Psychopedagogical Special Education: Intellectual Disability, Down Syndrome, Blindness, Deafness, and Pervasive Developmental Disorders
Base Notes: Psychopedagogical Special Education
Item 7: Intellectual Disability
Introduction
Terminology: Words such as fool, idiot, oligophrenic, subnormal, backward, and polluted were used in the past to define what we now call intellectual disabilities.
Different perspectives of study:
- Psychometric: Intelligence Quotient (IQ)
- Evolutionary
- Cognitive
- Functional
Five key principles apply to teaching any student, regardless of their intellectual capacity. These principles are based on providing support for:
- Feeling safe, loved, and esteemed
- Feeling free
- Developing a decent job
- Enjoying leisure time
- Feeling responsible
Concept of intelligence:
- Complex, not simple
- Changeable, not fixed
- Integrated with personality, not independent
- Multiple Intelligences: Interpersonal (relationships with others, teamwork) and Intrapersonal (good self-esteem, self-awareness)
Definition (AAMR – American Association on Mental Retardation)
Intellectual disability is characterized by intellectual functioning below average associated with limitations in two or more of the following adaptive skill areas: communication, home life, personal care, social skills, community use, self-direction, health, and safety.
Mental retardation manifests before age 18 years (AAMR).
Adaptive Behavior
- Health and safety: how to deal with diseases, self-care, etc.
- Functional academic skills: literacy, numeracy, etc.
- Recreation: Leisure activities, important for observation
- Work: Job-specific skills and competition
Predisposing Factors
- Hereditary (5%): errors of metabolism, genetics
- Early alterations of embryonic development (30%)
- Problems in pregnancy and perinatal period (10%): preterm delivery, hypoxia, trauma, etc.
- Medical conditions acquired during infancy and childhood (5%): infections, etc.
Characteristics
Age: Under 18 years
- Duration: Support needs may change throughout life (diagnosis of intellectual disability is maintained if support is needed in at least nine adaptive skills)
- Prevalence: 1% of the population (varies according to diagnostic tests)
- Heterogeneity: Each student is different, even with similar characteristics
- General delay: Intellectual disability is characterized by a general delay in development and learning, limiting performance in all areas of life. All areas of the child’s development need to be addressed.
Cognitive
- Lack of or difficulty in abstract thinking
- Cognitive rigidity (difficulty changing strategies when learned behaviors fail)
- Attention and memory problems
- Incomplete development
- Fatigue (get tired more easily)
- Slower pace
Memory Performance
Children with intellectual disabilities may have difficulty with short-term memory and using revision strategies, leading to challenges in consolidating information into long-term memory.
Motor Development
- Weaker reflexes
- Passivity in the environment
- Postural alterations
- Challenges with fine and gross motor skills
Language Development
- Large variations
- Linked to motor development
- Slow acquisition
- Problems in self-regulation and inner speech
Personal and Socio-affective
- Experience of failure (important to focus on personal adjustment)
- Lack of motivation (avoid patronizing, provide love, encouragement, and specific materials)
- Learned helplessness (related to depression)
- Impulsivity
- Limited development of personality
- Difficulty in structuring experiences and self-recognition
- High-risk group
Levels of Institutional Placement
- Level I: Ordinary Classroom: The regular classroom is the first option, promoting inclusion and integration.
- Level II: Special Classroom: Students may be integrated into regular classrooms part-time, with the special classroom as their primary placement.
- Level III: Special Education School: Private or public schools providing specialized education.
- Level IV: Residential Centres: Provide 24-hour institutional care, with academic instruction as one component of the intervention program.
Mercury Program
A program using cameras in classrooms to allow students who cannot attend in person to participate remotely.
Levels of Support
Four dimensions of evaluation are used to determine the intensity of support required:
- Dimension I: Intellectual functioning and adaptive skills
- Dimension II: Psychological/emotional considerations
- Dimension III: Physical/health/etiology considerations
- Dimension IV: Environmental considerations
Educational Interventions
Guiding principles include analyzing the environment and using appropriate supports.
Intensity of support:
- Intermittent: When necessary at specific times
- Limited: For a defined period
- Extensive: Long-term support
- Pervasive: Lifelong, high-intensity support
Supports should be adequate to avoid dependence.
Educational Intervention
Temporal priority:
- Dangerous behaviors
- Behaviors that impede learning
- Basic learning skills (eye contact, following directions, imitation)
- Manipulation of objects for play and group work
- Other learning
Procedure and Methodology for Instruction and Learning
- Behavior modification: Techniques such as the Premack Principle (reinforcing a less preferred behavior with a more preferred one) and task analysis (breaking down tasks into smaller steps) are used.
- Reinforcement: Positive reinforcement, negative reinforcement, punishment, and extinction are used to shape behavior.
- Token economy: A system of rewards to motivate students and gradually transition from extrinsic to intrinsic reinforcement.
- Time out: Removing a child from a reinforcing environment to interrupt inappropriate behavior.
Procedures and Methodology for Teaching and Learning
- Instructional mechanisms (helping students internalize activities)
- Reciprocal teaching
- Cooperative learning
- Inclusion in educational, social, and recreational activities with peers without disabilities
- Peer tutoring
Additional procedures:
- Successive approximations
- Modeling
- Reinforcement of incompatible behavior
- Reinforcement of alternative behaviors
- Stimulus control
- Instructional control
- Alternative behavioral programs (PCA) for teenagers and adults:
- Social skills program
- Orientation program to work
- Program of daily living skills
Item 8: Down Syndrome
Down syndrome is a chromosomal aberration caused by an extra chromosome in pair 21. There are three types of chromosomal variations:
- Trisomy: All cells have 47 chromosomes (most frequent, 95% of cases)
- Translocation: Chromosome 21 is attached to another chromosome (2-3% of cases)
- Mosaic: Different chromosome numbers in different cells (rare)
Definition
Down syndrome impacts genetic expression, leading to imbalances in protein synthesis and alterations in the central nervous system, specifically the brain, resulting in intellectual disability.
Etiology
- Incidence: 1.5 / 1,000 newborns
- Factors increasing the probability of having a child with Down syndrome:
- Women over 35 years
- Parents over 50 years
- Previous birth of a child with a chromosomal abnormality
Phenotype
Physical characteristics of Down syndrome may include:
- Head: Small size (microcephaly), delayed closure of fontanelles, sometimes alopecia
- Face: Underdeveloped facial bones, flat nose, flattened nasal bridge
- Eyes: Slanted eyes, Brushfield spots
- Ears: Small, folded helix, narrow ear canals
- Mouth: Narrow, cracked lips, small mouth, large tongue, delayed teething, missing or distorted teeth
- Neck: Wide and strong
- Chest: Sometimes depressed sternum
- Extremities: Small hands and feet, short and thick fingers, single palmar crease
Vision and hearing: Myopia, farsightedness, and mild to moderate hearing deficiencies are common.
Brain function and psychiatric disorders: Depression and behavior problems may occur, especially in adulthood.
Cognitive Processes
- Slow responses
- Need for highly structured information
- Weaker information retention
- Decreased cognitive skills with age
- Inefficient problem-solving skills
- Reluctance to take initiative in learning
- Easily distracted
- Difficulty sustaining attention
- Challenges with short-term memory and information processing
- Reduced long-term memory retrieval
- Difficulty with integration, interpretation, organization, conceptualization, abstract thought, and numerical operations
Psycholinguistic Characteristics
- Limited formal language, but effective for basic social demands
- Delayed language development
- Intelligibility problems (stuttering)
- Articulatory and phonological problems, reduced vocabulary, grammar and syntax difficulties
Temperament
Temperament may be challenging in early childhood but often improves between 3 and 6 years.
Educational Intervention
Children with Down syndrome may lose interest in learning easily and experience learned helplessness.
- Early care: Early intervention is crucial.
- Literacy programs: Visual learning strategies can be helpful due to challenges with auditory processing and short-term memory.
- Literacy areas: Focus on functional literacy skills for personal autonomy.
- Calculation: Use of games and token economy can be effective.
- Augmentative communication program: Alternative and augmentative communication (AAC) can support communication.
- Innovations: Peer tutoring, co-teaching, cooperative learning, differentiated instruction, and family involvement are important.
Item 9: Perception and Understanding of Blind Children
Concepts of Blindness
- Visual acuity: Ability to discriminate fine details
- Visual field: Capacity to sense the visible space
- Legal blindness: Visual acuity of 1/10 or less, or a visual field below 35 degrees
- Real blindness: Total lack of vision
Levels of visual impairment (Barraga, 1992):
- Blindness
- Profound visual disability
- Severe visual disability
- Moderate visual disability
Prevalence
- Childhood blindness is a major global problem.
- Refractive errors are a leading cause of visual impairment in children.
- Women are at higher risk of visual impairment.
- Most people with visual disabilities live in developing countries.
Causes
Leading causes of blindness include cataracts, refractive errors, glaucoma, macular degeneration, retinopathy of prematurity, and vitamin A deficiency.
Most cases of blindness are preventable or treatable.
Detection
Indicators of visual impairment may include:
- Squinting, red eyes, drooping eyelids, eye movements, frequent styes
- Headaches, nausea, dizziness, blurred vision
Major Obstacles in Developing Knowledge
- Object permanence
- Causality
- Space-time structures
- Environmental control
- Symbolization
- Understanding movement
Language and Communication
Blind children generally develop language skills similarly to sighted children, but may use more questions and have difficulty with nonverbal communication.
Motor and Adaptive Behavior
Tactile and kinesthetic senses are crucial for blind children. Bimanual coordination is important, and stereotyped movements may occur.
Schooling Process
Key considerations include assessment, placement, adaptation, and inclusion.
Difficulties in School
Challenges may arise from the child’s own stress and anxiety, as well as from teacher and peer attitudes and expectations.
Curriculum and Material Adjustments
- Psychomotor: Focus on overcoming fears, muscle control, balance, spatial orientation, and independent movement.
- Fine motor: Develop bimanual coordination, use of tools, and color recognition.
- Communication, language, and socialization: Encourage communication initiation, turn-taking, social interaction, and Braille learning.
- Work habits: Promote participation in organization and order, and frustration tolerance.
Methodological Considerations
- Spatial and organizational aspects: Stable environment, accessible classroom, appropriate lighting.
- Attitudes of teachers and peers: Avoid overprotection, provide clear descriptions, encourage participation.
- Material and technical resources: Use of alternative boards, tactile materials, low vision aids, Braille materials, and assistive technology.
Evaluation
Evaluation methods may include questionnaires, observation, and assessment of specific skills.
Item 10: Communication, Language, and Thought in Deaf Children
Definition of Deafness
Deafness is a hearing impairment that prevents understanding speech through hearing alone, even with hearing aids.
Hearing loss refers to a partial hearing impairment that makes understanding speech difficult but not impossible.
Types of Hearing Loss
- Conductive: Damage to the outer or middle ear
- Sensorineural: Damage to the inner ear or nervous system
- Mixed: Combination of conductive and sensorineural
- Prelingual: Occurs before language acquisition
- Postlingual: Occurs after language acquisition
- Congenital: Present at birth
- Acquired: Develops later in life
Hearing loss is also classified by degree, ranging from mild to profound.
Indicators of Hearing Loss
Indicators of prelingual and postlingual hearing loss may include delayed language development, difficulty understanding speech, inattention, and social withdrawal.
Etiology
Causes of hearing loss may include unknown factors, genetic abnormalities, prenatal factors, perinatal and neonatal factors, and postnatal factors.
Epidemiology
Hearing loss is a relatively common disability, affecting a significant number of students.
Motor Development
Motor development in deaf children is generally similar to that of hearing children, but some awkwardness or balance problems may occur.
Psychological Development
Deaf children follow similar developmental sequences as hearing children, but may experience delays in language, reading, writing, and social skills.
Socialization Development
Hearing impairment can lead to communication difficulties and social isolation. Early intervention and appropriate communication methods are crucial.
Academic Performance and Learning
Deaf children may experience academic challenges, particularly in language-based subjects. Visual learning strategies and appropriate communication methods are important.
Methods of Communication
The choice of communication method depends on the type and severity of hearing loss, as well as individual factors.
- Oral communication systems: Focus on developing spoken language skills, with or without lipreading.
- Complementation of oral communication: Use of sign language, cued speech, or other visual-gestural systems to support spoken language.
- Sign language: Primary use of sign language for communication.
A combination of oral and gestural communication (bilingualism) is often recommended.
Educational Intervention
Integration into regular classrooms with appropriate supports is generally preferred.
Strategies to promote communication in the classroom include:
- Optimal seating placement
- Simplified vocabulary and clear speech
- Visual aids and technology
- Peer support and group work
Additional considerations for lipreading include speaking slowly and clearly, facing the student, and providing good lighting.
Collaboration with families is essential.
Item 11: Pervasive Developmental Disorders
Historical Development of Studies
Understanding of autism has evolved over time, from psychogenic interpretations to a focus on neurobiological causes and educational interventions.
Definition of Autism
Autism is a pervasive developmental disorder characterized by impairments in social interaction, communication, and imagination, often accompanied by restricted interests and repetitive behaviors.
Characteristics
- Prevalence: 5 cases per 10,000 individuals
- Early manifestations may be subtle
- Continuous course, with possible progress in some areas
- Varying degrees of independence in adulthood
- Increased risk among siblings
Additional characteristics may include sensory sensitivities, self-injurious behaviors, and psychiatric disorders.
Theory of Mind
Autistic individuals often have difficulty understanding the perspectives of others, leading to challenges in social interaction and communication.
Asperger Syndrome
Asperger syndrome is a pervasive developmental disorder similar to autism, but without significant language delays or cognitive impairments.
Individuals with Asperger syndrome may have difficulty with social interaction, restricted interests, and repetitive behaviors.