MULTIPLE DISABILITIES

IDEA Definition

Multiple Disabilities: Impairments that occur simultaneously (such as mental retardation-blindness and mental retardation-orthopedic impairment), the combination of which causes such severe problems that they cannot be accommodated in special education programs solely for one of the impairments.

The term does not include deafness.

CHARACTERISTICSPeople with severe or multiple disabilities may exhibit a wide range of characteristics, depending on the combination, their severity and the person’s age. There are, however, some traits they may share, including:

Limited speech or communication

Difficulty in physical mobility learning

Tendency to forget skills through disuse

Presence of primitive reflexes

Trouble generalizing skills from one situation to another

A need for support in major life activities (domestic, community…)

Brain injury and possibly others

Along with multiple disabilities, they can also exhibit sensory losses and behavior and/or social problems.

HISTORY

Prior to the 1975 children with severe or

multiple disabilities were institutionalized.

After 1975, programs for special education were created but children were separated from typical students.

Currently the least restrictive environment (LRE) is the acceptable classroom setting.

CAUSESThere are three categories that the causes of severe and multiple disabilities can be divided. They are as follows:

Prenatal causes which include:

Chromosomal abnormalities Viral infections Drug and Alcohol use during pregnancy Mother`s malnutrition Physical trauma to the mother

Perinatal causes which include: Lack of oxygen supply to the baby`s brain Physical injury to the baby`s brain at birth Contracted infections during birth

Continued…Postnatal causes which include: Childhood infections such as meningitis & encephalitis

Traumatic brain injury from an accident or abuse

Lead poisoning

Reactions to medication

Exposure to toxins or other environmental conditions

As with other disabilities, the severity and complexity

depends upon the genetic abnormality, the amount of

damage to the brain, and the environment in which

the child is raised.

PREVALENCE

The percentage of students having severe and

multiple disabilities is very low. Approximately

.1% to 1% of the general school age

population have severe and multiple disabilities.

It is not likely that more than one student

with severe and multiple disabilities would be

enrolled in a general classroom at any given

time.

IMPLICATIONS FOR PHYSICAL EDUCATION

An individual with multiple disabilities may be challenged with:

Motor delays

Abnormal muscle tone

Muscle atrophy, contractures

Problem balancing

Behavioral problems

EFFECTIVE TEACHING STRATEGIES

Maintain a small teacher to student ratio

Use positive reinforcement

Establish rapport

Talk to child as if they were any other child

Mirror their movements to see if they notice;

assessing

Use all forms of communication - sign,

language, visual and tactile

Continued…

Learn from caregivers what the child likes and

dislikes

Slow instructions – avoid excess words

Teach in the pool

The warmer the better in most cases

Be aware of chlorine allergies

Continued…

Learn what primitive reflexes are still present

Focus instruction on lifetime physical activity

Use sensory integration instruction when

appropriate

Preschool age children should be included

My name is “Sam.” When I was born five weeks early (preemie)

in 2000, I wasn’t breathing. I was resuscitated and had to spend

five weeks in the

Neonatal ICU.

It was discovered that I had:

•Mild Cerebral Palsy (mostly

affecting my legs)

•Mild-moderate Autism

•Strabismus in my left eye

•Periventricular Leucomalasia

When I left the hospital I went home to my parents and family.

I was in an early intervention program from 1-3 yrs old. Because of my cerebral palsy I had braces on my legs and botox injections in my calves.

This is my dad doing my stretching exercises with me.

To help with my developmental growth I have sensory stimulation sessions, physical, speech and occupational therapy.

Today at age 9 I go to both regular and special education classes.

Because I have autism I feel most comfortable with what is familiar to me. When I am frustrated, I have coping mechanisms that help calm me.

Sometimes if I’m feeling really frustrated I may have a tantrum.

But most of the time I’m a happy kid that enjoys:

And one of my favorite past times is when I get to go to Wal-Mart and people watch!

OUR MISSION: To improve the quality of life for children

with multiple disabilities by providing comprehensive

education and rehabilitation programs.

At Pattison's Academy, children with severe and multiple

disabilities will be exposed to a community inclusive

rehabilitative program that is completely integrated with an

educational environment. Our goal will be to maximize each

child's education and function, while preventing and slowing

secondary deficits.

ReferencesChildren’s Hospital Boston. (2009). How we treat stabismus in

children. Retrieved April 4, 2010 from

http://www.childrenshospital.org/clinicalservices/Site1764/

mainpageS1764P8.html

Curtis, S.R. (1982). The joy of movement in early childhood. New

York: Teachers College.

Hallahan, D.P., & Kauffman, J.M. (2006). Exceptional learners :

an introduction to special education. Boston: Pearson.

National Dissemination Center for Children With Disabilities 2003.

Severe/multiple disabilities. Retrieved March 2, 2004, from

http://www.nichcy.org/pubs/factshe/fs10.pdf

ReferencesSherril, C. (1998). Adapted physical activity, recreation and sport:

cross disciplinary and lifespan (5th ed.). Boston: McGraw Hill.

Snell, M. (2010). Severe and education of individuals with multiple

disabilities - definition and types of severe and multiple

disabilities. Retrieved April 6, 2010, from

http://education.stateuniversity.com/ pages/2415/ Severe-

Multiple-Disabilities-Education-individuals-With.html

Zach, T., MD. (2010, March). Periventricular leukomalacia.

Retrieved April 4, 2010, from http://emedicine.medscape.com/

article/975728-overview