-deletion of chromosome 15 -1/12-15,000 -decreased muscle tone -hypergonadism -if inherited by father, 70% will get prader willi -same deltion inherited by mother, angelman's syndrome -inherited/mutational -capacity to learn -obsessive compulsive behavior |
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Mild Intellectual Disability |
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Definition
-Pervasive learning problems -lack of social adjustment, motivation, and or self management skills -discrepancy between their actual intellectual ability and their actual achievement -come with a variety of labels -not visibly apparent -cognitive, academic, and social characteristics -2-4 years behind peers -2-3 standard deviations below norm |
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Three groups of Mild Intellectual Disability |
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Definition
1) Specific Learning Disabilities-does not fall under regular ID-can occur in specific curricular areas, may be pervasive, does not cover sensory impairments, does not cover ID 2)Emotional/behavioral disturbance-functioning as ID even though they are intellectually capable-intelligence tests not showing/explaining deficits-innappropriate, dangerous behaviors-paranoia, obsessiveness, rigitity, schizophrenia 3) Mild MR |
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Definition
specific learning disabilities-50% mental retardation-10.6% emotional disturbance-8.2% |
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Remediation vs. Compensation |
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Definition
remediation-modifying instruction compensation-using assitive technology to support student growth
-30% remediation, 70% compensation and adjust according to growth and IEP (Edyburn, 2002) -want to build a good foundation without affecting quality of life -fair is not equal |
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Definition
-chances increase with mother's age -25 years- 1/1,250 -45 years- 1/30 -diagnostic tests-length of long arm or leg bone, length of nasal bridge, size of renal pelvis, small bright spots in heart, etc. |
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-brain disorder -normal pattern of neuronal activity is disrupted -must have 2 or more seizures to have epilepsy |
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-3 million americans -315,000 students in US -1/100 people develop epilepsy -1 in 10 people will have a seizure in their lifetime -more common than cerebral palsy, parkinson's disease, and multiple sclerosis combined |
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70% of seizures are unknown causes 30%: -brain trauma -brain tumors -poisoning (lead) -infections of brain -brain injury at birth -abnormal brain development |
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Generalized-involve the whole brain-absence and tonic-clonic symptoms-convulsions, staring, muscle spasms, and falls
Partial Seizures-involve only a part of the brain-common types include simple partial and complex partial-syptoms relate to the part of the brain affected |
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Definition
-Gneralized seizure -pause in activity with blank stare -brief lapse of awareness -possible chewing or blinking motion -usually lasts 1-10 seconds -may occur many times/day -May be confused with daydreaming, lack of attention, ADD |
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-Generalized seizure -sudden, hoarse cry -fall -convulsions -shallow breathing and drooling -loss of bowel control -skin, nails, lips may turn blue -generally lasts 1-3 minutes -followed by confusion, headache, tiredness, soreness, and speech dificulty |
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Definition
-Stay calm and track time -check for epilepsy seizure disorder I.D. (bracelet, necklace) -protect student from possible hazards (tables, chairs) -turn student on side -cushion head -after seizure, remain with student until awareness of surroundings is fully gained -provide emotional support -document seizure activity |
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When is a seizure an emergency |
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Definition
-First time seizure -convulsive seizure lasting more than 5 minutes -repeated seizures without regaining consciousness -more seizures than usual or change in type -student who is injured, has diabetes, or is pregnant -seizure occurs in water -normal breathing does not resume -parents request emergency evaluation |
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Definition
Full awareness maintained -rhythmic movements -sensory symptoms (tingling, weakness, sounds, tastes, smells) -Psychic symptoms-deja vu, hallucinations -usually lasts less than 1 minutes -may be confused with acting out, mysical experience, or psychosomatic illness |
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Definition
-Awareness impaired/inability to respond -often begins with blank dazed stare -clumsy or disoriented movements -often lasts 1-3 minutes -often followed by tiredness, headache, or nausea -may become combatative if restrained -may be confused with drunkenness or drug abuse and agressive behavior |
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Term
Complex Partial Seizure First Aid |
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Definition
-Stay calm, track time -Check for medical ID -Gently direct away from hazards -don't expect student to abey verbal commands -stay with student until fully aware -if seizure lasts 5 minutes beyond what is routine for that student or if another seizure begins before full consciousness is acheived, follow emergency protocol |
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Convulsive Seizure in a wheel chair |
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Definition
-do not remove from wheelchair unless absolutely necessary -secure wheelchair to prevent movement -fasten seatbelt loosely to prevent student from falling -protect and support head -ensure breathing is unobstructed and allow secretions to flow from mouth -pad wheelchair to prevent injuries to limbs -follow relevant seizure first aid protocol |
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convulsive seizure on a school bus |
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Definition
-safely pull over and stop bus -palce student on his/her side across the seat facing way from the seat back (or in aisle if necssary) -follow standard seizure first aid -continute to destination once full consciousness and awareness is regained |
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convulsive seizure in water |
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Definition
-support head so that both the mouth and nose are above water -remove student from the water as soon as it can be done safely -if the student is not breathing, begin rescue breathing -always transport student to the emergency room even if they appear fully recovered |
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-based on a study that burning fat for energy has an antiseizure effect -high fat content, no sugar and low carb and protein intake -requires strong family, school, and caregiver committment (no cheating allowed) |
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Definition
-implanted just under skin in the chest with wires that attach to vagus nerve in neck -delivers electrical stimulation to the vagus nerve in the neck that relays impulses to widespread areas of the brain -primarly used to treat partial seizures when medication is not working -use of special magnet to active the device |
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-used in acute or emergency situations to stop a siezure that wont stop on its own -approved by FDA for use by parents and non-medical caregivers -state/school district regulations often govern use in schools |
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-3-7% school aged children have it -2X more common in boys -22% increase from 2003-2007 -Diagnosed based off of behavioral symptoms |
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Term
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Definition
Type I-inattentive-hard to follow instructions, easily distracted, difficulty remembering daily routines
Type II-hyperactive-talks, fidgets, restless, impulsivity control, hard to wait their turn
Type III-Combined Type-mix of both
*has to be present by age 7 for combined type |
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ADHD Treatments and side effects
American Academy of Pediatrics Guideline for ADHD Medication |
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Definition
-Stimulants-best known, most widely used-70% respond positively-ritalin, dexadrine, adderall
-Non-stimulants-short acting (24 hours)-trial and error, not approved by FDA, not 1st line of defense
Side effects-sleeplessness, lack of eating, irritability, increase in HR
AAP-Pre-K-should be behavioral therapy only (severity may determine use of stimulants)-elementary school-behavioral therapy and/or FDA approved stimulants-adolescents-FDA medications AND behavioral therapy |
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Methods for Parents and Teachers to use with ADHD |
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Definition
-expectations at home should be expectations everywhere -create structure -help organize -clarify everything -frequent praise -limit choices -social-skills training -follow through with everything, do not cop-out or make excuses for child |
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Adapting the classroom environment for included learners |
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Definition
1) Create a structure optimal for learning-Robinson (1990) found that class size is most importatn for K-3, but decrease every year, same strategies in small groups can also be applied to large classrooms 2)inventory and evaluate all available teaching materials 3) develop a classroom routine-scedules plan 4) prioritize goals, assess-know the curriculum/standards, do diagnostic tests 5) create a system of documentation-accountability 6) appreciate small successes-you dictate attitude in the classroom 7) stay curent on best practice-ever-changing field 8) establish positive working conditions-build mutual respect 9) clearly mark work areas-avoid distractions, provide diagrams, etc. 10) reduce audtory/visual distractions-keep it simple, less is more 11) use strategic seating-rows, groups, can you see every child? can every child see you? for mild ID-closer to front, middle is preferred 12) use visual cues/schedules 13) specify classroom rules-psoitively frame guidelines 14) organize staff scheduling-gernal and invididual classroom schedules 15) organize materials |
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Definition
-assess pre-requisite/foundational skills modify activities as necessary to allow learner to respond in their strongest modality-asess same content standard but in a less complex, more concrete method -embed generalization-change context often
eg-touch math |
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Instructional adaptations |
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Definition
-utilize different instructional formats-large group, small group, 1 on 1 (peer, 2X more achievement than computer guided and 3X more achievement than reducing class size, and 4X as much achievement than lenghtening the school day by 1 hour) -provide choices -utilize strenghts to build on weaknesses -ulitize cooperative learning -shape task completion -have a variety of materials available -model the expectation of a manipulative/example |
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Definition
1) Identify behaviors in need of attention 2) define behavior according to its topography and function 3) fhoose and implement a reinforcement system 4) plan to teach replacement skills-know the inappropriateness of the behavior |
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Behavior management strategies |
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Definition
-state expectations clearly -catch the child being good -use specific praise -at a neutral time, describe alternatives to the challenging behavior -present limited choices |
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Term
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A sytematic approach of early and continual treatment from a team of professionals focused on meeting the needs of individual children and their families -mandated by federal legislation
Birth-3-covered by IDEA part C Age 3-5-covered by IDEA part B and individual states |
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1972 in North Carolina -111 families with at risk infants -randomized control -1/2 recieved treatment in developmental approach stimulating positive and responsive environment, 5 days/week 50 weeks/year -10-15 IQ points higher through adulthood |
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1977 -63 poveraged students -divided into three groups, one got program and home visits, next got home visits only, the other got no treatment, group 1 was the only one to benefit (10-15 IQ points) |
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The Infant Health and Development Program |
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1992 -985 premature/low birth weight infants -heavier birthweight, the higher the IQ -6.5 IQ points higher in lowest birth weight compared to highest birth weight control -By age 5-8, the gains were not sustained |
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Mothers with IQ less than 75 -home visits for 4 months, program through age 6 -30 points higher in IQ -18 points higher at age 10 -did not translate to higher achievement in the classroom |
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Inner City Michigan -children already diagnosed with developmental delay -late start treatment (4-5 years) -Greater IQ at age 6 -At age 15, both groups had same IQ -Intevention group stayed in school longer, had less teenage pregnancies, less criminal activity, more college attendance |
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Conclusion from 5 studies |
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Definition
-Children at high risk of developmental disabilities benefit from an EI program -Intensity, parent participation, and continuity impact improvement -different individual outcomes |
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5 essential operating principles for effective EI programs |
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Definition
1) multidisciplinary 2) intergenerational 3) individualized for children and families 4) contextually embedded in local service delivery program 5) research oriented using randomized controlled trials |
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7 essential elements for effective EI programs |
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Definition
1) timing and duration-birth->age 5 or 6 2) sufficient intensity- 5 days/week, 50 weeks/year 3) direct engagement of child-individualized 4) multiple types of support services-OT, PT, physician, teacher 5) careful monitoring and responsiveness to individual needs 6) follow through to maintain early benefits 7) cultural appropriateness-diverse populations, understand culture before entering home |
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