Variation Handicap Continuum

The Variation-Handicap Continuum

from Developmental Variations and Learning Disordersby Dr. Mel Levine and Dr. Martha Reed

Defining the problem

When is a child’s pattern of development simply unique, quirky, unusual - but not cause for concern?

When should a child receive intervention and accommodations?

What role does the child’s environment play?

Avoiding “All or Nothing” Thinking


“He can do it when he really puts his mind to it. If he really had a problem, he wouldn’t be able to do it at all.”



“She didn’t test low enough to qualify for a disability. It’s not like she’s failing. A C is a respectable grade.”




“He doesn’t need to change who he is to fit in better with the other kids. They’re just mean to anyone who’s at all different.”




“He doesn’t need to change who he is to fit in better with the other kids. They’re just mean to anyone who’s at all different.”

“I’ll never need to use this stuff in real life - I’ll just find a job where I don’t need math.”



✴ In what situations is this pattern of functioning a problem? Are there any situations in which it is not a problem, or even beneficial?



✴ How much of a problem is it currently?



✴ How much of a problem is it currently?

✴ If this pattern continues, will it become more problematic over time?



A pattern of functioning can be described along the continuum as a:



Variation



Variation

Dysfunction



Variation

Dysfunction

Disability



Variation

Dysfunction

Disability

Handicap

Variation

Variation

An unusual pattern of style, strength, and/or weakness in one or more components of a developmental function.

Variation


Example: A strong vocabulary, very good verbal reasoning, but some weakness in processing lengthy complex sentences.

Variation



Effects: Usually of little or no impact unless complicated by other factors or unusual expectations.

Variation



Effects: Usually of little or no impact unless complicated by other factors or unusual expectations.

Dysfunction

DysfunctionA pattern of developmental variation that significantly impairs performance in a particular developmental function


Example: A poor vocabulary, trouble finding words, and weakness of verbal memory – together thwarting overall linguistic skills



Effects: Variable, depending on severity, expectations, employment of compensatory strengths, and presence of other dysfunctions



Effects: Variable, depending on severity, expectations, employment of compensatory strengths, and presence of other dysfunctions

Disability

Disability

One or more dysfunctions that result in poor performance on a particular type of task

Disability


Example: A language dysfunction associated with a reading disability

Disability



Effects: Variable, depending on the importance of the affected task, and the age and social and/or educational setting of the child (e.g. a reading disability has more impact than a dancing disability)

Disability



Effects: Variable, depending on the importance of the affected task, and the age and social and/or educational setting of the child (e.g. a reading disability has more impact than a dancing disability)

Handicap

Handicap

A disability that is uncompensated for and that compromises a critical area of performance

Handicap


Example: A reading disability that renders the student unable to pass classes or tests critical for school success.

Handicap


Example: A reading disability that renders the student unable to pass classes or tests critical for school success.

Effects: Of high impact

Before we continue...


Think about our discussion about “worst subjects” in school. We talked extensively about characteristics of the environment - teachers, abstractness of subject matter, required background knowledge, and so on - that could have a negative impact.


Think about our discussion about “worst subjects” in school. We talked extensively about characteristics of the environment - teachers, abstractness of subject matter, required background knowledge, and so on - that could have a negative impact.

How might these factors nudge a student’s performance up or down the continuum?


Before we continue...Think about the multiple intelligences inventory that we filled out on the first night of class. Which of those categories are valued in your current work or school environment? How about your school environment growing up? Are some intelligences “tapped” more than others?


Traditional intelligence is thought of as encompassing all situations and types of tasks. In the multiple intelligence framework, however, can a child be extremely strong in some areas, and extremely weak in others?

Case Study: “Lorrie”Lorrie is a 1st grade girl who is happy and productive at school overall. Her least favorite subject is writing, because she often can’t remember how to form her letters. Sometimes she mixes up capital and lowercase letters. Other times she gets stuck trying to form the letters in a word and forgets what she was going to write. Lorrie’s stories are very short and simple on paper - though when she dictates them to her teacher, she adds a great deal of complexity and imagination.

Lorrie’s teacher isn’t too concerned. The class practices letter formation for 10 minutes a day during the morning routine, and Lorrie’s parents have bought several handwriting workbooks that she can work on at home. At this point, it appears that this is an isolated difficulty, and though it causes frustration for Lorrie, the teacher is able to help her through it and provide alternatives so that Lorrie can produce a satisfactory written product.

Lorrie’s parents are thrilled she has such an understanding teacher. Lorrie’s mother struggled with the same problem as a child, but her teachers marked her down for messy handwriting and thought that she was less intelligent because she worked so slowly and her written work was so simplistic.

Where would you place Lorrie on the continuum?

What about Lorrie’s mother?

Case Study: “Ricky”When Ricky was in 2nd grade, his parents noticed that he was spending a lot of time washing his hands. He also asked incessantly about germs and illness, and no matter how many times they reassured him that he was healthy, Ricky continued to worry. He wondered if he could be contaminated by encountering sick people in public. After Ricky saw a homeless man coughing in the bus terminal, he was afraid to go near any homeless person, or sit in a seat that a homeless person might have touched. Ricky started to refuse to go places, crying and pleading, developing headaches and even vomiting. By the end of 2nd grade, he was refusing to leave the house.

Ricky was diagnosed with Obsessive-Compulsive Disorder (OCD) and started cognitive-behavioral therapy, as well as anti-anxiety medication. His treatment plan included carefully controlled exposure to anxiety-provoking topics and situations, during which he would practice relaxation techniques. Over time, his condition improved, though he continued to experience headaches and vomiting episodes for the first two years after beginning treatment.

Ricky is now in 7th grade. His science class is studying contagious diseases. His science teacher reports that he got a bit flustered when the subject came up at first, but has learned the information well, and was particularly interested in talking about prevention and the immune system’s defenses.

Where was Ricky on the continuum at the end of 2nd grade?

How would you characterize Ricky’s condition now?

Ricky lives in New York City. How might his journey have been

different if he lived in a rural area?

More situations...“Chris” has always had trouble finding his way around. His early elementary school teachers never sent him anywhere without a buddy, and even now as a 5th grader, Chris frequently finds himself on the wrong floor of the building, or down the wrong hallway. He has learned to joke about it, but is secretly very embarrassed. He is extremely worried about what will happen when he has to switch classes for middle school next year. He is afraid to talk to his new principal or teachers because they might think he is a troublemaker, or worse, stupid. Chris’s friends have always helped him out, but what if they are not in the same classes?

“Myra” hates going to school because she doesn’t get along with the other girls in her class. She claims that they are interested in nothing except hair, fashion, and boys, and can be seen rolling her eyes when they giggle or make “ditzy” comments in class. After being asked by the teacher to make an effort with Myra, several girls invited her to sit with them in the cafeteria. Myra refused, thinking that the girls were doing it to tease her. Myra’s guy friends are mystified about the situation. They are starting to wonder who the “real” Myra is. Meanwhile, Myra has been assigned to work with one of the girls for a group project in social studies, and has been warned that teamwork will constitute part of the grade for the project.

The Variation-Handicap Continuum is a way of qualitatively describing an individual’s functioning.

It is a way of thinking about variations that should suggest potential actions to help an individual

“move up the continuum”.

It recognizes that variations are not inherently “good” or “bad”, but operate within a context.

Education

Variation Handicap Continuum