Developmental Disabilities

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Developmental Disabilities

• Scott E. Miller, M.A.
• Laura Farley, M.S.W.

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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.

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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

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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

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Definition (Contd.)

• E) reflects the persons 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.

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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)

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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.

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Examples of Developmental Disabilities

• Autism
• Behavior disorders
• Brain injury
• Cerebral palsy
• Down syndrome
• Fetal alcohol syndrome
• Mental retardation
• Spina Bifida
• Dyslexia
• ADHD

• Learning Disorder-diff w/ cognitive abilities
  incl. adaptive, fine motor, perceptual-motor,
  social lang. skills
• Learning Disability-normal cognitive abilities w/
  problems in reading, math, writing

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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

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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

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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.

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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

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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.

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Strategies

• Memory
• Take notes, 5 Ws
• Attention
• Self-talking
• Problem Solving
• List several solutions
• Organization
• Make a checklist preplan
• Impulsiveness
• Count to 5, 10, 1000

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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.

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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, dont hurry us
• Treat people as individuals
• Push a little, but never to the point of
  frustration

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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.