Lecture 1 - Porterville College

Report
P020A
Developmental 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
• “Intellectual
B. NO
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.
Definition of Intellectual disability
• Intellectual functioning
• AKA: intelligence
• general mental capacity
– Learning
– Reasoning
– Problem solving
Definition of Intellectual disability
• How can we measure intellectual functioning?
• IQ test.
• score <70 – 75 = limitation in intellectual
functioning.
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.
Definition of Intellectual disability
• Adaptive behavior
• Collection of conceptual, social, and practical
skills that are learned and performed by
people in their everyday lives.
Definition of Intellectual disability
• Conceptual skills
– Language & literacy
– Money
– Time
– Number concepts
– Self-direction
Definition of Intellectual disability
• Social skills
–
–
–
–
–
–
–
Interpersonal skills
Social responsibility
Self-esteem
Gullibility
Naïveté
Social problem solving
Ability to follow
rules/obey laws
– Avoid being victimized
Definition of Intellectual disability
• Practical skills
–
–
–
–
–
–
–
–
activities of daily living
Occupational skills
Healthcare
Travel/transportation
Schedules/routines
Safety
Use money
Use telephone.
Definition of Intellectual disability
• Standardized tests can
also determine
limitations in adaptive
behavior.
Definition of Intellectual disability
• Age of Onset
– Before 18
• This condition is one of several
developmental disabilities
Definition of Intellectual disability
• Assume
– Limitations coexist with strengths
– Level of functioning will improve
– if appropriate personalized supports are
provided
– over a sustained period
Definition of Intellectual disability
• 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
"Developmental
as developmental disabilities?
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:
Federal Definition of Developmental
Disabilities
• Severe, chronic disability 5 years+
1. Is attributable to a mental or physical
impairment or combination of mental
and physical impairments
Federal Definition of Developmental
Disabilities
• Severe, chronic disability 5 years+
1. Mental or physical impairment
2. Is manifested before the individual attains age 22
Federal Definition of Developmental
Disabilities
• Severe, chronic disability 5 years+ :
1. Mental or physical impairment
2. Is manifested before 22
3. Is likely to continue indefinitely
•
Federal Definition of
Developmental Disabilities
Severe, chronic disability 5 years+ :
1.
2.
3.
Mental or physical impairment
Is manifested before 22
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.
Federal Definition of
Developmental Disabilities
• Functional limitations
•
•
•
•
•
•
•
Self-care
Receptive and expressive language;
Learning;
Mobility;
Self-direction;
Capacity for independent living; and
Economic self-sufficiency.
Federal Definition of
Developmental Disabilities
• Severe, chronic disability 5 years+ :
1.
2.
3.
4.
5.
Mental or physical impairment
Is manifested before 22
Is likely to continue indefinitely
Results in substantial functional limitations (3+)
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?
• 3 major
criteria
:
A.YES
B. NO
– 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 theory
3 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=TRF27F2b
n-A
• http://www.youtube.com/watch?v=bpO5w9m
M-1M
SENSORIMOTOR
• Age
– Birth – 2 yrs
• Major developmental Task
1) Mobility
2) Sense of self
3) Object permanence
4) Form mental images
Preoperational
• Age
– 2 – 6 yrs
• Major developmental Task
1) Express self with
language
2) Understanding gestures
3) Conservation
Concrete operational
• Age
• Major developmental Task
– 6 - 12 yrs
1) Logical thinking
2) Reversibility & spatiality
3) Differentiate and classify
4) Socializing
5) Apply rules
Formal operational
• Age
• Major developmental Task
• 12 – 16 yrs 1) Abstract thinking
2) 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 self
B. Object permanence
C. Conservation
D. Reversibility
E. 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 intelligence
1. Problem solving
2. Verbal
3. 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
  ()
 100 = . .
ℎ  ()
Mental Age & IQ
• Mental age =
• “General measure of mental power”
Example
•


•
 6

× 100 = 
× 100 = _I.Q.__
Example
•


•
 6
 6
× 100 = 
× 100 = __I.Q.__
Example
•


•
 6
 6
× 100 = 
× 100 = __I.Q. 100__
•
•
•
Example
A.0.125
B.12.5
Mental Age:4
C.125
Chronological age: 32
D.8
What is there I.Q?
E.80
Example
•


•
 4
 32
× 100 = 
× 100 = __12.5__
•
•
•
Example
A.0.125
B.12.5
Mental Age:4
C.125
Chronological age: 32
D.8
What is there I.Q?
E.80
•
•
•
Example
A.2
Chronological age
B.20
– 16
Mental Age
C.200
–8
D.5
What is their I.Q?
E.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
2007
1997
Gender
#
%
Gender
#
%
Female
61,892
42.3%
Female
86,740
38.6%
Male
84,345
57.7%
Male
138,230 61.4%
Total
146,237
100%
Total
224,970 100%
People Served by DDS
2007
1997
Male
Male
Female
Female
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
4,031
2.8%
2,675
1.2%
722
0.5%
1,532
0.7%
Center
Other
Epilepsy or Seizure Disorder
2007
YES - 19.6%
NO - 80.4%
Cerebral Palsy or Similar Motor
Dysfunctions
2007
YES 17.9%
NO 82.1%
Autism
2007
1997
YES 19%
Yes 7%
No 93%
NO 81%
2007
No 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
Level
Mild
Moderate
Severe
Profound
Levels of ID
per DSM-IV
IQ
50 - 55 to 70
35-40 to 55
20 - 25 to 35 -40
Below 20 – 25
Wechsler Intelligence Scales
(Current as of 2012)
IQ Range ("deviation IQ")
130 and above
IQ Classification
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
120–129
110–119
90–109
80–89
Gifted or very advanced
Superior
High average
Average
Low average
70–79
Borderline impaired or delayed
55–69
Mildly impaired or delayed
40–54
Moderately impaired or delayed
Historically – 1916
IQ Range
Above 140
120–140
110–120
IQ Classification
"Near" genius or genius
Very superior intelligence
Superior intelligence
90–110
Normal, or average, intelligence
80–90
Dullness, rarely classifiable as feeblemindedness
70–80
Border-line deficiency, sometimes classifiable
as dullness, often as feeble-mindedness
Below 70
Definite feeble-mindedness
1923
IQ Range ("ratio IQ")
130 and above
IQ Classification
Very Superior
120–129
Very Bright
110–119
Bright
90–109
Normal
80–89
Backward
70–79
Borderline
1928
175 of above
Precocious
150–174
Very superior
125–149
Superior
115–124
Very bright
105–114
Bright
95–104
Average
85–94
Dull
75–84
Borderline
50–74
Morons
25–49
Imbeciles
0–24
Idiots
1958
IQ Range
IQ Classification
Percent Included
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
128 and over
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.

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