Learning Disabilities and Intellectual Disabilities: An Overview
Types of Learning Disabilities
Dyslexia
Difficulty processing language (Problems reading, writing, spelling, and speaking)
Dyscalculia
(Problems doing math, understanding time, and using money)
Dysgraphia
(writing, spelling, organizing ideas)
Dyspraxia (Sensory Integration Disorder)
(Problems with hand-eye coordination, balance, and manual dexterity) (fine motor skills)
Auditory Processing Disorder
(Hearing differences between sounds) Problems with reading, comprehension, language
Visual Processing Disorder
(Interpreting visual information) Problems with reading, math, maps, charts, symbols, pictures
Nonverbal Learning Disability
(Nonverbal cues) Unable to recognize and translate nonverbal cues, such as facial expressions or tone of voice, into meaningful information. (Impaired abilities to organize the visual-spatial field, Difficulty adapting to new or novel situations, Problem accurately reading nonverbal signals and cues)
Diagnosis of Learning Disabilities
- Average to above-average intellectual ability
- Severe processing deficits
- Severe aptitude-achievement discrepancies
- Measured achievement in an instructional setting
Incidence/Prevalence
- 3 million kids (ages 6-21) have an LD and receive special education in school
- LD form the largest category in special education
- 50% of special education kids have LD
- 3 males: 1 female
Risk Factors
- Male
- Genetic
Chronic Pain
Average pain 10.2 years. Evaluations: Physical therapy + BX pain evaluation. Pain affects emotionally/psychologically. Emotions can affect chronic pain.
Body Systems Implicated in Chronic Pain
- Nervous system
- Endocrine system
Risk Factors
- Female
- Middle Aged
Goals of Pain Management Programs
- Improve mood
- Improve ability to manage pain
- Quality of life
- Better socially (families like them better)
Treatment
- Short-term psychotherapy
- Breathing and meditation
- Biofeedback:
- Muscle tension
- Thermo: Decrease blood vessel constriction, Skin temp (90) = good, Skin temp (70) = bad.
- Cardio: Quiets autonomic nervous system, Increase endorphins, Quiets pain centers.
- Physical therapy, body awareness, gentle swimming.
Intellectual Disabilities
Neurodevelopmental disorder with onset during the developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains. AAIDD: community environment typical of peers and culture; limitations exist with strengths; need many-sided evaluations to determine disability and tailor individualized support.
Diagnosis Must Meet All Three
- Deficits in intellectual functioning such as reasoning, problem-solving, abstract thinking, etc.
- Deficits in adaptive functioning that result in failure to meet developmental and sociocultural standards for personal independence and social responsibility. Without ongoing support, adaptive deficits limit functioning in 1+ activities of daily life.
- Onset of intellectual and adaptive deficits during the developmental period.
Etiologies, Causes, Risk Factors
- Genetic and environmental factors
- 50% of the cause cannot be determined
- Fragile X syndrome or trisomy 21 (Down syndrome)
- Brain malformations and chromosomal abnormalities
- Maternal exposure to infections such as rubella, herpes
- Maternal abuse of drugs and alcohol
- Maternal exposure to toxic chemicals/radiation
- Maternal exposure to prescription drugs that have teratogenic effects
- Lack of oxygen supply in the uterus
- Postnatal brain injury
- Meningitis
- Age
- Number of Children
- Socioeconomic status (cost of prenatal care and poorer nutrition)
Classifying Severity
Mild
- 85% of people (IQ of 52-69)
- Many can achieve some academic success
- Mostly self-sufficient
- Elementary school with support
- Minimal supports
Moderate
- 10% (IQ of 36-51)
- Adequate communication skills, but limited complexity
- Social cues, judgment, and decisions regularly need support
- Can mostly do self-care but might need extended instruction
- Employment in with limited conceptual or social skills
- Independent living with moderate support (group home)
Severe
- 3-4% (IQ of 20-35)
- Communication skills are basic
- Self-care needs daily assistance
- Will require safety supervision and supportive assistance
- Residence in supported housing
Profound
- 1-2% (IQ of 19 & Below)
- Dependent upon others for all aspects of daily care
- 24-hour support
- Communication quite limited
- Co-occurring sensory or physical limitations
- Identified early because baby’s developmental benchmarks
Principles of Supported Employment
- Facilitated approach by job developer
- Use of long-term, 3rd party job coaching that is faded to minimal levels over the life of the individual’s employment
- Stable at 20% of scheduled work hours per month for 2 consecutive months
- Individual, group (sub-minimum wage paid by CRP), or work activity program (sub-minimum wage paid by CRP)