Developmental Disabilities Scott E. Miller, M.A. Laura Farley, M.S.W. What is a Developmental Disability? Over 6 million individuals in the United States have developmental disabilities. A developmental disability, according to the Developmental Disabilities Assistance and Bill of Rights Act, is defined as a severe, chronic disability which: • originated at birth or during childhood, • is expected to continue indefinitely, and • substantially restricts the individuals functioning in several major life activities. Definition The Federal Developmental Disabilities Act (Public Law 101-496) defines a developmental disability as a severe, chronic disability of a person five years of age or older which... A) is attributable to a mental or physical impairment or combination of mental and physical impairments; B) is manifested before the person attains age twenty-two; C) is likely to continue indefinitely; Definition (Contd.) D) 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; and Definition (Contd.) E) reflects the person’s need for a combination and sequence of special, interdisciplinary, or generic care, treatment, or other services which are lifelong or extended duration and are individually planned and coordinated; except that such term when applied to infants and young children means individuals from birth to age five inclusive, who have a substantial developmental delay or specific congenital or acquired conditions with a high probability of resulting in developmental disabilities if services are not provided. Disturbances of Function Interacting genetic, environmental, and social factors are important determinants of childhood brain development Brain cells divide, migrate, differentiate, establish connections (synapses) to form circuits, then die off (apoptosis) At maturation, coated with myelin to facilitate transmission Nerve impulses transmitted by chemical messengers (neurotransmitters) Disturbances of Function Interference with any stage of this cascade of events may alter subsequent stages, so that even short term disruptions may have long term effects later in life Example, the timing of exposure to neurotoxic chemicals is as important to the size of the exposure. Lead interferes with nerve cell differentiation, myelination, cell death, nerve impulse transmission. ETOH interferes with everything. Examples of Developmental Disabilities • Autism • Learning Disorder-diff • Behavior disorders w/ cognitive abilities • Brain injury incl. adaptive, fine motor, perceptual- • Cerebral palsy motor, social & lang. • Down syndrome skills • Fetal alcohol syndrome • Learning Disability- • Mental retardation normal cognitive • Spina Bifida abilities w/ problems in • Dyslexia reading, math, writing • ADHD Developmental Delay A developmental delay is the slowed or impaired development of a child who is under 5 years old and who is at risk of having a developmental disability because of the presence of one or more of the following: • Chromosomal conditions associated with mental retardation, • Congenital syndromes and conditions associated with delay in development, • Metabolic disorders, • Prenatal and perinatal infections and significant medical problems, • Low birth weight infants weighing less than 1200 grams, • Postnatal acquired problems known to result in significant developmental delays, • A child less than 5 years old who is delayed in development by 1.5 standard deviations or more in one or more of the following areas; communication, self-help, social-emotional, motor skills, sensory development or cognition, • A child less than 3 years of age who lives with one or both parents who have a developmental disability Developmental Disabilities and Mental Retardation Mental retardation is an inability of an individual to learn as quickly as others Mental retardation occurs when an individual has an IQ below 70 (Avg =100) & they have difficulty functioning independently Mild Mental Retardation is IQ between 55 – 69 Considered educable, achieve 4th to 7th grade levels Often function well in community and hold semi/unskilled jobs Moderate Mental Retardation is IQ between 40-54 Considered trainable, achieve to 2nd grade level Can learn educational skills, live in group homes, sheltered workshops Cognitive Retraining The purpose of cognitive retraining is the reduction of cognitive problems associated with brain injury, other disabilities or disorders, and/or aging. The overall purpose of the therapy is to decrease the everyday problems faced by individuals with cognitive difficulties, thereby improving the quality of their lives. Cognitive rehabilitation has two parts: restoring the actual cognitive skill, and learning to use strategies to compensate for the impaired ability. Cognitive Retraining-Part I The first part of cognitive retraining — restoring skills — is sometimes compared to rebuilding a weakened muscle. Exercises used in retraining programs may actually rebuild cognitive skills such as attention, concentration, memory, organization, perception, judgment, and/or problem solving Cognitive Retraining- Part II The second component of cognitive retraining is learning to use strategies, compensatory techniques, or "tools" to cope with weaker areas. Strategies are designed for each patient using his/her areas of strength to compensate for weaker skill areas. Learning to use these tools not only compensates for impaired ability, but may help to rebuild the skill itself. For example, using a checklist may actually improve attention skills. Strategies Memory Take notes, 5 W’s Attention Self-talking Problem Solving List several solutions Organization Make a checklist & preplan Impulsiveness Count to 5, 10, 1000 What do people with disabilities want? "We all want the same basic things out of life: a decent and comfortable place to call 'home', something meaningful to do during the day, some close friends with whom to share the good times and from whom we receive support in difficult times, and the opportunity to make our own decisions about things that will affect our personal lives. People with disabilities want these same basic things and are increasingly speaking up for themselves about what they want. And staff, family and State agency professionals are beginning to really listen." Excerpted from "Home, Sweet Home" by Susan L. Babin, IMPACT: Feature Issue on Supported Living (1995), published by the Institute on Community Integration. What we want: Keep your body language open & pleasant Use humor. Jokes make us comfortable Be friendly, nice, not too serious Be warm-hearted & act in a caring way Physical contact, such as hugs, is nice Try to understand us Use patience, don’t hurry us Treat people as individuals Push a little, but never to the point of frustration Treatment People with developmental disabilities benefit from comprehensive long-term services. With such services, people with disabilities are often able to be more active, productive, and independent, which benefits their communities as well.
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