P020A Developmental Disabilities

P020ADevelopmental Disabilities

Mrs. Elizabeth Keele

Course Content #1

• Explain in detail the American Association of Intellectual and Developmental Disabilities (AAIDD) definition of mental retardation.

What is the AAIDD?• Founded 1876• "Association of

Medical Officers of American Institutions for Idiotic and Feebleminded Persons"

Classification of MR 1910• Moron– 7-12 years

• Imbecile– 2-7 years

• Idiot– < 2 years

THESE TERMS ARE NOW

INAPPROPRIATE AND OFFENSIVE

Name Change…

• Am. Assoc. of Mental Retardation– 1921

Name Change• 2007• American

Association of Intellectual and Developmental Disabilities

Current definition & Criteria

Definition:

• Mental Retardation

• Intellectual Disability

Is intellectual disability the same as mental retardation? A. YES

B. NO • “Intellectual disability” is the preferred term

Intellectual disability

• Name has changes not the definition…

Definition of Intellectual disability

• Intellectual disability is a disability characterized by significant limitations in both intellectual functioning and in adaptive behavior, which covers many everyday social and practical skills. This disability originates before the age of 18.


• Intellectual functioning• AKA: intelligence• general mental capacity– Learning– Reasoning– Problem solving


• How can we measure intellectual functioning?• IQ test. • score <70 – 75 = limitation in intellectual

functioning.


• Intellectual disability is a disability characterized by significant limitations in both intellectual functioning and in adaptive behavior, which covers many everyday social and practical skills. This disability originates before the age of 18.


• Adaptive behavior• Collection of conceptual, social, and practical

skills that are learned and performed by people in their everyday lives.


• Conceptual skills– Language & literacy– Money– Time– Number concepts– Self-direction


• Social skills– Interpersonal skills– Social responsibility– Self-esteem– Gullibility– Naïveté – Social problem solving– Ability to follow rules/obey

laws – Avoid being victimized


• Practical skills– activities of daily living – Occupational skills– Healthcare– Travel/transportation– Schedules/routines– Safety– Use money– Use telephone.


• Standardized tests can also determine limitations in adaptive behavior.


• Age of Onset–Before 18

• This condition is one of several developmental disabilities


• Assume – Limitations coexist with strengths– Level of functioning will improve – if appropriate personalized supports are

provided –over a sustained period


• Only on the basis of such many-sided evaluations can professionals determine whether an individual has intellectual disability and tailor individualized support plans.

Is intellectual disability the same as developmental disabilities?• "Developmental

Disabilities" is an umbrella term

• includes intellectual disability

• also includes other disabilities that are apparent during childhood.

Federal Definition of Developmental Disabilities

• According to the Developmental Disabilities Act, section 102(8), "the term 'developmental disability' means a severe, chronic disability of an individual 5 years of age or older that:


• Severe, chronic disability 5 years+ 1. Is attributable to a mental or physical

impairment or combination of mental and physical impairments


• Severe, chronic disability 5 years+ 1. Mental or physical impairment2. Is manifested before the individual attains age 22


• Severe, chronic disability 5 years+ :1. Mental or physical impairment2. Is manifested before 223. Is likely to continue indefinitely


• Severe, chronic disability 5 years+ :1. Mental or physical impairment2. Is manifested before 223. Is likely to continue indefinitely

4. Results in substantial functional limitations in three or more of the following areas of major life activity• Self-care• Receptive and expressive language;• Learning;• Mobility;• Self-direction;• Capacity for independent living; and• Economic self-sufficiency.


• Functional limitations • Self-care• Receptive and expressive language;• Learning;• Mobility;• Self-direction;• Capacity for independent living; and• Economic self-sufficiency.


• Severe, chronic disability 5 years+ :1. Mental or physical impairment2. Is manifested before 223. Is likely to continue indefinitely4. Results in substantial functional limitations (3+)5. Reflects the individual's need for services,

supports, or other assistance that is of lifelong or extended duration

Intellectual disability • Intellectual

disability encompasses the “cognitive” part of this definition

Is intellectual disability determined by just an IQ test?

A.YESB.NO

• 3 major criteria :– intellectual functioning, – adaptive behavior, – onset <18

IQ test• Tool • < 75 indicates a

limitation in intellectual functioning

History of Intellectual disabilities

• Earliest documentation– 1552 B.C. – Luxor, Egypt

Treatment throughout history

• Depended on customs– Eliminated– Amusement– Slavery

Skill based program

• Dr. Jean-Marc Itard– 1774-1838– Father of Special Ed.

Residential Facilities• First:– Abendberg– Johann Guggenbühl – 1841 – Switzerland

USA rehabilitation & reintegration

• Dorthea Dix– Asylums

• Samuel Howe– Director of Perkins

Institution for the Blind in Boston

• Hervey Wilbur – 1st private institution

Eugenics

• Sterilization laws

Small Group Questions• What is the AAIDD?• What is the definition of mental retardation?• ID originates before what age?• What is another term for intellectual functioning?• What are the skill-sets associated with adaptive behavior? (Give

specific examples of each skill set)• What is the relationship between developmental disability and

intellectual disability?• What is the federal government’s definition of developmental

disability?• Who are Johann Guggenbuhl, Dorothea Dix, Samuel Howe and

Hervey Wilbur in relationship to ID?• What are eugenics laws?

Course Content #2

• Detail the general deficits experienced by mental retarded individuals as compared with normal individuals in 3 distinct development stages– Infancy – early childhood– Childhood – adolescence– Late adolescence - adulthood

Cognitive Theory• Jean Piaget• Intellect &

develop thought processes

Cognitive theory3 Major Concepts

• Schema– Idea’s that grow from experience

• Assimilation– Ability to absorb new information into

schemas• Accommodation– Schemas change with new information

• http://www.youtube.com/watch?v=TRF27F2bn-A

• http://www.youtube.com/watch?v=bpO5w9mM-1M

http://www.youtube.com/watch?v=TRF27F2bn-A

http://www.youtube.com/watch?v=TRF27F2bn-A

http://www.youtube.com/watch?v=bpO5w9mM-1M

http://www.youtube.com/watch?v=bpO5w9mM-1M

SENSORIMOTOR

• Age– Birth – 2 yrs

• Major developmental Task1) Mobility 2) Sense of self3) Object permanence4) Form mental images

Preoperational• Age–2 – 6 yrs

• Major developmental Task1) Express self with

language2) Understanding gestures3) Conservation

Concrete operational

• Age–6 - 12 yrs

• Major developmental Task1) Logical thinking2) Reversibility & spatiality3) Differentiate and classify4) Socializing 5) Apply rules

Formal operational

• Age• 12 – 16 yrs

• Major developmental Task1) Abstract thinking2) Testing hypotheses

A child forgets about the toy as soon as it is placed under a blanket – is an example of a

child's lack of…

A. Sense of selfB. Object permanenceC. ConservationD. ReversibilityE. Delayed gratification

Intellectual Disability

• Limitations in age-appropriate intellectual & adaptive behavior

• Life Span

Mild

• Identified– 2nd – 3rd grade– Master skills 6th

grade

Moderate

• Delays in preschool• Discrepancies widen

with age• h health problems• h behavior problems

Severe - Profound

• Identified at birth• CNS damage• Functional impairment

Cognitive Functioning

• Memory• Learning rates• Attention• Generalizing• Motivation

Memory

• Difficulty– Short-term memory

Learning Rate

• Less that typical• h # of trials

Attention

• Trouble attending to relevant vs. irrelevant stimuli

• i attention span

Generalization of Learning

• Difficulty transferring knowledge

Motivation

• Exhibit lack of interest• Learned helplessness

Adaptive behavior

• ADL’s• Social development• Behavioral Excesses

ALD’s

• Direct• Supports• Prompts• Simplified• Routine

Social Development

• i language• unusual behaviors• making and sustaining

friendship is a challenge

Behavioral Excesses

• h behavior problems• i self-control• “Dual diagnosis”– I.D. + psychiatric

condition

Small Group Questions• Who is the “father” of cognitive theory?• Define schema, assimilation and accommodation• What are the four stages of cognitive development and

what are the major tasks associated with each stage?• In general terms how is cognitive functioning affected

in clients with ID?• In general terms how is adaptive behavior affected in

clients with ID?• In general terms how is social development affected in

clients with ID?

Course Content #3

• State the formula for and compute I.Q.

What does IQ stand for?

• Intelligence quotient

What is intelligence?

• 3 behaviors equate with intelligence1. Problem solving2. Verbal3. Social

To determine intelligence…

• These concepts are incorporated into IQ tests in varying ways.

Intelligence Tests

• 1st

– 1905– Binet & Simon

• Favored– Verbal

• Revised– Stanford-Binet test

Common tests

• Wechsler test–Most common

• Vineyard Social maturity scale• Leiter international performance scale• Slosson Intelligence Test

What does IQ stand for?

• Intelligence quotient–William Stern

• Median score –100 –95 % between 70 and 130

IQ Formula

𝑀𝑒𝑛𝑡𝑎𝑙 𝐴𝑔𝑒(𝑀𝐴)h𝐶 𝑟𝑜𝑛𝑜𝑙𝑜𝑔𝑖𝑐𝑎𝑙 𝐴𝑔𝑒(𝐶𝐴)

𝑥100=𝐼 .𝑄 .

Mental Age & IQ

• Mental age = • “General measure of mental power”

Example

• _I.Q.__

Example

• __I.Q.__

Example

• __I.Q. 100__

Example

• Mental Age:4• Chronological age: 32

• What is there I.Q?

A.0.125B.12.5C.125D.8E.80

Example

• __12.5__

Example

• Mental Age:4• Chronological age: 32

• What is there I.Q?

A.0.125B.12.5C.125D.8E.80

Example

• Chronological age– 16

• Mental Age– 8

• What is their I.Q?

A.2B.20C.200D.5E.50

Is intellectual disability determined by just an IQ test?

• No!• 3 major criteria :– intellectual

functioning, – adaptive behavior, – onset <18

IQ test

• Tool • < 75 indicates a

limitation in intellectual functioning

Small Group Questions• What does IQ stand for?• What is the formula for IQ?• What behaviors or skills are associated with

intelligence?• What is the “average” IQ• What score on an IQ is considered ID?• What tests are used to determine IQ?

Course Content #4

• Describe the distribution of the developmentally disabled as a population

People Served by Calif. - DDS

1997Gender # %

Female 61,892 42.3%

Male 84,345 57.7%

Total 146,237 100%

2007

Gender # %

Female 86,740 38.6%

Male 138,230 61.4%

Total 224,970 100%

People Served by DDS

1997

MaleFemale

2007

MaleFemale

Age # %Birth – 2yrs 29,781 13.2%

3-13 yrs 61,684 27.4%

14 – 21 yrs 38, 820 17.3%

22 - 31 yrs 32,161 14.3%

32 – 41 yrs 22,002 9.8%

42 – 51 yrs 21,594 9.6%

52 – 61 yrs 12,987 5.8%

> 62 yrs 5,941 2.6%

Residence Type

1997#

1997%

2007#

2007%

Home 96,412 65.9% 165,284 73.5%

Comm. care 24,912 17.0% 27,133 12.1%

ILS / SLS 12,184 8.3% 19,492 8.7%

SNF / ICF 7,976 5.3% 8,854 3.9%

Developmental Center

4,031 2.8% 2,675 1.2%

Other 722 0.5% 1,532 0.7%

Epilepsy or Seizure Disorder2007

YES - 19.6%

NO - 80.4%

Cerebral Palsy or Similar Motor Dysfunctions

2007

YES 17.9%

NO 82.1%

Autism

1997

Yes 7%

No 93%

2007

YES 19%

NO 81%

2007No ID- 25%

Mild - 3*%

Moderate - 17%

Severe 8%

Profound 5%

Unknown 6%

Small Group Question

• Describe the distribution of the developmentally disabled as a population

Course Content #5

• List the ranges of I.Q. scores associated with various levels of intellectual disability according to the AAIDD

DSM - 5

• Eliminated levels per IQ –2013

Levels of ID per DSM-IV Level IQ

Mild 50 - 55 to 70Moderate 35-40 to 55Severe 20 - 25 to 35 -40Profound Below 20 – 25

Wechsler Intelligence Scales(Current as of 2012)

IQ Range ("deviation IQ") IQ Classification

130 and above Very Superior

120–129 Superior

110–119 High Average

90–109 Average

80–89 Low Average

70–79 Borderline

69 and below Extremely Low

Stanford-Binet Intelligence Scale Fifth Edition (2003)

IQ Range IQ Classification

145–160 Very gifted or highly advanced

130–144 Gifted or very advanced120–129 Superior110–119 High average90–109 Average80–89 Low average

70–79 Borderline impaired or delayed

55–69 Mildly impaired or delayed

40–54 Moderately impaired or delayed

Historically – 1916 IQ Range IQ Classification

Above 140 "Near" genius or genius120–140 Very superior intelligence110–120 Superior intelligence

90–110 Normal, or average, intelligence

80–90 Dullness, rarely classifiable as feeble-mindedness

70–80 Border-line deficiency, sometimes classifiable as dullness, often as feeble-mindedness

Below 70 Definite feeble-mindedness

1923

IQ Range ("ratio IQ") IQ Classification

130 and above Very Superior

120–129 Very Bright

110–119 Bright

90–109 Normal

80–89 Backward

70–79 Borderline

1928175 of above Precocious

150–174 Very superior125–149 Superior115–124 Very bright105–114 Bright95–104 Average85–94 Dull75–84 Borderline50–74 Morons25–49 Imbeciles0–24 Idiots

1958

IQ Range IQ Classification Percent Included

128 and over Very Superior 2.2

120–127 Superior 6.7

111–119 Bright Normal 16.1

91–110 Average 50.0

80–90 Dull normal 16.1

66–89 Borderline 6.7

65 and below Defective 2.2

Small Group Question

• List the ranges of I.Q. scores associated with various levels of intellectual disability according to the AAIDD

Course Content #6

• Describe expected levels of functioning of the developmentally disabled as a population

AAIDD core values:

• Full societal inclusion and participation

AAIDD core values:

• Equality, individual dignity & other human rights.

AAIDD core values:

• Choice and self-determination

AAIDD core values:

• Recognizing contributions

AAIDD core values:

• Participation in all aspects of life

AAIDD core values:

• Access to quality health, education, vocational, and other human services and supports.

Documents

P020A Developmental Disabilities