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Chapter Nine : 

Copyright 2001 by Allyn and Bacon 1 Chapter Nine Teaching Students with Autism, Traumatic Brain Injury, and Other Low-Incidence Disabilities

Chapter Nine Objectives : 

Copyright 2001 by Allyn and Bacon 2 Chapter Nine Objectives Define and describe students with autism and Asperger syndrome Define and describe students with traumatic brain injury Define and describe students with health problems and physical disabilities Describe various intervention strategies for students with autism, traumatic brain injury, health problems, and physical disabilities

Introduction : 

Copyright 2001 by Allyn and Bacon 3 Introduction In addition to students with sensory impairments, students may have other low-incidence disabilities, such as: Autism Traumatic brain injury Many other physical and health problems, including Cerebral palsy Spina bifida AIDS Cystic fibrosis Epilepsy Diabetes

Introduction (continued) : 

Copyright 2001 by Allyn and Bacon 4 Introduction (continued) Autism and traumatic brain injury are separate disability categories under the IDEA. Many other conditions (e.g., diabetes, cerebral palsy, spina bifida) may fall under the IDEA categories of Other Health Impairments or Orthopedic Impairments.

Working with Culturally Diverse Families & Personnel : 

Copyright 2001 by Allyn and Bacon 5 Working with Culturally Diverse Families & Personnel Typically, general educators will work with a variety of related service personnel when they have students with these disabilities. The fact that so many professionals will be working with these children and their families may have repercussions for families from culturally different backgrounds. Professionals providing services must be sensitive to the cultural traits that characterize culturally diverse families.

Autism: Overview : 

Copyright 2001 by Allyn and Bacon 6 Autism: Overview Autism is a pervasive developmental disorder. Autism has a significant impact on individuals and their families. The characteristics of students with autism vary dramatically. Autism was first described less than fifty years ago by Leo Kanner.

Autism: Overview : 

Copyright 2001 by Allyn and Bacon 7 Autism: Overview Early etiologic theories suggested that autism was caused by poor mother-child bonding—a cause now known to be untrue. During the past twenty years, research has indicated that autism is an organic disorder. Until 1990, autism was not a separate IDEA disability category.

Definition of Autism : 

Copyright 2001 by Allyn and Bacon 8 Definition of Autism There is no universally accepted definition of autism. Two definitions are: Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) Definition IDEA Definition: Autism is a developmental disability that primarily results in significant deficits in verbal and nonverbal communication and social interactions.

Some Facts About Autism : 

Copyright 2001 by Allyn and Bacon 9 Some Facts About Autism Autism usually presents itself before the age of three. Autism is a lifelong, severely disabling condition. Autism is typically marked by significant impairments in intellectual, social, and emotional functioning.

Identification of Autism : 

Copyright 2001 by Allyn and Bacon 10 Identification of Autism Autism is difficult to identify because: Children with autism display many characteristics exhibited by individuals with other disabilities. Children with autism are mistakenly classified as having multiple disabilities. No stable classification system is used among educators and other professionals who encounter children with autism. Because such a large group of professionals is usually involved, diverse definitions and eligibility criteria may complicate the identification process.

Prevalence & Causes of Autism : 

Copyright 2001 by Allyn and Bacon 11 Prevalence & Causes of Autism Autism is relatively rare. During the 1996-97 school year, 0.07% of the school-age population was receiving special education services for autism. This makes autism one of the smallest IDEA disability categories. Organic factors, such as brain damage, genetic links, and complications during pregnancy, may cause this condition. In most cases, however, the cause is unknown.

Characteristics of Autism : 

Copyright 2001 by Allyn and Bacon 12 Characteristics of Autism Affective and cognitive indifference Expressive affect Passive affect Anxiety and fears Cognition Self-injurious or self-abusive behaviors A very small number of children with autism display splinter skills that go well beyond their presumed capability.

Autism: Classroom Accommodations : 

Copyright 2001 by Allyn and Bacon 13 Autism: Classroom Accommodations In recent years, intensive interventions for students with autism have been somewhat effective. No single method is effective with all children with autism. Growing evidence suggests that placing children with autism with their nondisabled peers in general education settings, with appropriate supports, can make a significant difference in their behavior.

Effective Accommodations : 

Copyright 2001 by Allyn and Bacon 14 Effective Accommodations Appropriate role models, especially for young children with autism, may result in long-term, intellectual and adaptive behavior gains. Social skills training has been shown to be effective for students with autism. Functional activities and programs should be as developmentally and age-appropriate as possible.

Promising Strategies for Students with Autism : 

Copyright 2001 by Allyn and Bacon 15 Promising Strategies for Students with Autism Self-management Self-recording Self-reinforcement Did you know that… … over the past years, a major controversy has erupted in the education of students with autism over the use of facilitated communication -- a process in which a facilitator helps the person with autism type or use a keyboard for communication purposes. Recent studies have cast doubt on the efficacy of this strategy.

Asperger Syndrome : 

Copyright 2001 by Allyn and Bacon 16 Asperger Syndrome This syndrome is a condition associated with autism as students with these condition share many of the same characteristics. In contrast to their peers with autism, students with Asperger syndrome have: higher cognitive development more typical communication skills

IDEA Definition of Traumatic Brain Injury (TBI) : 

Copyright 2001 by Allyn and Bacon 17 IDEA Definition of Traumatic Brain Injury (TBI) Traumatic brain injury refers to an injury to the brain caused by external force resulting in total or partial functioning disability or psychosocial impairment or both that adversely affects educational performance. The term applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition, language, memory, attention, reasoning, abstract thinking, judgment, problem solving, sensory, perceptual, and motor abilities, psychosocial behavior, physical functions, information processing, and speech. The term does not include brain injuries that are congenital or degenerative or brain injuries induced by birth trauma.

TBI: An Overview : 

Copyright 2001 by Allyn and Bacon 18 TBI: An Overview TBI was added as a separate IDEA disability category in 1990. About 30,000 children suffer permanent brain injury each year. There are different levels of severity of traumatic brain injury: Mild Moderate Severe

Causes of TBI : 

Copyright 2001 by Allyn and Bacon 19 Causes of TBI Falls Vehicle accidents Abuse Lack of oxygen to the brain Infections Tumors Strokes

Persisting Features of TBI : 

Copyright 2001 by Allyn and Bacon 20 Persisting Features of TBI Physical/Mental Sensory Cognitive Language-Related Behavioral/Emotional The prognosis for recovery depends on many variables including the type of injury, rapidity and quality of medical and surgical care, rehabilitation, and educational intervention.

Classroom Accommodations for Students with TBI : 

Copyright 2001 by Allyn and Bacon 21 Classroom Accommodations for Students with TBI Intervention involves the efforts of many professionals. Students with TBI may have missed a significant amount of schooling. The injury may impact these students’ learning and functioning. Teachers should keep expectations for learning high. Students with TBI should be provided with multiple opportunities for practice.

Effective Instruction for Students with TBI : 

Copyright 2001 by Allyn and Bacon 22 Effective Instruction for Students with TBI Instruction should focus on: retaining impaired cognitive processes developing new skills or procedures to compensate for residual deficits creating an environment that permits effective performance identifying instructional procedures Improving metacognitive awareness Compensatory strategies include: attending language memory sequencing thought organization

Physical & Health Disabilities : 

Copyright 2001 by Allyn and Bacon 23 Physical & Health Disabilities Asthma Childhood Cancer Cerebral Palsy Cystic Fibrosis Deaf-Blind Juvenile Diabetes Epilepsy HIV/AIDS Muscular Dystrophy Prader-Willi Syndrome Tourette Syndrome

Asthma : 

Copyright 2001 by Allyn and Bacon 24 Asthma Most common chronic illness in children Affects approximately 3 million children under the age of 15 Characterized by episodes of coughing, shortness of breath, and wheezing, resulting in a narrowing of the small air passages Results in irritation of the bronchial tubes due to allergic reactions

Childhood Cancer : 

Copyright 2001 by Allyn and Bacon 25 Childhood Cancer Occurs in approximately 1 in 330 children prior to the age of 19 Includes: Leukemia Lymphoma Tumors of the central nervous system Bone tumors Tumors affecting the eyes Tumors of various organs

Cerebral Palsy : 

Copyright 2001 by Allyn and Bacon 26 Cerebral Palsy Disorder of movement or posture that is caused by brain damage Affects the voluntary muscles and often leads to major problems in communication and mobility Neither progressive nor communicable Has no cure although education, therapy, and applied technology can help individuals lead productive lives

Cystic Fibrosis : 

Copyright 2001 by Allyn and Bacon 27 Cystic Fibrosis This inherited, fatal disease results in an abnormal amount of mucus throughout the body, most often affecting the child’s lungs and digestive tract. Most children with this disease do not live to their midteens. As the disease progresses, the child has problems with stamina.

Deaf-Blind : 

Copyright 2001 by Allyn and Bacon 28 Deaf-Blind Needs of students who are both deaf and blind are extremely complex More appropriate terms to use: Dual sensory impairments Multiple sensory impairments 94% of children have residual hearing or vision that can facilitate educational programs

Juvenile Diabetes : 

Copyright 2001 by Allyn and Bacon 29 Juvenile Diabetes This metabolic disorder affects nearly 8 million people in the United States In this disorder, the pancreas cannot produce sufficient insulin to process food Symptoms include: increased thirst, appetite, and urination weight loss fatigue irritability

Epilepsy : 

Copyright 2001 by Allyn and Bacon 30 Epilepsy Characterized by a series of convulsions or seizures that are caused by abnormal electrical discharges in the brain There are several different types of epilepsy Approximately 1% of the population in the United States has epilepsy Most epilepsy can be controlled with medication

HIV/AIDS : 

Copyright 2001 by Allyn and Bacon 31 HIV/AIDS Infection occurs when the human immuno-deficiency virus attacks the body’s immune system HIV eventually becomes acquired immunodeficiency syndrome (AIDS) Fastest-growing groups with HIV are infants and teenagers HIV/AIDS transmitted through the exchange of blood or semen

Muscular Dystrophy : 

Copyright 2001 by Allyn and Bacon 32 Muscular Dystrophy Umbrella term used to describe several different inherited disorders that result in progressive muscular weakness Duchenne dystrophy is the most common and most serious: fat cells and connective tissue replace muscle tissue individuals lose ability to walk hands and arms are affected most die during young adulthood

Prader-Willi Syndrome : 

Copyright 2001 by Allyn and Bacon 33 Prader-Willi Syndrome Characterized by compulsive eating, obesity, and mental retardation Other characteristics Hypotonia (deficient muscle tone) Slow metabolic rate Underdeveloped testes and penis Excessive sleeping Round face with almond-shaped eyes Nervous picking of skin Stubbornness

Spina Bifida : 

Copyright 2001 by Allyn and Bacon 34 Spina Bifida Congenital condition characterized by malformation of the vertebrae and spinal cord Occurs in about 1 in 2,000 births Three types: Spina bifida occulta Meningocele Myelomeningocele (most common & severe)

Tourette Syndrome : 

Copyright 2001 by Allyn and Bacon 35 Tourette Syndrome This neuropsychiatric syndrome occurs 3 times more often in males than in females Prevalence for males as high as 1 in 1,000 Characterized by frequent and multiple motor or vocal tics, which may include: Motor tics Inappropriate laughing Rapid eye movements Winks and grimaces Aggressive behaviors Peculiar verbalizations

Chapter Nine:Reflective Questions : 

Copyright 2001 by Allyn and Bacon 36 Chapter Nine:Reflective Questions What is autism and Asperger syndrome, and what are the characteristics of students with these two disabilities? What is traumatic brain injury, and what are the characteristics of students with this disability? What are health problems and physical disabilities, and what are some of the characteristics that students with these conditions display? What are some effective intervention strategies for students with autism, traumatic brain injury, health problems, and physical disabilities?

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