STAFF DEVELOPMENT in SPECIAL EDUCATION Developmental and Psychological Disorders in Special Education: A General Overview AASEP s Staff Development Course Developmental and Psychological Disorders in Special Education Copyright AASEP (2006) 1 of 9
In the course of their experience, special educators will encounter a wide variety of developmental and psychological disorders. Many may be caused by intellectual, social, emotional, academic, environmental or medical factors. It is important that you have a basic understanding of the more common ones that may be presented by certain students. Your knowledge of these conditions can assist parents, doctors, other students in the class as well as the student him/herself.. Understanding the nature of certain disorders can enhance your total understanding of the child and the factors that play a role in the child's educational development. The most commonly used source for the diagnosis of psychological disorders used by professionals today is the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders- 4 th Edition, 2000). This publication has changed several times in its scope, understanding and format from its inception as DSM-I in 1952. Although this book is not used by school systems for diagnostic purposes, children with special needs will often receive outside professional diagnosis through the classification process used in DSM-IV-TR. This course will focus on common disorders that you may experience in your role as a special education teacher. Whenever possible, a description of each disorder, etiology (cause), and symptoms associated with the disorder will be discussed. 1-Developmental Disorders A-Mental Retardation This group of disorders is characterized by severe delayed development in the acquisition of cognitive, language, motor or social skills. The general characteristics of this diagnostic category are: 1. Consistent and significant subaverage intellectual performance 2. Significant deficits in the development of adaptive functioning 3. Onset prior to the age of 18 There are several possible contributing factors to this disorder including heredity, prenatal damage (prior to birth) i.e. maternal alcohol consumption,chromosomal changes, perinatal problems (at the time of birth) i.e. prematurely, malnutrition, postnatal problems (occurring after birth) i.e. infections, trauma and environmental or sensory deprivation during critical stages of development. AASEP s Staff Development Course Developmental and Psychological Disorders in Special Education Copyright AASEP (2006) 2 of 9
Types There are several subtypes that are classified by educational or psychological terminology. They are: Type Mild Mental Retardation Moderate Mental Retardation Severe Mental Retardation IQ range 55-69 approx. 35-54 approx. 20-34 approx. Profound Mental Retardation below 20 B-Autistic Disorder A very serious developmental disorder characterized by severe impairment in the development of verbal and nonverbal communication skills, marked impairment in reciprocal social interaction (a lack of responsiveness to, or interest in people) and an almost non existent imaginative activity. Also known as Infantile Autism or Kanner's Syndrome. The condition is usually reported by most parents before the age of three. The condition is, in almost all cases, lifelong. This condition is thought to result from a wide range of prenatal, perinatal and postnatal conditions i.e. maternal rubella, anoxia during birth, which affects brain function. Sex Ratio The condition is more common in males,approximately 3 or 4:1. C-Developmental Arithmetic Disorder This condition is marked by a serious marked disability in the development of arithmetic skills. This condition, often called dyscalculia, cannot be explained by mental retardation, inadequate teaching or primary visual or auditory defects and may be consistent throughout school. Usually becomes apparent between ages 6 (first grade) and 10 years of age (fifth grade). AASEP s Staff Development Course Developmental and Psychological Disorders in Special Education Copyright AASEP (2006) 3 of 9
D-Developmental Expressive Writing Disorder This disorder is characterized by a serious impairment in the ability to develop expressive writing skills that significantly interfere in the child's academic achievement. This condition is not the result of Mental Retardation, inadequate educational experiences, visual or hearing defects or neurological dysfunction. Considering the nature of the disorder and the levels of impairment, the age of onset can range from 7 (second grade) for the more severe types to age 10 or 11 (fifth grade) for the less severely impaired. The symptoms associated with this disorder include an inability to compose appropriate written text coupled with serious and consistent spelling errors, grammatical or punctuation errors and very poor organization of thought and text. E-Developmental Reading Disorder The more common features of this disorder include a marked impairment in the development of the child's decoding and comprehension skills which significantly interfere in the child's academic performance. As with most developmental disorders, this condition is not the result of mental retardation, inadequate educational experiences, visual or hearing defects or neurological dysfunction. This is sometimes commonly referred to as "dyslexia. This disorder is usually observed in children as young as 6 (first grade). Diagnosis of such a serious impairment in the later grades may result from the child's ability to compensate with high intellectual ability or poor educational diagnostics. Typical symptoms of this disorder include a slow, halting reading pace, frequent omissions, and loss of place on a page, skipping lines while reading without awareness, distortions, substitutions of words, and a serious inability to recall what had been read. AASEP s Staff Development Course Developmental and Psychological Disorders in Special Education Copyright AASEP (2006) 4 of 9
F-Developmental Expressive Language Disorder This disorder is characterized by a serious impairment in the child's ability to develop expressive language. This condition is not the result of mental retardation, inadequate educational experiences, visual or hearing defects or neurological dysfunction Some common symptoms associated with this disorder may include limited use of vocabulary, shortened sentences, slow rate of language development, simplified sentence structure and omissions of parents of sentences. The more serious forms of this disorder are usually diagnosed by age 3 while less severe forms may not be noticed until much later in development. 2-Behavior Disorders A-Attention Deficit Hyperactive Disorder Children with this disorder exhibit behaviors of inattention, hyperactivity and impulsiveness that are significantly inappropriate for their age levels. These behaviors may be severe and have an adverse affect on the child's academic achievement. (A more in depth discussion of this condition can be found in this section) The condition is 6-9 times more common in males than females and several conditions may contribute to the development of the disorder. These may include neurological factors, central nervous system dysfunction while other factors may be environment, abuse and neglect. The symptoms for this disorder should be present for a minimum of six months and may include some of the following: constant fidgeting difficulty maintaining him/herself in a seat excessive talking at inappropriate times ability to listen careless disorganized difficulty sustaining a focus on tasks or play activities easily distracted difficulty following instructions AASEP s Staff Development Course Developmental and Psychological Disorders in Special Education Copyright AASEP (2006) 5 of 9
B-Conduct Disorder This condition is characterized by a persistent pattern of behavior which intrudes and violates the basic rights of others without concern or fear of implications. This pattern is not selective and is exhibited in the home, at school, with peers and in the child's community. Other behaviors present with this condition may include vandalism, stealing, physical aggression, cruelty to animals and fire setting. Sex Ratio Empirical studies seem to indicate that 9% of the males and 2% of all females suffer from this disorder. The age of onset is usually before puberty for males and after puberty for females. While the causes are varied, parental rejection, harsh discipline, early institutional residence, inconsistent parenting figures as experienced in foster care, and so on. Categories: Type Solitary Aggressive Type Group Type Undifferentiated Type aggressive behavior towards peers and adults conduct problems mainly with peers as a group For those not classified in either above group C-Oppositional Defiant Disorder This disorder is usually characterized by patterns of negativistic, hostile and defiant behaviors with peers as well as adults. This disorder is considered less serious than a conduct disorder because of the absence of serious behaviors which violate the basic rights of others. Children with this disorder usually exhibit argumentative behaviors towards adults which may include swearing and frequent episodes of intense anger and annoyance. These symptoms are usually considered to be more serious and intense than those exhibited by other children of the same age. The behaviors associated with Oppositional Defiant Disorder usually appear around age 8 and usually not later than early adolescence. AASEP s Staff Development Course Developmental and Psychological Disorders in Special Education Copyright AASEP (2006) 6 of 9
D-Antisocial Personality Disorder This disorder is characterized by a pattern of irresponsible and antisocial behavior. The condition is usually first seen in childhood or early adolescence and continues throughout the child's development. This diagnosis is usually made after the age of 18 and the individual must have had a history of symptoms before the age of 15 indicative of a Conduct Disorder. It is common for these individuals to exhibit symptoms such as lying, stealing, truancy, fighting, vandalism, and physical cruelty to animals or people. They usually do not adhere to financial obligations, repeatedly perform antisocial acts that are grounds for arrest, and fail to conform to social norms. 3-Disorders of Childhood and Adolescence A-Anorexia Nervosa Children with this condition show a marked disturbance and unwillingness to maintain a minimal body weight for their age and height. An extreme distorted sense of body image exists and intense fears and worries about gaining weight become obsessive. It is not uncommon for Bulimia Nervosa (discussed later) to be an associated feature. In more severe cases death may occur. Studies seem to indicate that Anorexics are usually perfectionist, high achieving females. Sex ratio 95 % of the cases of Anorexia Nervosa are predominately found in females. Children with this disorder may also exhibit self induced vomiting, use of laxatives, increased reduction of food intake, preoccupation with becoming fat and noticeable increase in the frequency and intensity of exercise. In females, absence of menstrual cycles is common as the child's weight decreases and the body chemistry changes. AASEP s Staff Development Course Developmental and Psychological Disorders in Special Education Copyright AASEP (2006) 7 of 9
B-Bulimia Nervosa A condition characterized by recurrent episodes of uncontrolled consumption of large quantities of food (binging) followed by self induced vomiting (purging), use of laxatives or diuretics over a period of at least two months. Some research indicates that obesity during the teenage years might be a predisposing factor for bulimia in later life. The individual with bulimia nervosa exhibits symptoms characterized by binging and purging, use of laxatives and diuretics, obsessive preoccupation with body shape and weight and a feeling of lack of control over food consumption during binge episodes. C-Selective Mutism This disorder is characterized by persistent refusal to talk in one or more major social situations, including school, despite the ability to comprehend spoken language and speak. The resistance to speak is not a symptom of any other major disorder. : The possible causes for such a condition vary from maternal overprotection, immigration, mental retardation and hospitalization or trauma before the age of three. : Some symptoms associated with this disorder besides the refusal to speak include excessive shyness, social isolation, compulsive behavior, temper tantrums, negativism, clinging, and withdrawal. When in school or other anxiety provoking settings, behavioral characteristics may vary, with some children being much more withdrawn than others. Some children with Selective Mutism stand motionless and expressionless, and may demonstrate awkward or stiff body language. Some may turn their heads, avoid eye contact, chew or twirl their hair, or withdraw into a corner. Over time, some children learn to cope and participate in certain social settings by performing nonverbally or by talking quietly to a select few. Children with Selective Mutism tend to have difficulty initiating and may be slow to respond even when it comes to nonverbal communication. This can be quite frustrating to the child and may lead to falsely low test scores and misinterpretation of the child's cognitive abilities. Such scores will need to be reviewed for their accuracy. AASEP s Staff Development Course Developmental and Psychological Disorders in Special Education Copyright AASEP (2006) 8 of 9
D-Tourette's Disorder This disorder is characterized by motor and vocal ticing which may be exhibited in the form of grunting, coughs, barks, touching, knee jerking, drastic head movements, head banging, squatting and so on. The above symptoms may change as the child develops but the course of the disorder is usually lifelong. Associated features include Obsessive Compulsive Disorders (OCD), and ADHD (Attention -deficit Hyperactive Disorder discussed earlier). The condition is more common in males and family pattern are also common. Coprolalia (vocal tic involving the expression of obscenities)is an associated symptom in about 33% of the cases. E-Functional Encopresis The major symptom of this disorder is repeated involuntary or intentional passage of feces into clothing or other places which deem it inappropriate. The condition is not related to any physical condition, must occur for a period of six months on a regular basis and be present in a child over the age of 4 for diagnosis to take place. F-Functional Enuresis This disorder is characterized by repeated involuntary intentional elimination of urine during the day or night into bed or clothes at an age which bladder control is expected. A frequency of at least two times per month must be present for the condition to be diagnosed between the ages of five and six and at least once a month for older children. Familial Pattern In at least seventy-five percent of the cases, the child has a first-degree biologic relative who has, or has had the condition. The above disorders represent only a cross section of the conditions which you may encounter in the classroom. While expertise is not suggested, an understanding and awareness of such disorders can only increase your effectiveness with these children. As previously stated, a more elaborate explanation as well as further disorders associated with this developmental period can be found in DSM-IV-TR (2000). AASEP s Staff Development Course Developmental and Psychological Disorders in Special Education Copyright AASEP (2006) 9 of 9