Developmental Disabilities: A Public Health School Issue

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Developmental Disabilities A Public Health
School Issue
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What are Developmental Disabilities (DD)?

• Severe and chronic interference of a persons
  functionality which is attributable to a mental
  or physical impairment or a combination of mental
  and physical impairment.
• Manifested before the person attains age 22 is
  likely to continue indefinitely

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What are Developmental Disabilities (DD)?
(Continued)

• Results in substantial functional limitations in
  three or more of the following areas (self-care,
  receptive and expressive language, learning,
  mobility, self-direction, capacity for
  independent living, economic self-sufficiency)
• 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
  individually planned and coordinated. (Haring
  McCormick, 1986)

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How Prevalent are Developmental Disabilities?

• About 17 of U.S. children under 18 years of age
  have a developmental disability.
• Approximately 2 of school-aged children in the
  U.S. have a serious developmental disability

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What are the Major Developmental Disabilities?

• Autism
• Mental Retardation
• Cerebral Palsy
• Seizure Disorder

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Lets Look at these Disabilities
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What Characterizes Autism?

• Autism is diagnosed if the person exhibits
  symptoms listed within each of three domains.
  These are
• (1) Qualitative impairments in social
  interaction,
• (2) Qualitative impairment in communication, and
• (3) Restricted, repetitive, and stereotyped
  patterns of behaviors, activities, and interests

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Is There an Autistic Gene?

• Duke University Margaret Pericak-Vance and her
  collaborators have found evidence of chromosomal
  defects that may be linked to autistic spectrum
  disorder

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What is Mental Retardation?

• Characterized both by a significantly
  below-average score on a test of mental ability
  or intelligence, and
• By limitations in the ability to function in
  areas of daily life, such as communication,
  self-care, and getting along in social situations
  and school activities.
• Mental retardation is sometimes referred to as a
  cognitive or intellectual disability. 

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How Common is Mental Retardation?

• Mental retardation is the most common
  developmental disorder
• About 1 of children ages 3-10 years had mental
  retardation
• 1.2 of every 100 10-year-old children had mental
  retardation.
• Mild mental retardation was 3 times more common
  than severe mental retardation.

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What Causes Mental Retardation?

• Mental retardation can occur at anytime in the
  course of human development
• It can be caused by a genetic abnormality,
  injury, disease, or deprivation
• These causes can happen while in the whom, during
  the birthing process, or during childhood

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Can Mental Retardation be Prevented?

• We do not know how to prevent most conditions
  that cause mental retardation
• There are some causes that can be prevented
• Fetal alcohol syndrome (FAS) is one such cause
• Some metabolic conditions, such as
  phenylketonuria (PKU).

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How Can We Respond to PKU?
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What is the Cost of Mental Retardation?

• During the 1995-1996 school year, about 600,000
  U.S. 6- to 21-year-old children with mental
  retardation received special educational
  services, at a cost of about 3.3 billion. 

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What is Cerebral Palsy?

• Cerebral palsy is a disorder of movement or
  coordination caused by an abnormality of the
  brain
• Almost 70 have other disabilities, primarily
  mental retardation

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How Does the Law Protect School Age-Children?
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What is the Lanterman Act?

• Guarantees the right to services andsupports to
  help individuals diagnosed with developmental
  disabilities live an independent and
  productivelife.

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What are the Rights Guaranteed Under the
Lanterman Act?

• Treatment and habilitation
• Dignity, privacy and humane care
• Participation in an appropriate program
• Prompt medical care and treatment
• Religious freedom

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Lanterman Rights (Continued)

• Social interaction and participation in community
  activities
• Physical exercise and recreation
• Freedom from harm
• Choices in your own life
• The opportunity to make decisions.  4502.1

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What are Regional Centers?

• Non-profit corporate community agencies that
  provide services to people with developmental
  disabilities
• There are 21 regional centers in California and
• The main point of contact in your community
  between service management and the end-user.

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Who is Eligible for Regional Center Services?

• People with developmental disabilities
• People who are at high risk of giving birth to a
  child with a developmental disability and
• Infants who have a high risk of becoming
  developmentally disabled.

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What is a "substantial disability?

• A condition that is severe enough to be a major
  impairment of cognitive and/or social
  functioning.
• A condition that requires Interdisciplinary
  planning
• A condition that requires Coordination of
  Services

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What are the responsibilities of the regional
center?

• Search out and identify
• Provide intake and assessment
• Supply preventive services and
• Develop an Individual Program Plan (IPP).

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What Happens After Becoming Eligible?

• Within 60 days after the intake and assessment a
  written Individual Program Plan (IPP) must be
  developed
• It should focus on you and your family, where
  appropriate.
• It should promote community integration an
  independent, productive, and normal life and
• A stable and healthy environment.

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Why is the IPP So Important?

• It is a contract or agreement between the family
  of the consumer and the regional center
• It establishes what will be provided and what
  will not be provided
• It indicates who will provide the services and
• Who will pay for the services

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How is the IPP Developed?

• Gathering information and conducting assessments
  and
• Assessments may be formal or informal

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What Must the Regional Center do to Make the IPP
Work?

• Getting the services and supports
• Providing advocacy
• Identifying and building circles of support
• Ensuring quality of services and
• Developing new services

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What are the Entitlement Services and Supports?

• Assessment services
• Habilitation and training
• Treatment and therapy
• Preventive services
• An array of different living arrangements
• Community integration
• Employment/Day programs

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Entitlement Services and Supports (Continued)

• Family support services
• Relationship services and supports
• Emergency and crisis intervention services
• Specialized equipment
• Transportation services
• Facilitation/Self-Advocacy
• Interpreter/translator services
• Advocacy

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The History of Special Needs Children

• Prior 1975, approximately 1 million children with
  disabilities were shut out of schools
• Hundreds of thousands more were denied
  appropriate services
• Ninety percent of children with developmental
  disabilities were housed in state institutions.

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Current Status of Special Needs Children

• Three times the number of young people with
  disabilities are enrolled in colleges or
  universities as compared to prior to 1975, and
• Twice as many of today's 20 year olds with
  disabilities are working.

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The Unfulfilled Promises to Special Needs
Children

• Twice as many children with disabilities drop out
  of school.
• Drop outs do not return to school, have
  difficulty finding jobs and often end up in the
  criminal justice system.
• Girls who drop out often become young  unwed
  mothersat a much higher rate than their
  non-disabled peers.
• Many children with disabilities are excluded from
  the curriculum and assessments  

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PL94-142 Education for All Handicapped Children
(1975)

• Assures that all handicapped children have
  available to them a free appropriate public
  education (FAPE) regardless of how, or how
  seriously, he may be handicapped
• Mandates an individualized education program
  (IEP) for every student with a disability

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PL 98-199 Education of the Handicapped Act
Amendments (1983)

• Allows for federal funding to create parent
  training and information centers (PIC)
• Expands services for children from birth to age 3
  and the initiatives for transition services from
  school to adult living for students with
  disabilities

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PL 99-372 Handicapped Children's Protection Act
(1986)

• Allows parents or guardians to be reimbursed for
  reasonable legal costs if they WIN a hearing or
  court action.
• Requires that the case and the costs of the legal
  proceedings should be discussed with the lawyer
  prior to any legal action

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What IDEA Attempted To Do

• Raise expectations for children with
  disabilities
• Increase parental involvement in the education of
  their children
• Ensure that regular education teachers are
  involved
• Include children with disabilities
• Support quality professional development.

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IDEA Accomplishments

• Full-inclusion has become the standard
• Increased graduation rates
• Increased employment
• Greater college and University attendance
• More support programs for education
• Improved technology for all of us

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IDEAs Areas of Weakness

• Eligibility and over representation of racial and
  ethnic minorities
• Funding of IDEA
• Monitoring and enforcement and
• Discipline

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Overrepresentation of Minorities Under IDEA

• Prevent special education placement
• Intervene in general education
• Increase regular educational staffing
• Improve family centered services
• Improved school support services
• Increased funding for regular education

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Monitoring and enforcement

• Significant weaknesses exist in the current
  systems of monitoring and enforcement
• More timely system focused on solid outcomes for
  students
• More classroom time for teachers