Characteristics, prevalence and causes of severe disabilities
There is no clear definition of the term severe and multiple disabilities because according to psychologists and special educators there are numerous conditions associated with the severe and multiple disabilities that no single definition has ever captured. But there is a general agreement that most students suffering from severe and multiple disabilities exhibit mental retardation usually accompanied by other disabilities like delayed language skills and profound physical disabilities (Beukelman & Mirenda, 1992).
However, some of these students may exhibit a normal intelligence which unfortunately may be masked by their language and/or physical disabilities. The definition has two overriding themes; the extent or severity of the disability is considered to be far beyond moderate or mild levels, and the person suffers from two or more disabilities at the same time. On the other hand, the severe profound and multiple disabilities is far extreme. It is whereby the severity of the disability involves the impairment of the auditory and visual senses and is sometimes referred to as dual sensory impairment.
Apart from mental retardation it is accompanied by deaf and blindness in the child. The child also suffers severe behavioral problems. Characteristics of Severe and Multiple Disabilities As mentioned above, there is no single definition
Sometimes the distinctive characteristics among students suffering from these disabilities are more different than similar. However, studies have categorized the characteristics as follows; those concerning intellectual functioning, physical development, communication ability, health care needs and adaptive behavior. Intellectual Behavior Most students suffering from severe and multiple disabilities exhibit a severe impairment of brain functioning. A person’s intellectual ability is always measured by his or her intelligence test scores.
However, the conventional methods of testing intelligence do not work and studies are ongoing to find methods that would be appropriate for them. Academic evaluators have always had problems when it comes to testing of students with multiple disabilities (Beukelman & Mirenda, 1992). The students with multiple disabilities also suffer from low levels of awareness. The level of awareness in this case may range from those exhibiting lack of attention to those who are just unresponsive to stimuli such as noise, odor, movement, touch and others forms in their surrounding.
Those students with extreme conditions are fond of crying, sleeping or engaging in some stereotyping behaviors (Hosken, 2008). However, even if they have low levels of awareness, some of them would at times be attentive and show interest in what is happening around them. Adaptive Behavior Most of the individuals with multiple disabilities are able to acquire self-care skills. School programs for such individuals include learning instructions in self-care skills such as personal hygiene, dressing, toileting, household chores as well as feeding.
Although this learning process may take a longer period for one to be fully equipped, the result would be great in not only helping the student care for him/herself but would also help them interact with others in society (Beukelman & Mirenda, 1992). Closely related with the self-care skills are the social skills. Usually most of these individuals don’t have healthy social interaction with their peers or others in the society. However, some are quite outgoing and at times must be warned to avoid strangers.
Although, most of these individuals have improper social interaction, teachers and family members normally contend that they are capable of learning how to engage in healthy relationship with others. Social skills can be offered in some unique ways and would be the key determinant of how successful they would be in adjusting to societal needs as well as in living independently (Hosken, 2008). Communication Skills Majority of students suffering from multiple disabilities lack language and speech skills and therefore exhibit difficulties in expressing themselves.
However, lack of speech skills does not translate into lack of communication. It is said that even the severely impaired students do communicate. Because they exhibit difficulty in expressing themselves, it is important that the teacher or the caregiver to interpret their utterances correctly for the communication to be effective. For example, some these students turn their heads, move their bodies, make eye contact or make some noise. Such expressions can be very subtle and hard to see (Harmon & Jones, 2005). Physical Development
Medical research has revealed that students with severe and multiple disabilities normally have a delayed motor development. The impairment in the sensorimotor may further cause an abnormal muscle tone in such students. For instance, some may have underdeveloped muscle tone which would lead to inability to walk, sit or hold up one’s head. Others may also suffer an increased muscle tension that may result into inability to use fine muscles of the hands (Hosken, 2008). Sensory impairment is another common feature among individuals with severe and multiple disabilities.
Research suggests that about 2 in every 5 individuals with these disabilities will either be deaf, blind or suffer both. Where a child suffers both impairments, the other sensory body organs would not be able to obtain clear and consistent information. Because of this most of them would simply withdraw and have a passive and unresponsive behavior. Moreover, they will have difficulties in initiating a conversation and may find it hard to respond (Harmon & Jones, 2005). Health Care Needs There are various health care needs which are as complicated as the various type of severe and multiple disabilities.
For example, those who have underdeveloped muscle tone are said to develop numerous and frequent health complications. Since they have a problem in coughing they frequently suffer from cold. Caring for such individuals is further complicated by the fact that they are unable to swallow food and have to be fed by a stomach tube (Downing, 2002). Causes of Severe and Multiple Disabilities Research suggests that the cause of severe and multiple disabilities in about fifty percent of the children are yet to be established.
However, in the few cases that are known chromosomal abnormalities for example, a dysfunctional production of enzymes which would result into a buildup of tonic sub stances in the child’s brain, developmental disorders of the brain leading to brain malformations, genetic metabolic disorders as well as negative prenatal environmental effects, have been said to be responsible for a number of multiple disabilities (Hosken, 2008). Negative prenatal influences are associated by prenatal biomedical factors, where child-bearing women have poor health habits like excessive smoking or extensive use of certain medications.
Some of the severe and multiple disabilities can be prevented. Once a physician suspect a problem in a child, amniocentesis, ultrasound or biopsy may be employed to ascertain the disability. The major reason for having a prenatal check up is to identify any disability in a developing baby which must be treated before or immediately after birth. A prenatal surgery is recommended for problems like hydrocephaly so as to prevent the brain of the child from damaging.
To avoid and possibly prevent these disabilities, maternal education is highly recommended for young mothers. Since negative prenatal environment or practices are said to be one of the contributing factors, a good health practices is paramount for any child-bearing woman (Harmon & Jones, 2005). Prevalence The definition of the severe and multiple disabilities are as varied as the various types. Individuals with multiple disabilities usually have two or more combination of serious disabilities which may include impairment in the cognition, movement or sensory.
According the United States federal government’s definition, if one of the impairment results into severe educational problem then, the disabilities would qualify as a severe and multiple disabilities. But this definition normally leaves out the deaf-blindness disability which is defined separately as a different disability group (Downing, 2002). As compared to other disabilities, the definition of severe and multiple disabilities has been less precise therefore making estimation of their prevalence quite hard. However, most studies put the prevalence rate at 0. 25 and 0. 50 percent of the general population.
The prevalence rate is also considered to be relatively uniform in all the socioeconomic classes (Beukelman & Mirenda, 1992). Educational Approaches Systematic Instruction This involves teaching the students to adhere to some series of particular procedures. In this method, teachers or special needs professional would keenly monitor the performance of the children throughout the teaching duration. Studies have shown that this method is more efficient than the other modes of teachings. Teachers are supposed to prompt a child to demonstrate the learned sequence manually or verbally (Harmon & Jones, 2005).
These would range from the less intrusive like gesture and verbal cues to the more intrusive like physical guidance. Such prompts are helpful in ensuring that the student makes the correct responses and as the student makes more responses the easier it would be for the child to be reinforced in that exercise which would later become normal. And when the teacher is certain that the child has gotten the response right, the prompts are gradually removed so as to test whether the student can be able to respond independently.
It is very important that instructional learning for the adults includes the cues at the workplace. A professional would therefore ensure a quick transition from prompt dependency to dependency on the natural cues found within the work place. The cues in this case may include things used in the work itself, interactions with colleagues who would initiate the work process and the work environment itself. Helping the student learn how to depend on natural cues is an important step in instructional education because it prepares the student to be independent.
Again, it is important that the student is rewarded for a correct performance. In the case of severe and multiple disabilities students, certain rewards may be used to reinforce performance. For example, if a student loves music, he or she may be allowed to listen to music after completing a certain task (Harmon & Jones, 2005). Partial Participation and Adaptation This principle holds that students suffering from severe and multiple disabilities are not suppose to be sidelined from daily chores because such individuals might fail later in some environments.
It is therefore required that they contribute partially to every task and through adaptation they may be able to finish such a task. The partial participation principle suggests that instead of sidelining students with severe and multiple disabilities from certain tasks, instructional educators can help the students adapt. According to Hosken (2008) partial participation identifies four types of adaptations that if fully exploited may improve the students participation in the community.
These types of adaptations are; modifying skills which call for concentration on a particular skill, using personal assistance to help the students learn, using adaptive device like computer devices to guide the students and urging others to change their attitudes towards such students. Collaboration It is important to work as a team in helping the students with multiple disabilities be accepted and integrated not only in the society but also at school. The collaborative effort of professional and members of the community is therefore required for this to be achieved.
For example, a professional collaboration may be made between the school nurse and special educators. The school nurse may be required to administer medication to the students and monitor the child’s reaction which he or she should report to the educators who would have to plan for appropriate schooling based on the findings of the nurse (Hosken, 2008). Professionals may also channel their assistant to the student’s family members by assisting them get the necessary equipments or funds needed for the child’s care. These professionals may come through organizations working with the handicapped or may direct them towards such organizations.
Families with students suffering from multiple disabilities also needs constant help from other family members, friends as well as the church in assisting the student cope with and learn to be independent (Harmon & Jones, 2005). Fellow students who are not disabled may also assist. A peer teaching program is one initiative of ensuring that students help their disabled counterparts in learning. For example, peer educators may volunteer to help their disabled friends in dressing up, or applying make-up, walking or taking lunch together (Downing, 2002).
Other students company may help the students with multiple disabilities relieve boredom and also increase their self esteem. Co-workers at workplace and other community members may offer to help such persons. A job coach may be availed at work to help the individual with severe and multiple disabilities acquire job skills as well as social skills so as to able to interact with colleagues. For example, a job coach may help such an individual greet his colleagues each day and also help other workers learn how to relate with such a person (Downing, 2002).
Conclusion The future may look bleak for the children and students suffering from severe and multiple disabilities, who have needs as well as abilities just like everybody else. Hopefully, with a good educational model, unique and appropriate for each and everyone, these children are able to live independently and would accepted and integrated into society as individuals who are different but are just like us. Nevertheless, it is the role of the society to protect and take care of its members regardless of their conditions or disabilities.