Inclusive Education De-mystifying Intellectual Disabilities and investigating best practice.
Aims for this session: To understand what the term Intellectual Defiency means To understand the broad spectrum of intellectual disabilities, including common conditions that co-occur, and their key signs and symptoms. To understand key approaches to use with all children with Intellectual Disabilities, and some specific approaches for specific conditions.
There are some things that are common to all children with an Intellectual Disability They have a reduced intellectual ability compared to other children. This disability will affect them throughout their life, or from the time they acquired the brain injury. Everyday activities such as washing and dressing can be difficult. They will take longer to learn, and they usually find it hard to understand complex information. They will need extra support to learn new skills and may need support to interact with others.
Intellectual Disabilities: A wide spectrum Everyone with an intellectual disability has a different level of need. Support needs change over time. Some adults with intellectual disabilities have jobs and need limited support, whilst others need help to do everyday tasks. This spectrum is often known as mild, moderate and severe. For example, a child with Downs Syndrome may have a moderate intellectual disability. For children with additional sensory and physical disabilities, the term PMLD ( profound and multiple learning disabilities) may be used.
What is Best Practice for all children with Intellectual Disabilities? Children will find it difficult to generalise a new concept, such as big v small, or hard v soft. Sorting real items into two categories is a good way of teaching this. Use lots of concrete examples Children often have auditory processing delay so teachers need to WAIT after giving an instruction!! Move at child s pace Modify your speech: Use short, simple sentences. Use gestures and pictures. Even though the curriculum may give one week to teach a new concept, children with ID may need a whole term. Include them in whole class teaching, but their individual work should be pitched at the level they are at, with lots of REPETITION.
For many children, there is no clear diagnosis Intellectual disabilities / learning disabilities may be given as the diagnosis of exclusion. Doctors may rule out an underlying genetic, perinatal or developmental cause and then give the diagnosis of intellectual disabilities. For some children it if often not possible to say why they have a learning disability, and this can be very difficult for parents to accept.
Remember!... Most children with Intellectual Disability are visual learners. Due to their auditory processing delay, and difficulty following complex language, they often find it much easier to understand what you say if you show them a picture, symbol, object or gesture at the same time. They learn just like other children, but at a much slower pace. Teachers should not be afraid to do the same lesson again and again, as long as they use different materials! As their overall development matures more slowly than in other children, teachers should make the tasks fun and interactive as the children typically have limited attention control. Group work helps with this, such as turn-taking games like posting matching pictures into a post-box.
However, there are some conditions/ impairments which often co-occur ( or is the cause of) intellectual disabilities Genetic or foetal Conditions Downs Syndrome Brain Damage Cerebral Palsy (depends on type) Developmental Disorders Autism (50%) Fragile X Foetal Alchohol Syndrome Acquired brain injury (e.g. car accident, infection, malaria) Sickle Cell causing a stroke. Global Developmental Delay
3 common conditions/ impairments that cooccur with Intellectual Disability Autism ID Cerebral Palsy Downs Syndrome
1. Autism ( ASD) Every child with ASD has difficulties in 3 areas, even though the severity of Autism varies significantly. SOCIAL UNDERSTANDING AND BEHAVIOUR SOCIAL COMMUNICATION (VERBAL AND NON-VERBAL) RIGIDITY OF THINKING AND DIFFICULTIES WITH IMAGINATION
QUIZ: Which of the three main areas of impairment do the following signs/ symptoms fit into? Spins objects No eye contact Lack of creative play Plays alone Talks about just one subject Pulls adults hand to make requests
Sensory Aspects with ASD Hyposensitive Hypersensitive Some children may swing the scales the other way and may crave intense sounds, smells, and deep pressure. These children are hyposensitive.
Best Practice when teaching: Focus on visuals when explaining what is happening in a lesson and to encourage a nonverbal child to respond to a question, by offering choices. (photographs, pictures, or the most complex, symbols). Use limited speech. Establish clear routines in the classroom and create a visual timetable to explain what will happen next. Break tasks down into small manageable steps, with tangible positive reinforcement after each task such as putting a bottle-top in a jar (not just social praise.)
2+2 = 4 MATHS READING Visual Timetables help to calm children down as they know what is coming next. Reward charts help to focus their attention and motivate them to work. ART I am working for. ball HOME
2. Cerebral Palsy: True or False? All children with Cerebral palsy have an inability to fully control motor function, particularly muscle control and coordination. There is only one type of cerebral palsy. It is caused by damage to one or more specific areas of the brain, usually occurring during foetal development. It can also occur before, during or shortly following birth. It is a disease and can be contagious.
Children with Cerebral Palsy Not all children with Cerebral palsy have intellectual disabilities but it is common. It depends on the severity. Indeed, some children who have severe physical needs, and who cannot speak, may still have ageappropriate comprehension of language.
More facts about Cerebral Palsy Children with cerebral palsy may not be able to walk, talk, eat or play in the same ways as most other children. There is damage to the area of the brain controlling muscle tone: either too much, not enough, or a mixture of the two. There are 3 main types: Spastic (stiff and difficult movement), athetoid (uncontrolled movement) and ataxic (disturbed sense of balance and depth perception) There may also be a combination of these types.
Best Practice when teaching Although the theme here is on children with CP who also have intellectual defiency, it is important that the teachers think about the child s physical needs first. For example, if a young boy has to concentrate too much on controlling his muscles so he can balance in a chair, or lift his head up, he will not be able to concentrate on academic work. Try to support the child s muscles by providing supportive seating, head rests, trays, lap-belts etc.
1 MINUTE QUESTIONS! Do all children with CP who have difficulties speaking also have intellectual defiency? Think of two different ways that a teacher could ask a non-verbal child a question. Other than pointing, what other ways could a child signal a correct answer when given a choice of options?
Answers It is very common for children with CP to have difficulties with speaking, even if their intellectual disabilities are only mild. Teachers should ask closed, forced- choice questions, and give the children an opportunity to respond by pointing to a picture, an object or a symbol. ( Use yes/ no questions only if the child has a reliable response) A child could point with their finger, hand, foot, or head ( using a stick attached to a head-band) Increase the number of options, as the child progresses. Gradually, you can build a communication book, using a system of categories to aid navigation.
What about children with even more complex needs? Early play based learning, colour matching, learning to match Objects of photographs to Reference and objects. Sensory exploration Developing intentional communication Learning cause and effect Intentional communication using pictures or symbols. Pretend play is developing and the child is learning to sort into categories and not just identical objects.
3. Downs Syndrome / Trisomy 21 What is it? A genetic condition giving rise to a particular set of physical characteristics and some level of intellectual disability. What causes it? The baby is born with an extra copy of chromosome ( 21) in all their cells. They have 47 not 46. This happens equally in all races and nationalities.
Some positive character traits in children with Downs Syndrome They are typically very sociable and love to interact with people. They are particularly good at using and understanding gestures and mime, and often enjoy drama and acting. They are visual learners, and can be taught to read using a very visual approach matching words to pictures.. They will often retain whole sight words
The challenge of learning to talk Muscle control difficulties Hearing difficulties Problems understanding Delayed speech and language skills
Other areas for teachers to work on: These are all areas where children with Downs syndrome often benefit from extra practice, so teachers should set simple but motivating practice activities. Fine motor Obstacle courses, joining the dots, threading beads, cutting a picture out with scissors etc. Number skills Additional Difficulties Gross motor Matching numerals Using number lines Visual images for quantities/ amounts Working memory Play memory pairs, What s gone? Category games
Best Practice when teaching: As with previous sections, visual methods are the key, and can be used to support their speech, to explain what is happening next and to reinforce their reading skills. ( photographs, pictures, symbolsetc ) Children with Downs Syndrome also respond well to gesture, so it is helpful to say the spoken word alongside a sign for the key words in a sentence, to help the children to understand the meaning. They may need help to support their friendships, such as circle of friends/ play buddies. They also benefit from play-based teaching, as they have active imaginations and are concrete learners.
Summary of the top tips for all children with Intellectual Defiency! Concrete learning with lots of repetition Use Visuals and gestures Wait for a response! Use short clear sentences