Exceptional Education Student Descriptions

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Exceptional Education Student Descriptions

• Presented by
• James J. Messina, Ph.D.

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Exceptional Student Categories

• Mentally Handicapped
• Specific Learning Disability
• Hearing Impaired
• Blind/Visually Impaired
• Emotionally Handicapped
• Physically Impaired
• Autistic
• Speech and Language Impaired
• Homebound/Hospitalized
• Gifted

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Mentally Handicapped (EMH, TMH, SPMH)

• A mental handicap is defined as significantly
  sub-average general intellectual functioning
  existing concurrently with deficits in adaptive
  behavior and manifested during the developmental
  period
• Mentally handicapped students may not be able to
  learn quickly or as much as most other students
  his age
• Includes students who are EMH "educable," TMH
  "trainable," or SPMH "profound"

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Sources of Mentally Handicapped Condition

• 1. Down Syndrome
• Trisomy 21- Extra Chromosome 21-95
• Mosaic
• Translocation
• Prenatal Testing
• Chorionic villus sampling (CVS) 8-12 weeks
• Amniocentesis 12-20 weeks
• Percutaneous umbilical blood sampling (PUBS) 20
  weeks
• Incidence 1 in 800 or 350,000

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Sources of Mentally Handicapped Condition

• 2. Fragile X Syndrome-X Chromosome
• 3. Prader Willi Syndrome-Chromosome 15
• 4. Angelman Syndrome-Chromosome 15
• 5. Williams Syndrome-Elastin Gene-Chromosome 7
• 6. Rett Syndrome-defective regulatory MECP2 gene,
  found on the X chromosome-mostly females
• 7. Fetal Alcohol Syndrome
• 8. Congenital Cytomegalovirus CMV
• 9. Brain Injury
• 10. Others

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AAMR Levels of Support

• Intermittent - Support not always needed-provided
  on "as needed" basis most likely required at
  life transitions e.g. moving from school to work
• Limited - Consistent support is required, though
  not on a daily basis- support is of a
  non-intensive nature
• Extensive - Regular, daily support is required in
  at least some environments e.g. daily home-living
  support
• Pervasive - Daily extensive support, perhaps of a
  life-sustaining nature, is required in multiple
  environments

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EMH (IQ 69-55)

• An educable mentally handicapped student is a
  student who is mildly impaired in intellectual
  and adaptive behavior and whose development
  reflects a reduced rate of learning 
• The measured intelligence of an educable mentally
  handicapped student generally falls between two
  and three standard deviations below the mean, and
  the assessed adaptive behavior falls below that
  of other students of the same age and
  socio-cultural group

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People with EMH

• are likely to need only intermittent to limited
  support
• typically do not "look" different from their
  non-disabled peers
• often have only mild or moderate developmental
  delays, except in academics, which is often the
  major area of deficit
• often not identified until they enter the school
  setting, where their cognitive disability is most
  apparent

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People with EMH 2

• typically attain 3rd- to 6th-grade academic
  achievement levels by the time they finish high
  school
• as adults, many, though not all, with mild MR
  will be able to obtain independent employment
• many will marry, have children, and blend rather
  indistinguishably into the community
• for those who achieve total independence, the
  label of mental retardation is no longer
  appropriate

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TMH (IQ 54-40)

• A trainable mentally handicapped student is a
  student who is moderately or severely impaired in
  intellectual and adaptive behavior and whose
  development reflects a reduce rate of learning
• The measured intelligence of a trainable mentally
  handicapped student generally falls between three
  and five standard deviations below the mean, and
  the assessed adaptive behavior falls below that
  of other students of the same age and
  socio-cultural group

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People with TMH

• will probably need limited to extensive supports
• they are more likely to have a recognizable
  syndrome (such as Down Syndrome)
• may "look" different than their non-disabled
  peers
• their development is often significantly delayed
• they are typically identified as infants or
  toddlers
• most begin receiving special education during the
  preschool years

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People with TMH 2

• spend much of the school day in a separate
  classroom where they learn adaptive living skills
• as adults, most individuals with moderate to
  severe MR will not achieve total independence
• they are likely to continue to need limited to
  extensive support provided in group homes or
  semi-independent living situations or continue to
  live with their parents
• some individuals with moderate to severe MR may
  be able to succeed in modified competitive
  employment situations
• many will work in supported, non-competitive
  settings such as sheltered workshops

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SPMH (Severe IQ 39-25 Profound IQ 24 or below)

• A severe-profoundly mentally handicapped student
  is a student who is profoundly impaired in
  intellectual and adaptive behavior and whose
  development reflects a reduced rate of learning
• The measured intelligence of a profoundly
  mentally handicapped student generally falls
  below five standard deviations below the mean,
  and the assessed adaptive behavior falls below
  that of other students of the same age and
  socio-cultural group

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People with SPMH

• generally need services at pervasive level,
  typically throughout their life
• likely have multiple disabilities, particularly
  in mobility communication
• many use wheelchairs alternate forms of
  communication
• their communication deficits make it difficult to
  accurately assess their intellectual functioning
• in educational settings in their own classroom
• some adults remain in institutional settings, but
  most currently live in group homes

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Specific Learning Disabled (SLD)

• Specific learning disability means a disorder
  in one or more of the basic psychological
  processes involved in understanding or in using
  language, spoken or written, which disorder may
  manifest itself in imperfect ability to listen,
  think, speak, read, write, spell, or do
  mathematical calculations.
• Students with a specific learning disability seem
  to have average or better ability, health,
  vision, hearing, and intelligence, but are still
  unable to learn things as easily or as quickly as
  most other students their age

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Characteristics of Students with SLD

• Exhibit a wide range of traits, including
• Problems with reading comprehension
• spoken language
• Writing
• reasoning ability
• Hyperactivity, inattention perceptual
  coordination problems may also be associated with
  learning disabilities

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Characteristics of Students with SLD 2

• Other traits that may be present include
• uneven and unpredictable test performance
• perceptual impairments
• motor disorders
• impulsiveness
• low tolerance for frustration
• problems in handling day-to-day social
  interactions situations

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Learning disabilities may occur in the following
areas

• Spoken language Delays, disorders, or
  discrepancies in listening and speaking
• Written language Difficulties with reading,
  writing, and spelling
• Arithmetic Difficulty in performing arithmetic
  functions or in comprehending basic concepts
• Reasoning Difficulty in organizing and
  integrating thoughts
• Organization skills Difficulty in organizing all
  facets of learning

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Hearing Impaired

• Hearing impaired students have a loss of some or
  most of their ability to hear
• This includes students who are deaf or
  hard-of-hearing

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Structures of the Ear
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Hard of Hearing or Hearing Impaired

• an impairment in hearing, whether permanent or
  fluctuating, that adversely affects a child's
  educational performance

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Deaf

• a hearing impairment that is so severe that the
  child is impaired in processing linguistic
  information through hearing, with or without
  amplification
• deafness may be viewed as a condition that
  prevents an individual from receiving sound in
  all or most of its forms
• In contrast, a child with a hearing loss can
  generally respond to auditory stimuli, including
  speech

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Types of Hearing Loss

• 1. Conductive hearing losses are caused by
  diseases or obstructions in the outer or middle
  ear (the conduction pathways for sound to reach
  the inner ear). Conductive hearing losses usually
  affect all frequencies of hearing evenly and do
  not result in severe losses. A person with a
  conductive hearing loss usually is able to use a
  hearing aid well or can be helped medically or
  surgically.

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Types of Hearing Loss

• 2. Sensorineural hearing losses result from
  damage to the delicate sensory hair cells of the
  inner ear or the nerves which supply it. These
  hearing losses can range from mild to profound.
  They often affect the person's ability to hear
  certain frequencies more than others. Thus, even
  with amplification to increase the sound level, a
  person with a sensorineural hearing loss may
  perceive distorted sounds, sometimes making the
  successful use of a hearing aid impossible

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Types of Hearing Loss

• 3 A mixed hearing loss refers to a combination of
  conductive and sensorineural loss and means that
  a problem occurs in both the outer or middle and
  the inner ear
• 4 A central hearing loss results from damage or
  impairment to the nerves or nuclei of the central
  nervous system, either in the pathways to the
  brain or in the brain itself.

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Blind/Visually Impaired

• Visually impaired students have a loss of some or
  all of their ability to see
• This includes students who are blind or partially
  sighted

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Are You Color Blind?
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What number do you see? 8 or 3
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Do you see a 5 or 2?
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1. Read Numbers both sides?
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2. Read Numbers both sides?
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3. Read Numbers both sides?
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Results of Three Slides
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Types of Visual Impairments

• 1. "Partially sighted" indicates some type of
  visual problem has resulted in a need for special
  education

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Types of Visual Impairments

• 2. "Low vision" generally refers to a severe
  visual impairment, not necessarily limited to
  distance vision
• Low vision applies to all individuals with sight
  who are unable to read the newspaper at a normal
  viewing distance, even with the aid of eyeglasses
  or contact lenses.
• They use a combination of vision and other senses
  to learn, although they may require adaptations
  in lighting or the size of print, and, sometimes,
  braille

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Types of Visual Impairments

• 3. "Legally blind" indicates that a person has
  less than 20/200 vision in the better eye or a
  very limited field of vision (20 degrees at its
  widest point)
• 4. Totally blind students learn via braille or
  other non-visual media

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Emotional Handicapped (EH, SED)

• Emotionally handicapped students may seem to act
  differently, think differently, or have different
  feelings than most other students their age
• This includes students who are "severely
  emotionally disturbed - (SED)"

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Signs of Emotional Handicapping Condition

• Child as a inability to build maintain
  friendships relationships with other children
  teachers
• Child overreacts exhibits feelings or behaviors
  that are not suited to the circumstances
• Child shows a general, consistent mood of
  unhappiness or depression
• Child has physical symptoms or fears associated
  with personal or school problems
• Child has an inability to achieve academic
  progress.

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Physically Impaired (PI)

• Physically impaired students have a severe
  illness, condition, or disability which makes it
  hard for them to learn in the same ways as other
  students their age

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Cerebral Palsy Spastic cerebral palsy

• 70 to 80 of patients-muscles are stiffly
  permanently contracted
• spastic diplegia (both legs)
• left or right hemi-paresis (the left or right
  side of the body)
• In some cases, spastic cerebral palsy follows a
  period of poor muscle tone (hypotonia) in the
  young infant

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Cerebral PalsyAthetoid Cerebral Palsy

• 10 to 20-characterized by uncontrolled, slow,
  writhing movements
• Abnormal movements usually affect the hands,
  feet, arms, or legs in some cases, the muscles
  of the face tongue, causing grimacing or
  drooling
• Movements often increase during periods of
  emotional stress disappear during sleep
• May also have problems coordinating the muscle
  movements needed for speech, a condition known as
  dysarthria

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Cerebral PalsyAtaxic Cerebral Palsy

• 5 to 10-affects the sense of balance depth
  perception
• Affected persons often have poor coordination
  walk unsteadily with a wide-based gait, placing
  their feet unusually far apart experience
  difficulty when attempting quick or precise
  movements, such as writing or buttoning a shirt
• May also have intention tremor-beginning a
  voluntary movement, such as reaching for a book,
  causes a trembling that affects the body part
  being used that worsens as the individual gets
  nearer to the desired object

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Cerebral PalsyMixed Form

• It is not unusual for patients to have symptoms
  of more than one of the previous three forms
• Most common mixed form includes spasticity
  athetoid movements but other combinations are
  also possible

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Spina Bifida

• Spina bifida (SB) is a neural tube defect
  -disorder involving incomplete development of the
  brain, spinal cord, /or their protective
  coverings-caused by the failure of the fetus's
  spine to close properly during the first month of
  pregnancy
• Although spinal opening can be surgically
  repaired shortly after birth-nerve damage is
  permanent, resulting in degrees of paralysis of
  lower limbs
• SB may also cause bowel bladder complications
• Many with SB have hydrocephalus-excessive
  accumulation of cerebrospinal fluid in brain

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Three Forms of Spina Bifida

• Myelomeningocele severest form, in which the
  spinal cord its protective covering (the
  meninges) protrude from an opening in the spine
• Meningocele in which the spinal cord develops
  normally but the meninges protrude from a spinal
  opening
• Occulta mildest form, in which one or more
  vertebrae are malformed covered by a layer of
  skin

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Traumatic Brain Injury

• Occurs when a sudden physical assault on the head
  causes damage to the brain
• Damage can be
• Focal, confined to one area of the brain, or
• Diffuse, involving more than one area of the
  brain.

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TBI Closed Head Injury vs. Penetrating Head Injury

• TBI can result from a closed head injury or a
  penetrating head injury
• Closed head injury occurs when the head suddenly
  violently hits an object, but the object does
  not break through the skull
• A penetrating head injury occurs when an object
  pierces the skull enters the brain tissue.

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Types of Traumatic Brain Injuries

• Skull fracture -bone of the skull cracks or
  breaks
• Depressed skull fracture-pieces of the broken
  skull press into the tissue of the brain - can
  cause bruising of the brain tissue, called a
  contusion
• Contusion can also occur in response to shaking
  of the brain within confines of the skull, an
  injury called "countrecoup.
• Shaken baby syndrome is a severe form of head
  injury that occurs when shaken forcibly enough to
  cause extreme countrecoup injury

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Types of Traumatic Brain Injuries

• Damage to a major blood vessel within the head
  can cause a hematoma, or heavy bleeding into or
  around the brain.
• Severity of a TBI can range from a mild
  concussion to extremes of coma or even death
• Symptoms of a TBI may include headache, nausea,
  confusion or other cognitive problems, a change
  in personality, depression, irritability other
  emotional behavioral problems or seizures

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Epilepsy

• Epilepsy is a neurological condition, which
  affects the nervous system
• Epilepsy is also known as a seizure disorder
• It is usually diagnosed after a person has had at
  least two seizures that were not caused by some
  known medical condition like alcohol withdrawal
  or extremely low blood sugar

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Risk Factors for Seizures

• Babies who are small for their gestational age
• Babies who have seizures in the first month of
  life
• Babies who are born with abnormal brain
  structures
• Bleeding into the brain
• Abnormal blood vessels in the brain
• Serious brain injury or lack of oxygen to the
  brain
• Brain tumors
• Infections of the brain abscess, meningitis, or
  encephalitis

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Risk Factors for Seizures 2

• Stroke resulting from blockage of arteries
• Cerebral palsy
• Mental handicap
• Seizures occurring within days after head injury
  ("early posttraumatic seizures")
• Family history of epilepsy or fever-related
  seizures
• Alzheimer's disease (late in the illness)
• Fever-related (febrile) seizures that are
  unusually long
• Use of illegal drugs such as cocaine

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Autistic

• Autistic students may seem to act, talk, think or
  behave very differently from other students their
  age and not like to being close to people
• Delay or abnormal functioning in at least one of
  the following three areas with onset prior to age
  3
• social interaction
• language used in social communication
• symbolic or imaginative play

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Autistic 2

• These children have difficulty with peer
  relationships lack of engagement with others
• There may be a delay or total lack oflanguage
• Use of repetitive idiosyncratic language
• Preoccupation with parts of objects
• Hand or finger flapping
• Rocking

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Speech and Language Impaired

• Speech or language impaired students have
  problems in talking so that they can be
  understood, sharing ideas, expressing needs, or
  understanding what others are saying

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Homebound/Hospitalized

• A kind of Exceptional Student Education for
  students who must stay at home or in a hospital
  for a period of time because of a severe illness,
  injury, or health problem

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Gifted

• Gifted students are very, very bright or smart
  and learn things much more quickly than other
  students their age