Exceptional Learners Chapters 5-8

Early Intervention for ADHD

Diagnosis of young kids with ADHD is difficult. Recently, number of preschoolers identified as having ADHD has increased (prevalence rates of 2-6%). Parents report ADHD symptoms in kids begin when kid is between 2-4. Importance of educational principles of classroom structure, teacher direction, functional behavioral assessment, and contingency-based self-management are very important for preschoolers.

Mastering the Maze: The SPED Process

Forms required for preschool-aged children (53-60), Functional Behavioral Assessment (FBA) and Behavioral Intervention Plan (pages 109-112), and Manifestation Determination Review (MDR) (pages 113-116).

Mastering the Maze 2

Notice and Eligibility Decision Regarding Special Education Services (Specific Learning Disability) (pages 46-51)

An Alternative to the Federal Definition of EBD

The National Mental Health and SPED Coalition proposed an alternative definition in 1990. Advantages of this def: Uses current terminology that reflects pro preferences and concern for minimizing stigma; Includes disorders of emotion and behavior without problematic exclusions and that they can occur separately or in combo; School-centered but acknowledges disorders exhibited outside the school setting are also important; Does not include minor or transient problems or ordinary responses to stress; Sensitive to ethnic and cultural differences; Acknowledges the importance of trial interventions but doesn't require slavish implementation of them in extreme cases; Students can have multiple disabilities; includes the full range of emotional and behavioral disorders that are of concern to mental health and SPED pros and does so without problematic exclusions.

Early Intervention for Learners with Learning Disabilities

Very little preschool programming is available for kids with LDs because of the difficulties in identification at such a young age.

Perinatal Causes of Intellectual Disabilites

a variety of problems occurring while giving birth can result in brain injury and intellectual disabilities. If kid isn't positioned properly in uterus, brain injury can occur during delivery. A prob that sometimes occurs because of difficulty during deliver is anoxia, a complete deprivation of oxygen. Low birthweight (LBW) can result in behavioral and medical problems, including intellectual disabilities. LBW: 5.5 lbs or lower and is associated with poor nutrition, teenage pregnancy, drug use, and excessive cigarette smoking and is more common in moms living in poverty. Venereal diseases such as syphilis and herpes simplex can be passed from mom to kid during childbirth and can result in intellectual disabilities

Prevalence of EBD

o 6-10% of kids and youths of school age exhibit serious and persistent emotional/behavioral problems, but less than 1% of kids in the US are identified as having emotional disturbance for SPED purposes. Only a very small percentage of kids with serious EBD receive mental health services. This prob of under-identification poses a serious health risk. o Most common types of problems exhibited by students who're placed in SPED for EBD are externalizing (aggressive, acting-out, disruptive behavior). Boys outnumber girls in displaying these behaviors 5:1 or more. Boys tend to exhibit more aggression than girls, though antisocial behavior in girls is an increasing concern. o Juvenile delinquency and the antisocial behaviors known as conduct disorder present particular problems in estimating prevalence. Disabling conditions of various kinds are much more common among juvenile delinquents than among the gen pop. The social and economic costs of delinquency and antisocial behavior are enormous. Students who exhibit serious antisocial behavior are at high risk for school failure and other negative outcomes.

The AAIDD Definition of Intellectual Disability

o AAIDD definition: Intellectual disability is a disability characterized by significant limitations in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills. This disability originates before age 18. o This definition underscores 2 important points: Intellectual disability involves problems in adaptive behavior, not just intellectual functioning, and the intellectual functioning and adaptive behavior of a person with intellectual disabilities can be improved.

Psychological and Behavioral Characteristics of ADHD

o ADHD is characterized by a multiplicity of cognitive and behavioral deficits. The effects of ADHD on psychological and behavioral functioning can be pervasive, with a major impact on quality of life. The National Institute of Mental Health has identified several symptoms associated with major behavioral characteristics: inattention, hyperactivity, and impulsivity. o Deficits in Executive Functions and Behavioral Inhibition: § Executive Functioning (EF): term describing processes involved in controlling and regulating behavior (working memory (WM), inhibitory control or behavioral inhibition, and mental flexibility). Lots of evidence shows that ADHD results in EF deficits and fact that EF is prob controlled by the prefrontal and frontal lobes fits nicely with neuroimaging studied pointing to abnormality in these areas of the brain in persons with ADHD. With diminished self-regulation or executive control abilities, students with ADHD find it very difficult to stay focused on tasks that require effort or concentration but that aren't inherently exciting. Lots of evidence shows that students with ADHD have lower academic achievement than those without disabilities. § Behavioral Inhibition: involves the ability to delay a response; interrupt an ongoing response, if the response is deemed inappropriate because of sudden changes in the demands of the task; or protect a response from distracting or competing stimuli. Impulsivity is frequently used to describe problems with behavioral inhibition. Problems in behavioral inhibition can be reflected in the inability to wait one's turn, to refrain from interrupting convos, to resist potential distractions while working, or to delay immediate gratification to work for larger, long-term rewards. Deficits in behavioral inhibitions can also result in people have problems controlling emotions and arousal levels—they often overreact to negative or positive experiences. In the classroom, difficulties with behavioral inhibition, or manifestations of impulsivity, can present themselves during task switching or transitions. o Adaptive Behavior: many kids and adults with ADHD also have difficulties in adaptive behavior. Example: people with ADHD have more problems related to driving as adolescents and young adults (more accidents and traffic violations). o Social Behavior Problems: students with ADHD are more disliked by their peers and also have social difficulties with their parents, siblings, and teachers. Social rejection can lead to social isolation—many people with ADHD have few friends, even though they may want desperately to be liked, which sets up a vicious cycle. However, when they do have friends, the friendships tend to be close. o Coexisting Conditions: § Learning Disabilities: about ½ of kids with ADHD also have learning disabilities and some think relationship is strongest for students who have ADHD, Predominantly Inattentive Type. § Emotional or Behavioral Disorders: 25-50% of people with ADHD also exhibit some form of emotional or behavioral disorder. Some exhibit aggressive, acting-out behaviors, whereas others manifest behaviors that accompany anxiety or depression. Anxiety is evident in 15-35% of kids with ADHD, and they're vulnerable to having multiple anxiety disorders compared with kids without disabilities. § Substance Abuse: Adolescents with ADHD are more likely to experiment prematurely with alcohol, tobacco, or illicit drugs: nicotine-31%, alcohol-13%, cannabis-9%, and cocaine-2%. Attention problems are linked with nicotine dependence, and oppositional behavior is linked with cannabis and cocaine dependence. Some reports in pop media have claimed the treatment of ADHD with psychostimulants such as Ritalin leads kids to use illicit drugs, but there's very little research that backs up this claim.

Down Syndrome and Alzheimer's Disease

o According to postmortem studies, virtually all people with Down syndrome who reach 35 have brain abnormalities similar to those with Alzheimer's disease. Behavioral signs of dementia occur in well over half of people with Down syndrome older than 60. Unfortunately, maladaptive behaviors often increase as the dementia advances. o Findings that link Down syndrome to Alzheimer's have made researchers optimistic about uncovering the genetic underpinnings of both conditions. For example, researchers have found that a particular protein may be the key to the rapid onset of Alzheimer's in people with Down syndrome. Interestingly, no evidence shows that Alzheimer's occurs more frequently in adults whose intellectual disabilities are due to other causes.

Classification of Intellectual Disabilities

o Although AAIDD doesn't advocate for such classification, most school systems classify students with intellectual disabilities according to the severity of their condition: mild (IQ 50-70), moderate (IQ 35-50), severe (IQ 20-35), and profound (IQ below about 20) mental retardation/intellectual disabilities.

Assessment of Progress for ADHD

o Assessment of Academic Skills: Curriculum-based measurement (CBM) is appropriate method for monitoring academic progress for students with ADHD. Advantage for CBM is that measures take very little time to administer and are focused on a particular task. Assessment of Attention and Behavior: Two methods are commonly used to assess a student's attention to tasks and social/emotional behavior: rating scales and direct observation. An example of a rating scale that can be used to measure student outcomes or to monitor student progress is the Conners-3. The Conners-3 includes measures of oppositional behavior, inattention, anxiety, and social problems. Teachers should also directly observe students on a regular schedule to monitor attention, academic engaged time, and disruptive behavior. Behavioral recording systems provide a framework to conduct systematic observations. For example, momentary time sampling allows the teacher to conduct brief observations and collect data on a specific set of behaviors. In momentary time sampling, the observer determines the length of the observation and divides it into intervals (e.g., 15 minutes may be divided into 15 intervals of 1 minute each). At the beginning of each interval, the observer records whether the student is exhibiting the behavior of interest and then does not observe the student until the beginning of the next interval. A unique measure of student outcomes is the Telephone Interview Probe (TIP), which uses brief phone interviews of parents and teachers to determine the effects of interventions. Particularly useful for evaluating effects of psychostimulant medications on an individual at a specific time of day or setting. Many common rating scales are limited to broader time frames and don't provide the specificity required to make decisions in regard to treatment with meds. TIP provides ratings of inattention, impulsiveness, hyperactivity, oppositional behavior, and prob situations for 3 times points during the day.

Assessments of Progress of Intellectual Disabilities

o Assessment of students with intellectual disabilities focuses on a variety of domains, including academic skills, adaptive behavior, and quality of life. The academic skills of students with intellectual disabilities may be assessed using methods that are common across disability categories, such as curriculum-based measurement (CBM). Some students with intellectual disabilities participate in standardized academic assessments. Many students with intellectual disabilities, however, require accommodations to participate in standardized assessments or receive an alternative assessment method if they can't participate in traditional assessments with accommodations. o Assessment of Adaptive Behavior: may be integrated with interventions so that services are provided in a data-based decision framework. Can use these assessments to provide outcome data on an individual's success following intervention. Typically, special educators or other pros measure adaptive behavior indirectly, in that an "informant" who's intimately familiar with the student provides info on a rating scale or in an interview. The Vineland Adaptive Behavior Scales—Third Edition is a popular measure of adaptive behavior for people from birth-18 years and includes several domains: communication, daily living skills, socialization, motor skills, and maladaptive behavior. o Assessment of Quality of Life: Measuring quality of life presents a challenge because particular person's perceived quality of life may differ from that of larger society. Thus, outcome measures should include objective and subjective measures that consider society's view of quality of life along with a person's perceived level of satisfaction. Measure commonly used to asses adolescents and adults is the Quality of Life Questionnaire, which can be used with English and Spanish speakers and addresses 5 factors: satisfaction, well-being, social belonging, dignity, and empowerment/control. More objective scale is the BILD Life Experiences Checklist, which measures the extent to which a person has ordinary life experience and comprises of 5 areas: home, relationships, freedom, leisure, and opportunities for self-enhancement. o Testing Accommodations and Alternate Assessment: Testing accommodations are more likely to be used for students with milder intellectual disabilities, whereas alternate assessments are more likely to be used for students with more severe intellectual disabilities. Accommodations for students with intellectual disabilities on standardized tests can include modifications in scheduling, presentation format, and response format. Common scheduling accommodations include granting extended or unlimited time, or breaking the assessment into smaller, more manageable portions over several days. A typical presentation accommodation involves reading directions and problems to the student. Some students with intellectual disabilities may have physical difficulties and require response accommodations. For example, a student may dictate responses or use a tablet. Alternate assessments are for students who can't be tested using traditional methods, even if accommodations are provided. Alternate assessments should measure authentic skills, cover a variety of domains, and include multiple measures across time. Can include direct observations of specific behaviors, checklists, rating scales, and curriculum-based measures. Several domains should be covered, like functional literacy, communication, leisure-recreation skills, domestic skills, and vocational skills.

Definition of Learning Disability

o At a parents' meeting in the early 1960s, Samuel Kirk (1963) proposed the term learning disabilities as a compromise because of the confusing variety of labels that were being used to describe a child with relatively normal intelligence who was having learning problems. Such a child was likely to be referred to as minimally brain injured, a slow learner, dyslexic, or perceptually disabled. o Many parents as well as teachers found the label "minimal brain injury" problematic. Minimal brain injury refers to individuals who show behavioral but not neurological signs of brain injury. They exhibit behaviors (e.g., distractibility, hyperactivity, and perceptual disturbances) similar to those of people with real brain injury, but their neurological examinations are indistinguishable from those of individuals who do not have disabilities. Historically, the diagnosis of minimal brain injury was sometimes dubious because it was based on questionable behavioral evidence rather than on more solid neurological data. Moreover, minimal brain injury was not an educationally meaningful term, because such a diagnosis offered little real help in planning and implementing treatment. The term slow learner described the child's performance in some areas but not in others; and intelligence testing indicated that the ability to learn existed. Dyslexic, too, fell short as a definitive term because it described only reading disabilities, and many of these children also had problems in other academic areas, such as math. To describe a child as having perceptual disabilities just confused the issue further, for perceptual problems might be only part of a puzzling inability to learn. The parents' group founded the Association for Children with Learning Disabilities, now known as the Learning Disabilities Association of America. A few years later, pros and fed government officially recognized the term. o Interest in learning disabilities evolved as result of a growing awareness that a large number of kids weren't receiving needed educational services. Because they tested within normal range of intelligence, kids didn't qualify for placement in classes for kids with intellectual disabilities and though many of them exhibited inappropriate behavior disturbances, some of them didn't. o Several different definitions of learning disabilities have enjoyed some degree of acceptance since the field's inception in the early 1970s. Created by individual professionals and committees of professionals and lawmakers, each definition provides a slightly different slant. The two most influential definitions have been the federal definition and the definition of the National Joint Committee on Learning Disabilities (NJCLD). The definition of learning disorders in the Diagnostic and Statistical Manual of the American Psychiatric Association has played less of a role in the identification of children with LD in schools, although physicians use this definition frequently. o The Federal Def: Majority of states use a def based on the fed government's definition. This def, first signed into law in 1975, was adopted again in 1997 by the fed government and reauthorized in 2004. Definition: A disorder in psychological processes involved in understanding or using language which may be manifested in problems with listening, thinking, speaking, reading, writing, spelling, or doing mathematical calculations. Disorders Included: perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, developmental aphasia. Disorders Not Included: problems primarily due to hearing, visual, or motor disabilities; mental retardation, emotional disturbance; or economic, cultural, or environmental disadvantage o The National Joint Committee on Learning Disabilities (NJCLD) Def: The NJCLD, composed of reps of the major pro organizations involved with students with LDs, developed an alternative def. Presented their own def because of dissatisfaction with these factors in the fed definition: 1) Reference to psychological processes: in reaction to the widespread adoption of unproven perceptual training programs, the NJCLD objected to the "basic psychological processes" phrase; 2) Omission of the intrinsic nature of learning disabilities: the fed def makes no mention of causal factors, but the NJCLD considered LDs to be due to central nervous system (CNS) dysfunction within the individual; 3) Omission of adults: NJCLD responded to growing awareness that LDs aren't just a childhood disability; 4) Omission of self-regulation and social interaction problems, 5) Inclusion of terms difficult to define: use of hard-to-define terms perceptual handicaps, dyslexia, and minimal brain dysfunction; 6) Confusion about the exclusion cause: NJCLD preferred to be explicit about possibility that someone with another condition, such as intellectual disability, could also have a learning disability; 7) Inclusion of spelling: NJCLD believed no need to mention spelling since it was included in writing. On the basis of these weaknesses of the fed def, the NJCLD's definition: Learning disabilities is a general term that refers to a heterogeneous group of disorders manifested by significant difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning, or mathematical abilities. These disorders are intrinsic to the individual, presumed to be due to central nervous system dysfunction, and may occur across the life span. Problems in self-regulatory behaviors, social perception and social interaction may exist with learning disabilities but do not by themselves constitute a learning disability. Although learning disabilities may occur concomitantly with other handicapping conditions (for example, sensory impairment, mental retardation, serious emotional disturbance) or with extrinsic influences (such as cultural differences, insufficient or inappropriate instruction), they are not the result of those conditions or influences. o The American Psychiatric Association (APA) Def: Includes 4 criteria: 1) Persistent (occurring for at least 6 months) academic problems in at least one of 6 areas: (a) inaccurate or slow and effortful reading, (b) poor reading comprehension, (c) poor spelling, (d) poor written expression, (e) poor number sense, (f) poor mathematical reasoning 2) Substantial discrepancy between actual and expected academic skill(s) based on chronological age that results in significant interference with academic, occupational, or daily living skills 3) Learning difficulties that began in school-age years but which might not become evident until task demands increase (e.g., timed test, tight deadlines, long reports) 4) Learning difficulties are not due to other disabilities, e.g., intellectual disabilities, visual or hearing impairment, English language learner, poor instruction.

Causes of EBD

o Attributed the causes of EBD to 4 major factors: 1) Biological disorders and diseases; 2) Pathological fam relationships; 3) Undesirable experiences in schools; 4) Negative cultural or supernatural influences. o Although in the majority of cases, no conclusive empirical evidence indicates that 1 of these factors is directly responsible, some factors might give a kid a predisposition and others might precipitate it or trigger it. Some factors, like genetics, influence behavior over a long time and increase the likelihood that circumstances will trigger maladaptive responses. Other factors (like observing a parent beat the other) might have a more immediate effect and might trigger maladaptive responses in an individual who's already predisposed to prob behavior. Contributing factors heighten the risk of a disorder—rare to find a single cause leading directly to a disorder. Factors or conditions can change. The life course of a kid isn't fixed by any 1 factor or combo of factors. Educators must do their best to add whatever positive, risk-lowering factors they can, such as effective instruction, consistent discipline, warm relationships with students, and prob-solving and social skills. The earlier educators can intervene to lower risk, the better. o Biological Factors: Behaviors and emotions may be influenced by genetic, neurological, or biochemical factors, or by a combo of these. For example, prenatal exposure to alcohol can contribute to many types of disability, including EBD, but only rarely is it possible to demo a relationship between a specific biological factors and EBD. For most kids with EBD, no real evidence shows that biological factors alone are at the root of their problems. For those with severe and profound disorders, however, evidence suggests that biological factors contribute to their conditions. Increasing evidence shows that meds may be helpful in addressing the problems of many or most students with emotional or behavioral disorders if they receive state-of-the-art psychopharmacology and if proper precautions are used. All kids are born with a biologically determined behavioral style, or temperament. Although kid's inborn temperaments may be changed by the way they're reared, some people have long believed that kids with so-called difficult temperaments are predisposed to develop EBD. There's no 1 to 1 relationship between temperament and disorders, however. Other biological factors besides temperament, like disease, malnutrition, and brain trauma, can predispose kids to develop EBD. Substance abuse can also contribute to EBD. Except in rare instances, it isn't possible to determine that these factors are direct causes of prob behavior. The causes of emotional and behavioral disorders are seldom exclusively biological or psychological. Once a biological disorder occurs, it almost always creates psychosocial problems that also contribute to the EBD. Medication may be of great benefit, but it's seldom the only intervention that's needed. The psychological and social aspects of the disorder must also be addressed. o Family Factors: Even in severe cases of EBD, it isn't possible to find consistent and valid research findings that allow blaming parents. Relationship between parenting and EBD isn't simple, but some parenting practices are better than others. Educators must be aware that most parents of youngsters with EBD want their kids to behave more appropriately and will do anything they can to help them. These parents need support to help them deal with fam circumstances. The Federation of Families for Children's Mental Health was organized in 1989 to provide support and resources, and parents are organizing in many localities to help each other in finding additional assistance. o School Factors: Some kids already have EBD when they begin school; others develop such disorders during their school years, perhaps in part because of damaging experiences in the classroom. Kids who exhibit disorders when they enter school may become better or worse according to how they're managed in the classroom. We can't justify many statements about how such experiences contribute to the kid's behavioral difficulties. A kid's temperament and social competence can interact with the behaviors of classmates and teachers in contributing to emotional or behavioral problems. A real danger is that kids who exhibit prob behavior will become trapped in a spiral of negative interactions. In considering how teachers might be contributing to disordered behavior, they must question themselves about their academic instruction, expectations, and approaches to behavior management. Teachers mustn't assume blame for disordered behavior to which they aren't contributing, but it's equally important that teachers eliminate whatever contributions they might be making to their students' misconduct. o Cultural Factors: Aside from fam and school, many environmental conditions affect adults' expectations of kids and kid's expectations of themselves and their peers. Adults communicate values and behavioral standards to kids through a variety of cultural conditions, demands, prohibitions, and models. Cultural influences: level of violence in the media, use of terror as a means of coercion, availability of recreational drugs and level of drug abuse, changing standards for sexual conduct, religious demands and restrictions on behavior, and threat of nuclear accidents, terrorism, or war. Peers are another important source of cultural influence.

Identification of ADHD

o Authorities stress importance of using several sources of info before arriving at a determination that someone has ADHD. o 4 important components to identification: 1) medical examination, 2) clinical interview, 3) teacher and parent rating scale, and 4) behavioral observations. o Medical examination is necessary to rule out brain tumors, thyroid problems, seizure disorders, etc. as the cause of the inattention and/or hyperactivity. o Clinical interview of the parents and the kid provides info about the kid's physical and psychological characteristics, as well as fam dynamics and interaction with peers. Clinicians need to recognize the subjective nature of the interview situation. o In an attempt to bring quantification to the identification process, researchers developed rating scales to be filled out by teachers, parents, and sometimes the kid. o The clinician should observe the student. This can be done in the classroom and some clinicians who specialize in diagnosing and treating kids with ADHD have specially designed observation rooms to observe the kids performing tasks that require sustained attention.

Transition to Adulthood for EBD

o Basic options: Regular public high school classes, Consultant teachers who provide individualized work and behavior management, Resource rooms and self-contained classes for part or all of the day, Work-study programs in which vocational ed and job experience are combined with academic study, Special private or public schools that offer the regular high school curriculum in a diff setting, Alternative schools that offer highly individualized programs that are nontraditional in setting and content; and Private or public residential schools. o Incarcerated youth are neglected o Difficulty designing programs at secondary level because this category of youths is so varied. o Employment difficulty due to academic skills and behavior o May require intervention throughout life—outlook is especially grim for kids and youth with conduct disorders. o Complicated by challenging family relationships.

Classification of EBD

o Classification of EBD is sometimes thought to follow psychiatric designations, particularly the categories suggested by the current version of the APA's DSM-5. Much of the controversy about DSM-5 has centered on the fact that classification depends primarily, if not exclusively, on the way people behave or feel—their symptoms of what's presumably mental illness, rather than a specific malfunction of the brain. However, teachers must manage behavior and emotions in everyday interactions. For teachers, the DSM is important but is sometimes less helpful than classification based on behavior. o Researchers have identified 2 broad, pervasive dimensions of disordered behavior: externalizing and internalizing. Externalizing behavior: involves striking out against others. Internalizing behavior: involves mental or emotional conflicts, such as depression and anxiety. Some researchers have found more specific disorders, but all of the more specific disorders can be located on these 2 primary dimensions. Individuals may show behaviors characteristic of both dimensions—actually, comorbidity is common. Few individuals with an emotional or behavioral disorder exhibit only 1 type of maladaptive behavior. o Any kind of prob behavior may be exhibited to a greater or lesser extent; the range may be from normal to severely disordered. People with schizophrenia have a severe disorder of thinking and might believe that they're controlled by alien forces or might have other delusions or hallucinations. Typically, their emotions are inappropriate for the actual circumstances, and they tend to withdraw into their own private worlds.

Educational Considerations about ADHD

o Classroom Structure and Teacher Direction: William Cruickshank was 1 of the 1st to establish a systematic educational program for kids who today would meet the criteria for ADHD. 2 hallmarks of his program were reducing stimuli irrelevant to learning and enhancing materials important for learning, and creating a structured program with a strong emphasis on teacher direction. It's rare today to see teachers using all components of Cruickshank's program, especially cubicles (though this can be an accommodation for some). Degree of classroom structure and teacher direction advocated by Cruickshank is also rarely seen today. First, the intensity of structure could be achieved only in a self-contained classroom and most students with ADHD are in gen ed settings. 2nd, most believe that a structural program is important in the early stages of working with students with ADHD but that these students gradually need to learn to be more independent in their learning. o Functional Behavioral Assessment and Contingency-Based Self-Management: Functional behavioral assessment (FBA): important tool for teachers to use with students with emotional or behavioral disorders as well as for students with other types of disabilities when they also have behavioral problems. FBA involves determining the consequences, antecedents, and setting events that maintain inappropriate behaviors. Examples of typical functions of inappropriate behavior of students with ADHD are to avoid work and to gain attention from peers or adults. Contingency-based self-management: usually involve having people keep track of their own behavior and then receive consequences, often in the form of rewards, based on behaviors. A combo of FBA and contingency-based self-management techs has proven successful in increasing appropriate behavior of elementary and secondary students with ADHD. § The Role of Reinforcement: Reinforcement of some kind, such as social praise or points that can be traded for privileges is especially important for self-management techs to be effective. The use of behavioral procedures such as reinforcement is somewhat controversial, and some are opposed to their use. However, many authorities consider them almost indispensable in working with students with ADHD. o Service Delivery Models: Assume that majority of students with ADHD spend most of their time in gen ed classrooms. As will as students with disabilities, the best placement for students with ADHD should be determined on an individual basis.

Educational Considerations for Learning Disabilities

o Cognitive Training: concerned with modifying unobservable thought processes, prompting observable changes in behavior. Particularly appropriate for people with LDs because of its focus on problems of metacognition and motivation. Involves 3 components: 1) changing thought processes, 2) providing strategies for learning, 3) teaching self-initiative. § Self-Instruction: make students aware of the various stages of problem-solving tasks while they're performing them and to bring behavior under verbal control. § Self-Monitoring: students keep track of their own behavior, often through the use of 2 components: self-evaluation and self-recording. Students evaluate their own behavior and then record whether the behavior occurred. Students can be taught to self-monitor a variety of academic behaviors. § Scaffolded Instruction: teachers provide assistance to students with they're 1st learning tasks and then gradually reduce assistance so that eventually students do the tasks independently. § Reciprocal Teaching: interactive dialogue between teacher and students where teacher-student relationship is similar to that of an expert (teacher) and apprentice (student). The teacher gradually relinquishes role as sole instructor and allows student to assume role of co-instructor for brief periods. The teacher models and encourages the student to use strategies. o Metacognitive Training: addresses problems with planning ahead, selecting good learning strategies, and adjusting strategies based on performance. o Instructional Approaches for Academics: § For Reading: 5 essential components of effective reading instruction: phonological awareness training (knowing that speech consists of small units of sounds), phonics instruction (learning the alphabetic system), fluency instruction (ability to read smoothly and effortlessly), vocabulary instruction, and comprehension instruction. Teaching students with LDs to manipulate phonemes in words is highly effective in helping them acquire reading skills. Effective phonics instruction is explicit and systematic, and includes lots of opportunities to practice. For reading fluency, have students read aloud. Repeated readings, where students repeatedly read the same short passages aloud until they're reading at an appropriate pace with few or no errors, is especially beneficial. Successful techniques for teaching vocab are mnemonic instruction, learning strategies using morphemic analysis, direct instruction, and multimedia instruction. Important to provide ample opportunities for reading a wide range of materials. To directly teach vocab, review new or unknown words in a text prior to reading, extending instruction on specific words over time and across different contexts. § For Writing: Effective writing instruction for students with LDs involves teaching students explicit and systematic strategies for planning, revising, and editing compositions. Self-regulated strategy development (SRSD) is a research-based model that's been highly effective. SRSD approaches writing as a problem-solving task that involves planning, knowledge, and skills. Within SRSD are several strategies focused on diff aspects of writing. § For Math: explicit instruction. Need more structure and teacher direction. Teacher should sequence the instruction to minimize errors but when errors occur, they should be immediately rectified. Cumulative review of concepts and operations. Closely monitor student progress. § For Social Studies and Science: carefully structured and sequenced with emphasis on cumulative review and monitoring of student progress with activities-based instruction. With textbooks, content enhancement is important. Content enhancement: way of making materials more salient or prominent and examples are graphic organizers and mnemonics. Graphic organizers: visual devices that employ lines, circles, and boxes to organize info: hierarchic, cause/effect, compare/contrast, and cyclic or linear sequences. Mnemonics: using pics and/or words to help remember info. o Direct Instruction (DI): focuses on the details of the instructional process. A critical component of DI is task analysis. Task analysis involves breaking down academic problems into their component parts so that teachers can teach the parts separately and then teach the students to put the parts together in order to demonstrate the larger skill. Originally pioneered by Sigfried Engelmann and the late Wesley C. Becker, DI programs consist of precisely sequenced, scripted, fast-paced lessons taught to small groups of 4 to 10 students, with a heavy emphasis on drill and practice. DI programs are among the best-researched commercial programs available for students with LDs. Use of these programs results in immediate academic gains and may bring long-term academic gains. o Peer Tutoring: Classwide peer tutoring (CWPT): students who are taught by peers who are trained and supervised by classroom teachers. Peer-assisted learning strategies (PALS).

Definition of EBD

o Defining EBD has always been problematic. Pro groups and experts have felt free to construct individual working definitions to fit their own pro purposes. No one's come up with a def that all pros understand and accept. o EBD tends to overlap with other disabilities, especially learning disabilities and intellectual disability. o There's general agreement that EBD refers to: 1) Behavior that goes to an extreme; 2) a prob that's chronic; and 3) behavior that's unacceptable because of social or cultural expectations.

Psychological and Behavioral Characteristics of EBD

o Describing the characteristics of kids and youths with EBD is very challenging because EBD are extremely varied. Individuals may vary markedly in intelligence, achievement, life circumstances, and emotional and behavioral characteristics. o Intelligence and Achievement: Idea that kids and youths with EBD tend to be particularly bright is a myth. Research shows that the average student with an EBD has an IQ in the dull-normal range (90ish) and that few score above the bright-normal range. Compared to the normal distribution of intelligence, more kids with END fall into the ranges of slow learner and mild intellectual disability. Intelligence tests aren't perfect, and it can be argued that EBD might prevent kids from scoring as high as they are capable of. Still, the lower-than-normal IQs do indicate lower ability to perform tasks, and lower scores are consistent with impairment in other areas of functioning (academic achievement and social skills). IQ is a relatively good predictors of how far a student will progress academically and socially. Most students with EBD are also underachievers at school, as measured by standardized tests. Students with an EBD don't usually achieve at the level expected for their mental age. Many students with severe disorders lack basic reading and math skills, and the few who seem to be competent often can't apply their skills to everyday problems. o Social and Emotional Characteristics: Externalizing behavior: aggressive, seeking-out behavior and Internalizing behavior: anxious, withdrawn behavior and depression. A student at diff times may show both aggressive and withdrawn or depressed behaviors. Most students with EBD have multiple problems. Those with EBD may be socially rejected. Early peer rejection and aggressive behavior place a kid at high risk for later social and emotional problems. Many aggressive students who aren't rejected affiliate with others who're aggressive. Relationship between EBD and communication disorders is increasingly clear. Many kids and youths with EBD have great difficulty in understanding and using language in social circumstances. § Externalizing Behavior (Aggressive, Acting-Out): Conduct disorder is most common prob exhibited by students with EBD. Hitting, fighting, teasing, yelling, refusing to comply, crying, destructiveness, vandalism, extortion. Impulsively and often. Drive adults to distraction and aren't popular with their peers, unless they're also delinquents. Typically, don't respond quickly and positively to well-meaning adults who care about them and try to be helpful. Believe that aggression is learned behavior and assume that it's possible to identify the conditions under which it'll be learned. Kids learn many aggressive behaviors by observing parents, siblings, playmates, and people in the media. People who model aggression are more likely to be imitated if they're high in social status and are observed to receive rewards and escape punishment for their aggression. If kids are place in unpleasant situations and they can't escape from that or obtain rewards except by aggression, they're more likely to be aggressive. Aggression is encouraged by external rewards (social status, power, suffering of the victim, obtaining desired items), vicarious rewards (seeing others obtain desirable consequences for their aggression), and self-reinforcement (self-congratulation or enhancement of self-image). If kids can justify aggression in their minds (by comparison to behaviors of others or by dehumanizing their victims), they're more likely to be aggressive. Punishment can actually increase aggression under some circumstances: when it's inconsistent or delayed, when there's not positive alternative to the punished behavior, when it provides an example of aggression, or when counterattack against punisher seems likely to be successful. Research doesn't support that it's wise to let kids act out their aggression freely. Most helpful techniques: modeling nonaggressive responses to aggression-provoking circumstances, helping the kid rehearse or role-play nonaggressive behavior, providing reinforcement for nonaggressive behavior, preventing kid from obtaining positive consequences for aggression, and punishing aggression in ways that involve as little counter-aggression as possible (using time-out or brief social isolation rather than spanking or yelling). When combined with school failure, aggressive, antisocial behavior in childhood generally predicts a gloomy future in terms of social adjustment and mental health, especially for boys. § Internalizing Behavior (Immature, Withdrawn Behavior and Depression): Have serious consequences for people in their childhood years and carry a poor prognosis for adult mental health. Can't develop the close and satisfying human relationships that characterize normal development. Find it difficult to meet pressures and demands of everyday life. School environment is 1 in which anxious and withdrawn adolescents in particular experience the most distress. Probably has to do more with problems in terms of failures in social learning than internal conflicts and unconscious motivations. A social learning analysis attributes these behaviors to an inadequate environment. Causal factors may include over-restrictive parental discipline, punishment for appropriate social responses, reward for isolated behavior, lack of opportunity to learn and practice social skills, and models of inappropriate behavior. These kids can be taught the skills they lack by arranging opportunities for them to learn and practice appropriate responses, showing models engaging in appropriate behavior, and providing rewards for improved behavior. Depression is widespread and serious prob among kids and adolescents. Depression: disturbances of mood or feelings, inability to think or concentrate, lack of motivation, and decreased physical well-being. A depressed child or youth might act sad, lonely, and apathetic; exhibit low self-esteem, excessive guilt, and pervasive pessimism; avoid tasks and social experiences; and/or have physical complaints/problems as bed-wetting (nocturnal enuresis), fecal soiling (encopresis), extreme fear or refusal to go to school, failure in school, or talk of suicide or suicide attempts. Depression frequently occurs with conduct disorder. Suicide is among leading causes of death for people 15-24. Depression is linked to suicide and substance abuse is also linked to depression. Depression sometimes has a biological cause, and antidepressants are sometimes helpful, but these meds come with their own risks. In many cases no biological cause can be found. Depression can be caused by environmental or psychological factors, such as death of a loved 1, separation of 1's parents, school failure, rejection by peers, or a chaotic and punitive home environment. Just having someone to build close relationship with can help with depression. Interventions based on social learning theory have also been helpful—instructing kids and youths in social interaction skills and self-control techniques and teaching them to view themselves more positively. Too often, emotional aspects of EBD are overlooked, as well as what the experience of EBD is like from student's perspective. Along with inappropriate behavior, students with EBD suffer emotional trauma, including many emotionally wrenching experiences in school, and that they're often among the most marginalized students in schools.

Early Intervention for Intellectual Disabilities

o Early Childhood Programs Designed for Prevention: generally for kids who are at risk for mild intellectual disabilities. Fed government began providing funds for infant and preschool programs for at-risk kids and their families, with goal being to research their effects. Most programs focused on families in poverty. Results show they're highly effective for kids and parents. Some programs were center-based, some home-based, and some a combo. They improved academic achievement and employment while reducing poverty, SPED placement, delinquency, and crime and these outcome yielded cost savings to society. o Early Childhood Programs Designed to Further Development: generally for kids with more severe intellectual disabilities. Emphasis on lang and conceptual development. Because these kids often have multiple disabilities, other pros are frequently involved in their education. Many of the better programs include opportunities for parent involvement so parents can reinforce skills.

The Federal Definition of EBD

o Emotionally disturbed means a condition exhibiting 1 or more of the following characteristics over a long period of time and to a marked extent, which adversely affects educational performance: an inability to learn not due to intellectual, sensory, or health factors; an inability to build or maintain satisfactory relationships with peers and teachers; inappropriate types of behavior or feelings under normal circumstances; a general pervasive mood of depression or unhappiness; a tendency to develop physical symptoms or fears associated with personal or school problems. The term includes kids who're schizophrenic. The term doesn't include kids who're socially maladjusted unless it's determined that they're emotionally disturbed. § These inclusions and exclusions are unnecessary. The above criteria indicate that schizophrenic kids must be included and that socially maladjusted kids can't be excluded. The clause "which adversely affects educational performance" makes interpretation of the def impossible, unless the meaning of educational performance is clarified. If educational performance refers only to academic achievement, then kids with the behavioral characteristics listed but who achieve on grade level can be excluded. 1 of the most criticized parts of the def is its exclusion of kids who're socially maladjusted but not emotionally disturbed. Some states and localities have started to interpret social maladjustment as conduct disorder—aggressive, disruptive, antisocial behavior. The APA and the CCBD have condemned this practice, which has no scientific basis.

Transition to Adulthood for Learners with Learning Disabilities

o Factors Related to Successful Transition: lots of perseverance, ability to set goals for oneself, a realistic acceptance of weaknesses coupled with an attitude of building on strengths, access to a strong network of social support, exposure to intensive and long-term educational intervention, high quality on the job or postsecondary training, supportive work environment, and being able to take control of their lives. o Secondary Programming: Entering workforce: taught basic academic skills and functional skills, work-study, explore variety of jobs, engaging in paid work during high school is beneficial. College: continued support in academic subjects. Empower students to make informed choices and to take control of their lives. Ensure students take part in their transition planning. In addition to a transition plan, federal law now requires that schools develop a summary of performance (SOP) for individual students with a disability as they exit secondary school, whether by graduating or exceeding the age of eligibility. SOPs are designed to provide a summary of relevant information, such as assessment reports; accommodations that have been provided; and recommendations for future accommodations, assistive technology, and support services for use in employment, training, or postsecondary schooling. SOPs also have a section for the student to provide input. Because SOPs only began implementation in 2007-08, little research on their effectiveness exists. o Postsecondary Programming: includes vocational and technical programs as well as community colleges and 4-year colleges. In selecting a school, students and their families should explore what kids of student support services are offered. Important skill is self-advocacy: ability to understand one's disability, be aware of one's legal rights, and communicate one's rights and needs to professors and administrators.

Educational Considerations of Intellectual Disabilities

o Focus on educational programs varies according to the degree of the student's intellectual disability or how much support the student requires. Lesser degree of intellectual disability, the more the teacher emphasizes academic skills; greater degree of intellectual disability, the more the teacher stresses functional skills, such as self-help, community living, and vocational skills. o Major issue is how to ensure that students with intellectual disabilities haave access to the gen ed curriculum while also being taught functional skills. Authorities recommend a merger of functional and academic curricular standards. Blending academics and functional skills is embodied in functional academics, teaching academics in the context of daily living skills. Whereas kids without disabilities are taught academics (reading) to learn other academic content (history), kid with intellectual disabilities is often taught reading to learn to function independently. o Educational programming for students with intellectual disabilities often includes 2 features: systematic instruction and reinforcement. § Systematic instruction: teacher selects well-defined target behavior (student will learn to read 8 consonant-vowel-consonant words, student will learn to sort socks, underwear, and t-shirts in a dresser, etc.); implements instruction consistently with respect to sequencing and prompting/cueing; teaches foundational skills before teaching more advanced behaviors; has plan for how much to assist student with verbal or physical prompts/cues or modeling; monitors students performance and uses that info to make changes to instruction as needed. § Reinforcement: Research has consistently shown that students who are positively reinforced for correct responses learn faster. Positive reinforcement ranges from verbal praise to tokens that can be traded for prizes or other rewards. For students with severe intellectual disabilities, the more immediate the reinforcement, the more effective it is. The goal is to reach a point when the student doesn't have to rely on prompts and can be more independent. Service Delivery Models: Placements for students with intellectual disabilities range from gen ed classes to residential facilities. Degree of integration into gen ed tends to be determined by the level of severity. Many who believe that much of the momentum to educate students with intellectual disabilities in gen ed has begun to stall. Some students with sever disabilities are placed in gen ed classrooms, with schools providing extra support services in the class. Researchers have found classwide peer tutoring to be effective technique for helping integrate students. Important that special educator and gen educators work together to plan for students to succeed because without this, students are likely to be inattentive and socially isolated.

Causes of Learning Disabilities

o For years, many pros suspected that neurological factors were a major cause of LDs. Pros noted that many of the kids displayed behavioral characteristics similar to those exhibited by people who were known to have brain damage. o However, in the case of most kids with LDs, little neurological evidence exists of actual damage to brain tissues. Therefore, a kid with LDs is now referred to as having CNS dysfunction rather than a brain injury. Dysfunction doesn't necessarily mean tissue damage; instead, it signifies a malfunctioning of the brain or CNS. o Researchers have documented neurological dysfunction as a probable cause of LDs using neuroimaging techniques such as magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), functional magnetic resonance spectroscopy (fMRS), and positron-emission tomography (PET) scans, as well as measuring the brain's electrical activity with event-related potentials (ERPs). § MRI sends magnetic radio waves through head and creates cross-sectional images of the brain. § fMRI and fMRS are adaptations of the MRI. Unlike an MRI, they are used to detect changes in brain activity while a person is engaged in a task, like reading. § A PET scan is also used while a person performs a task. Person is injected with substance containing low amount of radiation, which collects in active neurons. Using a scanner to detect the radioactive substance, researchers can tell which parts of the brain are actively engaged during various tasks. § ERPs measure the brain's response to perceptual and cognitive processing. They result from the administration of an electroencephalograph (EEG). o Using these techniques, researchers have accumulated evidence for structural and functional differences between the brains of people with and without LDs, especially reading disabilities. Structural differences refer to things like size of the various areas of the brain. For example, researchers have found that the volume of certain areas of the brain is related to reading skills. Functional refers to activity in the brain. Findings have been relatively consistent in identifying structural and/or functional differences in the left temporal lobe and surrounding areas in people with dyslexia. Using ERPs, researchers have determined that newborns' responses to speech stimuli correlate to their lang scores in preschool and predict whether they'll have a reading disability at age 8. ERPs may eventually be reliable enough to be used with educational and psychological tests to identify kids at risk for later development of reading disabilities. o These studies aren't definitive evidence of a neurological basis for all students who are identified as having LDs. However, the results have turned many people into believers that CNS dysfunction could be the cause of many or most cases of LDs. o Genetic Factors: LDs can be inherited. 2 most common types of studies used to examine the genetic basis of LDs are familiality studies and heritability studies. Geneticists agree that no single gene causes a LD. Progress in identifying which genes are associated with LDs. Evidence suggests that some of these genes are associated with more than 1 type LD. § Familiality studies: examine degree to which a certain condition occurs in a single fam (tendency for it to run in the fam). About 35-45% of 1st degree relatives of individuals with reading disabilities also have reading disabilities. Risk for having reading disabilities increases for kids when both parents have reading disabilities. Same degree of familiality also found in families of people with speech and lang disorders and spelling disabilities. § Tendency for LDs to run in families may also be due to environmental factors. Heritability studies: compare prevalence of LDs in identical vs fraternal twins. Found that identical twins are more concordant than are fraternal twins for reading disabilities, speech and lang disorders, and math disabilities. o Toxins: Lead, which is particularly toxic to kids and the fetus. Unsafe lead levels can be found in the air, drinking water, food, and objects or surfaces painted with lead-based paint. High lead levels in water linked to lower performance on IQ and achievement tests. Air pollution. o Medical factors: several medication conditions, such as premature birth and pediatric AIDS, can cause LDs. Many of these can also result in intellectual disabilities, depending on the severity of the condition.

Identification of Learning Disabilities

o Identification procedures for learning disabilities are currently in a state of transition. With the fed government's 2004 reauthorization of IDEA, the way in which students may be found eligible for SPED services because of having learning disabilities has changed dramatically. Discuss achievement-ability discrepancy, which was the traditional approach to identifying LDs. Then discuss RTI, which is the federally preferred way of identifying LDs contained in the reauthorization. o Achievement-Ability Discrepancy: to be identified as having a learning disability, the student needed to exhibit a "severe discrepancy between achievement and intellectual ability." In other words, a child who was achieving well below his potential would be identified as having a learning disability. o The federal government left it up to individual states to decide precisely how they determined whether a student had a severe discrepancy. Most states relied on an IQ- achievement discrepancy, which is a comparison between scores on standardized intelligence and achievement tests. Many states adopted different statistical formulas for identifying IQ-achievement discrepancies. However, some of the formulas are statistically flawed and lead to inaccurate judgments, and those that are statistically adequate are difficult and expensive to implement. Furthermore, they give a false sense of precision. That is, they tempt school personnel to reduce to a single score the complex and important decision of identifying a learning disability. o In addition to the problem of using formulas, some authorities have objected to using an IQ-achievement discrepancy on other conceptual grounds. For example, some authorities have pointed out that IQ scores of students with learning disabilities are subject to underestimation because performance on IQ tests is partially dependent on reading ability. Also, some educators have pointed out that the idea of discrepancy is practically useless in the earliest elementary grades. In the 1st or 2nd grade, a kid isn't expected to have achieved very much in reading or math, so it's difficult to find a discrepancy. Because of this delay in identification, the IQ-achievement discrepancy approach has been called a "wait-to-fail" model. Response to Intervention (RTI) or Response to Treatment: On the basis of the criticisms of IQ-achievement discrepancy, researchers proposed an alternative means of identifying students as having LDs: a response to intervention (RTI) or response-to-treatment approach. 3 tiers of progressively more intensive instruction with monitoring of progress in each tier: Tier 1 involves evidence-based instruction in gen ed classroom, students who don't respond move to Tier 2 where they receive small-group instruction, and Tier 3 is evaluation for SPED. Some cautions about RTI: little research on effectiveness of RTI in identifying students with LDs, especially when implemented on large scale; most of what we do know about RTI is focused on reading; many gen ed teachers fail to use evidence-based instruction in Tier 1; variability occurs in Tier 2 with type of instruction, duration of instruction, and who instructor is; some students don't experience difficulties in reading until 3rd, 4th, 5th grade, when skills needed become more complex—students go undiagnosed because most RTI models are only implemented in the early elementary grades; some students referred to Tier 2 return to Tier 1 but then experience reading problems again and cycle back and forth between these tiers when they really need Tier 3. Despite these cautions, most school administrators see RTI as promising a more reliable way of identifying students with LDs. Virtually all states have implemented or are developing RTI models for use by local school divisions. Some of the cautions may be ameliorated because the fed government has made funding of research on RTI a high priority.

Transition to Adulthood for People with Intellectual Disabilities

o In secondary school, the vast majority of students with intellectual disabilities take at least 1 vocational course and a life skills/social skills course. When they take gen ed courses, the majority receive a modified gen ed curriculum. Although most authorities agree degree of emphasis on transition programming should be greater for older students, they also believe programming should begin in elementary school. 3 major areas to consider in planning for adulthood: life skills, employment skills, and self-determination skills. § Life Skills: skills adults need to live a fulfilling life by taking care of themselves and functioning in society. Divided into 2 categories: domestic skills and community skills. · Domestic Skills: learning to wash dishes, cook, do laundry, and manage a budget. How well the person can accomplish these tasks determines how independently they'll be able to live. · Community Skills: using transportation, procuring health care, banking, going to restaurants, grocery shopping. Determine how much a person can integrate into society. SPED teachers can do much to help prepare their students for community living—encourage them to volunteer for community service activities, hold discussions of what goals are for living arrangements, how to select a roommate, and what skills they can perform now at home to help prepare them for living more independently. Students can also be encouraged to engage in the school community, like becoming involved in attending school events and joining extracurricular clubs. § Employment: adults with intellectual disabilities have high rates of unemployment. With training, they can hold down job successfully, based on measures of attendance, employer satisfaction, and length of employment. Schools prepare for employment by providing opportunities to gain work experience—placed in work settings or introduce work experiences in school setting and gradually move to real work settings. · Sheltered workshop: structured environment in which a person receives training and works with other workers with disabilities on jobs requiring relatively low skills. Can be a permanent or transitional placement. Most common work settings, but criticisms: workers make low wages because they rarely turn a profit, no integration of workers who have disabilities with those who don't, and offer only limited job-training experiences. · Supported competitive employment: person with intellectual disabilities has competitive employment position but receives ongoing assistance, often from a job coach. In addition to on-the-job training, job coach might provide assistance in finding an appropriate job, interacting with employers and employees, using transportation, and involvement with other agencies. Research now indicates that when well-implemented, it leads to better employment outcomes. However, cautions: not being implemented widely enough to meet the demand and many people will need supported employment for a long time or even permanently. More along with self-determination. Clients shouldn't become too dependent on their job coach, so now advocate that job coach involve co-workers of persons with disabilities as trainers/mentors. · Customized employment: similar to supported employment but more emphasis on individualizing and negotiating a job match. 4 steps: (1) determining the interests and skills of the person with intellectual disabilities, (2) using that information to search for an appropriate job, (3) negotiating with the employer about how the person's skills are a match for what the employer needs, and (4) once hired, following up to ensure the individual has proper support and accommodations. · Self-employment: have their own businesses (housekeeping, pet-sitting, etc.). § Self-determination: ability to act autonomously, be self-regulated (evaluating and revising your own behavior), act in a psychologically empowered manner (believing that you have control over events to the extent that you'll be able to influence desired outcomes), and act in a self-realized manner (knowing and accepting your own strengths and weaknesses and using that knowledge to attain goals). Given their history of learning deficits and vulnerability for learned helplessness, people with intellectual disabilities often find self-determination difficult. Self-determination may be defined differently depending on the particular culture of the person. Contentious issue related to self-determination regards rights of persons with disabilities to have kids and to be provided public social services to aid them in their parenting. Person-centered planning: consumer-driven model that encourages individuals to make their own decisions with respect to services while pros mobilize resources and supports to help the individuals meet their goals.

People with Intellectual Disabilities Can Improve

o Intellectual disabilities can be improved and that very few, especially those with mild intellectual disabilities, can eventually improve to the point at which they're no longer classified as having an intellectual disability. § AAIDD holds that how well a person functions is directly related to the amount of support he receives from the environment. Supports: strategies and resources that a person requires to participate in activities associated with normative human functioning. Supports can come in a variety of forms: technological support, social support, and organizational support.

Identification of Intellectual Disabilities

o Intelligence Tests: many types of IQ tests available. School psychologists use individually administered tests rather than group tests when identifying students for SPED. 1 of most commonly used IQ tests for kids is the WISC-V, which consists of a Full-Scale IQ, as well as 4 composite scores: verbal comprehension, perceptual reasoning, working memory, and processing speed. Dividing mental age by chronological age and multiplying by 100 provides a rough approximation of a person's IQ score. IQ tests are among the most valid—the instrument measures what it's supposed to measure. A good indicator of the validity of an IQ tests is the fact that it's generally considered the best single index of how well a student will do in school. However, still need to be cautious for 4 main reasons: 1) individual's IQ score can change from 1 testing to another and sometimes change can be dramatic; 2) all IQ tests are culturally biased to a certain extent; 3) the younger the kid, the less validity the test has; 4) IQ tests aren't the absolute determinant when it comes to assessing a person's ability to function in society. o Adaptive Behavior: basic format of instruments used to measure adaptive behavior requires that a parent, teacher, or other pro answer questions related to the person's ability to perform adaptive skills.

Psychological and Behavioral Characteristics of Learning Disabilities

o Interindividual Variation: In any group of students with learning disabilities, some will have problems in reading, some will have problems in math, some will have problems in spelling, some will be inattentive, and so on. One term for such interindividual variation is heterogeneity. Although heterogeneity is a trademark of children from all the categories of special education, the old adage "No two are exactly alike" is particularly appropriate for students with learning disabilities. This heterogeneity makes it a challenge for teachers to plan educational programs for the diverse group of children they find in their classrooms. o Intraindividual Variation: kids with LDs also exhibit variability within their own profiles or abilities. For example, a kid might be 2 or 3 years above grade level in reading but 2 or 3 years behind grade level in math. Such uneven profiles account for references to specific LDs in the literature on LDs. o Academic Achievement Problems—Reading: Reading poses the greatest difficulty for most students with LDs. Most experience problems in several areas of reading: phonological awareness (phonemic awareness), decoding, fluency, vocabulary, and reading comprehension. Most have difficult at the early stages of reading (phonemic awareness and decoding), which affects their ability to read with fluency and comprehension. Phonological awareness is an understanding that the speech flow can be broken down into smaller units of sound such as words, syllables, onsets-rimes, and phonemes. Phonemic awareness is an understanding that specific words can be broken down into individual sounds. For example, the word sat has three phonemes or sounds: /s/ /˘a/ /t/. Phonemic awareness is of critical importance; research substantiates a causal relationship between a lack of phonemic awareness skills and the inability to decode. Decoding is the ability to convert the printed words to spoken words and is highly dependent on phonemic awareness. First the student must be able to break a word into its individual sounds and then blend them together to say the whole word (i.e., phonological recoding). Students who are able to decode automatically will typically develop reading fluency. Students who have difficulty decoding invariably have problems with fluency. Reading fluency refers to the ability to read effortlessly and smoothly. Reading fluency comprises three skills--reading words: accurately, at an appropriate pace, and with prosody. Prosody entails making your oral reading sound like spoken language, using appropriate intonation and expression. Problems with reading fluency are a major reason why students have difficulties with reading comprehension, the ability to gain meaning from print. With intensive, explicit, and systematic instruction in a comprehensive reading program that includes attention to the above interplay of skills, most students with LDs will learn how to read. For more info on reading strategies for students with LDs, visit the Reading Rockets website and websites of major pro organizations (DLD, CLD, etc.). o Academic Achievement Problems—Written Language: People with LDs often have problems in handwriting, spelling, and composition. A specific LD in writing is dysgraphia. These kids are often slow writers, and their written products can be illegible. Spelling can be a big prob because of the difficulty in understanding the correspondence between sounds and letters. Students with LDs frequently have difficulties in the more creative aspects of composition. Students with LDs use less complex sentence structures, fewer types of words, write paragraphs that are less well organized, include fewer ideas in their written products, and write stories that have fewer important components. o Academic Achievement Problems—Spoken Language: many students with LDs have problems with the mechanical and social uses of lang. They have trouble with syntax (grammar), semantics (word meanings), and phonology (the ability to break words into their component sounds and blend individual sounds together to make words). The social uses of lang are commonly referred to as pragmatics. Students with LDs are often unskilled conversationalists—long silences, not skilled at responding to others' statements or questions and tend to answer their own questions before their companions can respond, and tend to express task-irrelevant comments and make those with whom they talk uncomfortable. o Academic Achievement Problems—Math: Specific LD in math is called dyscalculia. Authorities now recognize that math disabilities may be just as prevalent or at least a close 2nd to reading disabilities. Difficulties with computation of math facts and word problems. Trouble with word problems is often due to the inefficient application of problem-solving strategies. Researchers have found that processing deficits in working memory and retrieval from long-term memory are implicated in mathematics disability. o Perceptual, Perceptual-Motor, and General Coordination Problems: some kids with LDs exhibit visual and/or auditory perceptual disabilities. A kid with visual perceptual problems might have trouble solving puzzles or seeing and remembering shapes. A kid with auditory perceptual problems might have difficulty discriminating between 2 words that sound nearly alike or following orally presented instructions. Some students with LDs have difficulty with physical activities involving motor skills—may involve fine motor (small motor muscle) and gross motor (large motor muscle) skills. Fine motor skills often involve coordination of the visual and motor systems. o Disorders of Attention and Hyperactivity: students with attention problems display characteristics such as distractibility, impulsivity, and hyperactivity. Unable to stick with 1 task for very long, failing to listen to others, talking nonstop, blurting out the first things on their minds, and being generally disorganized. These problems are often severe enough to be diagnosed as attention deficit hyperactivity disorder (ADHD). Around half of students with ADHD also have an LD. o Memory Problems: Students with LDs have at least 2 types of memory problems: working memory (WM) and retrieval of info from long-term memory (RLTM). Working memory (WM): ability to hold info in memory for a short period of time in order to use it to solve a prob. Students also have difficultly accurately and automatically retrieving info from long-term memory. Deficits in long-term memory retrieval are further affected by students' anxiety related to the task in the area of their disability. 1 of the major reasons kids with LDs perform poorly on memory tasks is that they don't use strategies. However, they can be taught memory strategies, like rehearsal, which can enhance their academic performance. o Executive Function Problems: Executive functioning (EF): covers cognitive processes that are necessary to control and regulate one's behavior—self-regulation. There are behavioral tests and questionnaires that measure EF. An example of a behavioral measure is the Tower of London Test (TLT). o Metacognition Problems: Metacognition: student's ability to think about their own thinking and is critical to learning, memory, and academic achievement. Important role of metacognition in learning is the ability to determine when you understand what's being taught and when you're struggling. Lack of metacognitive skills affects students with LDs in 3 ways: 1) ability to recognize task requirements (have problems judging how difficult tasks can be), 2) ability to select and implement appropriate strategies, 3) ability to monitor and adjust performance (example= comprehension monitoring: abilities used while 1 reads and attempts to comprehend textual material). o Social-Emotional Problems: kids with LDs do run greater risk than do their peers without disabilities of having depression, social rejection, suicidal thoughts, and loneliness. Plausible reason for this because these students have deficits in social cognition and misread social cues and misinterpret feelings and emotions of others. Also have difficulty taking perspective of others. Problems with social interaction tend to be more evident in kids who also have problems in math, visual-spatial tasks, tactual tasks, and self-regulation and organization. Individuals who exhibit this constellation of behaviors are referred to as having nonverbal learning disabilities. However, this term is a misnomer because these people often exhibit subtle problems in using lang, especially in social situations. Nonverbal learning disabilities may be caused by malfunctioning of the right half of the brain because of known linkages of math, visual-spatial, and tactual skills to the right cerebral hemisphere. Individuals with nonverbal learning disabilities are at risk for depression and suicide. o Motivational Problems: People with LDs tend to have an external rather than internal locus of control—they believe their lives are controlled by external factors such as luck or fate rather than internal factors such as determination or ability. People with this outlook sometimes display learned helplessness, a tendency to give up and expect the worst because they think that no matter how hard they try, they'll fail. These motivational problems are difficult because of the interrelationship between learning and motivational problems. o Inactive Learner with Strategy Deficits: student with LDs is an inactive learner, lacking in strategies for attacking academic problems. They don't believe in their own abilities (learned helplessness), have inadequate grasp og what strategies are available for prob solving (poor metacognition skills), and have problems producing appropriate learning strategies spontaneously. Can have difficulties working independently. Homework is a big prob for many students with disabilities, especially for those with LDs.

Definition of Intellectual Disability

o Issue of defining intellectual disabilities or mental retardation has been contentious. o Cautious attitude surrounding defining intellectual disabilities for 4 main reasons: § IQ tests are imperfect. Although they're the best measure we have of general intelligence and they're routinely used in the process of identifying people who have intellectual disabilities, factors (examiner bias, lack of expertise, lack of motivation of tester, etc.) can lead to their reduced reliability. § Pros became concerned about the number of kids from ethnic minority (African American and Native American students in public schools) groups who were being diagnosed as having intellectual disabilities. § Some believe that the diagnosis of intellectual disability results in a stigma that causes kids to have poor self-concepts and to be viewed negatively by others. § Some pros believe that to a certain extent, intellectual disability is a socially constructed condition. For example, AAIDD conceives of intellectual disability not as a trait residing in the individual, but as the product of the interaction between a person and her environment. o Note: some of these points haven't gone uncontested. Some argue that the AAIDD has gone too far in denying the existence of intellectual disability as an essential feature within a person and they acknowledge that all disabilities are socially constructed to a degree. Researchers have also pushed back on the idea that ethnic minority students are overrepresented in SPED—some claim minority students are underrepresented in SPED because schools may be overreacting to criticisms of racial discrimination and are leaning toward non-identification.

Prevalence of Learning Disabilities

o Just under 5% of kids between 6-17 have been identified by public school as having LDs. LD is the largest category of SPED. About ½ of all students identified by the public schools as needing SPED have LDs. o Increase and Decrease in Prevalence: 1976-2000, size of LD category more than doubled. Authorities maintain that rapid expansion reflects poor diagnostic practices. They believe kids are being overidentified, that teachers are too quick to label students has having an LD rather than entertain possibility that their own teaching practices might be at fault. Others, however, argue that some of the increase might be due to social and cultural changes, such as high poverty and stress, that have raised kid's vulnerability to develop learning disabilities. Evidence suggests that when faced with student who could qualify as having an intellectual disability, school personnel often bend the rules to apply the label of LD rather than the more stigmatizing label of intellectual disability. After peaking in late 1990s, the rate has been gradually but steadily decreasing, which may be due to effort to be more conservative in identifying LDs. How much this decrease might be due to the emergence of RTI as a replacement of IQ-achievement discrepancy as an identification tool is not yet known. o Gender Differences: boys outnumber girls by bout 3:1 in the LD category. May be because of their greater biological vulnerability and the fact that boys are more likely to be referred for SPED when they have academic problems because of other behaviors that bother teachers, like hyperactivity. Research on this issue is mixed.

Causes of ADHD

o Lots of controversy over what actually causes ADHD (too much tv and video games and sugar and food additives and artificial flavoring, coloring, and additives) but we now know that strong evidence links neurological abnormalities to ADHD. Using neuroimaging techs, researchers have made great strides in documenting the neurological basis of ADHD. As is the case with learning disabilities, research shows that ADHD most likely results from neurological dysfunction rather than from actual brain damage and heredity also plays a strong role in causing the neurological dysfunction, with teratogenic and other medical factors implicated to a lesser degree. o Areas of the Brain Affected: Frontal Lobes, Basal Ganglia, Cerebellum: Using neuroimaging techniques, researchers have found relatively consistent abnormalities in the frontal lobes, basal ganglia, and cerebellum of people with ADHD. Located in the front of the brain, the frontal lobes, and especially the very front portion of the frontal lobes, the prefrontal lobes, are responsible for executive functions (ability to regulate one's own behavior, etc.). Deep within the brain, the basal ganglia are responsible for the coordination and control of motor behavior. The cerebellum is also responsible for the coordination and control of motor behavior. Although it's pretty small, constituting only about 10% of brain mass, the fact that it contains more than ½ of all the brain's neurons attests to its complexity. o Neurotransmitters Involved: Dopamine and Noradrenaline: Neurotransmitters: chemicals that help in sending of messages between neurons in the brain. Researchers have found that abnormal level of the neurotransmitters dopamine and noradrenaline are involved in ADHD. o Hereditary Factors: No single ADHD-gene exists, rather multiple genes are involved and many of these genes are linked to how neurotransmitters move from neuron to neuron. § Family Studies: studies indicate that if kid has ADHD, the chance of their sibling or parent having ADHD is 4-8 times more likely than is the case for non-ADHD kids and their immediate relatives. Parents of kids with ADHD have 2.85x the odds of parents of kids without ADHD of having a mental disorder, such as anxiety disorder. § Twin Studies: studies show that identical twins are almost 2x more likely to both have ADHD than are fraternal twins. § Molecular Genetic Studies: Molecular genetics: study of the molecules (DNA, RNA, and protein) that regulate genetic info. Molecular genetic research on ADHD is in its infancy, but research is consistent with idea that several genes contribute to ADHD. o Toxins and Medical Factors: Evidence for these causes not as strong as heredity. Research indicates some kids with ADHD have higher levels of lead in their blood. Complications at birth and low birthweight are associated with ADHD. Smoking by moms-to-be puts their kids who're already genetically predisposed at an even greater risk of being diagnosed with ADHD.

Terminology Regarding EBD

o Many diff terms used to designate kids who have extreme social interpersonal and/or intrapersonal problems: seriously emotionally disturbed (SED), emotionally handicapped, emotionally impaired, behaviorally impaired, socially/emotionally handicapped, emotionally conflicted, seriously behaviorally disabled, and emotionally and behaviorally disordered (EBD, the term now most often used). o Seriously emotionally disturbed (SED) was used in fed SPED laws and regulations. Seriously was dropped in 1997. Emotionally disturbed (ED) is still the term used in IDEA. The term behaviorally disordered is consistent with the name of the Council for Children with Behavioral Disorders (CCBD, a division of the Council for Exceptional Children) and has the advantage of focusing on the clearly observable aspect of these kid's problems—disordered behavior. Many authorities favor terms indicating that these kids may have emotional or behavioral problems or both. In 1990, the National Mental Health and SPED Coalition, representing over 30 pro and advocacy groups, proposed the term emotional or behavioral disorder to replace emotional disturbance in fed laws and regulations. Unfortunately, the proposed terminology and definition haven't yet been adopted by the fed government or most states. o Another term you may encounter is prosocial. Prosocial behavior is the opposite of antisocial behavior. It refers to desirable ways of behaving.

Introduction to EBD

o Most kids and youths with EBD aren't good at making friends. They fail to establish close and satisfying emotional ties with others who can help them. The friends they do have are often deviant peers. Some students with EBD are withdrawn. Others may try to reach them, but these efforts are often met with fear and disinterest. Many students with EBD are isolated from others because they strike out with hostility and aggression. They're abusive, destructive, unpredictable, irresponsible, bossy, quarrelsome, irritable, jealous, defiant. Teachers and well-behaved peers tend to withdraw from or avoid them, which reduces their opportunities to learn academic and social skills. o A common misunderstanding is that kids with EBD aren't really disturbed; rather, they're just a pain in the neck, but students can be both disturbed and disturbing, have an emotional or behavioral disorder and irritate the teacher. Students who're consistently irritating are at high risk of acquiring EBD, if they don't already have 1, or of encouraging such disorders in others. o Another misunderstanding is that kids and youths with EBD exhibit their problematic behavior all the time, but EBD tend to be episodic, highly variable, and sometimes situation-specific. People also don't understand that a very good parent can have a very problematic child. o The problem arises because the social interactions and transactions between the child and the social environment are inappropriate—both the behavior and responses to it are problematic. This is an ecological perspective—an interpretation of the problem as a negative aspect of the child and the environment in which the child lives. And there are two equally serious mistakes people can make: First, assuming the problem is only in the child who exhibits inappropriate behavior; and second, assuming the child's behavior is not the problem, only the context in which it occurs. Sometimes the problem may begin with misbehavior, and sometimes it may begin with mismanagement. However, by the time special educators are involved, the problem usually involves both misbehavior and mismanagement.

Definition of ADHD

o Most pros rely on the American Psychiatric Association's (APA) criteria to determine if someone has ADHD. Recognizes 3 subtypes of ADHD: 1) ADHD, Predominantly Inattentive Type; 2) ADHD, Predominantly Hyperactive-Impulsive Type; and 3) ADHD, Combined Type. Criteria used to determine these subtypes include: 1) for inattention: trouble paying attention to details, difficulty sustaining attention, problems with organization, distractible; 2) for hyperactivity: fidgeting, leaving seat at inappropriate times, talking excessively; 3) for impulsivity: problems awaiting one's turn, interrupting others. o Between 7-9% of the school-age pop has ADHD. But because the US Department of Education doesn't recognize ADHD as a separate category of SPED, it's difficult to estimate how many students with ADHD are served in SPED. When the fed government began tracking the prevalence of students in all major SPED categories in the 1970s, ADHD wasn't included because the research was still in its infancy and the advocacy base for kids with ADHD wasn't yet well developed. In 1991, the US DoE determined students with ADHD would be eligible for SPED under the category of "other health impaired" (OHI) "in instances where the ADD is a chronic or acute health prob that results in limited alertness, which adversely affects educational performance." Students with ADHD can also qualify for accommodations under Section 504 of the Rehabilitation Act of 1973. o Growth of the OHI category since 1991 suggests that more and more students with ADHD are being identified as OHI. However, many authorities think that fewer than ½ of the students with ADHD who need SPED services are receiving them. o ADHD occurs more frequently in boys than in girls, 2:1. Some speculated that boys are identified more because they tend to exhibit the highly noticeable hyperactive or impulsive type of ADHD, whereas girls are more likely to exhibit the inattentive type. Some gender bias in referral may exist, but it's more about biological differences. o Some critics have asserted that ADHD is a US phenomenon, but statistics don't correlate with this. Prevalence rates at least as high as those in the US are found in several other countries and research on the behavioral characteristics of people with ADHD in different countries indicates that they share the same core systems, which argues against ADHD being determined by cultural factors. o Some critics have claimed that African American kids, especially boys, are diagnosed disproportionately as having ADHD, but research suggests that their rates are similar to those of white kids. The only ethnic diff is rates is that of Hispanic/Latino kids are diagnosed with ADHD less frequently than other ethnicities.

Identification of EBD

o Most students with EBD don't escape the notice of their teachers. Occasionally, such students don't bother anyone and are invisible, but it's usually easy for experienced teachers to tell when students need help. Often, teachers fail to assess the strengths of students with EBD. However, it's important to include assessment of students' emotional and behavioral competencies, not just their weaknesses/deficits. o The most common type of EBD is conduct disorder, an externalizing prob that attracts immediate attention, so identification is seldom a real prob. Students with internalizing problems might be less obvious but are still easy to recognize. Students with EBD are so readily identified with school personnel that relatively few schools bother to use systematic screening procedures. Also, the availability of special services for those with EBD lags far behind the need, and there isn't much point in screening for problems when no services are available to treat them. o Kids with schizophrenia are seldom mistaken for those who're developing normally. Kids with schizophrenia are a small percentage of those with EBD, and problems in their identification aren't usually encountered. However, they might 1st be identified as having another disorder, such as ADHD or depression, and later be diagnosed with schizophrenia. o The younger the kid, the more difficult it is to judge whether the behavior signifies a serious problem. Some kid's EBD goes undetected because teachers aren't sensitive to the kid's problems or because these kids don't stand out sharply from other kids in the environment who might have even more problems. Cultural bias can work either way, leading educators to wrongly identify some kids or fail to identify others. Some students with EBD don't exhibit problems at school. o Formal screening and accurate early identification for the purpose of planning educational intervention are complicated by the problems of definition. Generally, however, teachers' informal judgments have served as a reasonably valid and reliable means of screening students for emotional or behavioral problems. When more formal procedures are used, teachers' ratings of behavior have turned out to be accurate.

Correcting Misconceptions about Learners with Attention Deficit Hyperactivity Disorder

o Myth: All kids with ADHD are hyperactive. Fact: Psychiatric classification of ADHD attempts to account for the fact that some people display only inattention, or only hyperactivity/impulsivity, or both. o Myth: The primary symptom of ADHD is inattention. Fact: Recent conceptualizations of ADHD place problems with executive functioning and behavioral inhibition as the primary behavioral problems of ADHD. o Myth: ADHD is a fad, a trendy diagnosis of recent times in the US with little research to support its existence. Fact: Literature indicates that physicians recognized the existence of attention problems and hyperactivity in the 18th, mid-19th, and early 20th centuries. Serious scientific study of attention problems began in the early and mid-20th century. A firmly established research base now supports its existence, and the prevalence of ADHD in several other countries is as high as it is in the US. o Myth: ADHD is primarily the result of minimal brain injury. Fact: In most cases of ADHD, no evidence of actual damage to the brain exists. Most authorities believe that ADHD is the result of neurological dysfunction, which is often linked to hereditary factors. o Myth: African American kids are more frequently identified as having ADHD than white kids. Fact: National surveys indicate that the rate of identification of African American kids and white kids is the same. However, Latino/Hispanic kids are less likely to be identified as having ADHD. o Myth: The social problems of students with ADHD are due to their not knowing how to interact socially. Fact: Most people with ADHD know how to interact, but their problems with behavioral inhibition make it difficult for them to implement socially appropriate behaviors. o Myth: Using psychostimulants, such as Ritalin, can easily turn kids into abusers of other substances, like cocaine and marijuana. Fact: No evidence shows that using psychostimulants for ADHD leads directly to drug abuse. In fact, evidence shows that those who're prescribed Ritalin as kids are less likely to turn to illicit drugs as teenagers. However, care should be taken to make sure that kids or others don't misuse the psychostimulants prescribed for them. o Myth: Because students with ADHD react strongly to stimulation, their learning environments should be highly unstructured in order to take advantage of their natural learning styles. Fact: Most authorities recommend a highly structured classroom for students with ADHD, especially in the early stages of instruction.

Correcting Misconceptions about Learners with Learning Disabilities

o Myth: IQ-achievement discrepancy is a straightforward, error-free way of determining whether a student has a learning disability. Fact: Numerous conceptual problems arise when using an IQ-achievement discrepancy. o Myth: Response to intervention (RTI) has been documented to be an error-free way of determining whether a student has a learning disability. Fact: Little research exists on RTI, especially when implemented on a large scale; therefore, many questions remain regarding how best to implement it. o Myth: All students with learning disabilities are brain damaged. Fact: Many authorities now refer to students with learning disabilities as having central nervous system (CNS) dysfunction, which suggests a malfunctioning of the brain rather than actual tissue damage. o Myth: The fact that so many definitions of learning disabilities have been proposed is an indicator that the field is in chaos. Fact: Although at least 11 definitions have been proposed, pros have settled on 2: the fed definition and the def from the National Joint Committee on Learning Disabilities. These 2 definitions differ, but that also have similarities. o Myth: The rapid increase in the prevalence of learning disabilities is due solely to sloppy diagnostic practices. Fact: Although poor diagnostic practices may account for some of the increase, there are plausible social/cultural reasons as well. Evidence also indicates that school personnel may bend the rules to identify students as having learning disabilities instead of the more stigmatizing identification of having intellectual disabilities. o Myth: We know little about what causes learning disabilities. Fact: Though no simple clinical test exists for determining the cause of learning disabilities in individual cases, current research strongly suggests causes related to neurological dysfunction resulting from genetic factors, toxins, or medical factors. o Myth: Math disabilities are relatively rare. Fact: Math disabilities may be just as prevalent as reading disabilities. o Myth: We needn't be concerned about the social-emotional well-being of students with learning disabilities because their problems are in academics. Fact: Many students with learning disabilities also develop problems in the social-emotional area. o Myth: Most kids with learning disabilities outgrow them as adults. Fact: Learning disabilities tend to endure into adulthood. Most individuals with learning disabilities who're successful must learn to cope with their problems and make extraordinary efforts to gain control of their lives. o Myth: For persons with learning disabilities, IQ and achievement are the best predictors of success on adulthood. Fact: The best predictors of success for adults with learning disabilities are perseverance, goal setting, realistic acceptance of weaknesses and ability to build on strengths, exposure to intensive and long-term educational intervention, and especially the ability to take control of their lives.

Correcting Misconceptions about Learners with Emotional or Behavioral Disorders

o Myth: Most kids and youths with emotional or behavioral disorders go unnoticed. Fact: Although it's difficult to identify the types and causes of problems, most kids and youths with emotional or behavioral disorders, whether aggressive or withdrawn, are quite easy to spot. o Myth: Students with emotional or behavioral disorders are usually very bright. Fact: Some, but relatively few students with emotional or behavioral disorders, test high in intelligence; in fact, most have below-average IQs. o Myth: Most students who're seen by their teachers as a "pain in the neck" aren't disturbed; they're disturbing to others, but they aren't disturbed. Fact: Most students who're disturbing to others are also disturbed. 1 of the signs of emotional health and good adjustment is behaving in ways that don't cause others concern, being neither unusually aggressive and disruptive nor overly reticent and socially withdrawn. o Myth: Students with emotional or behavioral disorders exhibit problematic behavior constantly. Fact: Most students with emotional or behavioral disorders exhibit typical behavior most of the time. Their emotional or behavioral disorders are episodic. o Myth: Most students with emotional or behavioral disorders receive SPED and/or mental health services. Fact: The majority of students with emotional or behavioral disorders aren't identified and served in a timely fashion by either mental health services or SPED. Only a small percentage (like 20%) are served by SPED or mental health services. o Myth: Most students with emotional or behavioral disorders need a permissive environment in which they feel accepted and can accept themselves for who they are. Fact: Research shows that a firmly structured and highly predictable environment is of greatest benefit to most students. o Myth: Juvenile delinquency and the aggressive behavior known as conduct disorder can be effectively deterred by harsh punishment of kids and youths know that their misbehavior will be punished. Fact: Harsh punishment, including imprisonment, not only doesn't deter misbehavior, but also creates conditions under which many individuals become even more likely to exhibit unacceptable conduct.

Correcting Misconceptions about Learners with Intellectual and Developmental Disabilities

o Myth: Pros agree about definition of intellectual disabilities. Fact: Considerable disagreement exists among pros about definition, classification, and terminology. o Myth: Once diagnosed as having intellectual disabilities, a person retains this classification for life. Fact: A person's level of intellectual functional doesn't necessarily remain stable; this is particularly true for those who have mild intellectual disabilities. With intensive educational programming, some can improve to the point that they're no longer classified as having intellectual disabilities. o Myth: Intellectual disability is defined by how a person scores on an IQ test. Fact: The most commonly used definition specifies that an individual must meet 2 criteria to be considered as having intellectual disabilities: low intellectual functioning and low adaptive skills. o Myth: In most cases, it's easy to identify the cause of intellectual disability. Fact: Although the mapping of the human genome has increased our knowledge about causes of intellectual disabilities, it's still difficult to pinpoint the cause of intellectual disabilities in many people, especially those with mild intellectual disabilities. o Myth: Psychosocial factors are the cause of the vast majority of cases of mild intellectual disabilities. Fact: Exact percentages aren't available, but researchers are finding more genetic syndromes that result in mild intellectual disabilities; hereditary factors are also involved in some cases. o Myth: The teaching of vocational skills to students with intellectual disabilities is best reserved for secondary schools and beyond. Fact: Many pros now believe it's appropriate to introduce vocational content in elementary school to students with intellectual disabilities. o Myth: People with intellectual disabilities shouldn't be expected to work in the competitive job market. Fact: More people who have intellectual disabilities hold jobs in competitive employment. Many are helped through supportive employment situations, in which a job coach helps them and their employer adapt to the workplace.

Medical Considerations about ADHD

o One of most controversial topics in SPED is the treatment of ADHD with medication. Psychostimulants, which stimulate/activate neurological functioning, are the most frequent type of medication prescribed for ADHD. However, promising research is emerging on a number of nonstimulants, like Strattera. The most common stimulant prescribed for ADHD is Ritalin and Adderall and Vyvanse are also sometimes prescribed. Pros referred to the paradoxical effect of Ritalin because its effects appeared to be the opposite of those 1 would expect in the case of someone who doesn't have ADHD. Researchers have concluded, however, that Ritalin influences the release of the neurotransmitters dopamine and norepinephrine, enabling the brain's executive functions to operate more normally. Responsiveness to stimulants is very individual, so dosage level and number of doses/day vary from person to person. Ise of stimulants for ADHD has increased steadily but African American kids or kids from low socioeconomic status (SES) homes are less likely to be treated with stimulants—maybe due to comb of lack of access to medical/psychological services, cultural aversion to using meds for behavioral problems, and distrust of the medical system by people from low SES backgrounds. § Opposition to Ritalin: not all pros, parents, and laypeople are in favor of using psychostimulants for ADHD. Ritalin has been assaulted by the media. § Effectiveness: Despite negative publicity, most ADHD authorities are in favor of Ritalin's use. Research is overwhelmingly positive on the effectiveness of Ritalin in helping students to have more normalized behavioral inhibition and executive functioning. Ritalin leads to better results on parent and teacher rating scales and leads to higher academic achievement as well as improved classroom behavior. § Non-responders and Side Effects: around 30% of those who take Ritalin don't have a favorable response. Side effects possible: insomnia, reduction in appetite, abdominal pain, headaches, and irritability. Speculation that in small number of cases Ritalin causes tics or increases the intensity of tics. Anecdotal reports of a "rebound effect," in which a kid exhibits irritability as Ritalin wears off. In most cases, side effects are mild and can be controlled. § Drug Abuse: Common misconception is that kids taking Ritalin are more likely to become drug abusers but there's no evidence to suggest this. In fact, evidence shows that people with ADHD who take Ritalin as kids are less likely to turn to illegal drugs, perhaps because those who aren't medicated search out drugs to help them. § Cautions Regarding Medications: Medication should not be prescribed at the first sign of a behavior problem. Only after careful analysis of the student's behavior and environment should medication be considered. The use of psychostimulants for ADHD in the United States increased approximately eight-fold from the 1970s to the 1990s, and in the first 5 years of the 21st century, the rate approximately doubled. Although much of this increase in recent years can be attributed to an upsurge in prescriptions for females and adults coincident with the increase in diagnosis in these populations, it still should alert us to turning too quickly to medication as the answer to ADHD. • Although research has demonstrated the effectiveness of medication on behavioral inhibition and executive functions, the results for academic outcomes have not been as dramatic. Thus, teachers shouldn't assume that medication will take care of all the academic problems these students face. • Parents, teachers, and physicians should monitor dosage levels closely so that the dose used is effective but not too strong. Proper dosage levels vary considerably. • Teachers and parents shouldn't lead children to believe that the medication serves as a substitute for self-responsibility and self-initiative. • Teachers and parents shouldn't view the medication as a panacea; they, too, must take responsibility and initiative in working with the child. • Parents and teachers should keep in mind that psychostimulants are a controlled substance. There has been a dramatic increase in persons who do not have ADHD using stimulants as a way of gaining a "high," or for secondary and college students of improving academic performance, or for athletes of gaining physical performance. Interestingly, research results are mixed on whether stimulants actually improve performance in these domains. • Unfortunately, there has also been a dramatic increase in stimulant abuse. For example, between 2003 and 2013, national admissions to substance abuse treatment services for methylphenidate as a percentage of admissions for all illicit substances increased 25%. • The final key to the effective use of medication is communication among parents, physicians, teachers, and the child.

Transition to Adulthood for ADHD

o Previously, pros assumed ADHD diminished in adolescence and disappeared by adulthood. Now know that although symptoms, especially those related to hyperactivity, may decrease, ADHD persists into adulthood. 50% of those diagnosed with ADHD as kids still persist with major symptoms as adults and about 4-5% of adults have ADHD. Evidence suggests that working memory is still prob for adults with ADHD. Adults with ADHD are poor decision makers and are likely to exhibit mind-wandering. o Diagnosis in Adulthood: With greater recognition of ADHD by the scientific community as well as by the pop media, many are being diagnosed with ADHD in adulthood. Generally, more sever symptoms in childhood, the more likely that adults with ADHD will be high school dropouts and experience employment problems. Diagnosis of ADHD in adults can be controversial, but pros have made progress in identifying and treating ADHD in adults. Important that a thorough clinical exam be conducted for diagnosis as an adult. o Adult Outcomes: Adults with ADHD tend to have poorer outcomes with respect to educational attainment, psychiatric problems, marital difficulties, driving infractions, and addictive behaviors. Not all adults with ADHD experience unfavorable outcomes and actually leverage their ADHD symptoms to become successful. § College: students with ADHD tend to have more problems adjusting academically and socially. Time management is usually a big prob. Recommended technique for adults with ADHD is coaching, which involves identifying someone with whom the person with ADHD can rely on for support. The coach is someone who can regularly spend a few minutes to help keep person focused on goals. Coach provides structure and heaps on praise. § Employment: key to success is to select job/career that maximizes the person's strengths and minimizes weaknesses. § Marriage and Family: have all fam members become educated about facts associated with ADHD. Because ADHD is a fam issues, all members should be partners in its treatment.

Linking Genetic Syndromes to Particular Behavioral Phenotypes

o Researchers have begun to find general patterns of behavioral characteristics, or behavioral phenotypes, associated with some of the genetic phenotypes. o Researchers have identified Down syndrome, Williams syndrome, Fragile X syndrome, and Prader-Willi syndrome as having relatively distinctive behavioral phenotypes. For example, people with Down syndrome often have significant impairments in lang and grammar compared to visual-spatial skills; for individuals with Williams syndrome, the opposite is often true.

Psychological and Behavioral Characteristics of Intellectual Disabilites

o Some of the major areas in which people with intellectual disabilities are likely to experience deficits are attention, memory, lang, self-regulation, motivation, and social development. § Attention: often attend to the wrong things and difficulty allocating attention properly. § Memory: widespread memory difficulties but especially with working memory (WM), ability to keep info in mind while simultaneously doing other cognitive tasks. § Language: limitations in lang comprehension and production. Exact types of problems depend largely on cause of disabilities. § Self-regulation: ability to regulate one's own behavior. Also problems with metacognition: person's awareness of what strategies are needed to perform a task, the ability to plan how to use the strategies, and the evaluation of how well strategies work. Self-regulation is a component of metacognition. § Motivation: look for external rather than internal sources of motivation. § Social development: difficulty making friends due to inappropriate behavior and lack awareness of how to respond in social situations. Gullibility—cognitive limitation with inability to determine when something's deceptive claim and personality factor with overreliance on external motivational sources. Gullibility has figured into the wrongful conviction of numerous people with intellectual disabilities (case of Anthony Caravella). In 2002, the US Supreme Court in Atkins v. Virginia ruled against the use of the death penalty for persons who have intellectual disabilities.

Educational Considerations Regarding EBD

o Students with EBD typically have low grades and other unsatisfactory academic outcomes, have higher dropout rates and lower grad rates, and are often placed in highly restrictive settings. Important that their cultural identity not determine that they receive SPED services. o Special educators have never reached consensus about how to meet the challenge of educating students with EBD. A national agenda was written, but it was so vaguely worded that it has little value. o A combo of models now guides most ed programs. All credible conceptual models have 2 objectives: 1) controlling misbehavior and 2) teaching students the academic and social skills they need. Recognize need for integrating all educational, psychological, and social services these students require. More important than a particular conceptual model is the scientific approach, which demands adherence to an evidence base obtained by investigations following the scientific method. o Balancing Behavioral Control with Academic and Social Learning: Some suggest that quality of educational programs for students with EBD is often dismal and argue that the focus is often on external control of students' behavior, and say that academic instruction and social learning are too often secondary or almost entirely neglected. Behavioral control strategies are an essential part of educational programs for students with externalizing problems. Without effective means of controlling disruptive behavior, it's extremely unlikely that academic and social learning will occur. Excellent academic instruction will certainly reduce many behavior problems as well as teach important academic skills. Even the best instructional programs won't eliminate the disruptive behaviors of all students. Teachers of students with EBD must have effective control strategies, preferably involving students as much as possible in self-control. In addition, teachers must offer effective instruction in academic and social skills that'll allow their students to live, learn, and work with others. Teachers must also allow students to make all the choices they can—manageable choices that are appropriate for the individual student. o Importance of Integrated Services: In addition to problems as school, kids with EBD typically have fam problems and a variety of difficulties in the community (engaging in illegal activities, an absence of desirable relationships with peers and adults, substance abuse, difficulty finding and maintaining employment). Kids or youths with EBD might need, in addition to SPED, a variety of fam-oriented services, psychotherapy or counseling, community supervision, training related to employment, etc. o Strategies That Work: Balance concern for academic and social skills and provide integrated services. • Systematic, data-based interventions: Interventions are applied systematically and consistently and are based on reliable research. • Continuous assessment and progress monitoring: Teachers conduct direct, daily assessment of performance, with planning based on this monitoring. • Practice of new skills: Skills are not taught in isolation but are applied directly in everyday situations through modeling, rehearsal, and guided practice. • Treatment matched to problems: Interventions are designed to meet the needs of individual students and their particular life circumstances and are not general formulas that ignore the nature, complexity, cultural context, and severity of the problem. • Multicomponent treatment: Teachers and other professionals use as many different interventions as are necessary to meet the multiple needs of students (e.g., social skills training, academic remediation, medication, counseling or psychotherapy, and family treatment or parent training). • Programming for transfer and maintenance: Interventions promote transfer of learning to new situations; quick fixes nearly always fail to produce generalized change. • Sustained intervention: Many emotional or behavioral disorders are developmental disabilities and will not likely be cured but demand lifelong support. o Service Delivery: Only small percentage of kids and youths with EBD are officially identified and receive any SPED or mental health services. Consequently, those who do receive SPED tend to have very serious problems, though most have typically been assumed to have only mild disabilities. Perhaps students identified as having EBD tend to be placed in more restrictive settings than students in other high-incidence categories because their disabilities are more severe. Problems of students with EBD are often more serious than people have assumes. Severe applies to schizophrenia as well as to depression and conduct disorder—they can be disabling, serious, and persistent. § Trends Toward Inclusion: Trend in programs for students with EBD is toward integration into regular schools and classrooms whenever possible. Even when students are placed in separate schools and classes, educators hope for reintegration into the mainstream. Some educators, researchers, and parents argue that students with EBD who are at high risk for ongoing problems need the structure and support of a special class—being in a separate class can be better than being included in gen ed. § Different Needs Require Different Placements § Instructional Considerations: For students with EBD to learn from peer models of appropriate behavior, most will require explicit, focused instruction about whom and what to imitate. They might need explicit and intensive instruction in social skills, including when, where, and how to exhibit specific types of behavior. § Need for Social Skills: most students with EBD need specific instruction in social skills. Effective methods are needed to teach basic academic skills and social skills and affective experiences are as crucial as academic skills. How to manage one's feelings and behavior and how to get along with others are essential features of curriculum for many with EBD. § Needs of Juvenile Delinquents: Educational arrangements for juvenile delinquents are hard to describe because delinquency is a legal term, not an educational 1, and because programs for extremely troubled youths vary among states and localities. Special classes or schools are sometimes provided for youths who have histories of threatening, violent, or disruptive behavior. Some of these are administered under SPED law, but others aren't because pupils assigned to them aren't considered to have EBD. In jails, reform schools, and other housing detention facilities, educational practices vary widely. Education of incarcerated kids and youths with disabilities is governed by same laws that apply to those who aren't incarcerated, but the laws aren't always implemented. Many incarcerated don't receive assessment and education appropriate for their needs because of lack of resources, poor cooperation among agencies, and the attitude that delinquents and criminals aren't entitled to the same educational opportunities as law-abiding citizens. § Special Challenges for Teachers: need to tolerate lots of unpleasantness and rejection without becoming withdrawn or counter-aggressive. Can't expect that caring and decency will always be returned and must be sure of their own values and confident of their teaching and living skills. Must be able and willing to make wise choices for those who choose to behave unwisely. Training teachers to meet the academic and social needs of these students is very challenging. o Disciplinary Considerations: Educators now place emphasis on positive behavioral supports and behavior intervention plans for students with EBD. Increasingly, researchers recognize that prob behavior occurs less in classroom when teacher offers effective instruction, though good instruction alone isn't enough to resolve behavior problems. Many teachers and school admins are confused about what's legal—sometimes special rules do apply in some cases to students who have disabilities. Uncertainty or controversy usually surrounds a change in a student's placement or a suspension or expulsion due to a very serious misbehavior such as bringing a weapon or illegal drugs to school. IDEA discipline provisions for students with disabilities are intended to maintain a safe school environment without violating the rights of students with disabilities to fair discipline, taking the effects of their disability into consideration. § Zero Tolerance: a school policy, supported by fed and state laws, that having possession of any weapon or drug on school property will automatically result in a given penalty (usually suspension or expulsion) regardless of the nature of the weapon or drug or any extenuating circumstances. A fixed penalty for a given behavior without considering any circumstance or student characteristic presents particular problems for SPED. All educators realize the need for reasonable schoolwide discipline that brings a high degree of uniformity to consequences for particular acts. However, special educators argue for exceptions based on relevance of the student's disability to the event and note that zero tolerance hasn't made schools safer. § Manifestation Determination: Special rules apply to managing some of the serious misbehavior of students with disabilities. In some cases, typical school rules apply, but in others, they don't. Much of SPED advocacy regarding discipline is based on finding alternatives to suspension and expulsion. Keeping students out of school isn't an effective way of helping them learn how to behave acceptably. 3 concepts and related procedures provide the basis for much of the controversy surrounding the discipline of students with disabilities: 1) Determine whether the behavior is a manifestation of the student's disability; 2) Provide an alternative placement for the student's education for an interim period if temporary removal from the student's present placement is necessary; 3) Develop positive, proactive behavior intervention plans. Deciding whether a student's behavior is a manifestation of disability is called a manifestation determination (MD), based on the idea that it would be unfair to punish students for engaging in misbehavior that's part of their disability. However, if the misbehavior isn't a manifestation of disability, then the usual punishment should apply. MD is controversial, and some believe it's more political than educational in purpose. Some argue that the process undermines fairness since the rules or procedures for the MD aren't entirely objective. § Functional Behavioral Assessment (FBA): IDEA calls for functional behavioral assessment (FBA) if the student's behavior is persistently a prob, but the meaning of functional assessment isn't clear in the law's context. FBA assists educators in determining and altering the factors that account for a student's misconduct. Nevertheless, precisely what the law requires of special educators and other school personnel regarding FBA is uncertain. The intent of the law is to require teachers to assess student behavior in ways that lead to the selection of effective intervention strategies and to find out how to support desirable behavior. o Supports for Desired Behavior: Most critical part of the discipline provisions of IDEA is requirement that schools must devise a positive behavioral intervention plan (BIP) for a student with disabilities who has behavior problems—creating proactive and positive interventions and avoiding punishment. When discipline is involved, school must reevaluate the IEP and make efforts to address the misconduct using positive (nonpunitive) means to the greatest extent possible. Positive behavioral intervention and support (PBIS) integrates valued outcomes, the science of human behavior, validated procedures, and systems change to enhance quality of life and reduce problem behavior. Goal is to improve link between research-validated practices and the environment in which teaching and learning occur. Enhances the capacity of schools, families, and communities to design effective teaching and learning environments that improve lifestyle results for all kids/youth. These environments apply contextually and culturally appropriate interventions to make prob behavior less effective, efficient, and relevant and to make desired behavior more functional. However, it doesn't recognize the value of nonviolent negative consequences (punishment) in managing behavior. § Interim Alternative Education Setting: IDEA includes allowances for schools to use an interim alternative educational setting (IAES) in the discipline of a student with disabilities who cannot be managed satisfactorily in the general education classroom or school. For example, an IAES might be a separate special school serving students with behavior problems, a separate arrangement within the public school similar to in-school suspension, or a self-contained classroom. IAES is intended to encourage schools to use such alternatives rather than suspension or expulsion. The law doesn't define what an IAES must be, but only what it must provide: a continuation of education and modifications spelled out in the student's individualized education program (IEP). The IAES must also include specific programming to address and prevent the recurrence of the behavior that prompted the placement. Schools might use such settings for students with serious behavior problems as a way of preserving order and manageability of the typical classroom and school. However, regardless of the setting in which a student with emotional or behavioral disorders is placed, special educators should try to provide the most positive and functional behavioral support they can offer. § How Successful Are MDs, FBAs, PBIS, and IAES?: Some suggest that the FBA is much more complicated than many people think and that IDEA may have gotten considerably ahead of teachers' ability to do the necessary analyses. Although the idea is good, and a few educators may be able to perform a useful FBA, many functional analyses are poorly done.

The Human Genome and ENCODE Projects: Ethical Issues Pertaining to Intellectual Disabilities

o The US Human Genome Projected (1990-2003) resulted in the identification of the 20,000-25,000 genes in human DNA and the sequences of 3 billion chemical base pairs that make up human DNA. The ENCODE Project began in 2003 with goal of identifying all functional elements in the human genome sequence. o Some have raised concerns specific to intellectual disabilities—does use of genetic info to prevent intellectual disabilities devalue the lives of those who have intellectual disabilities? o On other hand, some argue that to renounce the use of genetic info to predict a disability in an unborn child can be ethically irresponsible (ex: Lesch-Nyan disease).

Prevalence of Intellectual Disabilities

o The average IQ score is 100. Theoretically, we expect 2.27% of the population to fall 2 standard deviations or more below this average. This is based on the assumption that intelligence is distributed along a normal curve. o The actual prevalence figures for students who are identified as having intellectual disabilities are much lower. In recent years, they have been well under 1%. Authorities surmise that this lower prevalence figure is due to one or a combination of three things: School officials (1) increased their use of adaptive behavior in addition to an IQ score to diagnose intellectual disabilities; (2) exhibited a preference to label students with IQs in the 70s as having learning disabilities because it's perceived as a less stigmatizing label; and/or (3) increased their propensity to identify children as having an autistic spectrum disorder (ASD) because of increased awareness of this condition.

The Changing Face of Living Options for People with Intellectual Disabilities

o The early part of 1900s in US witnessed increase in large residential institutions for people with intellectual disabilities, but this growth was brought to a halt in the late 1960s. Society was beginning to become more accepting and several reports of overcrowding and abusive practices. One of most dramatic reports was Christmas in Purgatory, a pictorial essay on squalid conditions of institutional life authored by Burton Blatt and photographed by Fred Kaplan. o Though large residential facilities still exist, they're disappearing and being replaced by community residential facilities (CRFs): aka group homes that accommodate small groups (3-10 people) in houses under the direction of house parents. Placement can be permanent or serve as temporary arrangement to prepare for independent living. They teach independent living skills in a more normal setting than a large institution. o Some question if CRFs go far enough in offering opportunities for integration into the community. They recommend supported living in which people receive supports to live in more natural, noninstitutional settings (own home, mobile home, condo, apartment).

Assessment of Progress for Learning Disabilities

o The notion of using assessment info to help plan educational strategies has gained much of its popularity from its pros working in the area of LDs. o Curriculum-based measurement (CBM): direct and frequent samples of performance on items from the curriculum in which students are being instructed. Each CBM has multiple forms of equivalent difficulty that are administered at regular intervals to determine whether a student is making progress toward a specific goal. Teachers implement the measures as short probes that require only minutes to administer. In reading, CBM typically focuses on oral reading fluency, which is determined by calculating the number of correct words per minute (CWPM) read on a grade-level passage. o Informal Assessment: informal reading inventory (IRI), a series of reading passages or word lists graded in order of difficulty. The teacher has the student read from the series, beginning with a list or passage that is likely to be easy for the student. The student continues to read increasingly more difficult lists or passages while the teacher monitors the student's performance. After compiling the results of the IRI, the teacher can use them to estimate the appropriate difficulty level of reading material for the student. Mathematics dynamic assessment (MDA) is another example of an informal assessment that can inform instruction. Using MDA, the teacher integrates research-based assessment techniques including (1) examining mathematical understanding at concrete, semiconcrete, and abstract levels; (2) assessing mathematical interests and experiences; (3) examining error patterns; and (4) using flexible interviews o Testing Accommodations: many students with LDs receive accommodations on standardized tests that alter scheduling, presentation format, and response format. The most common accommodations for students with LDs are extended time and small-group setting administration. Research isn't clear on accommodations' effectiveness.

Assessment of Progress for EBD

o The ongoing assessment program for students with EBD should include measures that address domains of social-emotional behavior that influence academic learning—interpersonal skills, study skills, motivation, and engagement. o Teachers typically use rating scales and direct observation to monitor students' progress in behavioral interventions. Many rating scales are available to assess students' social skills. o Numerous tests of academic achievement are also available. Unfortunately, academic progress of students with EBD has often not been carefully monitored because of the greater concern for these students' social-emotional behavior. However, academic failure and troublesome behavior are often so interrelated that aiding students in becoming academically competent is critically important in helping them achieve better social and emotional adjustment. One of the signs that these students' social-emotional adjustment is improving is their acquiring academic skills.

History of ADHD

o Today, ADHD is often the subject of criticism, being referred to as a phantom or bogus condition—a fashionable, trendy diagnosis for people who are unmotivated or lazy. Evidence indicates that the condition is extremely real for those who have it, and ADHD isn't a recently discovered trendy diagnosis. o Dr. Melchior Adam Weikard's Textbook, "Der Philosophische Arzt:" credited as the 1st to address the issue of attention deficits in the scientific literature. He was a highly respected German physician who served in numerous prestigious government positions. Published a textbook in 1775 that had a chapter called "Lack of Attention," in which he described the inattentive person as having deficits in concentration, being distracted by everything, getting off task, and not a good listener. o Sir Alexander Crichton's Treatise "On Attention and Its Diseases:" the 1798 treatise by this Scottish-born physician got more attention than Weikard's publication. Many of Crichton's notions about attention deficits are consistent with today's ideas and noted that the ability to attend wasn't automatic but required active effort. He theorized that a person could be born with attention disorders or could acquire them through diseases affecting the brain. o Dr. George F. Still's Children with "Defective Moral Control:" Still, a physician, provided an even more scientific account to the medical profession of what we now call ADHD. He delivered 3 lectures to the Royal College of Physicians of London in 1902 in which he described cases of kids who displayed spitefulness, cruelty, disobedience, impulsivity, and problems of attention and hyperactivity and referred to them as having "defective moral control," lacking the ability to inhibit or refrain from engaging impulsively in inappropriate behavior. 1 of the most influential current psychological theories is based on the notion that an essential impairment in ADHD is a deficit involving behavioral inhibition. Still's cases were also similar to today's discussion in 5 ways: 1) Still speculated that many of these kids had mild brain pathology; 2) many of the kids had normal intelligence; 3) the condition was more prevalent in males than females; 4) there was evidence that the condition had a hereditary basis; 5) many of the kids and their relatives also had other physical or psychological problems, such as tics and depression. o Kurt Goldstein's Brain-Injured Soldiers of WWI: Goldstein reported on the psychological effects of brain injury in soldiers who suffered head wounds in WWI. He observed in his patients disorganized behavior, hyperactivity, perseveration (tendency to repeatedly engage in the same behavior), and a forced responsiveness to stimuli. Perseveration is often cited by clinicians as a characteristic of people with ADHD and their forced responsiveness to stimuli is akin to distractibility. o The Strauss Syndrome: Goldstein's work laid the foundations for the investigations of Heinz Werner and Alfred Strauss in the 1930s and 40s. Having emigrated to the US from Germany after Hitler's rise to power, Werner and Strauss tried to replicate Goldstein's findings and noted the same behaviors of distractibility and hyperactivity in some kids with intellectual disabilities. In addition to clinical observations, they used an experimental task consisting of figure/background slides that were presented at brief exposure times. The slides depicted figures embedded in a background. They found that kids with supposed brain damage were more likely than those without brain damage to say that they had seen the background rather than the figure. Pros came to refer to kids who were hyperactive and distractible as exhibiting the Strauss syndrome. o William Cruickshank's Work: Using Werner and Strauss's figure/background task, Cruickshank found that kids with cerebral palsy were also more likely to respond to the background than to the figure. Whereas Werner and Strauss had assumed that the kids they studied were brain damaged, the kids Cruickshank studied all had cerebral palsy, a condition that's pretty easy to diagnose. Also, the kids Cruickshank studied were largely of normal intelligence, demonstrating that kids without intellectual disabilities could show distractibility. Cruickshank established an educational program for kids who would today meet the criteria for ADHD. However, at the time (1950s), many of these kids were referred to as minimally brain injured. An important element of Cruickshank's program that's stood the test of time is to provide classroom structure and to minimize distractions. o Minimal Brain Injury and Hyperactive Child Syndrome: 1956 study published on the aftereffects of birth complications that revived Still's notion that subtle brain pathology could result in behavior problems, like distractibility and hyperactivity. Pros began to apply the label of minimal brain injury to kids of normal intelligence who were inattentive, impulsive, and/or hyperactive. This term fell out of favor as professionals pointed out that it was difficult to document actual tissue damage to the brain and was replaced in the 1960s with hyperactive child syndrome because it was descriptive of behavior and didn't rely on vague and unreliable diagnoses of subtle brain damage. By the 1980s, this term had fallen out of favor because research pointed out that inattention, not hyperactivity, was a major behavioral problem of these kids. This recognition of inattention as more important than hyperactivity is reflected in the current definition of ADHD, but some authorities are now recommending that deficits in behavioral inhibition replace inattention as the primary deficit of ADHD.

Adaptive Behavior

o Today, we recognize that IQ tests are generally accurate but aren't perfect and are only 1 indication of ability to function. Pros consider adaptive behavior in addition to IQ in defining intellectual disability because they began to recognize that some students might score poorly on IQ tests but function well in their daily environment/be streetwise. § Adaptive behavior consists of social intelligence and practical intelligence. Social intelligence: understanding and interpreting people and social interactions. Practical intelligence: ability to solve everyday problems (preparing meals, using transportation systems, making change, using the Internet, and solving probs associated with particular job situations.

Causes of Intellectual Disabilities

o Upsurge in research that's increased understanding of causes of intellectual disabilities (Human Genome Project and ENCODE Project). o But not all causes of intellectual disabilities are genetically related, nor are all causes traceable to biological causes. For about 50% of cases, we can't pinpoint the cause of a child's intellectual disabilities. o Common way of categorizing causes of intellectual disabilities is according to the time when the cause occurs: prenatal, perinatal (at the time of birth), and postnatal.

Mental Retardation vs Intellectual and Developmental Disabilities

o Whatever name has been applied to these individuals by professionals has ended up being used pejoratively by the public. For example, in the early 1900s, the terms idiot, imbecile, and moron were acceptable labels for those who today would be referred to as having severe, moderate, or mild intellectual disability or mental retardation, respectively. These were actually official terms used by pros and sanctioned by pro organizations. Over the years, the term mentally retarded, especially its shortened term, retard, has come to be used as an insult. o In January 2007, the major pro organization for people with significant cognitive or intellectual disabilities, the American Association on Mental Retardation (AAMR), changed its name to the American Association on Intellectual and Developmental Disabilities (AAIDD). This change did meet with some resistance—some argue that finding a "slur-proof" term is fruitless and others argue that, unlike idiot, the term mentally retarded hasn't become a slur except in its shortened form retard. o In 2010, fed legislation solidified the use of the term intellectual disability. Public Law 111-256 mandated that intellectual disability replace mental retardation in many areas of the fed government. The term intellectual disability is actually more accurate than mentally retarded in describing the primary limitations of this group of individuals. Some argue that intellectual is more accurate than mental because the latter is often used to refer to emotions.

Early Intervention for EBD

o Young kids difficult to assess or diagnose because they often respond with hyperactivity, aggressiveness, or defiance to whatever risk factor might be involved. However, early identification and prevention is possible. First, young kids and families who have access to mental health services and good medical care are less likely to have problems. Second, parents and teachers who're nurturing, positive and encouraging, and who develop healthy relationships with young kids are less likely to see challenging behavior. 3rd, high quality preschool education helps foster social competence and is associated with fewer behavior problems. o Possible to identify at early stage those who are at high risk for EBD: extreme aggression, social withdrawal, social rejection, identification with deviant peers. They should be identified as early as possible, and their parents and teachers should learn how to teach them essential social skills and how to manage their prob behavior using positive, nonviolent procedures. If kids with EBD are identified very early and intervention is comprehensive, intense, and sustained, there's a good chance they can recover and exhibit developmentally normal patterns of behavior. o However, in practice early intervention doesn't typically occur: worry about labeling and stigma, optimism regarding child's development, lack of resources to address students' needs, and ignorance about the early signs of EBD.

Postnatal Causes of Intellectual Disabilities

§ can be biological in nature or psychosocial in nature. · Biological postnatal causes: infections, malnutrition, and toxins. 2 types of infections: meningitis and encephalitis. Meningitis: infection of the covering of the brain that may be caused by variety of bacterial or viral agents. Encephalitis: inflammation of the brain that results more often in intellectual disabilities and usually affects intelligence more severely. Toxin that's linked to intellectual disabilities is lead—the effect of lead poisoning on kids varies; high lead levels can cause death. · Psychosocial Postnatal Causes: kids who're raised in poor environmental circumstances are at risk for intellectual disabilities—extreme cases of abuse, neglect, or undersimulation. Inadequate exposure to stimulating adult-child interactions, poor teaching, and lack of reading materials can also result in intellectual disabilities, especially mild. Heredity can also play a role. For many years it's been assumed that psychosocial factors are cause of most cases of mild intellectual disabilities, whereas biological factors are cause of more severe. Recently, however, authorities have begun to suspect that many cases of mild might be caused by specific genetic syndromes: many cases of Prader-Willi and Williams and females with Fragile X syndrome with mild. Speculations that in near future, new genetic syndromes will be discovered as causes of mild intellectual disabilities.

Prenatal Causes of Intellectual Disabilites

§ chromosomal disorders, inborn errors of metabolism, developmental disorders affecting brain formation, and environmental influences. · Chromosomal Disorders: most common genetic syndromes: Down syndrome, Fragile X syndrome, Prader-Willi syndrome, and Williams syndrome. o Down Syndrome: usually not inherited. Anomaly at the 21st pair of chromosomes. In most cases, the 21st set of chromosomes (normal human cell contains 23 pairs) is a triplet rather than a pair (most common form also referred to as trisomy 21). Down syndrome is the most common form of intellectual disability that's present at birth. People with Down Syndrome may have thick epicanthal folds in the corners of their eyes, small stature, decreased muscle tone (hypotonia), hyperflexibility of joints, small oral cavity that can result in a protruding tongue, short and broad hands with a single palmar crease, heart defects, and susceptibility to upper respiratory infections. Degree of intellectual disability among people with Down syndrome varies widely, but most fall in the moderate range. More kids with Down syndrome have achieved IQ scores in the mild range presumably because of intensive SPED programming. Possible causes: age of mom, age of dad, exposure to radiation, and exposure to some viruses. § Methods used to screen for Down syndrome and other birth defects: · Maternal serum screening (MSS): blood sample taken from mom and screened for presence of elements that may indicate spina bifida or Down syndrome · Amniocentesis: sample of amniotic fluid from sac around fetus and analyzes fetal cells for chromosomal abnormalities. The amniotic fluid can be tested for presence of proteins that may have leaked out of the fetus's spinal column, indicating spina bifida. · Chorionic villus sampling (CVS): sample of villi (what later becomes placenta) and tests for chromosomal abnormalities. Can be done earlier than amniocentesis. · Nuchal translucency ultrasound: non-invasive procedure to see fluid from behind fetus's neck. Can be done earlier than amniocentesis. Greater than normal amount of fluid indicates possibility of Down syndrome. o Fragile X Syndrome: most common known hereditary cause of intellectual disabilities and 2nd most common syndrome. Associated with the X chromosome in the 23rd pair of chromosomes. In males, the 23rd pair consists of an X and a Y chromosome; in females, it consists of two X chromosomes. This disorder is called Fragile X syndrome because in affected individuals, the bottom of the X chromosome is pinched off in some of the blood cells. Fragile X occurs less often in females because they have an extra X chromosome, giving them better protection if one of their X chromosomes is damaged. People with Fragile X syndrome may have a number of physical features, such as a large head; large, flat ears; a long, narrow face; a prominent forehead; a broad nose; a prominent, square chin; large testicles; and large hands with nontapering fingers. Although this condition usually results in moderate rather than severe intellectual disabilities, the effects are highly variable; some people have less severe cognitive deficiencies and some, especially females, score in the normal range of intelligence. o Prader-Willi Syndrome: result of a genetic abnormality, but very few cases are inherited. Prader-Willi syndrome has two distinct phases. Infants are lethargic and have difficulty eating. Starting at about 1 year of age, however, they become obsessed with food. In fact, Prader-Willi is the leading genetic cause of obesity. Although a vulnerability to obesity is usually their most serious medical problem, people with Prader-Willi are also at risk for a variety of other health problems, including short stature due to growth hormone deficiencies; heart defects; sleep disturbances, such as excessive daytime drowsiness and sleep apnea; and scoliosis. The degree of intellectual disability varies, but the majority of individuals with Prader-Willi fall within the mild intellectual disability range, and some have IQs in the normal range. o Williams Syndrome: caused by the absence of material on the 7th pair of chromosomes. People with Williams syndrome have intellectual disabilities in the mild to moderate range and often have heart defects, unusual sensitivity to sounds, and elfin facial features. Not typically inherited but people with it can pass it on to their kids. · Inborn Errors of Metabolism: result from inherited deficiencies in enzymes used to metabolize basic substances in the body, such as amino acids, carbs, vitamins, or trace elements. o One of most common inborn errors of metabolism is phenylketonuria (PKU): inability to convert phenylalanine to tyrosine; the consequent accumulation of phenylalanine results in abnormal brain development. All states screen babies for PKU before they leave the hospital. Babies with PKU are immediately put on a special diet to precent occurrence of intellectual disabilities (milk, eggs, and artificial sweetener aspartame are restricted due to their high levels of phenylalanine). Pros now recommend continuing the diet indefinitely because those who stop are at risk for developing learning disabilities or other behavioral problems and women with PKU who go off the diet are at very high risk of giving birth to kids with PKU. · Developmental Disorders of Brain Formation: a number of conditions can affect the structural development of the brain and cause intellectual disabilities. Some are hereditary and accompany genetic syndromes, and some are caused by other conditions such as infections. 2 examples of structural development affecting the brain are microcephalus and hydrocephalus. o Microcephalus: head is abnormally small and conical. Intellectual disability that results ranges from severe to profound. No specific treatment and life expectancy is short. o Hydrocephalus: results from accumulation of cerebrospinal fluid inside or outside the brain. Blockage of the circulation of the fluid results in a buildup of excessive pressure on the brain and enlargement of the skull. Degree of intellectual disability depends on how early it's diagnosed and treated. 2 types of treatment: surgical placement of a shunt that drains excess fluid away from brain to abdomen or insertion of device that causes the fluid to bypass the obstructed area of the brain. · Environmental Influences: A variety of environmental factors can affect a woman who's pregnant and thereby affect the development of the fetus she carries. Examples: maternal malnutrition and exposure to radiation. Infections to mom can also affect the developing fetus and result in intellectual disabilities—Zika virus and Rubella. o Fetal alcohol spectrum disorders (FASD): include a range of disorders in kids born to women who've consumed alcohol while pregnant. Most severe is fetal alcohol syndrome (FAS): kids with FAS have abnormal facial features, growth retardation, and intellectual disabilities. o Zika virus (spread by mosquito bites): when pregnant women infected, at high risk of giving birth to babies with microcephaly. o Rubella (German measles): potential cause of blindness and can result in intellectual disabilities. Most dangerous in 1st trimester (3 months) of pregnancy.