INTRODUCTION TO

SPECIAL EDUCATION
B.Ed

Course Code: 8631 Units: 11–9

Faculty of Education
Department of Special Education
ALLAMA IQBAL OPEN UNIVERSITY, ISLAMABAD
1st Printing ........................................ 2018

Quantity ...........................................

Price .................................................

Printer .............................................. AIOU-Printing Press, H-8, Islamabad.

Publisher .......................................... Allama Iqbal Open University, Islamabad

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 COURSE TEAM
Course Team Chairman: Dr. Tanzeela Nabeel
Course Development Coordinator: Dr. Shaista Majid
Writers: Dr. Tanzeela Nabeel
Dr. Shaista Majid
Dr. Hina Noor
Mr. Sharif Ullah
Mrs. Anila Inam
Mr. Muhammad Imran Nazir
Reviewers: Dr. Shahida Sajjad
Dr. Shagufta Shehzadi
Dr. Tanzeela Nabeel
Dr. Shaista Majid
Dr. Zahid Majeed
Mrs. Sadaf Noveen
Members: 1. Prof. Dr. Shagufta Shahzadi
Department of Special Education,
University of Karachi.
2. Prof. Dr. Nasir Sulman
Department of Special Education,
University of Karachi.
3. Prof. Dr. Naseer ud Din (late)
Professor, Department of Special
Education, University of the Punjab, Lahore.
4. Prof. Dr. Abdul Hameed
Dean, School of Social Sciences and
Humanities, University of Management &
Technology, Lahore.
5. Dr. Zahid Majeed
Assitant Professor, Department of Special
Education, AIOU, Islamabad.
Course Coordinator Dr. Shaista Majid
Editor: Mr. Fazal Karim
Composing & Layout: Mr. Malik Mateen Ishfaq

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 FOREWARD

The Teacher Education Programs have great significance in the society. The mission
of these programs is preparing qualified potential teachers by equipping them up to
date knowledge, and skills to teach effectively. Faculty of Education is preparing
qualified and competent teachers nation-wide. The faculty and administrators are
engaged in the continuous support and strengthening of the mission of Allama Iqbal
Open University. The development, improvement, and successful implementation of
the Teacher Education programs are also focus of the attention for the Faculty of
Education.

Teacher plays a pivotal role in teaching learning process. A teacher must complete
some kind of teacher education before becoming a full-time teacher. The quality of
student's success is directly linked with the quality of teaching. Teachers are
responsible for developing suitable instructional strategies to facilitate students
despite of their abilities in order to achieve the curriculum expectations. Teachers
also use suitable methods for the assessment and evaluation of students learning.
Teachers motivate students and apply variety of teaching and assessment approaches
in the classroom, dealing with individual students needs and ensuring sound learning
opportunities for every student.

With the explosion of knowledge in all fields of study, there is also an increase in
knowledge regarding teaching strategies, pedagogy and assessment techniques. The
world is becoming a globalized village. This globalization process and the social
changes linked with it demand the introduction of permanent changes and reforms in
the educational systems. The teacher's new role is very crucial. In their new role,
teachers should support both the students, parents and society. Teachers should act as
guides for their students and facilitate them in their individual progress, taking into
consideration the challenges of the globalization process. Science and technology can
be helpful in shaping students views about life and learning. Now a days science and
technology exist in a broader social and economic context and in turn have a
significant impact on society and the environment. Teachers must provide
opportunities for students to develop interest in learning new concepts. They must
also ensure that students acquire the knowledge and skills need for active
participation in day to day learning activities. For this, there is need that teachers
should be equipped with latest knowledge and skills regarding teaching special
needs students so that they can cope up successfully with the challenges of latest
school programs as well as the challenges from the society.

Prof. Dr. Zia Ul-Qayyum

Vice Chancellor

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 COURSE INTRODUCTION
Introduction to Special Education is a foundation course of Special Education and
Inclusive areas at B.Ed level. It deals with the developmental perspectives of
special education, types and basic needs of special children, and the provision of
special services. This introductory course will help the students to understand the
advance courses of B.Ed degree program of special education and Inclusive
Education. The teaching methodology of this course is distance teaching along
with the visitsof special schools.

LEARNING OUTCOMES
The course is designed to:
1. Clarify the terminology of special education

2. Give the full exposure to students about the historical and legislative
background of special education

3. Facilitate the students to understand the major categories of exceptionalities

4. Study the attitude towards handicap and organize and manage special needs
of schools.

5. Make them aware about the early identification, assessment and early
intervention of children with special needs.

6. Discuss various trends and issues of special education

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 CONTENTS
Unit–1: Introduction to Special Education.................................................. 1
Introduction ........................................................................................ 2
Objectives .......................................................................................... 2
1.1 Basic Concept and Terminology of Special Education ............ 3
1.2 Evolution in the Status of the Disabled Person ......................... 7
1.3 Pathological and Sociological Approaches to Special Education .. 13
1.4 Special Education System in Pakistan ...................................... 15
1.5 Policy and Legislation............................................................... 16
1.5.1 International Legislations.............................................. 17
1.5.2 Legislation in Pakistan .................................................. 18
1.5.3 National Policies of Special Education ......................... 20
1.6 Self-Assessment Questions ....................................................... 25
1.7 References ................................................................................. 26

Unit-2: Types of Exceptionalities-I .............................................................. 29

Introduction ........................................................................................ 30
Objectives .......................................................................................... 30
2.1 Classification System of Exceptionalities................................. 31
2.2 Type1-Visual Impairment ......................................................... 35
2.2.1 Causes and Implication of visual Impairment .............. 35
2.2.2 Assessment of Visual Impairment ................................ 48
2.2.3 Education and Training ................................................. 51
2.3 Type 2-Hearing Impairment ..................................................... 65
2.3.1 Causes and Types of Hearing Loss ............................... 67
2.3.2 Educational Implications .............................................. 68
2.3.3 Teaching and Learning Approaches ............................. 71
2.4 Exercises ................................................................................... 74
2.5 Activity ..................................................................................... 75
2.6 Self-Assessment Questions ....................................................... 75
2.7 References ................................................................................. 76

Unit-3: Types of Exceptionalities-II ............................................................ 77

Introductions ..................................................................................... 78
Objectives .......................................................................................... 78
3.1 Type-3 Physical and Health Impairment .................................. 79
3.1.1 Categories ..................................................................... 79
3.1.2 Assessment.................................................................... 85
3.1.3 Adaptations in Curriculum, Instruction and Evaluation 86
3.2 Type 4- Emotional and Behavior Disorders ............................. 88

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 3.2.1 Categories of Emotional and Behavior Disorders ........ 89
3.2.2 Characteristics of Behavior ........................................... 97
3.2.3 Strategies for Teaching Students with Emotional and
Behavior Disorder ......................................................... 97
3.2.4 Educational Implications and Intervention Techniques
for Supporting Positive Behavior.................................. 98
3.2.5 Challenges and Issues ................................................... 99
3.3 Self-Assessment Questions ....................................................... 99
3.4 References ................................................................................. 101

Unit-4: Types of Exceptionalities-III ........................................................... 103

Introduction ........................................................................................ 104
Objectives .......................................................................................... 104
4.1 Type 5- Communication Disorders ........................................... 106
4.1.1 Normal Human Communication Process and Language
Development ................................................................. 106
4.1.1.1 The Building Blocks of Language ................. 106
4.1.1.2 The Development of Speech and Language .. 109
4.1.2 Disorders of Speech, Voice and Language ................... 110
4.1.2.1 Speech Disorders ........................................... 111
4.1.2.2 Language Disorders ....................................... 112
4.1.3 Language Diversity in the Classroom and Remedial
Teaching........................................................................ 114
4.1.3.1 Areas of Language Development during
School-age Years ........................................... 115
4.1.3.2 Alternative Strategies for Classroom Teachers 117
4.1.3.3 Intervention Principles ................................... 118
4.2 Type 6- Specific Learning Disabilities ..................................... 119
4.2.1 Types of Learning Disabilities ...................................... 121
4.2.1.1 Common Types of Learning Disabilities ....... 122
4.2.2 Causes, Diagnosis and Assessment Techniques ........... 122
4.2.3 Adaptations in Teaching ............................................... 126
4.2.3.1 Adapting Assessment/Evaluation Process ..... 128
4.2.3.2 Remedial Instructions within Curriculum...... 129
4.3 Self-Assessment Questions ....................................................... 131
4.4 References ................................................................................. 133

Unit-5: Types of Exceptionalities-IV ........................................................... 135

Introduction ........................................................................................ 136
Objectives .......................................................................................... 136
5.1 Type 7- Intellectual and Developmental Disabilities................ 137

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 5.1.1 Classification and Assessment ...................................... 140
5.1.2 Implications of Intellectual and Developmental Disabilities 143
5.1.3 Instructional Approaches .............................................. 144
5.2 Type 8- Gifted and Talented ..................................................... 145
5.2.1 Defining Multiple Intelligence ...................................... 146
5.2.2 Identification and Accommodation of Diversity .......... 147
5.2.3 Gagne’s Model of Gifted .............................................. 150
5.3 Teaching Strategies for Academic Skills, Functional skills and
Social Competencies ................................................................. 157
5.4 Self-Assessment Questions ....................................................... 161
5.5 References ................................................................................ 163

Unit-6: Early Identification, Assessment and Early Intervention of Special

Children ............................................................................................ 165
Introduction ........................................................................................ 166
Objectives .......................................................................................... 167
6.1 Basic Assumptions and Principles of Intervention ................... 168
6.2 Review of Research on Early Identification, Early Assessment
and Early Intervention.............................................................. 172
6.3 Models of Early Interventions .................................................. 182
6.4 Concepts and Significance of Multi Disciplinary Approach .... 190
6.5 Self-Assessment Questions ....................................................... 194
6.6 Web Links ................................................................................. 194

Unit-7: Attitude Towards Handicap: Individual, Family & Community 195

Introduction ........................................................................................ 196
Objectives .......................................................................................... 197
7.1 Positive and Negative Attitudes ................................................ 198
7.2 Attitudes and Social Psychology of the Handicapped .............. 202
7.3 Labeling .................................................................................... 205
7.4 Goffaman’s Theory of Stigma .................................................. 206
7.5 Handicapped Persons in the Family and Community ............... 209
7.6 Self-Assessment Questions ....................................................... 214
7.7 References ................................................................................. 215

Unit-8: Organizing and Managing Special Needs in School ..................... 217

Introduction ........................................................................................ 218
Objectives .......................................................................................... 219
8.1 Special Education Needs........................................................... 220
8.2 Curriculum Design for Special Education Needs ..................... 221
8.3 Placement and Management in: ................................................ 224

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 8.3.1 Residential School / Day School................................... 225
8.3.2 Itinerant Teacher / Peripatetic Teacher ......................... 226
8.3.3 Special Education Consultants...................................... 228
8.3.4 Resource Room ............................................................. 230
8.4 Competencies of Special Education Teacher ............................ 232
8.5 Classroom Organizing and Management .................................. 234
8.5.1 Classroom Organization................................................ 234
8.5.2 Classroom Management................................................ 238
8.6 Transition and Vocational Rehabilitation Services................... 241
8.7 Self-Assessment Questions ....................................................... 243

Unit-9: Current Trends and Issues in Special Education ......................... 244

Introduction ........................................................................................ 246
Objectives .......................................................................................... 246
9.1 Issues in Identification, Diagnosis, Assessment and placement 247
9.2 Segregation vs. Integration vs. Inclusion .................................. 249
9.3 Special Education vs. Regular Education ................................. 252
9.4 Special Curriculum vs. Regular Curriculum ............................. 254
9.5 Adaptations in Curriculum, Instructions and Evaluation.......... 255
9.6 Individualized Education Program ........................................... 258
9.7 Activity ..................................................................................... 260
9.8 Self-Assessment Questions ....................................................... 260
9.9 References ................................................................................. 261

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Unit: 1

INTRODUCTION TO SPECIAL
EDUCATION

Written By:
Sharif Ullah

Reviewed By:
Dr. Shaista Majid
 INTRODUCTION
The educational progress of a country is best indicated by the quality of its special
education, which is based on the realization of equal educational opportunity. Special
education deals with education of the disabled or handicapped and the gifted. Education
of the disables is linked to justice, while that of the gifted is concerned with the
accomplishment of an individual's potential. In recent years the educational agenda of the
government is to care about the disadvantaged and cultivating the talents, and the
promotion of special education as an effort to boost the national competitiveness.

The History of Special Education presents a four-part narration that traced by its
emergence in fascinating foundation from 16th-century Spain through the Age of
Enlightenment in 17th-century France and England to 18th-century issues in Europe and
North America of placing, curriculum, and early intervention. It considers the status of
teachers in the 19th century and social trends and the movement toward integration in
20th century programs as well.

Special education is a product of human compassion and the need to reduce social and
economic problems sustains it. Democratic ideals focus further on the importance of
special education and the legislation to safeguard the rights and interests of the disabled
protects it. The purpose of this unit is to enable the readers to make information on
special education available to the public and explain the policy of government, describes
the history, administration, current status, key measures of and outlook for special
education.

OBJECTIVES
More specifically it is hoped that the study of this unit will enable the students to:
1. modern trends in special education and then relate them to future possibilities in the
field of special education.

2. identify the causes of emergence of special education as a discipline of study and

demonstrate its importance for the coming generation.

3. describe the significant changes which have taken place in the field of special
education and the manner in which they are influencing the system of education.

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1.1 Basic Concept and Terminology of Special Education
It is the type of education given to a child with special educational needs. It is special
because it has the following characteristics:
 Qualitative in nature and expensive
 Makes use of Specially trained personnel
 Requires the use of special teaching and learning materials/equipment
 Employs special teaching methods
 Emphasises the Individuality of student,etc.

What do you imagine when you think about special education? You might think about the
children with disabilities spending the day tucked away in different kinds of classroom,
separated from most of the kids of their age. Special education today is still focused on
helping children with disabilities to learn. But this no longer has to mean placing kids in a
special classroom all day long. In fact, federal law requires that students who receive
special education services be taught alongside their non-disabled peers as much as
possible. For example, some students with dyslexia may spend most of the day in a
general education classroom. They may spend just an hour or two in a resource room
working with a specialist on reading and other skills. Such students might need more
support than that, or even they might need to attend a different school that specializes in
teaching kids with learning disabilities.

There is no “one size fits all” approach to special education. It’s tailored to meet each
student’s needs. Special education refers to a range of services that can be provided in
different ways and in different settings. If a child qualifies for special education, he/she’ll
receive individualized teaching and other key resources at no cost. The specialists who
work with the child will focus on his strengths as well as on his challenges. parents are
the important members of the team that decides what he/she needs to make progress in
school.

1.1.1 Terminology of Special Education

The world of special education is challenging enough for specialists in the field to stay
abreast of the terminology.

Special education (also known as special needs education, aided education or exceptional
education) is the practice of educating students with special educational needs in a way
that addresses their individual differences and needs. Ideally, this process involves the
individually planned and systematically monitored arrangement of teaching procedures,
adapted equipment and materials, and accessible settings. These interventions are
designed to help individuals with special needs achieve a higher level of personal self-
sufficiency and success in school and in their community, which may not be available if
the students were only given access to a typical classroom education.

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Common special needs include learning disabilities, communication disorders, emotional
and behavioral disorders (such as ADHD and ADD), physical disabilities(such as Brittle
Bone Disease, Cerebral Palsy, Muscular Dystrophy, Spinal Bifida, and Frederich's
Ataxia, etc.), and developmental disabilities. Students with these kinds of special needs
are likely to benefit from additional educational services such as different approaches to
teaching, the use of technology, a specifically adapted teaching area, or a resource room.
Intellectual giftedness is a difference in learning and can also benefit from specialized
teaching techniques or different educational programs, but the term "special education" is
generally used to specifically indicate instruction of students with disabilities.
Special education is designed specifically for students with special needs, whereas
remedial education can be designed for any students, with or without special needs. In
most developed countries, educators modify teaching methods and environments so that
the maximum numbers of students are served in general education environments.
Therefore, special education in developed countries is often regarded as a service rather
than a place. Integration can reduce social stigmas and improve academic
achievement for many students.

The Individuals with Disabilities Education Act (IDEA) is the federal law that defines
and regulates special education. The law requires public schools to provide special
education services to children ages 3 to 21 who meet certain criteria. (Children younger
than 3 can get help through IDEA’s early intervention services.) To qualify for special
education services, a student must:
 Have a documented disability that is covered by IDEA, and
 Need special education in order to access the general education curriculum

“Access” is an important term in education. The curriculum would be made accessible to

the students with disabilities. Difficulties in the learning, such as difficulty reading, the
school needs to come up to the child access the reading material. There is a defined
process that determines, which students are eligible for special education. This process
involves a comprehensive evaluation of the child. It also looks at other aspects of his
development. Parents can request an evaluation of their child. The testing of child is
conducted in special education at no cost to the parents.

Federal law also says that students with learning disabilities should be educated alongside
their non-disabled peers “to the maximum extent possible.” Schools use many strategies
to help students receiving special education services succeed in general education
settings. These strategies include:
 Assistive technology such as providing a laptop to help a student with a writing
disability take notes in class
 Accommodations such as seating the student near the teacher (and far from
distractions) or allowing him to give oral reports instead of writing essays
 Modifications such as reducing the amount of homework a student is assigned
 Paraprofessionals who serve as teachers’ aides helping students with various tasks
such as taking notes and highlighting important information

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Other types of classrooms or placements should be considered only if you and the school
think your child will not be able to experience success in the general education
classroom. There are some important things to consider before changing your child’s
placement. For example, it’s important to know that schools can’t use budget issues as a
reason to refuse to provide accommodations and services.

Sometimes even with supports and services, some students might not be able to keep up
with the pace of a general education classroom. There are some other possible alternative
placements as mentioned below:
 Self-contained classroom: Some students may make more progress in a classroom
that is only for students receiving special education services. A self-contained
classroom is taught by a special education teacher and typically has far fewer
students than a general education classroom. With a lower ratio of students to
teachers, a self-contained classroom can offer more one-on-one teaching that is
tailored to each student’s goals and objectives. Self-contained classrooms are
sometimes referred to as special classrooms. Some students may spend all day in
self-contained classrooms. Other students may spend part of the day
“mainstreamed” in general education classrooms such as for art and P.E.
 Inclusion classroom: A third option that is popular at many schools is called
an inclusion classroom. This type of classroom includes a mix of students who do
and do not receive special education services. A special education teacher and a
general education teacher share equal responsibility for teaching the class. They
weave in lots of learning supports to help students with different learning styles and
skill levels.
 Out-of-district placement: Some students may need more specialized teaching or
support than their local school district can provide. If a child isn’t making adequate
progress, the district may agree to what’s called out-of-district placement. This is
when the district covers the cost of educating a child somewhere else, such as:
 A public school in another district
 A private day school that specializes in teaching kids with certain kinds of
disabilities
 A boarding school where students live full-time

Sometimes school districts will agree to an out-of-district placement. But sometimes

families have to use dispute-resolution strategies to achieve this outcome.

Accommodations are a key component of special education. Much like a wheelchair

ramp allows more people to access a building, classroom accommodations allow more
students to access the general curriculum. For example, if a child has dyslexia, text-to-
speech software that reads aloud the words on a computer screen can help him access
material that is at a higher level than he could read on his own. There are also
accommodations for taking tests. Students are expected to learn the same material. But
they can show what they know in a different way. For example, if a child has a reading
disability, the teacher might ask the test questions aloud. Some students

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receive accommodations on standardized tests as well classroom tests. Getting extra time
to complete tests is a common accommodation.

When people talk about accommodations, they often talk about modifications as well. It’s
important to understand the difference between accommodations and modifications.
Accommodations refer to how a student learns. Modifications refer to how much a
student is expected to do or learn. For example, some students may be given shorter
writing assignments or fewer math problems. Other students may be provided books with
a lower reading level than the ones that are assigned to their non-disabled peers. It’s
common for a student to receive both modifications and accommodations. Some students
may receive one type of support but not the other. And some students might not need
either. Here are examples of common accommodations and modifications.

Federal law allows schools to provide certain kinds of services that aren’t strictly
educational but are needed so that students can benefit from special education. These are
called related services. For example, a child who has dysgraphia or dyspraxia may need
one-on-one sessions with an occupational therapist to improve handwriting skills. Other
examples of related services include:
 Mental health counseling for children and parents
 Social work to provide support to children and families and assist in
developing positive behavioral interventions
 Speech-language therapy to improve communication skills that affect learning
 Transportation to and from school and, in some cases, to and from extracurricular
activities.

Another term you may hear is “supplementary aids and services.” These can include
adapted equipment, such as a special cushion that can help kids with attention or sensory
processing issues stay seated and focused for longer periods of time. Other examples of
supplementary support include assistive technology and training for staff, students and
parents.

The IEP is often described as the cornerstone of special education. That’s because
this legally binding document details a student’s annual learning goals as well as the
special services and supports the school will provide to help him meet those goals. Before
your child can receive special education services, you and the school must complete
several steps. Here’s how the process generally works:
i. Referral for evaluation: When your child is struggling and a learning or attention
issue is suspected, you or the school can ask for an evaluation. Your request may
be accepted or denied. Either way, the school must explain its decision to you. The
school can’t evaluate your child unless you give written permission.
ii. Evaluation: If the school agrees to evaluate your child, the school psychologist
and other specialists will give your child various tests. They also may observe him
in the classroom. The evaluation will identify whether your child has one of the 13
disabilities covered by the IDEA. The evaluation will also provide information

6
 about his educational needs. Medical conditions such as ADHD are diagnosed by a
physician or another medical professional. However, federal law doesn’t
necessarily require a medical evaluation to identify a child as having ADHD. Some
school districts have policies that allow school psychologists to diagnose ADHD as
part of the special education evaluation. School psychologists need to have
appropriate training to do this.
iii. Determination of eligibility: After the evaluation, a special team from the school
meets with you to discuss whether your child has a disability and if it affects his
ability to learn. (If your child doesn’t meet the requirements for an IEP, he may
qualify for a 504 plan, which can provide many of the same accommodations and
services.)
iv. Developing the IEP: If your child is eligible for special education, his IEP
team creates a plan to meet his needs. You are an equal member of this team
and play a very important role. You know and understand your child better than
anyone else on the team. Your insights can help ensure that your child receives the
services and supports he needs to succeed in school.

There’s a common saying in public schools: “Special education is not a place. It’s a
service.” Take advantage of the resources that are available to your child. And remember
that many of these resources are available to your child in a general education classroom.
If you’re debating whether to have your child evaluated for special education, thinking
through some key questions could help you make up your mind. If you decide to go for it,
Understood can help you prepare for the evaluation and develop the IEP. And if you
choose not to get an evaluation, or if your child is denied special education services, this
site has other suggestions for how you can help your child.

Activity:
i. What do you imagine when you think about special education?
ii. What does related services mean to you?
iii. Name the team of experts in an I.E.P team?
iv. Differentiate between accomodation and modification.
v. Define the terms special education, general education, mainstreaming and inclusive
education.

1.2 Evolution in the Status of the Disabled person

The Evolution of Disability Policy “The Evolution of Disability Policy” presents a brief
overview of the early history and evolution of disability policy and practice, highlighting
special education, accessibility standards and employment strategies. In early Medicine,
disabilities were narrowly defined as impairments or disturbances at the level of the
body; medical problems to be either prevented or corrected. Early scientific inquiries
into disability tended, therefore, to consist of compartmentalized research into the
disabling outcomes of specific medical conditions. This scientific compartmentalization
of disability contributed to segregated institutional responses to disability which led to the
formation of separate advocacy and self-help organizations for each type of disability.

7
Two enduring trends were thus established which have exerted a powerful influence over
the circumstances of disabled people for nearly two centuries; one towards approaching
disability from a medical perspective, and the other towards the institutional
compartmentalization of people with disabilities according to disability type.

The Eighteenth Century discovery that people with disabilities could learn precipitated
the emergence of special schools and custodial care institutions for the visually and
hearing impaired. Such institutions did not emerge until much later for people with
physical disabilities, and most of them were affiliated with hospitals. This divergence in
institutional responses to the different disability communities resulted in differences in
the capabilities of those communities which tended to favor the visually and hearing
impaired. Until the emergence of the disability rights movements of the 1960s and 70s,
most education of people with disabilities took place in segregated facilities supported by
churches and charitable organizations. During this period, government involvement in
special education tended to be meager and carried out through ministries and departments
of social welfare, not education.

Employment strategies for people with disabilities emerged in the 1920s and 1930s.
During this early period, most of Europe tended to favor quota and quota levy systems
while the emphasis in the United States, Canada, Sweden, Finland and Denmark tended
to be on vocational rehabilitation and training strategies. The Soviet Union employed a
unique system of reserved employment schemes and state authorized disabled-run
enterprises. Though elements of all three approaches continue to exist in various forms,
vocational rehabilitation has enjoyed the most widespread acceptance, and still serves as
the centerpiece of many national disability policies. Though clearly an improvement
over the custodial care strategies that preceded them, traditional vocational rehabilitation
strategies have tended to focus too heavily on adapting disabled people to existing
marketplaces, and too little on the need to make the marketplaces themselves more
accessible and accommodating. They have also tended to waste resources on expensive,
counterproductive and socially isolating segregated institutional systems. Policies to
reduce architectural and design barriers are relatively new and, in their absence, built
environments have typically been designed with characteristics that unnecessarily restrict
the activities of people with below “normal” functional capabilities. In recognition of the
limitations imposed on people with disabilities by unnecessary architectural barriers,
accessibility standards appeared in the United States in 1961 and Great Britain in 1965.
Statutory requirements emerged later in the 1960s in Sweden and Denmark. The first
compliance mechanisms appeared in the United States in 1981 and Britain in 1985.

1.2.1 Evolution of Human Rights of Disabled Persons

In the 1940s and 1950s the United Nations was active in promoting the well-being and
rights of persons with physical disabilities through a range of social welfare approaches.
The United Nations provided assistance to Governments in disability prevention and the
rehabilitation of disabled persons through advisory missions, workshops for the training
of technical personnel and the setting up of rehabilitation centers. Seminars and study
groups were means of exchanging information and experience among experts in

8
disability. Fellowships and scholarships were awarded for trainers. As a result of
initiatives from within the community of disabled persons, the 1960s saw a fundamental
reevaluation of policy and established the foundation for the full participation by disabled
persons in society.
In the 1970s, United Nations initiatives embraced the growing international concept of
human rights of persons with disabilities and equalization of opportunities for them. In
1971, the General Assembly adopted the "Declaration on the Rights of Mentally Retarded
Persons". This Declaration stipulates that mentally retarded persons are accorded the
same rights as other human beings, as well as specific rights corresponding to their needs
in the medical, educational and social fields. Emphasis was put on the need to protect
disabled persons from exploitation and provide them with proper legal procedures. In
1975, the General Assembly adopted the "Declaration on the Rights of Disabled
Persons", which proclaims the equal civil and political rights of disabled persons. This
Declaration sets the standard for equal treatment and access to services which help to
develop capabilities of persons with disabilities and accelerate their social integration.

1.2.2 Commission on the Status of People with Disabilities 'A Strategy for
Equality' (1996)
The Commission on the Status of People with Disabilities was established in November
1993 by the Minister for Equality and Law Reform. The Report of the Commission sets
out an equality strategy that will, if implemented, 'set about removing the barriers which
stand in the way of people with disabilities who want to live full and fulfilled lives, and
that will also benefit greatly the parents and carers of people with disabilities. The
Commission's strategy involves legislative solutions, proposals for new policy initiatives
and new structures for delivery of equality services within a framework of rights, not
charity.

The Commission appointed a number of Working groups and individuals to examine and
develop proposals on various issues (Education, Arts/Culture, Work/Training, Family
Supports/Personal Supports, Housing/Accommodation, Health, Mobility/Transport,
Rights of People with Disabilities, Sexuality and Relationships, Technology/
Communications, and Consultative Process).

The report of the Commission on the Status of people with Disabilities is the result of
lengthy consultation with and participation of people with disabilities, their families and
carers whose views were expressed at 'Listening Meetings' throughout the country, and of
written submissions made to the Commission.

The Report includes a series of 402 recommendations under the following headings:
1. Policy and Structural Changes
i. Legal status of people with disabilities
ii. Policy development and implementation
iii. Delivering the necessary services
iv. Costs: Budgeting for equality

9
2. Economic Rights
i. Income and disability
ii. Work and training
iii. Insurance

3. Social and Civil Rights

i. Access
ii. Health
iii. Education
iv. Housing and accommodation
v. Transport and mobility
vi. Technology and communications
vii. The law and the legal system
viii. Political rights
ix. The inclusion of women with disabilities
x. Sexuality and relationships
xi. Religious practice
xii. Arts and culture
xiii. Media
xiv. Sports, leisure and recreation

1.2.3 The Legacy of the Commission on the Status of People with Disabilities
(1993)
The Americans with Disabilities Act (ADA) was signed into US law in July 1990. The
ADA Bill was being considered by Congress. It was impossible not to get caught up in
the energy and excitement of that time about the prospect of legislation, the prime
purpose of which was to provide a ‘clear and comprehensive national mandate for the
elimination of discrimination’ and ‘clear, strong, consistent, enforceable standards’ in
relation to disability discrimination. Looking back now, an anti-discrimination law might
seem to have been a good but somewhat limited goal. But back then it was ground-
breaking and inspirational.

The National Rehabilitation Board (NRB) was at this time undertaking a major review of
its role. And a key issue which we wanted to address was the question of disability rights.
When NRB launched a strategic plan in 1991, it said its mission was ‘on behalf of the
State and in consultation with people with disabilities, to enable and empower people
with disabilities to live the life of their choice to their fullest potential.’ The plan asserted
that one of the ways by which this mission was to be accomplished was by promoting
recognition of rights and equality of opportunity through, inter alia, encouraging new
legislation.

In furtherance of that last objective, NRB in Autumn 1992 asked Dr Gerard Quinn of the
Faculty of Law at UCG to oversee a review of disability legislation in Australia, Canada
and the US in order to help inform the debate in Ireland on what legislation was needed
to provide a firm foundation for equality of opportunity and full participation in society

10
of persons with a disability. While that work was underway, the Government announced
that a Cabinet Minister for Equality and Law Reform would be appointed with
‘responsibility for seeing that equality becomes reality through institutional,
administrative and legal reform.’ The person appointed to that post was Mervyn Taylor TD.
In November 1993 the Commission on the Status of People with Disabilities was
established by Minister Taylor. The priority task given to the Commission was ‘to advise
the Government on practical measures to ensure that people with a disability can exercise
their rights to participate, to the fullest extent of their potential, in economic, social and
cultural life,’ echoing the NRB mission statement quoted earlier.

The Commission submitted its report to Government in November 1996.. Some 600
written submissions were received, 327 of which came from individuals with disabilities,
111 from parents and others close to persons with disabilities and 162 from organizations.
The Commission held 30 well-attended ‘listening meetings’ around the country as well as
a number in and around Dublin. The Commission appointed a large number of working
groups (with over 150 members in all) as well as a panel of Advisors. Given the level,
extent and quality of participation, it was hardly surprising that the Commission’s report
to Government ‘A Strategy for Equality’ contained as many as 402 recommendations.
The Commission was not the only significant happening at this time. The Commission
report records: ‘After various stops and starts over the years, the Irish disability
movement restarted again towards the end of the UN Decade of Disabled Persons (1981-
1990). As the European Movement of disabled people grew, more Irish people with
disabilities became aware of it and wanted to be part of it. This led to the establishment
and growth of organizations controlled by people with disabilities. The core message of
politically active groups such as the Forum of People with Disabilities, the Centre for
Independent Living and the Advocacy Ireland Movement was and continues to be heard
both by the media and by policymakers.

Activity:
i. What employment strategies for people with disabilities emerged in the 1920s and
1930s?
ii. What types of requirements emerged later in the 1960s in Sweden and Denmark?
iii. What are the recommendations of the General Assembly’s"Declaration on the
Rights of Mentally Retarded In 1971?

1.2.4 Modern Age

Education in general and special education in particular are undergoing rapid and
dramatic changes, and a number of current trends offer implications for future policy and
practice. It is becoming clear that principles of special education are shaping the future of
all education. As schools become more inclusive, attention is focused on accommodating
student diversity, emphasizing the role of the learner in creating knowledge, and
supporting individualized instruction and assessment. Early education is increasing, with
the major goal of preventing learning problems. As regular and special education merge,
individualized programs and cooperative practices are becoming available to all students.
As school structures change, so too will pre-service and in-service programs that prepare

11
educational personnel. Emerging trends in professional education include integrated
interdisciplinary models for joint preparation of regular and special educators, social
workers, therapists, and other personnel; innovative delivery systems such as field-based
models, distance education, and alternative certification; and evolving national standards
to promote consistency in training and licensing across states. Technological advances
have particular significance for special needs students, especially in the areas of assistive
devices, multimedia instruction, and distance education. Changes in practice will lead to
changes in educational policy on a broad scale. The inclusion movement will lead to a
unified educational system that provides special services to every child based on
identified needs. Early intervention and high school transitional services will become
commonplace.

1.2.5 Special Education for the 21st Century

In the late 20th century, a tidal wave of calls for reform and inclusion of special needs
students swept over public special education. The current debates over implementing
these themes today are authoritatively addressed by 19 distinguished scholars in this
thorough volume. Organized into three cohesive sections, it begins with the issues of
educational reform and the emerging discourses of disability and integration in the
inclusion movement. Respective chapters appraise specific arguments for inclusion and
the federal legislation and litigation surrounding and supporting special education.

The second part features the thorny issue of assessment, the technological revolution in
special education, and the disposition of teacher training. The third section scrutinizes the
inclusion of various populations of students with exceptional needs, particularly how
teachers can make an easy transition from ideology to educational practice.

Special Education in the 21st Century sets the standard for extrapolating future directions
by wisely weighing classroom practices for different groups and the technical problems
of resources, management, social groupings, instructional design, and the supposition that
teachers will automatically change to accommodate an even greater diversity of learners
In recent years, much has been written and said about how to best prepare today’s
students for the personal and professional challenges they are likely to meet as they move
into the ever-changing 21st century world. For most, it is believed that a solid grounding
in academic subjects such as reading, writing, math, social studies, science and
technology will be essential for life and all types of employment. Additionally, students
will need to know how to gather new information from a variety of traditional and
technological sources, be creative problem solvers and work well with others. Over the
past few years, federal and state educational standards and testing requirements have
been revised with the intention of helping more and more students, both mainstream and
those with special needs, leave school with such a solid educational base.

Yet, in special education, where student’s abilities and needs are vast and future goals
and plans can sometimes be dictated by disabilities, “one size” educational standards do
not necessarily fit most. Based on this reality, BOCES special education teachers and
supervisors are working on how to best deliver high quality, standards-based education

12
that will matter most to their students. “Just as our colleagues in the mainstream are
considering the skills and attitudes their students will need most to succeed after
graduation, we are taking a thoughtful look at exactly how we can tailor our programs
and instruction in ways that will best prepare our students for the21st century,” says Inge
Jacobs, director of the BOCES Special Education Division.

Activity:
i. As schools become more inclusive, what will be the ultimate impact on students
attention?
ii. What are the particular significance of technological advances for special needs
students?

1.3 Pathological and Sociological Approaches to Special Education

The purpose of a special education evaluation is to determine whether the student has one
or more disabilities; the present level of performance and educational needs of the
student; whether the student needs special education and related services; and whether
any additions or modifications to the special education and related services are needed to
enable the student to meet the measurable annual goals in the IEP and participate, as
appropriate, in the general education curriculum (Virginia Special Education Regulations,
8 VAC 20-81-70). The VDOE publication, Guidance for Evaluation and Eligibility for
the Special Education Process, provides specific information on referral, assessment, and
eligibility decision-making.

Upon referral for evaluation, a team, having the same composition as the IEP team and
other qualified individuals as appropriate, reviews existing data and determines whether
additional data are needed to determine eligibility. The team reviews: evaluations and
information provided by the parents of the student; current classroombased and state
assessments, and observations; and observations by teachers and related services
personnel (Virginia Special Education Regulations, 8 VAC 20-81-70 B). If the team
decides that additional data are needed to determine whether a student is eligible for
special education and related services due to a possible communication disorder, a full
and complete assessment of communication abilities may be conducted by the SLP.
Other professionals in the school division or in the local medical community may
complete other assessments as requested by the team.

The evaluation of a student to determine whether he/she has a speech-language impairment

should be multifaceted and include multiple data sources (teachers, parents, students, other
service providers), types of data (quantitative and qualitative), a variety of types of
measures and procedures (authentic assessment strategies, criterion-referenced measures,
normreferenced tests, dynamic assessment procedures, etc.), and several environments
(classroom, playground, home) as appropriate for each child. As a result of the evaluation,
the eligibility team will have a complete picture of the student’s communication abilities
and needs. The resulting speech-language evaluation report should:
i. provide a comprehensive assessment of the student’s communication skills,

13
ii. identify strengths and weaknesses, and
iii. present information for determining whether the student has a speechlanguage
impairment that adversely affects educational performance.
Speech-language pathologists have expertise in language and should ensure that all
components of the evaluation consider language differences and dialect use. Evaluation
data that provides evidence of dialect use or language difference should be documented
and may not be considered a disability. When language differences or dialects are
inappropriately viewed as errors, students may be inappropriately identified as having a
disability. Virginia regulations clearly state that “tests and other evaluation materials used
to assess a student must not be discriminatory on a racial or cultural basis.” (8VAC 20-
81-70) Additional information on language diversity is provided in the special topics
section. During a speech-language assessment, all procedures, tests, and materials must
meet specific conditions (Virginia Special Education Regulations, 8 VAC 20-81- 70 C).
Examples of these conditions include:
 Assessment measures must be provided in the student’s native language or other
mode of communication unless it is clearly not feasible to do so.
 A variety of assessment tools and strategies should be used to gather relevant
functional and developmental information on a student; this must include information
related to enabling a student to be involved in and progress in the general education
curriculum, or, in the case of a preschooler, to participate in developmentally
appropriate activities. The evaluation materials, including, but not limited to, any
norm-referenced tests that were administered, should assist in determining whether
the student has a disability and, if eligible, the contents of the IEP.
 The assessment instruments must be validated for the purpose for which they are
used and administered by trained personnel in accordance with the instructions
provided by their producer and should be able to provide evidence of adequate
sensitivity and specificity.
 Any measure (norm-referenced, criterion-referenced, or systematic observation),
administered by qualified personnel, may be used to assist in determining whether
the student meets the criteria to determine that a student.

1.3.1 Strategies
Among a lot of strategies, we have:
 Ensure that schools, curricula, assessment procedures and teaching and learning
materials are accessible and fair for all.
 Promote the availability and training of relevant professionals as well as facilities
for medical assessment; educational assessment, training in social skills,
psychological assessment, occupational therapy, and speech/language assessment.
Also, ensure early identification and stimulation of children with disabilities as
well as coordinated support services for families of children with disabilities
 Promote a system of flexible examination structure that permits pupils/students to
sit for exams in diverse forms (e.g. verbal listening/verbal exams, use of picture
exchange communication, written, etc to meet the diverse educational needs).

14
 Ensure that physical infrastructure designs of existing schools are modified to
enhance
 opportunities for persons with SEN.
 Ensure that physical infrastructure designs of existing schools are modified to
enhance opportunities for persons with SEN.
 o Ensure that all new school physical infrastructure designs and constructions (for
all new schools) enhance opportunities for persons with SEN.

Activity:
i. What is the purpose of a special education evaluation?
ii. What should the resulting speech-language evaluation report include?

1.4 Special Education System in Pakistan

The importance of education for every person as well as every nation cannot be over-
emphasized. Its importance is increased to a greater extent in case of persons with
disabilities, as education can help them to adjust in the society. In special education, there
are specially designed instructions to meet the unique needs and abilities of disabled
children. Disabled children have conditions that adversely affect their progress in
conventional educational programmes. Gifted children are those who demonstrate high
capacity in intellectual, creative, or artistic areas, may perform poorly in regular
educational programmes. Special education services can help both disabled and gifted
children make progress in education programmes. However, only disabled children are
taken in special education programmes in Pakistan.

The Government of Pakistan recognizes its responsibility to educate the handicapped

pupils first time in the report of Commission on National Education, 1959. But the
proposal to provide education for these children was not made until the Education Policy
1972-1980, and in the Fifth Five Year Plan (Pakistan Planning Commission, 1978), a
modest sum was allocated to special education. In 1980s, much greater government
involvement was witnessed and increased budgetary provision for special education,
though still insufficient, was made. During the Sixth Five Year Plan (1983-1988), the
social welfare programme concentrated on strengthening existing institutions of social
welfare and special education. In order to overcome organizational setbacks, the Federal
Directorate General of Special Education with provincial counterparts was set up in 1985.
Today a considerable number of special education institutions are functioning under the
control of the provincial governments for the children having different disabilities.
Recently, the special education institutions run by the federal government are devolved to
the respective provincial governments in the consequences of the implementation of 18th
amendment in the Constitution of the Islamic Republic of Pakistan.

Although the achievement in the form of services for the disabled children has been
insignificant as compared to the need and problem of disability in the country, yet there is
some hope for the future, and education is the best tool for enabling special children to

15
take charge of their destinies. The present paper focuses on a review of the special
education in Pakistan in the perspective of educational policies and plans. The present
study aimed at reviewing the efforts of the Government of Pakistan in the introduction
and expansion of the services for the persons with disabilities. For this, the provisions of
special education and related services were analyzed in the educational policies and five-
year development plans.

1.4.1 Special Education in Five Year Plans

Historically, educational policy and practice in Pakistan has been influenced by the
legacy of the British (1757 - 1947) (Fontana and Lari, 2006). A specific programme for
the disabled persons named “Services for the Physically Handicapped” was included in
the very First Plan of National Development (1955-60). However the programme could
not be fully implemented due to lack of administrative support, funds, trained
personnel’s, etc. The programme had since been repeated in the subsequent four plans
1960 to 1983. In the Fifth Five Year Plan, a notable sum of 26 million was allocated for
the purpose as compared to 2 million provided in the First Plan. The establishment of
four model special education institutions for disabled children in Islamabad, under the
Ministry of Health and Social Welfare, was an achievement of the Fifth Plan (1978-83).

In the 1980s, much greater government involvement was witnessed and increased
budgetary provision for special education (though still inadequate) was made (Lari,
2006). During the Sixth Plan (1983-1988), the social welfare programme focused on
improving existing institutions of special education and social welfare, both government
and non-government. In order to overcome organizational setbacks, a Federal Directorate
General of Special Education with provincial counterparts was set up in 1985 and the first
National Policy for Rehabilitation of the Disabled was formulated in 1986 (Lari, 2006).

While quoting WHO figures for disability (10 to 15b of the population), and recognizing
the need for special schooling and rehabilitative services, the Seventh Five-Year Plan
(Pakistan Planning Commission 1988) noted that the existing facilities were few and
inadequate. The facilities came under the Ministry of Social Welfare and Special
Education (recently devolved), which is responsible for providing both special schooling
and integrated and comprehensive rehabilitative services to children with disabilities.

1.5 Policy and Legislation in Special Education

The Education for All (EFA) movement which was launched at the World Conference on
Education for All in Jomtien, Thailand declared the rights of all children, young people
and adults to education in 1990. In 1994, the World Conference on Education on Special
Needs Education held at Salamanca adopted the principle of Inclusion as an important
means of achieving the Education for All as put forward in Jomtien. A decade after the
Jomtien declaration, its vision and mission were reaffirmed at the World Education
Forum meeting in Dakar in 2000. This Forum highlighted the continuing barriers in
education experience by disadvantaged groups and called for positive action to overcome
them. Key International Treaties, Policies Etc. Include:
i. 1948 United Nations (UN) Universal Declaration on Human Rights,

16
ii. ii. 1989 UN Convention on the rights of the child,
iii. 1994 UNESCO Salamanca Statement and framework on Special Needs Education,
iv. 2000 World Forum on Special Needs Education in Dakar, Senegal.

1.5.1 International Legislations

Access to education for students with special education needs is a global phenomenon.
The underlying assumptions, educational strategies, and authorization of legislation
governing special education differ across nations, and are inextricably linked to local
context, societal values, and beliefs about pedagogy and disability.

1.5.1.1 Education Philosophies

Three major philosophies have governed how a nation identifies and educates children
with special needs. Historically, the medical model is the most widespread and has been
used in both diagnosis and educational treatment of children with disabilities. Children
receive a medical diagnosis based on psychological and physical impairments across
selected domains and both strengths and weakness are identified for education and
training. Children with similar diagnoses and functional levels are grouped together for
instructional purposes. Standardized testing is often used to provide a diagnostic name for
a disability. According to Thomas Oakland and Sherman Hu, the accuracy of diagnoses is
questionable as standardized tests are often not suitably normed, and reliability and
validity estimates are often not available, making international comparisons difficult.

In the environmental model, disabilities are experienced as a function of the interaction

between the person and the environment. Environments can be defined in terms of
psychological and social environments as well as physical environments. Environmental
impediments include architectural barriers, lack of assistive technology, and/or limited
transportation. Instructional techniques and learning opportunities can be structured to
compensate for environmental deficiencies to ensure that children learn and achieve skills
of adaptive living. The role of the environment has been recognized in a World Health
Organization classification scheme for individuals with disabilities.

The inclusion model incorporates aspects of the environmental model and views children
as having a right to education with and alongside their nondisabled peers. Schools are
organized to ensure that each student, disabled or nondisabled, receives age-appropriate,
individualized attention, accommodations, and supports to provide access to the general
education curriculum. Assistive technology often facilitates inclusive schooling practice
for both teacher and student.

1.5.1.2 Classification
Attempts to make meaningful international comparisons among students and the
instructional supports and programs for children with disabilities are exceedingly
difficult, given the differing definitions and eligibility criteria. For example, the
Organisation for Economic Co-operation and Development (OECD) reports a range
between 1 percent to 35 percent of the primary and lower secondary education population
across twenty developed nations receiving special needs additional resources, including

17
special teachers, assistive technology, classroom adaptations, and specialized teaching
materials. Additional resources are typically provided to a higher proportion of males
than females (averaging 63b to 37b, respectively).
The OECD also investigated how nations addressed the needs of students requiring
support in the general-education curriculum and expanded their indicators designed to
compare the proportions of students with disabilities, learning difficulties, and social and
economic disadvantages. Three categories emerged. Category A refers to students who
have diagnosed disabilities about which there is substantial international agreement (e.g.,
blind/partially sighted, deaf/hard of hearing, autism, cognitive disabilities, or multiple
disabilities). Category B is an intermediary classification and refers to students who have
difficulty learning and are not easily categorized in either Category A or C. Category C
refers to students who have difficulty learning because of socioeconomic, cultural, and/or
linguistic factors.An examination of special education philosophies and approaches
reveals the following:
 Special education often consists of national and local governmental involvement in
funding and service provision that is supplemented by the work of
nongovernmental service organizations. Oversight of these programs by
governments varies widely.
 The medical model is the predominant philosophy in developing countries and in
many developed countries. Environmental and inclusive models are emerging and
are in varying stages of planning and implementation, primarily in the western
developed nations.
 There are no coordinating international agencies monitoring global progress in
special education, but the United Nations Educational, Scientific and Cultural
Organization (UNESCO) and the United Nations Children's Fund (UNICEF) have
developed teacher education materials in an effort to broaden the "Education for
All" initiative to include children with disabilities.
 International funding sources for education (e.g., World Bank, Inter-American
Development Bank, etc.), are proposing more inclusive approaches to special needs
education.
 All nations recognize a need for improved teacher education, particularly in
teaching children with special needs in regular classrooms.
 Nations with great needs for special education, usually the developing countries,
are attempting to develop family or village-centered programs called community-
based special education. These programs have been shown to be successful.
 A movement toward school-university partnerships shows promise in grounding
teacher preparation in the practice of schooling.

1.5.2 Legislation in Pakistan

The 1981 Disabled Persons Employment and Rehabilitation Ordinance was designed to
provide for the employment, rehabilitation and welfare of disabled persons. The main
characteristic of the Ordinance is the fixing of one percent quota in jobs in all agencies.
The existing Ordinance also allocates quota of one percent to the disabled persons in
admission to educational and professional institutions. A 1985 literacy ordinance was
passed by Parliament in 1987 which emphasised that all Pakistani citizens should acquire
basic literacy skills, including those who are handicapped.

18
Responsibility and Organisation
The Ordinance provides for establishment of a National Council for the Rehabilitation of
Disabled Persons. The Council is chaired by the Secretary of the Ministry of Social
Welfare and Special Education, and is comprised of one representative of each of the
three branches of the Armed Forces, of the Ministries of Manpower, Labour, Health,
Education, Communications, Water and Power, Petroleum and Natural Resources,
Industries, Planning Administrator General Central Zakat Organisation, Trade Unions
NCSW, and four persons from NGOs concerned with the welfare of disabled persons.
The National Council is to:
 formulate policy for the employment, rehabilitation and welfare of disabled
persons;
 evaluate, assess and co-ordinate the execution of its policy by the Provincial
Councils; and
 have overall responsibility for the achievement of the Ordinance’s purposes.

Each Provincial Government shall establish a council to be called the Provincial Council
for the Rehabilitation of Disabled Persons. The composition of the council is similar to
the National Council. There is a Directorate General of Special Education. This
Directorate established special institutions for the handicapped.

Identification, Assessment and Orientation

The National Institute of Handicapped (NIH) has been established to; - co-ordinate
national efforts for prevention of disabilities and develop an integrated referral system
throughout the country, - plan and develop a system of early detection and disseminate
information in the form of guidelines to persons involved, - plan and develop a
multiprofessional assessment and diagnosis system at all levels for prevention, care,
training and rehabilitation of disabled persons, - co-ordinate and support treatment of
disabled by various institutions, - provide treatment for the disabilities by
multiprofessional specialists. It will also utilize existing facilities by effective co-
ordination with major hospitals and Post Graduate Medical Centres for cases of severe
disability, - carry out research in different fields of disability, - provide hospital facilities,
initially for 50 disabled persons, to be extended up to 10 disabled persons in the second
phase.

Age Range Covered by Legislation

The age range is not covered through legislation. In primary level schools the age range is
5-12 years.

Integration
National policy on Education and Rehabilitation of disabled (1985 and reviewed in 1988)
contains special mention of integration of disabled children into regular schools. The aim
is to make it a regular feature of the educational system. Lack of experienced personnel in
managing the education of students with special needs in integrated settings is the main
obstacle in this process.

19
Financing of Education for Special Needs
The Directorate General of Special Education receives their regular budget from the
Federal Government. The ordinance establishes a Disabled Persons Rehabilitation Fund
which collects grants from the federal government and private institutions.

Curriculum
Entitlement The aims of education for disabled children are the same as for other
children. However, for disabled children the priorities in learning and pace of progress is
different. Curriculum guidelines which form the basis of designing syllabus have been
prepared by NISE and are available for the teachers. The disabled students who are
capable of following the normal education curriculum are taught the same regular
textbooks with some adjustments and modifications. Pupils who have severe learning
problems are given training in self-help and daily living skills.

Post 16 Years – Vocational Education

Specialized training programmes in selected skills are provided for moderately and
severely disabled persons at federal and provincial levels. In the federal capital a National
Training Centre for Disabled (NTCD) has been established in Islamabad.

Teacher Training
Training of teachers and other professionals is the prime role of the National Institute of
Special Education. The major aims are; - To develop programmes for manpower training
in special education for employment of professionals in federal or provincial centres or
nongovernmental organisations. - To organise short term as well as long term courses
leading to certificates, diplomas and degrees in special education. - To develop and
publish material for the guidance of special education teachers and parents, and the
general public. - To assist centres to develop curricular responses to the needs of their
pupils.
They also organise short term courses which provide specialized knowledge and skills in
specialized areas. Post-graduate level degree courses in special education and various
areas in disability are offered by specific education departments at the Allama Iqbal Open
University, Karachi University and Punjab University.

1.5.3 National Policies of Special Education

1.5.3.1 Special Education Policies of Pakistan

Immediate after creation of Pakistan, a need was felt to organic the education system
according to the requirements of newly born country. The responsibility of the
Government to educate its handicapped pupils was recognized in the commission on
national education (Pakistan Ministry of Education, 1959). But the proposal to provide
education for these children was not made until the Education Policy 1972-1980.

1.5.3.2 Report of the Commission on National Education (1959)

This Commission on National education was appointed by a resolution adopted by the
Government of Pakistan on December 30, 1958. It comprised of "0 prominent

20
educationists H experts from various departments related to education. The President of
Pakistan inaugurated the commission. The commission started its function with the
inaugural address on January 15, 1959 and presented its report to President on August 26,
1959. The Commission found that government should be responsible for training of
teachers who will serve the institutions for the handicapped run by private
philanthropists. The Commission focused the following major areas;
 For the education and rehabilitation of special children, it was felt that the
professionals such as the doctor, psychologist, physiotherapist, etc must share with
the teacher the responsibility for helping those children to achieve at least some
degree of productive activity and a satisfactory adjustment in the society.
 It was recommended that for almost all of the disability types, the general
education should be combined with vocational education so that the individual may
be equipped to earn his own living and trained to live cheerfully within the limits of
his disability.
 The responsibility of society for the education and other care of these children was
highlighted in the report of the Commission. Owing to our limited resources, it was
suggested to mobilize the community to accept its responsibility for the education
of the handicapped.
 Because the experience of other countries revealed that the actual care of
handicapped children was suitably and effectively performed by the more personal
medical and educational services of private philanthropic organizations, it was
recommended to benefit from such organizations. To overcome the limitations of
resources and to benefit the ability of private organizations, it was suggested that
there should be a partnership between the Government and representatives of social
organizations, to set up agencies specifically for the care of the several types of
handicapped persons.
 The Government suggested providing at its own expense and responsibility the
highly specialized training of teachers to serve in the institutions for the
handicapped. Initially, there should be at least one centre for the training of
teachers for the blind and another for the training of teachers for the deaf and mute
in our country. To take over such a program, our personnel were suggested to be
sent abroad for training and specialization. In the Education Policy (1972-80),
arrangements for special education for handicapped children were planned to make
by opening new institutions and strengthening the existing ones, so that the
handicapped children should be provided the opportunity to become productive and
self-reliant citizens of the country. Educational institutions, generally known as
public schools and including such institutions as Aitcheson college, & ahore,
wholly or partially financed by Government, were inaccessible to the poor students
for the education of gifted and intelligent children, it was decided that all public
schools and institutions falling within the category would be taken over by the
Government and converted into schools for the gifted to provide an enriched
program to gifted students, entirely free, drawn fromall over the country without
reference to their financial status or social background. The National Education
Policy and Implementation Program(1979) was announced in 1979. In its
foreword, the main purpose of the new policy was declared to recommend daring
new effort for reconstruction of education in the country.
21
Following were the major focus areas of the Policy.

1.5.3.3 Policy Statement

In the policy statement, education, treatment, institutional care and rehabilitation of the
handicapped was stated important moral and religious obligations as a nation. According
to the policy, the handicapped citizen should be so rehabilitated as to enable them to enter
the main stream of national life.

1.5.3.4 Rationale
The policy document admitted the fact that there were great efforts of the philanthropic
organizations for the progress made in the field of special education in the country. As
the private organizations were limited in resources and ability, hence coordination among
similar organizations was not easy. The institutions for special children established by the
Government were inadequate in terms of teachers, equipment, books and other physical
facilities. The Policy recognized that the Government would be failing in its
responsibilities if it did not assume direct charge of education and rehabilitation of the
handicapped

1.5.3.5 Programs
The following programs were proposed in the policy regarding the education of the
handicapped children.
 Survey of existing facilities for education of the handicapped in all the four
provinces.
 Identification of institutions, which had the potential of becoming national
institutions.
 development of National demonstration Pilot Projects for Education of the disabled
and handicapped.
 development of projects for identifying needs for strengthening existing institutions
for the disabled. It was proposed that the educational programs for the handicapped
children would include provision of general education together with the vocational
education of the right type so that the handicapped persons did not grow up as a
burden on the resources of the nation but could be directed into productive
activities. As there was only one school in Pakistan to train teachers for the deaf
and dumb schools, it was planned to provide such institutions for the handicapped
at government’s expenses. One teacher-training institute for the deaf and dumb
would be opened in !ind and another for Blind in the Punjab. The efforts of the
philanthropist organizations were proposed to support supplement and coordinate
by the government in opening more special schools in the communities and
strengthening the existing ones. Active involvement of health, Social Welfare and
Industry would be sought to prepare and launch integrated programs for the
handicapped. The curricula and syllabi of special education were also to be made in
according to the needs and requirements of the disabled persons as well as society.

22
1.5.3.6 Education and Training
Pakistan has made significant progress in all related areas since the establishment of
directorate General of Special Education (DGSE) and National Trust for the Disabled
(NTD) at the federal level in eighties. The provincial governments and NGOs joined the
movement and initiated special projects. At International level, the movement towards
making special education an integral part of education has been gaining acceptance.
Therefore, integration and mainstreaming of children with disability in normal system of
education should be promoted at all levels. following measures were proposed for to
achieve the goal.
 Provision of special aids and equipment, alignment of policies between the federal,
provincial and district governments at the level of relevant ministries and
departments, changes in curriculum in collaboration with relevant
departments/agencies, and provision of specialized aids and equipment.
 The existing system of post-graduate training in special education at the university
level was planned to further strengthen.
 The training institutes like National Institute of Special Education (NISE) were
proposed to further strengthen their program of Teacher Training and research to
improve special education services. Similarly, the number of training institutions
available for occupational therapy and physiotherapy were planned to increase
along with training centres for speech the rapists and other relevant professionals.

1.5.3.7 Vocational Training and Employment and Rehabilitation

Vocational training, employment and rehabilitation of disabled persons were the main
focus areas of the National Policy for Persons with disabilities (2002). To achieve the
target, the policy concentrated on the use of information and assisting technology, self-
employment. It was planned to give incentives to employers for the provision of
employment to disabled/special persons.

1.5.3.8 Research and Development

Both academic and applied research was planned to encourage for the benefit for persons
with disabilities both at the federal and provincial levels. 1fforts would be made to enlist
the interest and support of the universities and other organizations particularly in the
areas of medicine, social work, psychology, vocational training, engineering and
technology.

1.5.3.9 Advocacy and Mass Awareness

To create a positive public attitude towards the persons with disabilities, the positive
images of the persons with disabilities was planned to highlight by the projectionof their
success stories through mass media. All possible channels, at community as wellas media
level, are also planned to utilize for the creation of public awareness about thenature and
types of disabilities and the need for community support for their identificationas well as
rehabilitation.

23
1.5.3.10 Sports and Recreation
Provision of appropriately designed sports and recreational facilities for children with
disabilities and adults were planned to undertake in collaboration with all public and
private authorities. Each district/local authority was expected to ensure that budgetary
provisions to enable groups of persons with disabilities to establish clubs for sports and
recreation and to provide appropriate free premises

1.5.3.11 Design of Buildings and Parks and Public Places

The safe and easy access of persons with disabilities in public places/buildings was
planned to ensure by introducing the codes of practice for the design of new public
buildings and for the adaptation of existing premises. for this, it was planned that designs
of public buildings will be prepared with the consultation of the Ministry of Social
Welfare, Special Education, which provided specifications for such aspects of those
buildings used by persons with disabilities such as ramps, lifts, toilets etc. Accessibility to
other buildings of public use also requires special designing to facilitate easy approach
for persons with disabilities.

1.5.3.12 Institutional Arrangement/Mechanism

The policy proposed the following institutional arrangements for its successful
implementationE
 As the role of federal Government in meeting the needs of disabled persons is very
important at national level, the present support level of the federal government for
efforts in the field of education and rehabilitation of person with disabilities was
planned to enhance. for this purpose, joint efforts of the concerned Ministries in
addition to the Ministry of Social Welfare and Special Education were proposed to
fulfil the objectives, laid down in this Policy.
 The role of provincial governments is crucial in providing all the required facilities
to a maximum number of persons with disabilities. Based on the needs assessment,
the provincial governments are expected to draw up action plans for public and
private sectors. federal Government would also provide assistance in areas of
curriculum development and research.
 District governments are expected to enhance the scope of programs for persons
with disabilities. It was planned to include the introduction of the system of
integration of children with disabilities in normal schools in the area of jurisdiction
of district councils and union councils in the local bodies system.
 It was planned to seek community involvement, for which the establishment of
voluntary organizations are planned to encourage. The resources of NGOs in the
field of community social work were planned to channel in the direction of projects
for the welfare and uplift of persons with disabilities.
 To be effective, rehabilitation requires the involvement of a wide variety of
professionals, organizations and community at large. Involvement of “Special
friends” and voluntary support groups were planned to ensure.

24
1.6 Self Assessment Questions
1. What is special education? Define the terminologies used in special education. Also
discuss the concept of special education.

2. Write a brief discussion about the historical and legislative and the background of
special education.

3. Discuss the major categories of exceptionalities, their characteristics and causes.

4. Write briefly the legislation in special education and special education system of
Pakistan.

5. What are the current issues and trends of special education? Give your own
recommendations for the solution of these trends and issues of special education.

25
1.7 References
Benz, M. R., Lindstrom, L., & Yovanoff, P. (2000). Improving Graduation and
Employment Outcomes of Students with Disabilities: Predictive Factors and
Student Perspectives. Exceptional Children.

Bateman, D., & Bateman, C. F. (2001). A principal’s guide to special education.

Arlington. VA: Council for Exceptional Children.

Billingsley, B. S. (1993). Teacher retention and attrition in special education: A

critical review of the literature. Journal of Special Education

Billingsley, B. S., & Cross, L. H. (1991). Teachers’ decisions to transfer from special to
general education. Journal of Special Education.

Brownell, M. T., & Smith, S. W. (1993). Understanding special education attrition: A

conceptual model and implications for teacher education. Teacher Education and
Special Education.

Burrello, L. C., & Lashley, C. (1992). On organizing the future: The destiny of special
education. In K. Waldron, A. Riester, & J. Moore (Eds.), Special education: The
challenge for the future, (pp. 64-95). San Francisco: Edwin Mellen Press.

Coleman, J. S. (1990). Foundati ons of social theory. Cambridge, MA: Belknap Press of
Harvard University Press.

Cook, B. G., Semmel, M. I., & Gerber, M. M. (1999). Attitudes of principals and special
education teachers toward the inclusion of students with mild disabilities: Critical
differences of opinion. Remedial and Special Education.

Cazden, C. B. (2001). Classroom discourse: The language of teaching and learning.

Educational Researcher., A. & Mallinson, C (2011) Understanding English Language

Variation in U.S. Schools. New York, NY: Teachers College Press.

Embich, J. L. (2001). The relationship of secondary special education teachers’ roles and
factors that lead to professional burnout. Teacher Education and Special Education.

Gersten, R., Keating, T., Yovanoff, P., & Harniss, M. K. (2001). Working in special
education: Factors that enhance special educators’ intent to stay. Exceptional
Children.

26
Gonzalez, P. (1996). Causes and cures of teacher attrition: A selected bibliography
focusing on special educators. Alexandria VA: National Association of Directors of
Special Education, (ERIC Document Reproduction Service.

Katsiyannis, A., Conderman, G., & Franks, D. J. (1996). State practices on inclusion: A
national review. Remedial and Special Education.

In J. I. Goodlad & T. C. Lovitt (Eds.), Integrating general and special education. New
York: Macmillan.

Kauffman, J. M., & Hallahan, D. P. (Eds.). (1995). The illusion of full inclusion: A
comprehensive critique of a current special education bandwagon. Austin.

Kearns, J. F., Kleinert, H. L., & Clayton, J. (1998). Principal supports for inclusive
assessment: A Kentucky story. Teaching Exceptional Children.

Lipp, M. (1992). An emerging perspective on special education: A development agenda

for the1990s. Special Education Leadership Review.

Lipsky, D. K., & Gartner, A. (1997). Inclusion and school reform: Transforming
America’s classrooms. Baltimore: Brookes.

Loucks-Horsley, S., & Roody, D. S. (1990). Using what is known about change to inform
the regular education initiative. Remedial and Special Education.

LYNCH, JAMES. 1994. Provision for Children with Special Educational Needs in the
Asia Region. World Bank Technical Paper Number 261, Asia Technical Series.
Washington, DC: The World Bank.

MAZUREK, KAS, and WINZER, MARGRET A. 1994. Comparative Studies in Special

Education. Washington, DC: Gallaudet University Press.

Monteith, D. S. (2000). Professional development for administrators in special education:

Evaluation of a program for underrepresented personnel. Teacher Education and
Special Education.

OAKLAND, THOMAS, and HU, SHERMAN. 1994. "International Perspectives on

Tests Used with Children and Youth." Journal of School Psychology.

Oetting, J. & McDonald, J. (2002) , Methods for Characterizing Participants’

Nonmainstream Dialect Use in Child Language Research, JSLHR.

Oetting, J., Cantrell, J., and Horohov, J. (1999) A Study in Specific Language
Impairment (SLI) in the Context of Non-standard Dialect, Clinical Linguistics and
Phonetics.

27
Organisation For Economic Co-Operation And Development. 1995. Integrating Students
with Special Needs into Mainstream Schools. Paris: Organisation for Economic
Co-operation and Development.

Organisation For Economic Co-Operation And Development. 2000. Education at a

Glance; OECD Indicators. Paris: Organisation for Economic Co-operation and
Development.

Portsmouth, NH: Heinemann. Craig, H. et al., (2003) Phonological Features of Child

African American English, JSLHR, v 46 623-635 Godley, A., Sweetland, J.,

REYNOLDS, CECIL R., and FLETCHER-JANZEN, ELAINE. 2000. Encyclopedia of

Special Education, 2nd edition. New York: Wiley.

Spaulding,T., Plante, E., and Farinella, K. (2006) Eligibility Criteria for Language
Impairment - Is the Low End of Normal Always Appropriate? Language, Speech,
and Hearing Services in Schools.

Tabbert, Russell, (1994) Linguistic Diversity in America: Will We All Speak “General
American?”

Virginia Department of Education (2007) FOR CULTURAL COMPETENCE:

Knowledge, Skills, and Dispositions Needed to Embrace Diversity. Richmond,
VA.

Wheeler, S., Minnici, A., & Carpenter, B. (2006). Preparing teachers for dialectally
diverse classrooms.

Wheeler, R., Swords, R. (2006) Code-switching: Teaching Standard English in Urban

Classrooms (Theory & Research Into Practice) National Council of
StateUniversity.

i. http://education.stateuniversity.com/pages/2437/Special-Education.
International-Context.html#ixzz4ZSzyM9C6.
ii. www.eric.ed.gov/ERICWebPortal/search/detailmini.
iii. http://www.mcpherson.com/418/special_ed/terms_defintions.html
iv. Special Education Dictionary: Parentpals.com Special Education Guide
v. http://www.parentpals.com/2.0dictionary/dictnewsindex.html
vi. Special Education in Plain Language
vii. http://www.csea7.k12.wi.us/sped/Parents/plintro.htm
viii. http://www.direct.gov.uk/EducationAndLearning/Schools/Special.
http://www2.ed.gov/rschstat/research/pubs/adhd/adhd-identifying_pg3.html.

28
Unit: 2

TYPES OF EXCEPTIONALITIES-I

Written By:
Shaista Majid

Reviewed By:
Dr. Shahida Sajjad
 INTRODUCTION
A visual impairment is any visual condition that impacts an individual’s ability to
successfully complete the activities of everyday life. Students with visual impairments
are infants, toddlers, children and youths who experience impairments of the visual
system that impact their ability to learn. The effect of visual problems on a child’s
development depends on the severity, type of loss, age at which the condition appears,
and overall functioning level of the child. Many children who have multiple disabilities
may also have visual impairments resulting in motor, cognitive, and/or social
developmental delays.

A young child with visual impairments has little reason to explore interesting objects in
the environment and, thus, may miss opportunities to have experiences and to learn. This
lack of exploration may continue until learning becomes motivating or until intervention
begins.

The visually handicapped child cannot see parents or peers, therefore he or she may be
unable to imitate social behavior or understand nonverbal cues. Visual handicaps can
create obstacles to a growing child’s independence. This unit deals with the visual
impairments in detail. It highlights the causes and different types of visual conditions. It
emphasizes the assessments of visual lose as well discusses the teaching and learning
conditions for the visually handicapped children.

OBJECTIVES
After the successful completion of this unit you will be enable to:
1. understand the meaning and nature of visual impairments

2. realize the causes and types of visual impairments

3. discuss the functional implications of visual impairments

4. describe the educational implications of visual impairments

5. estimate the functional vision sight and low vision

6. teach the students with visual impairments

7. specify the role of special educators in the centers of visually handicapped children

8. manage the teaching and learning environment for the visually handicapped
children.

30
2.1 CLASSIFICATION SYSTEM OF EXCEPTIONALITIES
Public Law 94-142 says that all handicapped children whatever the sever condition they
have must receive a free public education which give emphasis to special education and
related services designed to meet their unique needs. This emphasize is consistent to the
needs not on the categories. But the children belonging to different categories of
exceptionalities possess special educational needs different from others. All the special
children have the right to be catered according to their special educational needs. Let us
have the detail view of all categories of exceptionalities.

A child goes through the formal process of assessment and identification to be called as
having special educational needs or exceptional child. The team of experts of different
professions and including parents assess whether a student is exceptional and determines
determine the placement that will best meet the student’s needs. The team uses
information from observations, test results and assessments to determine whether the
student meets the criteria to be identified as exceptional. Then decides if the student is
exceptional and which category of exceptionality best describes the student’s needs.

Again we refer to the Public Law 94-142 to view the categories of children and youth
with handicapping conditions. It highlights the categories as under:
i. Learning disabled
ii. Speech impaired
iii. Hard of hearing and deaf
iv. Mentally retarded
v. Emotionally disturbed
vi. Orthopedically impaired
vii. health impaired
viii. Visually handicapped
ix. Deaf-blind
x. Multi-handicapped

The categories as highlighted by P.L. 94-142 can be more comprehensively categorized

as under:
i. sensory handicaps including hearing and vision impairments
ii. intellectual deviations, including gifted as well as mental retardation
iii. communication disorders, such as speech and language dysfunction
iv. learning disabilities/minimal brain dysfunction,
v. behavior disorders, including severe emotional disturbances
vi. physical handicaps and health impairments, including neurological defects,
orthopedic conditions

you are refer to the Categories of Exceptionality and Definitions Section III January,
2001(retrieved from http://www.peelschools.org/parents/specialed/sep/documents/
B7categories.pdf) for the list of exceptional children and definitions of each category.
The Ministry of Education has defined five categories of exceptionality and ten sub-
categories. The exceptionality categories are:

31
1. Behaviour 2. Communication • Learning Disabled • Autistic • Language Impairment •
Speech Impairment • Hard of Hearing 3. Intellectual • Gifted • Mild Intellectual
Disability • Developmental Disability 4. Physical • Blind-Low Vision • Physical
Disability 5. Multiple

Let us read the categories in detail.

1. Behaviour
A learning disorder characterized by specific behaviour problems over such a period of
time, and to such a marked degree, and of such a nature, as to adversely affect
educational performance and that may be accompanied by one or more of the following:
i. Inability to build or maintain interpersonal relationships
ii. Excessive fears or anxieties
iii. Tendency to compulsive reaction
iv. The inability to learn which cannot be traced to intellectual, sensory, or other health
v. factors, or any combination thereof

Ministry Category and Definition: (Ministry of Education – January 1999)

2. Communication

Learning disabled
Learning disabilities is a generic 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 and presumed to be due to central nervous system dysfunction. Even though a
learning disability may occur concurrently with other handicapping conditions (e.g.,
sensory impairment, mental retardation, social and emotional disturbance) or
environmental influences (cultural differences, insufficient/inappropriate instruction,
psychogenic factors), it is not the direct result of those conditions or influences.
(Hammill, Leigh, McNutt, & Larsen, 1981, p. 336)

Identification of learning disabilities is carried out by a team. The team may determine
that a child has a specific learning disability if; ‘a child does not achieve commensurate
with his or her age and ability levels in one or more of the following areas when provided
with learning experiences appropriate for the child’s age and ability levels; oral
expression, listening comprehension, written expression, basic reading skill, reading
comprehension, mathematic calculations, or mathematics reasoning’ and if the team finds
that a child gas a severe discrepancy between achievement and intellectual ability in one
or more of the same areas of functioning; listening, thinking, speaking, reading, writing,
or mathematical abilities.

A learning disorder evident in both academic and social situations that involves one or
more of the processes necessary for the proper use of spoken language or the symbols of
communication, and that is characterized by a condition that:

32
i. is not primarily the result of:
 impairment of vision;
 impairment of hearing;
 physical disability;
 primary emotional disturbance;
 cultural difference;
 developmental disability and

ii. results in a significant discrepancy between academic achievement and assessed

intellectual ability, with deficits in one or more of the following:
 receptive language (listening, reading);
 language processing (thinking, conceptualizing, integrating);
 expressive language (talking, spelling, writing);
 mathematical computations;

iii. may be associated with one or more conditions diagnosed as:

 a perceptual handicap;
 a brain injury;
 minimal brain dysfunction;
 dyslexia;
 developmental aphasia;
Ministry Category and Definition:(Ministry of Education – January 1999

Autism
A severe learning disorder that is characterized by:
i. disturbances in: rate of educational development, ability to relate to the
environment, mobility, perception, speech, and language
ii. lack of representational symbolic behaviour that precedes language
Ministry Category and Definition: (Ministry of Education – January 1999

Language Impairment
A learning disorder characterized by impairment in comprehension and/or use of verbal
communication or the written or other symbol system of communication, which may be
associated with neurological, psychological, physical, or sensory factors, and which may:
i. Involve one or more of the form, content, and function of language in
communication and
ii. Include one or more of the following:
 Language delay
 Dysfluency
 Voice and articulation development which may or may not be organically or
functionally based
Ministry Category and Definition: (Ministry of Education – January 1999)

Speech Impairment
A disorder in language formulation that may be associated with neurological,
psychological, physical, or sensory factors, that involves perceptual motor aspects of

33
transmitting oral messages, and that may be characterized by impairment in articulation,
rhythm, and stress.
Ministry Category and Definition: (Ministry of Education – January 1999)

Deaf and Hard of Hearing

An impairment characterized by deficits in language and speech development because of
a diminished or non-existent auditory response to sound.
(Ministry Category and Definition: Ministry of Education – January 1999)

3. Intellectual
Giftedness
An unusually advanced degree of general intellectual ability that requires differentiated
learning experiences of a depth and breadth beyond those normally provided in the
regular school program to satisfy the level of educational potential indicated.
Ministry Category and Definition: (Ministry of Education – January 1999)

Mild Intellectual Disability

A learning disorder characterized by:
i. an ability to profit educationally within a regular class with the aid of considerable
curriculum modification and supportive service;
ii. an inability to profit educationally within a regular class because of slow
intellectual development;
iii. a potential for academic learning, independent social adjustment and economic
self-support.
Ministry Category and Definition: (Ministry of Education – January 1999)

Developmental Disability
A severe learning disorder characterized by:
i. an inability to profit from a special education program for students with mild
intellectual disabilities because of slow intellectual development
ii. an ability to profit from a special education program that is designed to
accommodate slow intellectual development
iii. a limited potential for academic learning, independent social adjustment, and
economic self-support
Ministry Category and Definition: (Ministry of Education – January 1999)

4. Physical
Blind and Low Vision
A condition of partial or total impairment of sight or vision that even with correction
affects educational performance adversely.
Ministry Category and Definition: (Ministry of Education – January 1999)

Physical Disability
A condition of such severe physical limitation or deficiency as to require special
assistance in learning situations to provide the opportunity for educational achievement

34
equivalent to that of pupils without exceptionalities who are of the same age or
developmental level.
Ministry Category and Definition: (Ministry of Education – January 1999)

5. Multiple Exceptionalities
A combination of learning or other disorders, impairments, or physical disabilities, that is
of such nature as to require, for educational achievement, the services of one or more
teachers holding qualifications in special education and the provision of support services
appropriate for such disorders, impairments, or disabilities. Ministry Category and
Definition: (Ministry of Education – January 1999

2.2 Type 1-Visual Impairment

Many people have some type of visual problem at some point in their lives. Some cannot
see objects at longer distances. Others have problems in reading small print. These types
of conditions are often easily treated with eyeglasses or contact lenses.

But when one or more parts of the eye or brain that are needed to process images become
diseased or damaged, severe or total loss of vision can occur. In these cases, vision can't be
fully restored with medical treatment, surgery, or corrective lenses like glasses or contacts.

2.2.1 Causes of Visual Impairments

Terminology and Definition

The following terms are commonly used.
 Visually impaired: an umbrella term for people who have irretrievable sight loss.
 Blind: a person can register as blind if they can only read the top line of an
optician’s eye chart from three metres or less.
 Partially sighted: someone who can read the top line of an optician’s eye chart from
six metres or less.
Visual impairment is a term that is used to describe any kind of vision loss, whether it's
someone who cannot see at all or someone who has partial vision loss.

This term refers to people with permanent sight loss and covers a wide spectrum of
different impairments. It does not include those whose sight problems can be corrected by
spectacles or contact lenses, though it does include those whose sight might be improved
by medical intervention.

Some people are completely blind, but many others have what's called legal blindness.
They haven't lost their sight completely but have lost enough vision that they'd have to
stand 20 feet from an object to see it as well as someone with perfect vision could from
200 feet away.

The terms partially sighted, low vision, legally blind, and totally blind are used in the
educational context to describe students with visual impairments. They are defined as
follows:

35
 “Partially sighted” indicates some type of visual problem has resulted in a need
for special education;
 “Low vision” generally refers to a severe visual impairment, not necessarily
limited to distance vision. Low vision applies to all individuals with sight who are
unable to read the newspaper at a normal viewing distance, even with the aid of
eyeglasses or contact lenses. They use a combination of vision and other senses to
learn, although they may require adaptations in lighting or the size of print, and,
sometimes, braille;
 “Legally blind” indicates that a person has less than 20/200 vision in the better eye
or a very limited field of vision (20 degrees at its widest point); and
 Totally blind students learn via Braille or other non-visual media.

According to the International Classification of Diseases -10, there are four levels of
visual function, (WHO-fact sheets, Update and Revision 2006):
 normal vision
 moderate visual impairment
 severe visual impairment
 blindness.

Moderate visual impairment combined with severe visual impairment is grouped under
the term “low vision” and low vision taken together with blindness represents all visual
impairment.

2.2.1.1 The Causes

People rarely lose their eyesight during their teen years. When they do, it's usually caused
by an injury like getting hit in the eye or head with a baseball or having an automobile or
motorcycle accident.

According to the Global estimates of visual impairments - 2010 “the principal causes of
visual impairment are uncorrected refractive errors and cataracts, 43% and 33 %
respectively. Other causes are glaucoma, 2%, age related macular degeneration (AMD),
diabetic retinopathy, trachoma and corneal opacities, all about 1%. A large proportion of
causes, 18%, are undetermined. The causes of blindness are cataract, 51%, glaucoma,
8%, AMD, 5%, childhood blindness and corneal opacities, 4%, uncorrected refractive
errors and trachoma, 3%, and diabetic retinopathy 1%, the undetermined causes are 21%”
(Pascolini, & Mariotti, 2010).

Some babies have congenital blindness, which means they are visually impaired at birth.
Congenital blindness can be caused by a number of things — it can be inherited, for
instance, or caused by an infection (like German measles) that's transmitted from the
mother to the developing fetus during pregnancy.

Conditions that may cause vision loss after birth include:

Amblyopia (pronounced: am-blee-oh-pee-uh) is reduced vision in an eye caused by lack
of use of that eye in early childhood. Some conditions cause a child's eyes to send
different messages to the brain (for example, one eye might focus better than the other).
The brain may then turn off or suppress images from the weaker eye and vision from that
eye then stops developing normally. This is also known as a "lazy eye." Strabismus

36
(misaligned or crossed eyes) is a common cause of amblyopia, since the brain will start to
ignore messages sent by one of the misaligned eyes.

Cataracts are cloudy areas in part or all of the lens of the eye. In people without
cataracts, the lens is crystal clear and allows light to pass through and focus on the retina.
Cataracts prevent light from easily passing through the lens, and this causes loss of
vision. Cataracts often form slowly and usually affect people in their 60s and 70s, but
sometimes babies are born with congenital cataracts. Symptoms include double vision,
cloudy or blurry vision, difficulty seeing in poorly lit spaces, and colors that seem faded.

Diabetic retinopathy (pronounced: reh-ton-ah-pa-thee) occurs when the tiny blood

vessels in the retina are damaged due to diabetes. People with retinopathy may not have
any problems seeing at first. But if the condition gets worse, they can become blind.
Teens who have diabetes should be sure to get regular eye exams because there are no
early warning signs for this condition. To help prevent retinopathy, people with diabetes
should also avoid smoking, keep their blood pressure under control, and keep their blood
sugar at an even level.

Glaucoma is an increase in pressure inside the eye. The increased pressure impairs vision
by damaging the optic nerve. Glaucoma is mostly seen in older adults, although babies
may be born with the condition and children and teens can sometimes develop it as well.

Macular degeneration (pronounced: mah-kyoo-lur dih-jeh-nuh-ray-shun) is a gradual

and progressive deterioration of the macula, the most sensitive region of the retina. The
condition leads to progressive loss of central vision (the ability to see fine details directly
in front). Macular degeneration is often age related (it occurs in older people, especially
older than 60), but sometimes it can occur in younger people. Excessive exposure to
sunlight and smoking can increase the risk for age-related macular degeneration.
Symptoms may include increased difficulty reading or watching TV, or distorted vision
in which straight lines appear wavy or objects look larger or smaller than normal.

Trachoma (pronounced: truh-ko-muh) occurs when a very contagious microorganism

called Chlamydia trachomatis causes inflammation in the eye. It's often found in poor
rural countries that have overcrowded living conditions and limited access to water and
sanitation. Blindness due to trachoma has been virtually eliminated from the USA.

2.2.1.2 Implications of Visual Impairments

The visually handicapped children have a limited ability to learn incidentally from their
environment. Whatever we learn is received and processed through sight. It is believed
that up to 80% learning occurred through visual cues. The other senses such as touch and
hearing do not fully compensate for the loss of sight.

Vision loss results in a low motivation to explore the environment, initiate social
interaction, and manipulate objects. The limited ability to explore the environment may
affect early motor development.

The visually handicapped students cannot share common visual experiences with their
sighted peers, and therefore vision loss may negatively impact the development of
appropriate social skills.

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i) Educational Implications
The majority of learning generally occurs through vision. The student with vision
impairment may have restricted capacity to obtain information through observation and
visual demonstrations. Other specialised strategies may need to be employed in order for
the student to learn new skills. Therefore, vision impairment can significantly impact on
all aspects of the student's education, including:
 academic areas
 communication
 mobility
 independent living skills
 social interactions.

These frequently need to be explicitly taught to the student. In addition, these students are
likely to require a considerable increase in time allocation for learning new tasks.

For a student with vision impairment to access the curriculum and learning environment,
adjustments may need to be considered regarding:
 presentation of learning materials in alternative formats
 alternative formats for class activities and assessment items
 specialised equipment including low vision aids or Braille equipment
 assistive technology
 time allowed to complete tasks
 accessibility within the learning environment for safe and independent access and
mobility
 extra time and opportunity to preview and review audio visual material
 environmental conditions such as lighting and glare.

Writing materials
Blind children use the Perkins Brailler to write Braille and a range of new technology has
been introduced in recent years to provide speech and print output from Braille input. For
those children with useful residual vision, a dark felt tip pen on white or yellow paper should
provide the necessary level of contrast, moving if possible at a later date to using a dark soft
lead pencil. The older child should be able to make his own decision regarding paper
preference, but the younger child may be helped by using bold lined or squared paper.

Reading materials
Besides size of print, it is important to consider the quality and quantity of print used. The
size, colour and contrast of print on paper determines quality and should be the primary
consideration. Print can be enlarged by some form of magnification using a low vision aid,
or by an enlarging photocopier but it can be counterproductive to enlarge poor quality
copies as the faults are also magnified. We should also remember that magnification is not
always the answer as the greater the magnification, the smaller the field; those children with
limited fields of vision should be allowed to use the smallest print possible, so that the
remaining field of vision receives the maximum amount of information.

Contrast and clarity are essential, it is also important to try and avoid those books which
have print across the illustrations, causing unnecessary confusion. Some children may also
prefer to place a card or ruler under the line they are reading and "reading windows" can be
particularly useful to the child who finds it difficult to focus on a word or line of print.

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Always ensure that the visually impaired child has the sole use of work materials, whether
it be books, diagrams, maps etc, avoiding the need to share. He will also need extra time to
complete visually demanding tasks and it may even be necessary to reduce the amount of
reading/writing you can realistically expect in the same time as the other pupils.

As the child moves up the school, the teaching assistant may have to adapt her methods
to ensure the child's access to the curriculum is maintained. For example, if extensive
note taking is required, either from the blackboard, dictated or other means, you may
have to do one of the following:
i. Ask the teacher to say the notes aloud as he puts them up on the blackboard; they
can then be tape recorded if necessary.
ii. Ask the teacher to give you the notes in advance so that you can make
arrangements for a suitable print or Braille copy to be made.
iii. Arrange for one of the child's friends, preferably one who is a neat writer, to make
a carbon copy or arrange for his notes to be photocopied.

Specialised Equipment
The visually impaired child should have free access to any Low Vision Aid (LVA) which
will improve his functional vision LVAs include hand-held or stand magnifiers,
illuminated magnifiers, binoculars and hand-held telescopes, spectacles, including those
with specially prescribed telescopic attachments and closed circuit TV (CCTV) which is
available in black / white and colour models. LVAs are supplied by the Educational
Service for the Visually Impaired (see address at beginning of booklet) and many LVAs,
apart from CCTVs can be prescribed free of charge by the consultant ophthalmologist in
conjunction with the ophthalmic optician attached to the LVA clinic. CCTVs loaned by
the ESVI arc particularly adaptable and useful for reading, mapwork and even
demonstrations. The CCTVs electronically enlarges material onto a TV screen and most
models can flow accommodate a typewriter. If the teaching assistant is to assist the child
to make effective use of their specialised LVA, the assistant should consult the peripatetic
support teacher who will advise on how to teach the child to use the LVA efficiently.

Other Equipment Used

The type of equipment used obviously depends on the nature and severity of the child's
visual impairment. However other equipment which may be used could include one of or
several of the following:
Perkins Brailler for those unable to communicate through print, tape-recorder (perhaps
with a variable speech attachment or speed compressor so that listening rate can be
speeded up), talking calculator, talking thermometer, Braille ruler, large print typewriter,
to name a few as recent advances in electronic devices are too numerous to outline here.

Access to the Curriculum

Work in school is based largely on visual information - texts, drawings, pictures, maps,
diagrams, posters, demonstrations, TV and video, experiments etc. However access to the
curriculum for a visually impaired learner is not just about access to the printed word and
other visual information, important though this is. It is also about the quality of their
educational experiences.

A little help, if used appropriately, can go a long way to ensuring that the quality of their
learning experience is not compromised when compared to their normally sighted peers.

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In this section we will look at the implications for learning and the type of help that a
visually impaired child might need in trying to access a normal mainstream curriculum.

Reading
Obviously a visually impaired child does not see as well or as much at a single gaze as a
normally sighted child. The quality and size of print will make all the difference to a
young child’s motivation to read and we need to make sure that all children are visually
comfortable with the books we are offering them. Our service will be happy to advise on
optimum print sizes for individual children with visual difficulties.

These children may experience greater reading difficulties as they get older when they
are expected to read increasing quantities of text with a decreasing size of print.

There is an increasing range of very well produced large print fiction for top primary and
secondary school students. Our service has a range of such books for loan or it can be
arranged for other titles to be reproduced in the same way on request.

Even with comfortably sized print, their visual impairment may impose on these children
a slower reading rate than would normally be the case. A greater physical effort may also
be required and this in turn may well compromise levels of concentration and
comprehension.

Sustained periods of reading may be counterproductive – shorter concentrated “bursts”

may well produce better results.

In the “Literacy Hour” it is very helpful if our student can have access to an individual
copy of the “Big” book. Young children will also enjoy taped versions of their reading
books – particularly if prepared by their “favourite” teacher or support assistant.

Consider the provision of desk copies if you are doing a lot of board work and also the
enlargement of any learning materials, handouts etc. that include small text, diagrams or
graphic detail. Further guidance on differentiating learning materials for visually
impaired pupils is included in the next “teaching strategies” section of this booklet.

Magnification aids can be helpful for short pieces of text or difficult visual detail but
should not be regarded as primary aids for sustained reading tasks.

Writing
Visually impaired children often develop bad habits when learning their letter-formation.
They will naturally like to be cued in visually and will tend to start all letters from the
line (if you are using lines).

A visible starting point for letters starting above the line can therefore be helpful. A blank
piece of paper can be quite a challenge for these children. For this reason lines (quite
dark) can be helpful to guide a child’s writing across the page.

Margins also give a useful starting point for each new line of writing.

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Tape
Writing can be a very tedious operation for a child with poor vision. Reading their own
writing can be an even greater challenge! It is a pity for a child’s creativity to be limited
by their ability (or otherwise) to write. For children who really have a problem “getting it
down on paper” then perhaps tape recording could be used in conjunction with a support
assistant to “scribe” and / or word process the result. Dictaphones can now be purchased
quite cheaply.

Word Processing
Word processing can be a very useful way for a visually impaired child to record their
work and achieve high quality presentation (and correctly spelt!). Good touch-typing
skills will obviously reduce the visual demands of writing and it may be helpful to
consider the introduction of keyboard and touch-typing skills at the primary stage. Some
students with poor vision and good keyboard skills may be provided with a laptop to use
when they are deemed ‘ready’. This enables them to record their work in a well-presented
form that everyone can read.

If a student has a personal lap top then work assignments can also be keyed in for them
(by teacher or support staff) in a print size of their choice.

Computer Access
There are various ways to improve computer access for a visually impaired child, such as
enlarged high contrast key stickers, large keyboard, concept keyboard and the use of
enlarged print for word processing.

Cursors can also be made more visible and specialist software is also available to provide
on screen magnification or speech output.

When working at a computer it is important to avoid nasty reflections in the monitor screen
which can be caused by windows or ceiling lights. These problems can be largely
eliminated if, firstly the classroom has efficient blinds, and secondly if the child keeps the
screen at eye level. If in doubt get down to the pupil’s level and see what it is like for them.

Spelling
Many of us like to check visually if we are not sure of a spelling. This can be a problem
for VI students as visual checking is not so easy or accurate. We need to make sure they
have good visual spelling “models”.

Maths
Maths can be tricky for visually impaired pupils as it involves detailed and practical
work. Examples are often worked through on the board and these presentations and
examples may need to be duplicated as an individual desk copy.

Many of the topics covered in Maths depend on sequential learning (i.e. new learning
based on previous knowledge). It is very important to know if concepts are fully
understood before progressing. Some extra 1:1 time for reinforcement may be needed to
ensure this is happening.

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At the primary level there are a number of “concrete” learning aids that may be helpful.
For example Cuisenaire rods, unifix cubes, pegboards, number sets, hundred squares.

Some specialised resources may be appropriate to some pupils. These would include
talking and large display calculators, tactile rulers and protractors.
Topics such as graph work and geometry can be very difficult because of the detail
required. Magnification aids can be helpful for reading small measures such as rulers or
protractors. Dark-squared Exercise books and more visible graph paper can be purchased
from specialist suppliers.

Science
Much of what applies to maths will also apply here. Science lessons can be more
problematic because of the significant amount of practical work involved.

Reduced visual acuity or problems associated with depth perception can make practical
work in science quite tricky particularly as containers etc. are often made of colourless
glass or plastic and experiments require the manipulation of small equipment and the
exercise of quite detailed visual judgments.

It is important for visually impaired students to become fully involved in practical work
in order to have the same learning experience as their class mates. Unfortunately, in
reality, it is not uncommon for them to literally take a back seat and let others take the
lead when an experiment is being undertaken in pairs or small groups.

A few tips:
 A piece of contrasting card held behind a thermometer or measuring flask can
enhance contrast and make reading easier.
 Speech output scales and large display thermometers are available.
 Food colouring can be added to water to increase visibility.
 Blu-tack can be handy to hold things down or to act as a tactile marker.
 Accidents can be avoided by highlighting (paint or tape) the tops of measuring
flasks – especially the taller ones.
 If goggles have to be worn, reserve a good scratch free pair for any student with a
visual difficulty.

Design and Technology

Much of the above, with regard to practical work will also apply to the DT lessons.

There is probably an added health and safety issues here because of the range and nature
of the equipment being used. Our student may need more time to be trained, under close
supervision, to become familiar with this equipment.

Some electronic equipment is now available in large display or speech read out.

For some detailed visual tasks, eg soldering, wiring a plug or circuit board magnification
aids maybe useful. For example aids that “clip-on” glasses (“wantelmakers glass”)
particularly as this type of aid will often be more acceptable (in the students perception)
in a workshop situation than in the normal classroom.

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Humanities
Geography and History are both reading and vision intensive subjects. They also rely on
concepts and experiences that are hard to bring in to the classroom and this may make it
harder for students who need first hand experiences.

Field trips of any kind are going to be invaluable to pupils with a visual impairment. The
help of a support assistant on these occasions will be vital - not only to ensure safety in an
unfamiliar environment but to explain, interpret and reinforce information that might
otherwise be easily lost by a visually impaired pupil.

Map work is always going to be tricky. Enlarging a map will not always help - not all
schools have got a colour photocopier! It will probably be better to use a small dome
magnifier to enlarge the particular detail in question.

In history, museum visits or the use of artefacts can give valuable hands-on experiences.
Historical source material can often be indistinct and visually difficult to interpret
(usually black and white). Like maps they will often be better in their original form
rather than enlarged, viewed with the use of a good magnification aid. Video material is
often viewed in these lessons and this can be difficult for our students. They may need to
see them more than once to gain full benefit.

Physical Education and Games

Clearly there will be elements of the PE and Games curriculum that will prove difficult
for the visually impaired pupil.

Many individual activities ( gymnastics, swimming, athletics, cross country running,

circuit training etc.) will be a lot easier than other group or team activities such as tennis,
basketball, hockey, football etc., which require not only good vision but also efficient
hand eye co-ordination.

PE teachers should be aware of the implications for individual pupils in their groups who
are visually impaired and make what allowance they can. This may depend on the
particular nature of the child’s visual impairment and advice on this would be available
from the Vision Support Team.

Generally speaking, instructions need to be clear with the child near by during any
demonstration that is given.

There tends to be an increased emphasis on ball games in secondary schools. These often
present a difficulty for our pupils. It is always helpful to use high contrast balls for these
games - the best colour may depend on whether the game is indoors (gym or sports hall
environment) or outside, which may involve different colour surfaces (all weather, grass,
tarmac etc.) and a high proportion of “sky” background.

In general a white ball for the gym and an orange ball for outside is a good rule of thumb.

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Social Skills
Visually impaired children can often be unaware (slow to develop an understanding) of
the social skills needed to make good peer group relationships.

They are often not good at observing cause and effect relationships or the difference
between good and inappropriate behaviour. The same can often apply to their own
personal care and hygiene. They may legitimately need more help and guidance in all
these matters than their fully sighted peers.

Independent Mobility and Daily Living Skills

It is likely that if you teach young visually impaired children they will need some help to
develop independence and life skills appropriate to their age and ability. It is important
that these students are helped to help themselves because we want them to become as
(safely) independent as possible.

For blind children or those with severe visual impairment our team includes a mobility
specialist whose role is to enable these children to develop skills that will enable them to
become safe independent travellers.

The School Environment

It is important to consider the wider school environment in terms of making life as
visually comfortable as possible for all pupils.

There are some common themes that will apply to all areas of a school and it is important
not to confine one’s attention solely to the classroom when considering the visual
environment. There will be issues of safety, accessibility and equality of opportunity in
all the different parts of a school.

Steps and Stairs

These are probably the most potentially dangerous features of a school to a visually
impaired pupil - particularly concrete outside steps possibly without handrails. In split
site or large campus schools, these steps can often become very busy thoroughfares
between lessons.

It will be very helpful to visually impaired pupils if these steps are highlighted with about
two inches of white or yellow paint on the leading edges of each step. There should also
be a hand rail on at least one side.

Interior staircases are not quite so easy to highlight permanently but this can be done with
high contrast adhesive tape. Busy staircases will probably need to be retaped from time to
time. It is important to maintain this type of highlighting as partially highlighted
staircases can be quite dangerous.

Signs and Labels

There will be many different signs and labels around any school to identify various rooms
and departments and to indicate their use. Again the same rules of clarity and contrast
will apply - a dark background generally helping to enhancing visibility. The siting of
signs and labels should also be given some thought so that they are visually accessible at

44
eye height - it would be a pity to spoil the visibility of a clear label by locating it at the
top of a door.

The Learning Environment – the classroom

Below are some general considerations for teachers who wish to make their classroom
environments “user friendly” for visually impaired pupils.

The visual environment of your classroom is an important factor that can aid or hinder all
your children’s learning.

There will be many features of your classroom that you are stuck with and which cannot
be altered - e.g. location, aspect, shape and size, position of doors and windows, height of
ceiling.

However there may be other features of the classroom visual environment that can be
improved and it may be a good idea to make a swift audit of your room to see how it
measures up against the following guidelines.

Lighting
Most schools have pretty good lighting levels but it is often the busiest areas -corridors,
cloakrooms and critically, staircases (top and bottom) which often have the poorest
lighting levels often making these far more “stressful” areas than the classrooms.

A frequent symptom of visual impairment is a sensitivity to bright reflected light or glare

and complaints related to this are amongst the most common that we get from our
visually impaired students. So... in your classroom:
 Does the sun ever stream in the window causing glare?
 Can the lighting levels be varied - are the lights in your classroom separately
switched or is it all or nothing?
 Are there blinds or curtains at the windows - do they work - are they used
effectively?
 Are there pools of unlit areas in your classroom that can sometimes appear quite
dark?
 Is the room well lit giving it good overall illumination? If you have fluorescent
lighting is it effectively diffused?

Although visually impaired children dislike glare they need good overall levels of diffused
artificial lighting. Bare fluorescent tubes can often be as uncomfortable as direct sunlight.

The best way to reduce the amount of glare and reflected light in your classroom is to
avoid shiny surfaces (including the floor) if possible and have blinds on the windows that
work. Unfortunately very few blinds (particularly the best ones) seem to be “child proof”
- the most successful are probably the roller type which tend to be a bit more robust than
other varieties.

A good level of diffused overhead lighting can make a big difference to the clarity and
contrast of all visual materials and presentations (distance and near) in your classroom.
Be prepared to respond to requests from children with poor vision for classroom lights to
be put on long before others may consider it necessary.

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Decor
Decor is very much interrelated with lighting. Décor will include features such as walls,
floors, ceilings, furniture, displays and people. A major problem in many areas around a
school can be caused by glare created by light reflecting off walls and shiny surfaces. The
use of colour to absorb light in your classroom can make a big difference to the visual
comfort of your pupils - and need not be very expensive. Pastel shades for your walls -
rather than the universal magnolia - will create a much “calmer” environment. On the
other hand bold colours can help to identify frequently used storage areas. They can also
be useful to “frame” doorways, notice boards, light switches etc.

Visual Displays
All visual displays have a great deal more impact if they are well spaced and mounted on
a strongly contrasting background. Dark colours are best. Make sure important
information (especially if it needs to be read) is mounted at eye level and in a position
that can be accessed closely - with the child able to use finger pointing if necessary.

Storage Areas
To help visually impaired children work and organise themselves independently in your
classroom it will be helpful if all storage areas (pencils, rulers, scissors etc. etc.) are
easily accessible, consistently used and clearly labelled.

Lockers and Pegs

It is also important to think about the best position for the visually impaired child’s tray
locker or cloakroom peg to help them avoid confusion in crowded areas and to become as
independent as possible. Often the best place will be the obvious one such as the top
corner for a tray or the “end” peg near the doorway for the child’s coat.

A sensible “bags and coats” policy -particularly in a secondary school will help avoid
clutter and create less potential difficulties for your V.I. students who will be more prone
than most to tripping over obstacles at ground level.

Signs and Labels

All the signs notices and labels that you use in your class should be bold clear and
incorporate good contrast. This is best achieved by using a dark background -black can
be very effective. Again they need to be located at an accessible eye height.

Acoustic Environment
Remember that visually impaired pupils tend to be more reliant on auditory input. Anything
that improves the class and school acoustic environment will be of help to both Hearing and
Visually Impaired pupils. The use of carpet, curtains, cushions or soft furnishings and a
reduction in the amount of smooth reflective surfaces can make all the difference.

ii) Functional implications

A multiply impaired student who cannot control eye movements will miss landmarks,
will not make eye contact, and will not gather visual spatial information as readily as the
normally sighted child (and would therefore have fewer accurate spatial concepts). All of
these implications mean that the multiply impaired child will have difficulty navigating
through space. The visually impaired child with nystagmus looks more impaired

46
(considering oculomotor skills alone) then they really are. Nystagmus is a necessary eye
movement for the student with macular damage. Strabismus has more serious
implications. It leads to permanent amblyopia, which means that there will be functional
(ie. for all practical purposes "real") blindness in the eye that is turned. The amblyopic
eye will function with about 20/200 acuity when the good eye is patched, but when both
eyes are open it will be "blind." The implication is that the visually impaired child will be
blind to all objects presenting on the amblyopic side of the body (not good for classroom
work, and not good for crossing streets).

Impairments Affecting the Optical System

The iris is the colored part of the eye. It is a sphincter muscle, meaning that when it
relaxes it opens, and when it contracts it closes. The hole in the iris that can enlarge or
shrink is called the pupil. Damage to the iris results in decreased activity of the muscle;
either it reacts sluggishly (opening and closing slowly), or it fails to react at all.

Damage to the lens in an eye can be from foreign chemicals, from aging, and from
trauma. When the damage causes white, denatured protein to spot a lens, the doctors
report that a patient has a cataract (their name for denatured protein). Cataracts,
especially if they occur in the center of the lens, can interfere with the transmission of
light (and visual information) through the eye. Eyes with old lenses (people over 45) or
with cataracts, change focus weakly or not at all.

The vitreous has a small affect on the refractive status of the eye, but not enough to be
significant compared to the lens and cornea. The vitreous can fill with blood when retinal
vessels break. It can also get contaminated with tissue fragments, particularly in some
disorders. Blood and debris can be washed from the vitreous as the fluid is refreshed, or
surgical replacement can be performed in serious cases.

Congenital abnormalities can affect the structure of the eyes. Sometimes eyes are very
tiny (micro-ophthalmia) and sometimes eyes are enlarged and appear to bulge (this is
often related to a thyroid problem). If the structure of the eye is affected, the drainage
systems for the aqueous and vitreous can get plugged resulting in glaucoma. Glaucoma is
the build up of fluid in the eye that results either from a blockage of the drainage system,
or from eyes that produce fluid faster than they filter-off old fluid. Structural damage can
also affect the operation of the pupil or the lens.

Corneal scarring, cataracts, blood or debris in the vitreous and aqueous, all block the
passage of visual information coming into the eye. If reflected light patterns do no hit the
retina totally and without distortion, then visual information cannot be processed correctly.

Glaucoma causes fluid pressure to push against the back of the eye. If left untreated,
retinal cells begin to die in a characteristic fashion. Visual field loses result in blind spots
initially, leading to tunnel vision, and then blindness.

A cataract is a hard substance floating in a fluid medium. When cataracts are present,
expect to find a decreased ability to focus. A cataract will block vision most when it is
located directly along the axis of the eye. If it is on the edge of the lens, it will probably
not affect vision significantly.
Damage to the iris causes a disruption in the ability to regulate brightness.

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Impairments Affecting the Retinal System
Malnutrition can selectively destroy central vision at the retinal level. Other disorders
impact primarily on the peripheral processing system. Retinitis pigmentosa destroys
peripheral cells initially. Conditions like retinopathy of prematurity often damage
portions of the peripheral retina sparing central vision.

Impairments Affecting the Optic Tracts

Tumors that push on the optic tracts cut off blood supply and cause ischemia, thereby
affecting vision. The pituitary gland is located near the optic chiasm and is often
implicated when specific retinal level changes occur (papilledema in one eye and optic
atrophy in the other). After nerves leave the retina and enter the optic tracts they separate
out into functionally specific bundles. If a tumor pushes on a particular nerve bundle,
some very specific diagnostic characteristics develop. Most commonly there are very
sharply demarcated field losses, like bilateral hemianopsias, or quadrant losses. Often
both eyes are involved. These serious disorders can often be detected using perimetry
(visual field testing).

2.2.2 Assessment of Visual Impairment

Children with visual impairment should be assessed early to benefit from early
intervention programs available. A medical doctor who specializes in examining,
diagnosing, and treating eyes and eye diseases is known as ophthalmologist. When
someone goes for an examination, the ophthalmologist will look at the structure of that
person's eye. Other simple tests an ophthalmologist may perform include:
Visual acuity test. A person reads an eye chart to measure how well he or she sees at
various distances.
Visual field test. Ophthalmologists use this test to measure side, or peripheral, vision.
Tonometry test. This test determines the fluid pressure inside the eye to evaluate for
glaucoma.

Students with visual impairments should undergo examinations by ophthalmologists

and/or optometrists to determine the nature and degree of the visual impairment. An eye
report should be requested from the eye specialist and included in the cumulative records.
The educational consultant for students with visual impairments will interpret the medical
report for school personnel and identify the educational implications.

Essential Assessments for Students with Visual Impairments

Essential assessment involves the following;
i. Functional Vision Assessment
ii. Learning Media Assessment
iii. Expanded Core Curriculum Needs Assessment

i. Functional vision measures how well a student uses visual information to perform
various tasks in various environments. Assessment of functional vision is an ongoing
process to determine a student’s level of functional vision through interviews,
observations and assessments. Some are mentioned below:
 Review of Records and eye-care professional reports
 Interviews
 Observations
 Appearance of the eyes

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 Visual reflexes
 Visual response to light
 Visual response to objects
 Muscle imbalance
 Eye preference

The functional vision assessment is always paired with a learning media assessment
(often considered one assessment) in the field of visual impairment.

ii. The learning media assessment (LMA) is defined as "an objective process of
systematically selecting learning and literacy media" (Koenig and Holbrook). The LMA
gathers three types of information on each student:
 The efficiency with which the student gathers information from various sensory
channels: visual, tactual, and auditory
 The types of general learning media the student uses, or will use, to accomplish
learning tasks
 The literacy media the student will use for reading and writing

iii. The Expanded Core Curriculum (ECC) is the body of knowledge & skills needed
by students with vision loss in order to be successful in school & in post-graduate
pursuits as a result of unique, disability-specific needs. It does not replace the Core
Curriculum, it is a supplement.

Expanded Core Curriculum (ECC) Needs Assessment involves the following;

 Compensatory/functional academic skills, including communication modes
 Orientation and Mobility
 Social Interaction
 Independent Living
 Recreation and Leisure
 Career Education
 Assistive Technology
 Sensory Efficiency
 Self-determination

Assessment of Vision
Most visual screening procedures are based on the use of the Snellen Chart plus careful
observation for symptoms of eye trouble in the classroom. Hermann Swollen, a Dutch
professor of ophthalmology, developed his chart in 1862. The Snellen Chart is the most
commonly used chart for measurement of distant, central field acuity. The standard
letter chart may be used for literate children, but the E symbol chart is especially suitable
for young children.

Visual Acuity: Visual acuity is defined as the ability to see or distinguish small
separations between portions of the visual fields. The testing distance for distant visual
acuity is usually set at twenty feet or six meters, because rays of light are practically
parallel at tills distance, and the muscle controlling the shape of the lens in the normal
eye is believed to be in a state of rest when viewing objects at this distance.

49
Visual acuity is recorded in the form of a fraction in which the test distance, usually twenty
feet, is recorded as the numerator. The denominator represents the distance at which the
smallest letters seen should be read by the normal eye. A visual acuity of 20/200 indicates
that the child reads at twenty feet the line which should be read by a normally seeing eye at
a distance of 200 feel. The Snellen E is designed so that the entire letter subtends an angle
of five minutes and the spaces between the bars subtend angles of one minute at the
designated distance. At 200 feet the Snellen E measures 3.48 inches square.

The Snellen fraction is:

Distance at which symbol is clearly seen
Visual Acuity = distance at which the smallest symbol read subtends an angle of five
minutes.

Special Screening Tests

Some screening procedures make use of other tests in addition to the Snellen Chart.
Factors , such as parental attitude, community resources, and efficiency of the basic
Snellen should be considered before adding other special screening tests. Special
tests which are often used to supplement the Snellen Chart include the convex
(plus) lens distance vision test for farsightedness, tests for vertical and horizontal
muscle balance, and a depth perception test when needed for vocational placement.
The Massachusetts Vision Test is an example of a battery of tests which includes
a test for visual acuity with convex lens and muscle balance supplementary tests.

The Plus Lens Test is a more reliable test to detect hyperopia. The child’s vision is
checked on the Snellen Chart or on one of the binocular instruments while he is
wearing plus lenses mounted in a small, inexpensive frame. The plus lenses are of
2.25 diopters for all ages (National Society to Prevent Blindness, 1982). If the child
can see the 20-foot line at twenty feet from the chart with both eves while
wearing these lenses, he should be referred. The Plus Lens Test is a part of the
Massachusetts Vision Test. Several of the binocular instruments provide for the use
of plus lens tests with their own referral criteria.

Visual Screening of Low Functioning Children

Visual screening of very young children or low functioning children is sometimes
difficult. Factors such as brief attention span, lack of interest in the test, anxiety in
performing before onlookers, fatigue, and difficulty in communication with the
tester can hinder the screening process.

Variables which influence the results of the test depend heavily on the intellectual
development of the child. His sense of form , span, and visual memory, coupled
with his previous experience with the objects pictured on the test chart, will
greatly influence test result results. The examiner can help to overcome some of
this emotional difficulties by showing patience and developing rapport with the
child before the testing procedure is initiated. He can help to develop a
communication system with children who have very little expressive language ability. In
some cases the examiner may need to train the child to make a proper nonverbal
response to sample test items.

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Directional Symbols Tests for Low Functioning Children
The E-Test was modified for preschoolers by locating flowers, rabbit, sky, and ground on
sides of the E. The child indicates the direction by naming the reference picture rather
than by pointing. This screening device is called the Michigan Junior Vision Screener.

A subjective method is used for nonverbal children to make operant measurement of

visual acuity. A lever press was used to signify a visual discrimination of the Snellen E.
The severely retarded subjects were conditioned to press a lever in response to the upright
letter E and to ignore an inverted E by reinforcement and punishment. Acuity was
measured by varying stimulus size and distance from subject.

Toy Test for Low Functioning Children

The child is shown a set of ten toys consisting of familiar objects, and he is
asked to name them if he can from a distance three meters or ten feet. These
include a car, plane, doll, two knives, two forks, and two spoons.

Geometric and Symbol Picture Tests For Low Functioning Children

The use of the picture chart has also been found to be a successful means of vision
screening of very young children. The picture charts are more understandable but the E-
Chat is more accurate for children from the age of three. The toy test does not give a
very accurate measure of visual acuity, and the children may keep on playing with toys.

Objective Techniques
A test of vision may be conducted by a pediatrician during infancy. Failure to respond to
a light flashed in the eye, absence of protective blinking when an object approaches the
eye and incapacity to follow moving objects with responsive eye or head
movements are signs of a temporary or permanent visual loss. Additional
indications of total blindness or subnormal vision include the following: failure of
an infant between two weeks and six months to gaze persistently at a light and
failure of an infant over six months to follow a moving light in front of his eyes.
The presence of nystagmus, or strabismus, or uniform deviation of both eyes is an
indication of subnormal vision.

Color Discrimination Tests

The most commonly used methods of testing color vision are discrimination of
colored dot patterns and the matching of colors. The simplest type of color-vision
test is designed to detect children who have defective red-green and yellow-blue
color vision. Although such a test is not recommended to be given in the usual
vision screening program, it is recommended that a test for color vision be given at
least once during the child’s school experience.

2.2.3 Education and Training

The classroom teacher is key to planning and implementing an effective educational
program. The classroom teacher:
 shares information collected during the information gathering stage;
 is aware of the parents’ or guardians’ expectations for their child’s program;
 is aware of the needs of a student with a visual impairment;

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 plans and carries out instructional programs;
 modifies instructional methods and materials allowing ample time for
 preparation of adapted resources;
 develops strategies for assessing and communicating student progress; and
 maintains ongoing communication with the student, parents and other
 teachers.

Special Education/Resource Teacher

The resource teacher is usually the teacher designated to coordinate the student’s
program. In addition the resource teacher:
 provides diagnostic assessment to determine student strengths and areas of
 need;
 generates ideas and suggestions for program modification and/or adaptations;
 provides advice about materials and resources;
 orders materials from the Saskatchewan Learning Resource Centre and acts
 as a liaison between the school and the Resource Centre;
 plans and carries out instructional programs;
 develops strategies for assessing and communicating student progress;
 maintains ongoing communication with parents and other teachers; and
 initiates and organizes support team meetings.

2.2.3.1 Strategies for Blind Students

Classroom accommodations will be quite varied and should be individualized according
to the specific needs of the student. However, there are some basic best practices that can
guide the development of the most effective adaptations.

One thing to always consider is that it is often difficult for these students to become as
fully independent as they are capable of being. The classroom teacher should encourage
independence as often as possible to avoid the trap of “learned helplessness.” Encourage
the student to move independently through the classroom, and organize your classroom
accordingly. Materials, desks, and other objects in the classroom should be maintained in
consistent locations. Ensuring that cabinets are fully closed, chairs pushed in, and doors
are not left half ajar will help with safety in navigating the classroom. Part of becoming
independent for students with a visual impairment is learning when to advocate for
assistance. Not all instructional tasks will be immediately possible for a student with a
visual impairment, even with accommodations. The key is to design your instruction so
that the student has the most opportunity to act independently. The student’s orientation
and mobility specialist and teacher of students with visual impairments can assist with
room arrangements and room familiarization.

Adapting your classroom to accommodate a student with a visual impairment is a

relatively easy task—it just requires an awareness of the student’s level of visual
functioning (how the student sees) and how the student works and learns. For example,
for the student with low vision, make sure that he is near the front of the room where he
can see the blackboard. Control lighting variables when presenting learning materials to
those students who are sensitive to light and glare. Use verbal cues with those students
who cannot see body movements or physical cues. A trained teacher of students visual
impairments can help you make a few simple changes to classroom design that may mean
all the difference in the education of the student with a visual impairment.

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One key accommodation that is absolutely essential is access to textbooks and
instructional materials in the appropriate media and at the same time as their sighted
peers. For students who are blind this may mean braille and/or recorded media. For the
student with low vision, this may mean large print text or the use of optical devices to
access text and/or recorded media while in class. Working closely with a student’s
teacher of students with visual impairments in advance helps ensure accessible materials
and availability of these materials in a timely manner.

Assistive Technology
In order to access print information, students with visual impairments must be trained in
the use of a number of adaptive devices, methods, and equipment that are collectively
referred to as assistive technology. Some of this technology allows access to information
presented on a computer while others are devices to be used independently. Computer
hardware and software are continuously advancing, allowing for more access to
information than ever before. Some examples:

Computer adaptations
 Braille translation software and equipment: converts print into braille and braille
into print.
 Braille printer: connects to a computer and embosses braille on paper.
 Screen reader: converts text on a computer screen to audible speech.
 Screen enlargement software: increases the size of text and images on a computer
screen.
 Refreshable Bbraille display: converts text on computer to braille by an output
device connected to the computer.

Adaptive devices
 Braille notetakers: lightweight electronic note-taking device that can be connected
to a printer or a braille embosser to produce a printed or brailled copy.
 Optical character reader: converts printed text into files on a computer that can be
translated into audible speech or Braille with appropriate equipment and software.
 Electronic braillewriter: produces braille, translates braille into text or synthetic
speech.
 Talking calculators: calculates with voice output.

Optical devices
 Closed Circuit Television (CCTV): enlarges an image to a larger size and projects
it on a screen
 Magnifiers: enlarges images
 Telescopes: used to view distant objects

A specially trained teacher of students with visual impairments can help supply many of
these devices and can provide training for the student to become independent and
proficient in using assistive technology.

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2.2.3.2 Strategies for the students with low vision
The low vision students have some sight to do daily work. The teacher has to deal with
differently. Firstly they may be motivated by warm welcome. The teacher can use the
following steps:

Introduction
 Encourage the student to answer questions posed by other students about the
 eye condition.
 Verbalize praise and disapproval or use gestures such as a hand on the shoulder.
 Students with low vision may miss the message sent with facial expressions and
body language.
 Be specific with descriptive language when explaining the location of a person or
object.
 Talk directly to the student, using direct eye contact. Encourage the student to look
at you when being addressed or when speaking to you.
 Encourage the student to look directly at people when conversing with them.
 Use a normal tone of voice.
 Feel comfortable using terms such as “look” and “see”. They will be part of the
student’s vocabulary.
 Provide the student with the coat hook or locker closest to the door so it is easy to
locate.

Safety
Students with visual impairments face an extra challenge when traveling around the
school building. Most areas of the school present potential problems. Procedures such as
fire drills, changing classes, going to the library and assemblies require that a plan of
action be in place. Assess each room that the student will be using for potential hazards.
These suggestions will help provide a safe environment.
 Familiarize the student with the school building as soon as possible.
 Limit clutter in the hallways, stairs and classrooms that the student will be using.
 Students with low vision should become familiar with the location of all furniture
 and fixtures in the room. If furniture must be relocated, be sure to inform the
student.
 Highlight the edges of stairs and steps with contrasting coloured tape or paint.
 Keep all cupboard or closet doors closed.
 Train teachers and other students in the sighted guide technique.
 When going on a field trip or traveling in an unfamiliar environment, arrange for a
buddy.
 Unless the student is familiar with your voice, identify yourself when conversing
with them. Have other students do the same. Always tell the student when you are
leaving them.

Seating
The seating in the classroom will depend on the functional vision of the student.
 Usually a student with a visual impairment will sit in the front of the classroom to
be in closer proximity to the teacher and board.
 If the right eye is stronger, being on the left side of the classroom is best and vice
versa.

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 Source of lighting needs to be considered. A student with a visual impairment
should not face direct light from windows or lighting. The teacher should avoid
standing directly in front of a window or light source when teaching.
 If the student uses a reading stand or tilt-topped desk, be sure the desk provides for
good posture to decrease fatigue. The student’s feet should be flat on the floor and
the reading stand tilted so that the student does not have to bend his/her neck
uncomfortably.
 For group activities such as story time or videos, the student may require
preferential seating.
 A sound field system may be considered for amplification of the teacher’s voice
and reduction of extraneous noises.

Teaching Tips
 A program plan is usually developed on an annual basis by the student’s support
team and is reviewed regularly.
 Plan ahead. If a student with low vision requires enlarged texts, audiocassettes or
printed materials, they should be ordered or prepared ahead of time.
 Talk while you teach. The student may miss visual cues and written instructions.
 Teach in close proximity to the student when doing demonstrations or using visual
aids.
 Verbalize notes as you write on the board. If a student cannot see or keep up with
board work, provide him with an enlarged print copy or a scribe to write the notes
using NCR (no carbon required) paper. Print may be easier to read than cursive
writing.
 Allow the student to go up to the board or move the desk closer in order to view or
copy the material.
 Check regularly to ensure that the student is making accurate notes.
 Provide extra time to the student. He/she will take longer to complete most tasks.
The quantity of work required may be decreased.
 Consider oral exams or a scribe to write exam answers.
 Use tactile, concrete and real life material as much as possible. This provides
opportunities for kinesthetic and tactile learning.
 Sufficient desktop and shelf space is needed to accommodate special materials. The
student will need to learn to organize his/her notes, desk, shelves and locker.
Colour coding notebooks and files may help. Maintaining organization should
become the student’s responsibility.
 Alternate visual tasks with non-visual tasks to avoid eye fatigue.
 The student with low vision requires the same discipline and behavior expectations
as other students.
 Say, “Tell me what you see” rather than “Can you see this?” when checking if a
student can see specific visual material.
 Try to relate new learning to the student’s experiences and knowledge. This will
help to bridge gaps in learning.
 If a large volume of reading is required, consider having a teacher assistant or
another student read the material to the student, or obtain it on audio tape.
 Skip the non-essentials. Older students can highlight important information in print
material. Point out parts of the text that can be skipped.
 Provide outlines, point form notes, identify key concepts to help avoid fatigue and
frustration when studying.

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 The student with low vision may need extra explanation of some materials.
 Hand-over-hand techniques work well to demonstrate certain skills.
 Encourage the student to be assertive. He/she needs to learn when and how to
request and refuse help and how to make his/her needs known.
 Encourage independent effort and incorporate proactive measure to reduce the
likelihood of the student becoming dependent on others.
 The student’s ability to participate in certain activities such as physical education,
science labs and visual arts may be affected by his/her functional vision.
Modification may be required.

Assignments and Examinations

Assignments and examinations can pose considerable difficulty for the student with low
vision. Examination results should reflect the student’s knowledge of the subject content.
Each student’s individual needs require consideration. The student may take more time to
complete an assignment or examination than other students. Consider the student’s well
being when assigning homework, particularly if it requires extensive reading or writing.
A student with low vision is often fatigued by the end of the school day and work quality
may be reduced. Some of the following stategies may be used to enhance a work quality.
 Allow additional time for completion of assignments and examinations.
 Allow the student to complete an examination in more than one sitting if necessary.
 Reduce the number of examples required to demonstrate the student’s
understanding of a concept or mathematics operation.
 Reduce the number of questions to be answered.
 Provide an alternate way of testing the student’s knowledge.
 Provide a scribe.
 Give the examination orally. Accept a computer print-out or answers recorded on
an audiocassette.
 Avoid the use of computer answer sheets.
 The procedures to apply for special provisions for provincial testing are included in
Appendix 5. Application should be made 8 to 12 months prior to the exam.

Lighting
 Eliminate glare as much as possible. This reduces visual fatigue. Shiny desk tops
and glossy paper will reflect light and should be avoided. Placing a black or dark
matte paper on the desk or tabletop will help to minimize glare and provide
contrast. Matte finish paper is recommended for the student’s work.
 The level of illumination required will depend on the student’s visual disability.
Some students can be extremely light sensitive. Natural, artificial, day and night
lighting present different functional problems and require different solutions for
each student. To determine the best lighting, the student and teacher must
experiment with lighting conditions.
 Aids to control illumination indoors include occluders to improve contrast and
block glare, visors to control light intensity and glare, absorptive lens and filters
and incandescent lamps. Incandescent lamps emphasize the yellow-red light and
have reflector shades and spring arms to help reduce glare and/or increase lighting
levels. High-intensity lamps may also be useful. If lamps are used, the light should
not shine directly into the student’s eyes. Place the lighting to eliminate glare and
shadows.

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 Overhead projectors often have glare. A student with low vision may need a
personal print copy of an overhead transparency.
 When the student uses the computer, an anti-glare filter screen may be needed.
 Outdoors, visors or wide-brimmed hats can control light intensity, and absorptive
lenses and filters can minimize glare and reflection.

Contrast
The teacher can increase the amount of information available to a student by maximizing
contrast. Sharp contrast between an object and its background makes the object more
visible to the student. This is essential in reading, writing, drawing, cutting, pasting and
physical education.
 Black and white or black and yellow provide the best contrast. Intense blue, green
or purple on a buff or light yellow background may be preferable if glare is a
problem. Experiment with the color of paper the student prefers.
 Keep the chalkboard as clean as possible. The student may have a preference for
yellow or white chalk. Large chalk can be purchased. A white board provides good
contrast if glare can be eliminated and a dark marker is used.
 Reduce visual distractions around an object.
 Avoid using materials with confusing patterns.
 Keep diagrams sharp, bold and simple. Too many details are confusing.
 Bold, sharp print provides good contrast. When enlarging print copies, try to
achieve clear, non-blurry copies.
 Bold-lined paper, with varying amounts of space between the lines, may be helpful.
 The student may prefer to use pencils and pens with larger points and darker lead
and ink.

Curriculum Suggestions for Teaching Students with Low Vision Mathematics

 Students with low vision must physically manipulate concrete materials to master
the basic concepts of math.
 The basic concepts of addition, subtraction, multiplication and division should be
thoroughly understood before being practiced on the abacus or talking calculator.
 Practice mental math skills.
 Provide a compartmentalized tray in which to place articles for counting and
matching.
 Pictorial directions for young students are helpful.
 Demonstrate measuring instruments individually to students with low vision.
 When doing activities involving measuring, the units used should be sufficiently
large so that the student can work without assistance.
 Provide a worksheet instead of having the student copy from the board.
 Use real coins when teaching money.
 Digital talking watches can be used for teaching time.
 Inlaid geometric puzzles are useful for teaching fractions.
 Use black line graph paper.
 Large print texts or the use of a closed circuit television can be especially helpful in
providing enlarged images of charts, diagrams, fractions and when teaching
geometry.

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Language Arts
 Labeled objects in the room should be at the student’s eye level.
 Point out details in pictures to aid with comprehension.
 Use a template or line guide to help a student focus on what they’re reading.
 Adjustable reading stands can promote good reading posture and reduce neck and
back fatigue.
 Emphasis should be placed on vocabulary building, word-attack skills and
comprehension rather than speed. Students with low vision will read slower.
 Large print is not necessary for all students with low vision. Often normal print
held close to the eyes is legible. Bold, clear print is best.
 Oral drills will help improve the student’s spelling.
 Paper with well-spaced bold black lines is useful for printing and handwriting.
 The younger student should have a written example of the alphabet on his/her own
desk.
 The student should be given time to practice reading handwriting.
 Introduce keyboarding skills by grade 3 or 4.

Arts Education
 When written music is used, a larger format and darker staff lines may be
necessary.
 Encourage the student to develop an interest in playing an instrument.
 Develop the student’s appreciation of music.
 Encourage the student with low vision to attempt the same visual arts activities as
other students.
 Paper with raised line drawing or black line drawing will indicate where the student
should colour.
 Clay and paper sculpture, textile arts, 3-dimensional forms, finger painting and
collage are art forms and activities that students with visual impairments can enjoy.
 Participation in drama provides the opportunity to learn everyday gestures and
movements that the student with low vision may not learn through visual
observation.
 A heavy string or tape on the floor will indicate where the student should walk and
move to on the stage in drama.

Science
 Raised line, large print or bold line diagrams can be used. Avoid detail.
 Assistance may be required in a lab to describe changes and aid in measurement.
 The student should be allowed to examine the apparatus and materials before an
experiment. Some science equipment is available with tactile markings.
 The student should be as close as possible to a demonstration.
 Use real life articles or models if possible.

Social Studies
 Raised line, large print or bold line maps and atlases should be used. Too much
detail may be confusing.
 Large print textbooks are available from the Saskatchewan Learning Resource
Centre.
 Reference materials may be scanned and listened to on a computer with voice
access to decrease the amount of reading required.

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Industrial Arts
 Orientation of the room should take place before the term begins.
 One-to-one instruction may be needed to teach the student what the tools are and
their location.
 The student should become proficient with hand tools before advancing to electric
tools. Hand-over-hand instruction may be necessary.
 Students with low vision should be taught to use equipment as if they had no
vision. Working in this way will prevent them from holding their faces dangerously
close to the equipment.

Unique Curriculum Needs for Students with Low Vision

A student with low vision will participate in the regular school program with adaptations
made as needed. He/she will need more directed instruction in the following areas than a
child with normal vision:
 visual efficiency;
 concept development;
 listening skills;
 knowledge of the eye condition;
 sensory-motor skills/physical education;
 visual aids and adaptations;
 communication;
 orientation and mobility;
 self concept and socialization;
 daily living skills;
 career education;
 recreation and leisure; and
 sexuality education.

The development and implementation of the student’s program plan is coordinated by the
resource and classroom teachers. The program plan will include the student’s unique
curriculum needs. It is important to hold regular meetings with the support team,
particularly those who will be working directly with the student. This provides the
opportunity to discuss daily, weekly or long-range program plans.

Children with low vision are eligible for preschool services as provided by the school
division.

Visual Efficiency
Visual efficiency is a combination of visual acuity and perception and can be improved
through instruction. Teaching students with low vision to look will not change their
visual acuity, but it may help them to use their vision more efficiently.
Use visual efficiency skills to:
 use spatial concepts and vocabulary;
 discriminate by tactile means (in attending to a visual task);
 visualize discrimination of:
 size, colour, shades of colour,
 shapes, symbols and forms,
 objects,

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 seeing similarities in, and differences between, the inner details and shapes of
similar objects;
 be able to match and sort;
 focus attention on and respond to visual stimuli;
 visually organize the whole from separate parts (e.g., puzzles);
 recognize pictures;
 discriminate among and recognize black-outline drawings of animals and
household objects;
 develop visual closure skills:
 identify common objects regardless of minor structural changes,
 identify common objects that are partially hidden;
 trace and copy accurately (eye-hand coordination);
 recognize objects in the foreground and in the background;
 track visually;
 use vision to facilitate gross motor movement;
 use vision to locate and point to a person or object;
 use vision to facilitate fine motor tasks;
 use visual memory:
 recognize a change in a familiar setting,
 retrieve an object from where it was last seen,
 identify a missing object;
 scan; and
 develop near, middle, distance and peripheral visual skills.

Concept Development
A concept is a mental representation, image, or idea of what something should be.
Students with low vision need assistance making the connection between vocabulary and
real objects, body movements and abstract ideas. They often miss a lot of the incidental
learning available through vision and frequently develop inaccurate concepts. Following
are useful strategies to aid in concept development.
 Pre-teach vocabulary and key concepts which relate to the curriculum through
verbal explanations and concrete experiences using a multisensory approach. For
example, orient the student to the library before library time.
 Pre-teaching can be provided by someone other than the teacher, such as a peer, an
older student, a teacher assistant or parent.
 After the student has participated in pre-teaching and classroom instruction, it is
crucial to review concepts and vocabulary. Say, “Describe what you understand by
this term.”
 Concepts must be experienced repeatedly in various environments in order for the
information to be generalized and for the student to gain expertise.

Listening Skills
Students with visual impairments achieve much of their learning through listening.
Develop listening skills in the following areas:
 auditory perception;
 sound discrimination;
 sound location;
 association of sounds and objects or situations;
 interpreting auditory information;

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 listening for sequence;
 listening for detail;
 listening for main ideas;
 new vocabulary;
 listening to follow instructions;
 learning to listen to audiocassettes;
 using earphones to minimize distractions;
 reading the questions to be answered before listening to the information;
 playing short portions of a tape and stopping to make notes; and
 adjusting the speed of the tape player.

Knowledge of the Eye Condition

A student needs to understand and to be able to tell others comfortably about the cause of
his/her visual impairment. This understanding leads to acceptance and the ability to deal
with the visual impairment. The student needs to understand:
 structure and function of the eye;
 eye care and service;
 diagnosis, cause, implications and prognosis of student’s eye condition;
 adaptations to the environment to enhance vision; and
 visual exercises, if needed.

Sensory-Motor Skills/Physical Education

Reduced vision can diminish the motivation to learn basic motor skills and reduce
opportunity to practice these skills. Physical fitness is as important for the student with
low vision as the sighted child. Sensory-motor skills are necessary for good concept
development, physical conditioning and orientation and mobility skills.

The student with low vision should participate in the regular physical education program.
Adaptations may be required depending on the functional vision of the student. He/she
may not be able to participate in all activities and team sports. A parallel physical activity
should be provided.

Visual Aids and Adaptations

A student with low vision may benefit from using optical and non-optical aids and
adaptations as prescribed by the eye care specialist. Aids such as binoculars and
adaptations such as lighting are explored to maximize a student’s visual experience.
Include these:
 training in the use of optical aids;
 appropriate lighting (depending on the eye condition, lighting needs will vary); and
 environmental adaptations:
 avoid glare,
 provide high contrast, and
 seat the child for optimal vision. The student may need to sit further back in the
classroom when using a visual aid.

Communication
The student with low vision will be included in the regular language arts program with
the following considerations in reading, listening and writing assignments.

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Reading Skills
A student with low vision needs print in a size that he/she can see. The appropriate print
size is determined by the functional vision assessment. Most storybooks for young
children are in large print. Choose books that have good contrast between the print and
the page.

Reading requires the efficient use of visual skills such as tracking, scanning, fixating and
shifting gaze. Students with low vision must exert more energy to read fluently and
sustain reading over a longer period of time. Different adaptations may be required at
different age levels.
 Use a multi-sensory approach when teaching the alphabet. Real objects should be
used to illustrate the initial sounds of words.
 Modify the amount of reading and provide audiocassettes or have someone read to
the student, if necessary.
 Use a line marker if the student has difficulty tracking and/or locating the place in
the text.
 Encourage the student to highlight important information when reading.
 Use a typoscope or template over a page of print to locate the next line.
 Allow the student to hold the page as close to the eyes as is necessary to read the
print.
 Allow the student to take breaks from visual tasks. Students may tire if they are
engaged in visual tasks for extended periods of time.
 Encourage the student to take responsibility for requesting a break when needed.
 Intersperse visual activities with non-visual activities.
 Bold, well-spaced letters are often easier to see than larger letters.
 Use highly contrasting letters to make print easier to read.
 Large print books are available from the Learning Resource Centre|libraries.

Listening Skills
 As discussed in an earlier section, a student with impaired vision will rely more
heavily on listening skills. It is very important to develop those skills.
 Look directly at the student when you are talking and address him/her by name.
 Talk in a clear, natural voice. Be sure the student is looking directly at you as well.
 Give all instructions orally. Take note of how many steps the student can follow at
a time.
 Provide exposure to audiocassettes, records, radio and TV to encourage
development of listening skills.

Writing Skills
 Allow the student to write in the size of print that is easy for him/her to read. Allow
the student to hold the page as close to the eyes as is necessary to read.
 Legibility is more desirable than style or speed. The student may prefer printing to
cursive writing.
 Felt pens, primary pencils, raised and bold lined paper can be used to make the
student’s writing more legible and make it easier for the student to write.
 Provide access to a computer at an early age, especially if the student continues to
demonstrate difficulty with writing skills. Screen enlargement software may be
purchased.

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 Keyboarding skills are important for a student with low vision. There are several
keyboarding software programs available that include speech. Large
 print letter overlays for keyboards are available from Resource Center.

Orientation and Mobility

Children with low vision need to learn techniques that enable safe and efficient travel
from an early age if they are to function independently in and be knowledgeable about
their environment.

Self Concept and Socialization

A visual impairment may interfere with the student’s ability to observe appropriate social
behaviours and learn basic life skills. Social and life skills that other students learn
naturally through observing others and modeling, must be taught specifically to the
student with low vision. Teach and encourage the student the following skills.
 Turn and face the speaker. Some students do have eccentric viewing and need to
tilt the head in order to see the person to whom they are speaking.
 Modify behaviours common to students with low vision such as rocking and
repeated eye rubbing.
 Initiate a conversation or play activity. The student will often wait silently until
someone else takes the initiative. Teach and practice appropriate conversation
openers with the student.
 Participate in conversation with others. He/she should use age-appropriate
vocabulary and topics.
 Understand and respect the personal space of others. The student will also need to
be able to ask others, in a courteous way, to respect his or her personal space.
 Explore objects tactually to gain information and form accurate concepts. However,
it is necessary for the student to learn when it is acceptable to touch, particularly
when this relates to appropriate and inappropriate physical contact.
 Communicate his/her needs.
 Participate in a variety of group activities.
 Learn nonverbal communication skills. Give help to interpret facial expressions,
body language and gestures.
 Learn and demonstrate courteous behaviour.
 Recognize emotions and express them in socially acceptable ways.
 Develop skills in problem solving and decision making.
 Develop a positive and accurate self-concept.
 Recognize his/her strengths and weaknesses.
 Recognize and share feelings about his/her visual impairment.
 Become aware of and respond to peer pressure.
 Access counseling and support for adolescents. This service may be available from
a school counselor, a psychologist, or an education consultant. This is the stage
when students will experience puberty, learn about relationships and dating and
need to come to terms with the possibility of not being able to drive a car. It is
particularly important for the student to develop a strong self-image at this time
when peer acceptance is influenced by appearance and behaviour.

Daily Living Skills

All children, both sighted and visually impaired, need to learn self-care skills. With low
vision children, this may take more direct teaching using task analysis. It is important for

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all children to be able to contribute to the family chores, both for purposes of developing
self-esteem and learning to function independently. The student needs skills in the
following:
 personal hygiene;
 dressing, organization and care of clothing;
 table manners and eating;
 eating out;
 money management;
 preparing food;
 housekeeping;
 shopping;
 use of the telephone and other communications technology;
 health and safety;
 time concepts;
 self-advocacy;
 problem solving and decision making; and
 organizing of personal property and time:
 organize books, materials and equipment. Locate the required items when they are
needed and put them away when finished with them,
 develop an understanding of completing tasks on time,
 be able to plan time usage and how to balance time between tasks,
 assume responsibility for materials and equipment,
 use address books, calendars, journals and other personal organization tools,
 be able to follow a time-table, and
 keep track of assignments, grades and schedule changes.

Career Education
Unemployment and underemployment of adults with low vision is a continuing concern.
Career education is essential to the employability of adults with visual impairments.
Students with low vision need to deliberately and directly explore a wide variety of career
options.

Career education curriculums that have been developed for sighted children may need
supplementary instruction from a teacher who works with students with visual
impairments. Career education at the exploration level for younger students could well
mean many field trips into the community so that the student with low vision will have
exposure to people and work situations. The student must develop a realistic
understanding of his/her limitations and potential.
Emphasize the following:
 self awareness;
 strengths;
 weaknesses;
 interests/abilities;
 values;
 goals;
 prevocational skills;
 career awareness;
 career exploration;
 job preparation;

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 interview skills;
 resume writing;
 application forms;
 job seeking skills;
 awareness of sources of funding for Employment Assistance for Disabled Persons;
 awareness that many post-secondary institutions have support services for students
with disabilities; and
 employment issues related to the visual impairment (informing potential
employers, adaptations in the workplace).

Recreation and Leisure

Recreation and leisure activities will vary with the student’s age and functional vision.
These activities may range from pretending and playing with toys to artistic abilities
and using technology, equipment and tools. Recreation and leisure offer opportunities
for students to use their abilities, be active, feel self-worth, release tension, show
others what they can do, get along with others and receive recognition or rewards.
Many recreation and leisure activities promote lifetime skills that play an important part
in developing a satisfactory life. Recreation and leisure activities provide opportunities
for students to integrate and apply skills acquired in many curricular areas. Students with
blindness and low vision need additional encouragement to pursue these activities. The
student should develop:
 an awareness of leisure activities and how to manage leisure time well;
 skills for solitary play and solitary leisure activities;
 skills for social play and social leisure activities;
 an interest to learn about or join a community club or group;
 an interest in physical play, physical games, physical fitness and sports;
 an enjoyment of pets and nature;
 an enjoyment of music and dance;
 an interest in a hobby;
 skills for reading, writing, speaking and drama as leisure activities;
 skills for using science and technology for leisure purposes;
 an interest in taking lessons (music, gym, drama, swimming, dance); and
 an interest in attending camps available for the visually impaired.

2.3 Type 2-Hearing Impairment

Hearing is the pathway through which verbal communication develops. If a person does
not hear perfectly than he/she is likely to speak incorrectly. Hearing also influences
learning and academic progress. Early detection of hearing is important for the child’s
overall development. A defect in hearing mechanism creates problem in perception of
information. Hearing impairment reduces our knowledge of the world around us.
Children suffering from auditory loss may have difficulty in hearing either from one or
both ears or may have no power of hearing at all. Various terms are used to denote this
type of impairment, as for example; ‘hard of hearing’, ‘deaf’, ‘partially deaf’, ‘deaf mute’
and ‘partial hearing’, etc. certain variables are involved to cover the multidimensional
nature of this impairment by which true classification of this type raises questions. Some
of the important variables are; degree of hearing loss, age of onset and type of hearing
loss. Similarly children with modality involved other than the ear are referred to as ‘deaf
children’. The children who are born deaf are called as ‘congenitally deaf’ whereas those

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who got lost their hearing power after birth are known as ‘adventiously deaf’. Beside all
the terms described above, the experts have also divided hearing impairment into two sub
groups; i) pre-lingual deaf; hearing impairment is marked before speech and language
pattern develop, and ii) post-lingual deaf; hearing impairment is marked after the
attainment of speech and language pattern.

The hearing impairment is usually described by the terms slight, mild, moderate and
severe, and profound depending on the average hearing level measured in decibel
throughout the frequencies (500 to 2,000Hz).

The Ear
Human ear contains many parts. These parts; outer, middle and inner ear, function for us
to hear sounds. Outer ear consists of the external ear (pinna) and the auditory canal (a
passage of one inch length and ¼ inch wide). The outer ear ends at the eardrum
(tympanic membrane). The outer ear receives and passes the sounds to the middle ear.
The middle ear is full of air and contains three tiny bones- the ossicles; the maleus, incus
and stapes (called the ossicular chain). The ossicular chain forms a bridge between the
tympanic membrane and the entrance to the inner ear.
The sound waves after passing through ear drum and the ossicular chain (middle ear
bones or middle ear space-fluid) enter into the inner ear. The inner ear contains
semicircular canals-the cochlea which looks like a snail-shell. This part is filled with
fluid containing nerve-endings. It receives the vibrated impulses (the stimuli) from the
middle ear and transfers them to the auditory nerve. The auditory nerve carries the stimuli
(the message) to the brain to be interpreted for an action.

The inner ear convert sound waves into the electric impulses (currents) and passes the
sound messages to the brain through the auditory nerve in the form of signals. The
structure of the human ear is given in the following diagram.

Source: Harvard Medical School Centre for Hereditary Deafness (2004). Common
Causes of Hearing Loss for Parents and Families, (p.1).

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The type of hearing loss that occurs depends on the part of the ear that is not working
properly.

Types of the Hearing Loss

There are two main types of hearing loss; conductive hearing loss and sensorineural
hearing loss. There may occur a mixed hearing loss.

Conductive hearing loss; conductive hearing loss is common among the hearing
impairments of children. It occurs due to the impairment in the mechanism of
transmission of sound waves (sound conduction) through the outer ear and the middle
ear. Any blockage temporary or permanent or abnormality of outer and/or middle ear
causes conductive hearing loss. The other most common cause of conductive hearing loss
is inflammation or infection of the middle ear which is called otitis media.

Sensori-neural hearing loss; A sensori-neural hearing loss may be genetic in origin or

may be caused by the disease or injury. It may occur due to the damage or missing of
actual nerve endings or if sound cannot be perceived, however the loud stimulus may be.
This condition is sometimes called perceptive loss and can only be remediated by
educating the child to learn other communication skills.

Mixed hearing loss; Sometimes there may be occurrence of both conductive and sensori-
neural hearing loss in children.

2.3.1 Causes of Hearing Impairments

There are several causes of hearing impairment known uptill now. The causes of hearing
impairment are usually classified from two aspects; exogenous or endogenous.
Exogenous means that the causing agent / element stem from outside the body such as
disease, toxicity, or injury and reduces the auditory system’s ability to receive and
transmit sounds. The causes of hearing impairment that occur after birth are also known
as ‘adventious’ causes. The endogenous hearing impairment is present at birth. It is either
transmitted (inherited) from parent’s genes or any abnormality occurred during fetus
development. The causes of deafness are also grouped as; i) pre-natal (before birth), ii)
peri-natal (during birth), and iii) post natal (after birth) on the basis of the time of
occurrence.

Let us read the following common causes of deafness and severe hearing impairment in
children;

i. Virus Infection
Sometimes pre-natal cause of deafness is due to a virus infection. The most common one
is maternal rubella which is also known as German measles. When it affects a pregnant
woman, it has been shown to cause deafness, visual impairment, heart disorders and a
variety of other serious disabilities in the developing child. Maternal rubella continues to
be a significant cause of hearing impairment but an affective vaccination for rubella is
available and women of childbearing age should receive it.

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Meningitis is the main cause of adventitious hearing impairment (post natal or acquired).
It is an infection causes by bacteria or virus. This disease destroys the sensitive acoustic
apparatus of the inner ear. Body balance difficulties also occur along with other effects.
Children who lose their hearing due to meningitis have profound hearing losses but do
not likely to have other additional handicapping conditions.

ii. Heredity
Heredity is another leading cause to hearing impairment. It is also called congenital
hearing impairment (present at birth). It is strongly evidenced that congenital hearing
impairment runs into the families.

iii. Prematurity And Annoxia

Premature birth of child and other complications of pregnancy appear to increase the risk
of deafness and other disabilities. Annoxia (lack of Oxygen) is another peri-natal cause of
hearing impairment. In both cases the deafness may be of sensori-neural nature.

iv. Otitis Media

Another significant cause of hearing impairment is otitis media. It is an infection of
inflammation of the middle ear. Otitis media may results in building up fluid in ear and
raptures the ear drum if it left untreated.

v. Drugs
Some drugs taken by mother during pregnancy can also cause hearing impairment in a
child. For example a medicine ‘Thalidomide’ if taken can cause ear-deformity. Some
other examples are quinine and streptomycin.

vi. Other Causes

Other causes that have become reduced due to medical treatment/advancement include
blood (Rh) incompatibility between mother and child, mumps, and measles or injury.
Children having multiple handicapping conditions also have significant hearing
impairment.

Some environment factors such as noise pollution, repeated exposure to loud sounds or
industrial noise, jet air-crafts, guns, amplified music, extensive use of portable
headphones sets at high volume and frequent deep sea diving are increasing as causes of
hearing impairment.

2.3.2 Educational Implications

The hearing loss how minimal is it may affect the language learning and influence
educational progress. The extent of the difficulty depends upon;
 The type of loss (conductive or sensori-neural),
 The degree of loss,
 The age of onset,
 The time of detection,
 The time of intervention,
 The home environment , and
 The presence of other handicaps.
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Some points of primary importance are discussed as below:

Degree of hearing loss

There are various level of hearing loss ranging from mild to profound. The severity of
loss is described in decibels. The larger number shows the more sever loss because the
child is unable to hear anything below the identified level. Speech and language of the
individual is affected by the frequencies involved. If the loss is greater in speech
frequencies (500, 1000, 2000 Hz), the impairment will be severe. The hearing loss may
be present in one ear (unilateral) or in both ears (bilateral). Persons having unilateral loss
can function normally except the problems only with locating sounds. The persons with
mild to moderate bilateral loss can take benefit from amplification; making sounds
powerful by increasing its intensity. Persons with severe loss of 60n to 90 db can be
trained to use their remaining hearing with amplification. The profoundly deaf persons
(bilateral losses of more than 90 db) rely on manual language and speech reading for
communication but they can sometimes take benefit from amplification.

The hearing impaired children fall behind in language comprehension and use. They
become unable to keep up with the increased complexity of language system.

Age of Onset
Sometimes hearing loss occurs before language learning age (prelingual age) or at birth.
As the child does not develop language in this period therefore the speech is affected.
80% of language development normally occurs by the age of 3 years. The child whose
hearing loss occurred after the age of language learning (post lingual age) is less likely to
have severe educational problems as compared to the child who experienced prelingual
hearing loss. Since the auditory system is the main channel for normal language learning,
so the children with prelingual hearing loss cannot take benefit of the constant verbal
input coming from their surroundings for normal language development and therefore
need explicit teaching rather than simple normal exposure to ordinary language input.

Time of Identification and Intervention

For intervention the child needs to be identified as early as possible. Because if the passed the
stages of language learning then it will become difficult for him to communicate normally.
The children should be identified as early as possible to give them chances of auditory
discrimination followed by the complex linguistics afterward. They should be taught/trained
in using their residual hearing in order to acquire the building blocks essential for learning
language skills in the same sequence as hearing children.

Intelligence
Traditionally the intelligence is evaluated by using standardized intelligence tests that
give results in an IQ score. The research studies indicated that the hearing impaired
children have the same levels of intelligence as their non handicapped normal hearing
counterparts of same age group have when tested with performance tests instead of verbal
intelligence scales. So hearing loss does not appear to affect intelligence as measured by
performance intelligence tests.

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Language
Language of hearing impaired children is affected by the hearing loss. It is not as rich as
that of individual who hear normally. Usually the severely and profound hearing
impaired have very little concrete vocabulary. Their sentences are shorter and less
complex. The hearing impaired students face problems in grammatical structure. They
omit plurals, tenses, possessives, prepositions and other little words such as ‘a’ and ‘the’.
These students tend to use a very simple subject-verb-object order. Researchers have
recommended the tremendous use of total communication; use of speech along with
nonverbal cues/sign language for teaching language to the hearing impaired children.

Speech
The hearing impaired children cannot articulate sounds correctly. Articulation is only part
of the problem that lags them behind. Other factors are poor timing and rhythm. The
hearing impaired children have tendency to prolong both stressed and unstressed syllabus
and to insert more and longer pauses than necessary. It results in slow speech. Variation
in pitch is abnormal and it tends to lack linguistic content. Nasality is also a general
problem. Substituting one sound for another and prolonging the voicing of a single sound
are other behaviors that contribute to unintelligibility in the speech of the hearing impaired
children. Thus unintelligible speech lags them behind in performance at schools.

Academic achievement
The hearing impaired children show poorer academic achievements as compared to their
learning potential. The most affected area is reading because it is based on language
knowledge. Concept formation is the area where the teachers have to pay attention. Once
the concepts developed there is nothing difficult for the hearing impaired children to
progress. The educational implications of hearing loss must also be addressed through;
Minimizing the additional handicapped
Early identification and intervention of hearing loss
Starting schooling earlier
Good reading habits
Total communication

Assessment

Audiological: Hearing loss should be measured technically by an audiologist. The

assessment the instrument reports written in educational terms are a great help for the
hearing impaired children to progress academically. The instrument that is used to
measure hearing is called an audiometer. It shows a series of carefully adjusted tones that
vary in frequency (pitch) and intensity (loudness). Testing is carried out in a specially
designed sound proof room/booth. The results of this testing are shown on a graph called
an audiogram.

Speech: assessment of speech is called speech eudiometry. Testing of speech

comprehension is done only when child have some developed language. Usual clinical
test procedures can not be used for infants or young hearing impaired children who have
not developed language.

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There are various methods which are used to determine;
At what level the child hear speech?
How well the speech is understood?
The evaluator can use speakers or headphones and different types of materials.
The children respond by looking towards the source of the speech (the loudspeaker),
pointing to pictures, or actually repeating the words they hear.
In order to determine the ability of the individual to understand speech under optima
listening conditions, the lists of one-syllable words are presented through earphones or
loudspeakers. The results are reported in terms of the percentage of words that the child
identifies correctly. Children with severe to profound hearing losses often have difficulty
in discriminating one word from another.

Objective: additional information about an individual’s auditory system is gathered

through the objective audiometry. This testing does not involve any behavioral responses.
One method used for this purpose is called impedance audiometry. It identifies a
conductive hearing loss. Another objective test is used for the retarded children or
children with developmental delay who are not able to produce behavioral responses. In
this test electrodes are placed on the scalp to pick up the responses to auditory stimuli.
The results are recorded on a chart to show how the peripheral auditory system perceives
high-frequency sound.

Parental attitude
Parental attitude has a significant impact on the educational process. The hearing
impaired parents would show more acceptances towards hearing impaired child as
compare to the hearing parents. They would easily understand the educational
implications of hearing loss and help the child in learning. The hearing parents take more
time to understand and locate the real problem in learning. Once the communication
system (style) built by the parents, the child would become able to communicate with
others successfully. Over protection keeps the children lag behind in learning
independently. Parents are also helpful in minimizing the emotional problems created due
to the misunderstanding the situation.

2.3.3 Teaching and Learning Approaches

The intervention for the education and training of the child should be started soon after
getting the diagnosis or medical/surgical treatment if any. The provision of hearing aid is
the first thing to be done with the child. A microphone of hearing aid picks up sound
waves and changes them to electric energy. The amplifier of the hearing aid increases the
power (intensity) and the receiver changes the electrical energy back into the louder
sound. The battery provides energy to the hearing aid. The teacher in the class room can
use the group hearing aid. It eliminates the background noise and the teacher speaks
directly to the students. Learning of how to use the residual hearing capacity is essential
for the education of all hearing impaired children and youth.

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1. Modes of Communication
In order to enable the hearing impaired children and youth to live in normal society and
participate in the communication around them, it is necessary that children with hearing
impairment must learn to speak, read lips and remaining hearing. The hearing impaired
students require instructions in three aspects of language; content, syntax, and function.

i. The Aural-Oral Approach

This approach emphasizes the use of remaining hearing through amplification. This
hearing capacity if appropriately improved can be used as an aid in receiving and
producing speech. Students are taught to speak or form the sound. Reading and writing
skills are introduced as additional methods for acquiring and using language. Only
children with severe and profound hearing losses cannot receive all necessary
information given by the auditory channel, lipreading (speech reading). Some
information may be missed during speech reading. These can be obtained by feeling the
movements of the speaker (touching of the cheeks and nose of the speaker).

Auditory training must be provided to all hearing impaired children. The severely and
profound hearing impaired children must be taught not only the sounds of the language as
they occur in connected speech but also proper phrasing and pitch patterns.

ii. Manual Communication Modes

In this approach messages are sent by manipulating the fingers, arms and upper torso
(trunk/chest) and are received visually. American Sign Language (ASL) is a manual
communication system. It has thousand signs. Finger spelling in America is based on
codes of one-handed, manually formed symbols for each letter of English alphabet, the
ordinal numbers, and some punctuation. The distinct finger positions can be easily learnt
by the children and used to convey any message that can be written.

In few past years a number of new, modified sign systems have been created to convey
English language in a manual mode. Manual English uses many ASL signs but added new
signs for pronouns, articles and other structural elements. In ASL and Manual English
different signs are used for different ideas. In all language systems signs are modified by
the finger spelling position of the hand(s) to give the expression of synonyms.

iii. Total Communication

The combination of aural-oral and manual communication approaches is called total
communication. Though it was originated in late 1960’s but now got popularity in its use.
The philosophy behind is that the hearing impaired individuals should be given the
communication skills they need in any form possible; aural-oral, manual, and written.
With these skills the hearing impaired can lead independent lives, and can become
socialize with other not only the persons like them but also with normally society. It is
fact that an early use of all means of communication establishes the basic communication
pathway ways as efficiently as possible follows by the establishment of specific language
system. In this approach various practices like auditory training, speech reading, finger
spelling, sign system, reading and writing are used all together frequently to attain
optimal comprehension and total understanding in the communication situation. The total
communication uses all the components of an oral program and sign language.

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2. Methods of Teaching Language
Language learning is a problem for the pre-lingual deaf children with severe or profound
hearing loss. Very précised programs of formal language instructions have been prepared
and used by the special educators. They tried to remediate language defects through these
programs. Basically two methods have been used for this purpose;
i. The grammatical method
ii. The natural method
The grammatical method presents specific grammatical rules to guide the construction of
sentences. In the natural method linguistic hypotheses are formulated and tested. In this
program based method an extensive use in natural and meaning full situations is carried
out for construction of language and introduction of new vocabulary.

The hearing impaired children must be provided with the opportunity of language
learning through structured teaching. A combination of two approaches involves the use
of daily experiences to learn vocabulary and grammatical rules appropriate to the
functional level of the child.

3. Curriculum Modifications
A number of curricula have been developed for hearing impaired students. Majority of
the curricula involve the specific areas related to the child hearing needs/conditions; for
example auditory training and speech. Generally the basic assumption of these curricula
is the normal developmental processes. These curricula provide a good framework for
identifying or developing the appropriate teaching materials. The standard material for
the normal hearing students can be frequently used except the subject matter which needs
to be presented with modified form. The teachers must rewrite materials on specific
language skills (linguistic structure) before introducing the content of the course.

At secondary and post secondary level the hearing impaired students require the rapid
assimilation of the large quantities of written material because of the less access to the
auditory media. Therefore the secondary level curriculum must have plenty of simplified
text material and supplemented with study guides, computer assisted instruction and other
visual media such as captioned films and film strips.

4. The Learning Environment

Children learning depends on the opportunities the learning environment provide to them
according to their needs. The environment that provides chances of interaction with other
hearing or normal hearing age mates is considered the best one for the hearing impaired
children because of opportunities of communications. Some experts belief that placing
hearing impaired children in supported regular education classes is academically and
socially beneficial for them. But in the regular education setting the individualized
education program must be prescribed to bring the hearing impaired student at the
optimal level of functioning. The environment should also be supported by the
appropriate support services such as; note takers, interpreters, and tutors. The visually
enhanced strategies would also help in making the concepts clear. In addition to it the
school must involve parents, special education personnel and other professionals in
assessment, placement and for evaluation. Sessions of speech therapy may be arranged
for children with mild hearing loss. Children with profound hearing loss may be

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integrated for some specific academic subjects or social skills while they are primarily
enrolled in special class or resource room.

5. Technological Innovations
Computer-assisted Instructions: Educators of hearing impaired children must explore
and use the innovative strategies; computer instruction. Utilization of microcomputers is
upgrading the education of hearing impaired children and youth. Computers are very
good visual medium for them. Thus only using a communication modality with
computers can help a lot in academic learning in no time. In addition the hearing
impaired children can be engaged in an interactive learning process through many
techniques; the software through which immediate reinforcement and error correction is
possible. The computers may be used with the telecommunication devices for the deaf
(TDDs). It can make it possible for them to access the fast world of electronic mail,
bulletin boards, consumer services and other benefits available to the hearing impaired
children and youth. The educators should encourage the children to take full benefit of
this new and powerful tool for the development of adequate communication skills and
academic learning and evaluation.

Cochlear Implants: this is a device that is surgically placed in the ear. It’s one part
called ‘magnetic coil’ is placed under the skin behind the ear. Another ‘external coil’ is
held in place by the implanted magnet. A wire extending from the implanted coil and
ending in an electrode is placed in the fluid of cochlea (inner ear). The external coil is
connected to an electrical pack that looks like a body-type hearing aid. This pack can be
worn in a pocket, or on a belt or in a pouch. It also has a tiny microphone that can be
hooked over the ear or clipped to a shirt collar, or worn on a barrette. The microphone
picked up sounds that are carried to this pack or signal processor. The processor converts
the sounds to electrical signals which are then transmitted through the implanted coils to
the electrode in the cochlea. In that way the electrical impulses in the auditory nerve are
stimulated. These impulses are then carried up through the auditory pathways to the
brain. The cochlear implant carried electrical impulses directly through the system to the
brain. The sound heard through a cochlear implant is different from the sounds heard by
the hearing aid. The surgery to implant involves the opening of the mastoid (a structure
with in the skull that leads to the middle ear) and the middle ear.

2.4 Exercise
Q. What is distinction between a conductive haring loss and a sensorineural hearing
loss?

Q. Enlist some prenatal, perinatal and post natal causes of sensorineural hearing loss.

Q. What are the components of total communication? Discuss the rational of using
this approach to communication.

Q. How might the regular curricula be modified for hearing impaired students?

Let us do an activity to ensure the application of the gained knowledge.

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2.5 Activity

Visit a center for the visually handicapped children for one day and observe the
followings:
i. Identify the children who are totally blind children with low vision
ii. Notice their mobility skills and attention towards the identification of sound
iii. Observe their classroom management and lighting conditions, etc.

2.6 Self Assessment Questions

1. Define visual impairment, discuss the causes of this type of disability.

2. Explain the implications that visual impairment impose on the children.

3. Why is assessment of visual impairment necessary?

4. Specify the role of teacher in classroom accommodations for the totally blinds and
low vision children?

5. Organize educational implications for the low vision children.

6. Discuss the curriculum areas for the visual impaired students.

7. What is hearing impairment? Explain its causes and different types.

8. Discuss the teaching and hearning approaches to hearing impairment

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2.7 References

American Foundation for the Blind (n.d.). Statistics and Sources for Professionals.
Retrieved December 1, 2007 from
http://www.afb.org/Section.asp?SectionID=15&DocumentID=1367.

Huebner, K. M., Merk-Adams, B., Stryker, D., & Wolffe, K. (2004). The national agenda
for the education of children and youths with visual impairments, including those
with multiple disabilities. New York: AFB Press.

National Dissemination Center for Children with Disabilities (2004). Fact Sheet 13.
Retrieved December 1, 2007 from www.nichcy.org/pubs/factshe/fs13txt.html.

Spungin, S. (2002). When you have a visually impaired student in your classroom: A
guide for teachers. New York: AFB Press.

Turnbull, A., Turnbull, R. & Wehmeyer, M. L. (2007). Exceptional lives. Special

education in today's schools. Upper Saddle River, NJ: Pearson Merrill Prentice
Hall.

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Unit: 3

TYPES OF EXCEPTIONALITIES-II

Written By:
Dr. Tanzila Nabeel

Reviewed By:
Dr. Shagufta Shezadi
 INTRODUCTION
A physical disability is a limitation on a person's physical functioning, postures, mobility
and stamina.

The causes of physical disability may be congenital or acquired. People with congenital
physical disabilities are either born with physical difficulties or develop those soon after
birth. The acquired disabilities are those which develop through injury or disease. The
age at which condition develops determine the impact. Physical disabilities can be the
result of congenital birth issues, accidental injury, or illness.

OBJECTIVES
The objectives of the unit are, to enable the students, to:
1. categorize the physical disabilities and health impairments.

2. comprehend the sub categories of each type of physical disability which affect the
daily living skills and education of children.

3. have information on emotional problems in children.

4. differentiate between psychiatric disorders and behavioral disabilities.

5. learn the teaching strategies for physical disabilities.

6. practice the coping and teaching strategies for students with psychiatric disorders
and behavioral disabilities.

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3.1 Type 3- Physical and Health Impairments
3.1.1 Categories
There are two major categories of physical disabilities:
A. Musculo - Skeletal Disabilities
B. Neuro - Skeletal Disabilities

A. Musculo - Skeletal Disabilities

Defined as the inability to carry out activities associated with movements of the
body due to deformity in muscles, bones and joints. The disabilities grouped under
musculo- skeletal disability are:
i. Loss or deformity of Limbs
ii. OsteogensisImperfecta
iii. Muscular Dystrophy

i. Loss or Deformity of Limbs

This may be due to birth defect, disease or accidents. The person may require an
artificial limb to compensate the functional loss of activities.

ii . OsteogensisImperfecta
Osteogenesisimperfecta (OI) is a genetic disorder in which bones break easily.
Sometimes the bones break for no known reason. OI can also cause weak muscles,
brittle teeth, a curved spine, and hearing loss. OI is caused by one of several genes
that aren't working properly. When these genes don't work, it affects how you make
collagen, a protein that helps make bones strong. OI can range from mild to severe,
and symptoms vary from person to person. OI varies in severity from person to
person, ranging from a mild type to a severe type that causes death before or
shortly after birth. In addition to having fractures, people with OI also have teeth
problems (dentinogenesisimperfecta), and hearing loss when they are adults.
People who have OI may also have muscle weakness, loose joints (joint laxity) and
skeletal malformations. A person may have just a few or as many as several
hundred fractures in a lifetime. A defective development of the connective tissues
at the growing age that leads to softening of bones and the affected person
experience deformed posture. The person is with brittle bones.

Types of Osteogenesis Imperfecta (OI)

There are four well-known types of OI. These types are distinguished mostly by fracture
frequency and severity and by characteristic features. Three additional types of OI (type
V, VI and VII) have also been identified.
 Type I OI is the mildest form of the condition. People who have type I OI have
bone fractures during childhood and adolescence often due to minor trauma when
these individuals reach adulthood they have fewer fractures.

 Type II OI is the most severe form of OI. Infants with type II have bones that
appear bent or crumpled and fractured before birth. Their chest is narrow and they

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 have fractured and misshapen ribs and underdeveloped lungs. These infants have
short, bowed arms and legs; hips that turn outward; and unusually soft skull bones.
Most infants with type II OI are stillborn or die shortly after birth, usually from
breathing failure.

 Type III OI also has relatively severe signs and symptoms. Infants with OI type III
have very soft and fragile bones that may begin to fracture before birth or in early
infancy. Some infants have rib fractures that can cause life-threatening problems
with breathing. Bone abnormalities tend to get worse over time and often interfere
with the ability to walk.

 Type IV OI is the most variable form OI. Symptoms of OI type IV can range from
mild to severe. About 25 percent of infants with OI type IV are born with bone
fractures. Others may not have broken bones until later in childhood or adulthood.
Infants with OI type IV have leg bones that are bowed at birth, but bowing usually
lessens as they get older.

Some types of OI are also associated with progressive hearing loss, a blue or grey tint to
the part of the eye that is usually white (the sclera), teeth problems
(dentinogenesisimperfecta), abnormal curvature of the spine (scoliosis) and loose joints.
People with this condition may have other bone abnormalities and are often shorter in
stature than average.

iii. Muscular Dystrophy

Muscular dystrophy is a group of disorders characterized by a progressive loss of
muscle mass which results in loss of strength. The most common form of muscular
dystrophy is known as Duchenne muscular dystrophy which typically affects young
boys. The disease is genetic, and consequently, a history of muscular dystrophy in the
family increases the chance of an individual developing the disease.

There are a number of types of muscular dystrophy which includes the following:
 Duchenne muscular dystrophy - the most common form of the illness. Symptoms
normally start before a child's third birthday; they are generally wheelchair-bound
by 12 and die of respiratory failure by their early-to-mid-twenties.
 Becker muscular dystrophy - similar symptoms to Duchenne but with a later
onset and slower progression; death usually occurs in the mid-forties.
 Myotonic (Steinert's disease) - the myotonic form is the most common adult-
onset form. It is characterized by an inability to relax a muscle once it has
contracted. The muscles of the face and neck are often affected first. Symptoms
also include cataracts, sleepiness, and arrhythmia.
 Congenital - this type can be obvious from birth or before the age of 2. It affects
girls and boys. Some forms progress slowly whereas others can move swiftly and
cause significant impairment.

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Symptoms of muscular dystrophy

Initial symptoms
 A waddling gait
 Pain and stiffness in the muscles
 Difficulty with running and jumping
 Walking on toes
 Difficulty sitting up or standing
 Learning disabilities, such as developing speech later than usual
 Frequent falls

Later symptoms
 Inability to walk
 A shortening of muscles and tendons, further limiting movement
 Breathing problems can become so severe that assisted breathing is necessary
 Curvature of the spine can be caused if muscles are not strong enough to support its
structure
 The muscles of the heart can be weakened, leading to cardiac problems
 Difficulty swallowing - this can cause aspiration pneumonia, and a feeding tube is
sometimes necessary

Causes of Muscular Dystrophy

Muscular dystrophy is caused by mutations on the X chromosome. Each version of
muscular dystrophy is due to a different set of mutations, but all prevent the body from
producing dystrophin. Dystrophin is a protein essential for building and repairing muscles.

Duchenne muscular dystrophy is caused by specific mutations in the gene that encodes
the cytoskeletal protein dystrophin. Dystrophin makes up just 0.002 percent of the total
proteins in striated muscle, but it is an essential molecule for the general functioning of
muscles.

Dystrophin is part of an incredibly complex group of proteins that allow muscles to work
correctly. The protein helps anchor various components within muscle cells together and
links them all to the sarcolemma - the outer membrane.If dystrophin is absent or deformed,
this process does not work correctly, and disruptions occur in the outer memarine. This
weakens the muscles and can also actively damage the muscle cells themselves.

In Duchenne muscular dystrophy, dystrophin is almost totally absent; the less dystrophin
that is produced, the worse the symptoms and etiology of the disease. In Becker muscular
dystrophy, there is a reduction in the amount or size of the dystrophin protein.

Currently, there is no cure for muscular dystrophy, but certain physical and medical
treatments can improve symptoms and slow the disease's progression.

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B. Neuro - Skeletal Disabilities
These disabilities are characterized by inability of affected body parts to perform
controlled movements. This inability may occur due to some disease or
degeneration of muscles.
i. Cerebral Palsy
ii. Spina Bifida
iii. Polio
iv. Paralysis
v. Spinal Cord Injury

i. Cerebral Palsy

Types of Cerebral Palsy

Classification of Cerebral Palsy is based on;
 Severity level
 Topographical distribution of the problem
 Motor Function

Classification Based on Severity Level

Cerebral Palsy is often classified by severity level as mild, moderate, severe, or no CP.
These are broad generalizations that lack a specific set of criteria.
 Mild – Mild Cerebral Palsy means a child can move without assistance; his or her
daily activities are not limited.
 Moderate – Moderate Cerebral Palsy means a child will need braces, medications,
and adaptive technology to accomplish daily activities.
 Severe – Severe Cerebral Palsy means a child will require a wheelchair and will
have significant challenges in accomplishing daily activities.

Classification Based on Topographical Distribution

Topographical classification describes the effects on the body parts.
 Monoplegia/monoparesis means only one limb is affected.
 Diplegia/diparesis mean two limbs are affected – primarily the lower limbs.
 Hemiplegia/hemiparesis indicates the arm and leg on one side of the body are
affected.
 Paraplegia/paraparesis means the lower half of the body, including both legs, is
affected.
 Triplegia/triparesis indicates three limbs are affected. This could be both arms
and a leg, or both legs and an arm. Or, it could refer to one upper and one lower
extremity and the face.
 Quadriplegia/quadriparesis means that all four limbs are involved.
 Pentaplegia/pentaparesis means all four limbs are involved, with neck and head
paralysis often accompanied by eating and breathing complications.

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Classification Based on Motor Function
This type of classification is based on the type of movement affected by the muscles and
joints.
 Ataxia: Individuals have low muscle tone causing floppiness and low tension.
Balance of the body while walking is affected. Motor skills such as writing, typing,
or using scissors are difficult to manage.
 Spasticity: Spastic CP is characterized by jerky movements having muscles and
joints stiffness. This condition prevents the normal development of motor function.
Spastic cerebral palsy often makes simple tasks difficult, such as walking and
picking up small objects. The signs and symptoms of spastic cerebral palsy are
different for every child. Differences in symptoms depend on the severity of the
child’s brain injury and any co-occurring disorders that may be present.
 Athetoid:Athetoid cerebral palsy, or dyskinetic cerebral palsy, is a movement
disorder caused by damage to the developing brain. This type of cerebral palsy is
characterized by abnormal, involuntary movement. They have trouble controlling
movement in their hands, arms, feet and legs, making it hard to walk and grasp
objects.

Types of Muscle Tone

 Hypertonia/Hypertonic — increased muscle tone, often resulting in very stiff

limbs. Hypertonia is associated with spastic Cerebral Palsy
 Hypotonia/Hypotonic — decreased muscle tone, often resulting in loose, floppy
limbs. Hypotonia is associated with non-spastic Cerebral Palsy.

ii. Spina Bifida:

There are four types of spinal bifida:
Occulta, closed neural tube defects, meningocele, and myelomeningocele.

 Occulta is the mildest and most common form. With occulta one or more vertebrae
(bones that make up the spine) are not properly formed. The name “occulta,” meaning
“hidden,” means that the malformation, or opening in the spine, is covered by a layer of
skin. This form of spina bifida does not usually cause disability or symptoms.
 Closed neural tube defects are the second type of spina bifida. This form consists
of a group of spinal defects in which the spinal cord is marked by a malformation
of fat, bone or membranes. In some patients there are few or no symptoms; in
others the malformation causes partial paralysis with urinary and bowel problems.
 Meningocele, the meanings (protective coverings around the spine) push out from
the spinal opening, and may or may not be covered by a layer of skin. Some
patients with meningocele may have few or no symptoms. Others may experience
symptoms that are similar to closed neural tube defects.
 Myelomeningocele, the fourth form, is the most severe. This occurs when the
spinal cord shows through the opening in the spine resulting in partial or complete
paralysis of the parts of the body below the spinal opening. The paralysis may be

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 so severe that the patient with this type of spina bifida is unable to walk and may
have urinary and bowel dysfunction.

iii. Polio
Poliomyelitis (polio) is a highly infectious viral disease, which mainly affects
young children. The virus is transmitted by person-to-person spread mainly through
the faecal-oral route or, less frequently, by a common vehicle (e.g. contaminated
water or food) and multiplies in the intestine, from where it can invade the nervous
system and can cause paralysis.

Initial symptoms of polio include fever, fatigue, headache, vomiting, stiffness in the neck,
and pain in the limbs. In a small proportion of cases, the disease causes paralysis, which
is often permanent. There is no cure for polio, it can only be prevented by immunization.

Signs and Symptoms

Polio is a viral illness that, in about 95% of cases, actually produces no symptoms at all
(called asymptomatic polio). In the 4% to 8% of cases in which there are symptoms
(called symptomatic polio), the illness appears in three forms:
 a mild form called abortive polio (most people with this type may not even suspect
they have it because their sickness is limited to mild flu-like symptoms such as
mild upper respiratory infection, diarrhea, fever, sore throat, and a general feeling
of being ill)
 a more serious form associated with aseptic meningitis called nonparalytic
polio (1%-5% show neurological symptoms such as sensitivity to light and neck
stiffness)
 a severe, debilitating form called paralytic polio (this occurs in 0.1%-2% of cases)

People who have abortive polio or nonparalytic polio usually make a full recovery.
However, paralytic polio, as its name implies, causes muscle paralysis — and can even
result in death. In paralytic polio the virus enters the bloodstream via intestinal tract. This
virus then attacks the nerves which govern the limbs thus causing paralysis. Though the
illness lasts for a few days but the damage to the nerves are for lifetime.

iv. Paralysis
The most common causes of paralysis are:
 Stroke
 Head Injury
 Spinal Cord Injury
 Multiple Sclerosis

Stroke
All organs in our body require oxygenated blood supply for proper functioning. Any
hindrance in the pathway of it cause brain cell die which results in stroke hence paralysis.

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Head Injury
A severe head injury can cause brain damage by damaging the blood vessels and nerves.
Paralysis can occur if a part of the brain that controls specific muscles is damaged during
a severe head injury. Damage to the left side of the brain can cause paralysis on the right
side of the body, and damage to the right side of the brain can cause paralysis on the left
side of the body.

Spinal Cord Injury

Spinal Cord injuries can occur due to motor accident, falls from height or with any strike
to the spinal cord which can cause damage to the nerves which run from brain through
neck and spine, inside a tube of vertebrae. The nerves inside the spinal cord transmit
signals to and from the brain and body. If the neck or spine is injured, the spinal cord can
also be damaged. This means the brain may no longer be able to transmit signals to the
muscles, causing paralysis.

The exact location where the spinal injury occurs can have a significant effect on how
severe and wide-ranging the paralysis is.

Multiple Sclerosis
In this condition nerve fibers in the spinal cord become damaged by the immune system.
The substance called Myelin surrounds nerve fibers which help with the transmission of
nerve signals. In the condition of Multiple Sclerosis, Myelin around the nerve fiber
becomes damaged by the body’s own immune system. This disturbs the messages
coming to and from the brain hence may result in paralysis.

3.1.2 Assessment
Physical impairments may result in temporary, permanent or intermittent conditions.
Cerebral Palsy, Muscular Dystrophy, Spinal cord injuries results in permanent disabilities
whereas some types of strokes, muscle spasms; allergies stamina affecting health
impairment has temporary impacts. Coordination and balance may be mildly or severely
affected by any of these conditions. The characteristics of students with physical or health
disabilities are as unique to the individuals as the conditions that created their special
needs. Students with physical disabilities, require substantial alterations to the physical
environment. For still others, the health situation requires intense special
accommodations. The assessment procedures and strategies would vary for each student
depending upon the type and the severity level.

The purpose of initial assessment is to find out the strengths and weaknesses of the
person, the types of interventions he/she requires, the support in terms of assistive
technology required for daily routine, studies/work and any other functional purpose.
Thecomprehensive assessment should identify the educational needs of the student
related to the physical impairment and his or her learning skills. The assessment may
require adaptations to traditional assessment tools to compensate for motor and sensory
skills. The multidisciplinary assessment team will include teachers and other specialists
with knowledge in the area(s) of suspected educational needs.

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Team Members
A Physical and Health Disabilities Teacher is required to be a member of the IEP team.
This person is responsible for planning and completing evaluation/reevaluation for
students with physical impairments from pre-Kindergarten to age 22. The role of a P/HD
teacher is to provide expertise in determining the educational implications and strategies
unique to the physical disability; assist in developing appropriate goals and objectives,
curricular modifications, adaptations, accommodations and use of assistive technology to
meet curriculum requirements and to present disability specific services.

In addition, services may be provided by one or more of the following team members:
 Physical Therapist
 Occupational Therapist
 Nurse
 Doctor
 Special Educator
 Speech Language therapist

Frequent Educational Needs

 Provision of compensatory skills through adaptations, modifications, technology,
and equipment for motor and perceptual skills
 Provision of educational strategies for organizational, attending, and memory skills
 Development of self-advocacy skills regarding the student's needs as they relate to
the physical impairment
 Development of evacuation plans, safety consideration, mobility, health plans
 Opportunity to access all curricular and educational experiences, including
participation in courses requiring lab or hands-on work, field trips, music
programs, and extracurricular activities.

3.1.3 Adaptation in curriculum, Instruction and Evaluation

Curriculum adaptations for children with special needs are based on the premise that each
child as an individual is with unique combinations of strengths and limitations. The
adaptations must be carried out with the conviction that it would support the individual
abilities, interests, learning styles and developmental rates.

The literature review suggests seven types of modifications and adaptations in curriculum
for children with disabilities (Wolery&Wilburs 1994; Hemmeter et al. 2001; Sandall,
Schwartz, & Joseph 2001; Sandall et al. 2002).

 Altering the environment: Altering the physical and social environment and the
timing of activities to promote a child’s participation, engagement, and learning.
 Adapting the material: Modifying materials so that the child can participate as
independently as possible.
 Modification in activities: Simplifying a complicated task by breaking it into
smaller parts or reducing the number of steps.

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 Working with child’s preferences: Identifying and integrating the child's
preferences for materials or activities so that the child takes advantage of available
opportunities.
 Organizing peer support: Utilizing peers to increase a child's participation.
 Providing invisible support: Purposefully arranging naturally occurring events
within an activity.
 Providing adult support:An adult intervening or joining the activity to support
the child’s level of participation.

Instructional Strategies for Students with Physical Disabilities

 Use mnemonics such as SLANT (Sit up, lean forward, ask questions, nod your
head, track the teacher).
 Consider environmental issues: seating placement in classroom, workspace free
from distractions, proximity seating, and student remove all non-related materials
from space.
 Use textured mats under worksheets and manipulatives to stabilize work area.
 Provide a paper stabilizer (clipboard, non-slip writing surface).
 Use colored highlighters to direct attention to key information.
 Use digital timer to help pace student while working.
 Use a line or a place-marker.
 Provide adapted paper (bold line, raised line, enlarged spacing).
 Use colored sticky notes to draw attention or clarify important information.
 Use large pencils and/or pencil grips/weighted pencils.
 Use adaptive equipment for posture: booster seats, arm rests, etc.
 Use computers with touch screen capabilities.
 Demonstrate all concepts with manipulatives.
 Provide copies of work that is presented on the board or textbook to cut down on
“copying” for students.
 Vary group size for instruction.
 Provide large-print handouts of text.
 Provide a bookstand for books and assignment pages.
 Provide specifically lined/oriented paper.
 Make available computer speech-enhanced text and lessons.
 Use drawings and real-life examples such as lunch counts and class lists.

Evaluation
Students with a mobility disability may need particular adjustments to assessment tasks.
Once you have a clear picture of how the disability impacts on performance you can
consider alternative assessment strategies, such as those suggested below:
 A reader or an oral examination (either presenting answers on tape or participating
in a viva) are alternatives to the conventional written paper. An oral examination is
not an easy option for students. Give the same time for an oral examination as for a
written exam, but allow extra time for the student to listen to and refine or edit
responses. In your assessment, allowance should be made for the fact that spoken
answers are likely to be less coherent than written answers.

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 For some students the combination of written and oral examination will be most
appropriate. Allow students to write answer plans or make outline notes, but then to
answer the question orally. Your assessment should be based on both the notes and
the spoken presentation.
 Students may need to use a personal computer or a personal assistant in an
examination. If so, it may be necessary to provide extra space for equipment or a
separate examination venue if the noise from equipment (e.g. a voice synthesiser) is
likely to be distracting for other students.
 Provide extra time in examinations for students who have reduced writing speed.
Some students with a mobility disability may need rest breaks. Take-home
examinations and split papers may be options, given that some students may need
double time to complete examinations.
 Allow extensions to assignment deadlines if extensive research involving physical
activity (e.g. frequent trips to the library or collection of data from dispersed
locations) is required.

3.2 Type 4- Emotional and Behavior Disorders

Emotional and Behavior disorders is an umbrella term under which such problems occur
which are not exhibited in physical terms but do need modifications for teaching and
learning processes. Such persons are emotionally disturbed or emotionally challenged
and exhibit behaviors which are socially or culturally defiant. Some of the characteristics
and behaviors seen in children who have an emotional disturbance include:
 Hyperactivity (short attention span, impulsiveness);
 Aggression or self-injurious behavior (acting out, fighting);
 withdrawal (not interacting socially with others, excessive fear or anxiety);
 Immaturity (inappropriate crying, temper tantrums, poor coping skills); and
 Learning difficulties (academically performing below grade level).
 Not maintaining a satisfactory level of interpersonal relationship with his peer
group.
 Unable to learn to an appropriate level of his age without exhibiting any intellectual
or physical disability.
 Remain in pervasive mood of unhappiness or depression under normal
circumstances which cannot be explained otherwise.
 Develops fears and inappropriate behaviors without any apparent reasons in normal
circumstances.

Many children who do not have emotional disturbance may display some of these same
behaviors at various times during their development. However, when children have an
emotional disturbance, these behaviors continue over long periods of time. Their
behavior signals that they are not coping with their environment or peers.

Children with the most serious emotional disturbances may exhibit distorted thinking,
excessive anxiety, bizarre motor acts, and abnormal mood swings.

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3.2.1 Categories of Emotional and Behavior Disorders
Under the umbrella term of Emotional and Behavioral Disorders, there are two
categories: Psychiatric Disorders and Behavioral Disabilities.

a. Psychiatric Disorders
This category encompasses a wide range of conditions. Psychiatric disorders are defined
as mental, behavioral, or perceptual patterns or anomalies which impair daily functioning
and cause distress.

The DSM is one of the most widely used systems for classifying mental disorders and
provides standardized diagnostic criteria. The latest edition of the diagnostic manual is the
DSM-5 and was released in May of 2013. This list of psychological disorders reflects many
of the changes made between the earlier edition of the manual and the most recent version.

Some of the major categories of disorder include the following:

 Anxiety Disorders
 Bipolar and Related Disorder
 Disruptive, Impulse-Control, and Conduct Disorders
 Feeding and Eating Disorders
 Obsessive – Compulsive Disorder
 Neurocognitive Disorders
 Dissociative Disorders
 Neurodevelopmental Disorders
 Personality Disorders
 Sleep-Wake Disorders
 Substance-Related and Addictive Disorders
 Trauma and Stressor-Related Disorder

In this section we will discuss a few of the many psychological disorders.

1. Anxiety Disorders
The person going through an inner turmoil overwhelmed and appears in the state of panic
and nervousness is said to have Anxiety. This condition can cause serious illness which
would interfere the routine life. People with this condition may have feelings of terror,
sweating, palpitations or irregular heartbeats.

The general symptoms include:

 Feelings of panic, fear, and uneasiness
 Problems sleeping
 Cold or sweaty hands or feet
 Shortness of breath
 Heart palpitations
 Not being able to be still and calm
 Dry mouth
 Numbness or tingling in the hands or feet

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 Nausea
 Muscle tension
 Dizziness

Causes of Anxiety Disorders

Anxiety is caused by a combination of reasons which include changes in the brain
functioning and environmental stress. The changes in the brain impact the functioning of
the brain circuit which regulate fear and emotions. Studies have shown that severe or
long lasting stress can change the way nerve cells within these circuit transmit
information from one region of the brain to another. Certain environmental factors -- such
as a trauma or significant event -- may trigger an anxiety disorder in people who have an
inherited susceptibility to developing the disorder.

Treatment of Anxiety Disorders:

One or a combination of the following therapies may be used for most anxiety disorders:
 Medication: Drugs used to reduce the symptoms of anxiety disorders include
many antidepressants, certain anticonvulsant medicines and low-dose
antipsychotics, and other anxiety-reducing drugs.
 Psychotherapy: Psychotherapy (a type of counseling) addresses the emotional
response to mental illness. It is a process in which trained mental health
professionals help people by talking through strategies for understanding and
dealing with their disorder.
 Cognitive-behavioral therapy: This is a particular type of psychotherapy in which
the person learns to recognize and change thought patterns and behaviors that lead
to troublesome feelings.
 Dietary and lifestyle changes
 Relaxation therapy
Most effective treatments for psychotic disorders are comprehensive, involving
appropriate medication, mental-health education, and psychotherapy for the
sufferer of psychosis and his or her loved ones. It will also include the involvement
of community support services when needed.

2. Bipolar and Related Disorders

Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes
unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks.

There are four basic types of bipolar disorder; all of them involve clear changes in mood,
energy, and activity levels. These moods range from periods of extremely “up,” elated,
and energized behavior (known as manic episodes) to very sad, “down,” or hopeless
periods (known as depressive episodes). Less severe manic periods are known as
hypomanic episodes.

 Bipolar I Disorder— defined by manic episodes that last at least 7 days, or by

manic symptoms that are so severe that the person needs immediate hospital care.
Usually, depressive episodes occur as well, typically lasting at least 2 weeks.

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 Episodes of depression with mixed features (having depression and manic
symptoms at the same time) are also possible.
 Bipolar II Disorder— defined by a pattern of depressive episodes and hypomanic
episodes, but not the full-blown manic episodes described above.
 Cyclothymic Disorder (also called cyclothymia)— defined by numerous periods
of hypomanic symptoms as well numerous periods of depressive symptoms lasting for
at least 2 years (1 year in children and adolescents). However, the symptoms do not
meet the diagnostic requirements for a hypomanic episode and a depressive episode.
 Other Specified and Unspecified Bipolar and Related Disorders— defined by
bipolar disorder symptoms that do not match the three categories listed above.

3. Disruptive and Impulse Control Disorders

The impulse control disorders are a loosely grouped set of conditions that have in
common that they all centrally feature behavior that is acted out in an uncontrolled, and
impulsive manner that often has self-destructive consequences. The DSM lists the
following impulse control disorders:

Kleptomania is characterized by the repetitive, uncontrollable stealing of items not

needed for personal use

Trichotillomania is characterized by repetitive hair-pulling causing noticeable hair loss

and resulting in clinically significant distress or functional impairment (American
Psychiatric Association, 2000).

Intermittent explosive disorder is characterized by recurrent, significant outbursts of

aggression, which result in assaultive acts against people or property, are disproportionate
to outside stressors, and not better explained by another psychiatric condition (American
Psychiatric Association, 2000).

Pyromania is characterized by deliberate and purposeful fire-setting on more than one

occasion (American Psychiatric Association, 2000).

4. Eating Disorders:
Eating disorders are serious behavior problems. They can include severe overeating or
not consuming enough food to stay healthy. They also involve extreme concern about
your shape or weight.

Types of eating disorders include

 Anorexia nervosa, in which you become too thin, but you don't eat enough because
you think you are fat
 Bulimia nervosa, which involves periods of overeating followed by purging,
sometimes through self-induced vomiting or using laxatives
 Binge-eating, which is out-of-control eating

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5. Obsessive – Compulsive Disorder:
Obsessive-compulsive disorder (OCD), formerly considered a type of anxiety disorder, is
now regarded as a unique condition. It is a potentially disabling illness that traps people
in endless cycles of repetitive thoughts and behaviors. People with OCD are plagued by
recurring and distressing thoughts, fears, or images (obsessions) they cannot control.
The anxiety (nervousness) produced by these thoughts leads to an urgent need to perform
certain rituals or routines (compulsions). The compulsive rituals are performed in an
attempt to prevent the obsessive thoughts or make them go away.

What Causes OCD?

Although the exact cause of OCD is not fully understood, studies have shown that a
combination of biological and environmental factors may be involved.

Biological Factors
The brain is a very complex structure. It contains billions of nerve cells -- called neurons
-- that must communicate and work together for the body to function normally. Neurons
communicate via chemicals called neurotransmitters that stimulate the flow of
information from one nerve cell to the next. At one time, it was thought that low levels of
the neurotransmitter serotonin were responsible for the development of OCD. Now,
however, scientists think that OCD arises from problems in the pathways of the brain that
link areas dealing with judgment and planning with another area that filters messages
involving body movements.

Symptoms of OCD
The symptoms of OCD, which are the obsessions and compulsions, may vary. Common
obsessions include:
 Fear of dirt or contamination by germs
 Fear of causing harm to another
 Fear of making a mistake
 Fear of being embarrassed or behaving in a socially unacceptable manner
 Fear of thinking evil or sinful thoughts
 Need for order, symmetry, or exactness
 Excessive doubt and the need for constant reassurance

Common compulsions include:

 Repeatedly bathing, showering, or washing hands
 Refusing to shake hands or touch doorknobs
 Repeatedly checking things, such as locks or stoves
 Constant counting, mentally or aloud, while performing routine tasks
 Constantly arranging things in a certain way
 Eating foods in a specific order
 Being stuck on words, images or thoughts, usually disturbing, that won't go away
and can interfere with sleep
 Repeating specific words, phrases, or prayers
 Needing to perform tasks a certain number of times
 Collecting or hoarding items with no apparent value

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6. Neuro-Cognitive Disorders
The primary feature of all neurocognitive disorders (NCDs) is an acquired cognitive
decline in one or more cognitive domains. The NCDs are those in which impaired
cognition has not been present since birth or very early life, and thus represents a decline
from a previously attained level of functioning. Neurocognitive disorders can
affect memory, attention, learning, language, independence.

In DSM- IV, neuro-cognitive disorders list Dementia, Delirium and Amnesia. NCD’s
also include cognitive problems arising due to Alzheimer’s disease, Parkinson disease or
traumatic brain injury. Although cognitive deficits are present in many mental disorders
but only those disorders are included for NCD DMS V whose core features are cognitive.
(Ref. American Psychiatric Association).

7. Dissociative Disorders
Dissociative disorders are characterized by an involuntary escape from reality
characterized by a disconnection between thoughts, identity, consciousness and memory.
Dissociative disorders usually first develop as a response to a traumatic event to keep
those memories under control. Stressful situations can worsen symptoms and cause
problems with functioning in everyday activities. However, the symptoms a person
experiences will depend on the type of dissociative disorder they are experiencing.

The total population of people with dissociative disorders is estimated at 2%, with
women being more likely than men to be diagnosed. Almost half of adults in the United
States experience at least one depersonalization/derealization episode in their lives, with
only 2% meeting the full criteria for chronic episodes.

Symptoms
Symptoms and signs of dissociative disorders include:
 Significant memory loss of specific times, people and events
 Out-of-body experiences
 Depression, anxiety and/or thoughts of suicide
 A sense of detachment from your emotions or emotional numbness
 A lack of a sense of self-identit

Causes
Dissociative disorders usually develop as a way of dealing with trauma. Dissociative
disorders most often form in children exposed to long-term physical, sexual or emotional
abuse. Natural disasters and combat can also cause dissociative disorders.

Diagnosis
Doctors diagnose dissociative disorders based on a review of symptoms and personal
history. A doctor may perform tests to rule out physical conditions that can cause
symptoms such as memory loss and a sense of unreality (for example, head injury, brain
lesions or tumors, sleep deprivation or intoxication). If physical causes are ruled out, a
mental health specialist is often consulted to make an evaluation.

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Treatment
Dissociative disorders are managed through various therapies including:
 Psychotherapiessuch as cognitive behavioral therapy (CBT) and dialectical
behavioral therapy (DBT)
 Eye movement desensitization and reprocessing (EMDR)
 Medicationssuch as antidepressants can treat symptoms of related conditions
 The goals of treatment for dissociative disorders are to help the patient safely recall
and process painful memories, develop coping skills, and, in the case of
dissociative identity disorder, to integrate the different identities into one functional
person. There is no drug that deals directly with treating dissociation itself. Rather,
medications are used to combat additional symptoms that commonly occur with
dissociative disorders.

8. Neurodevelopmental Disorders
Neurodevelopmental disorders are disabilities associated primarily with the functioning
of the neurological system and brain. Examples of neurodevelopmental disorders in
children include attention-deficit/hyperactivity disorder (ADHD), autism, learning
disabilities, intellectual disability (also known as mental retardation), conduct disorders,
cerebral palsy, and impairments in vision and hearing. Children with neurodevelopmental
disorders can experience difficulties with language and speech, motor skills, behavior,
memory, learning, or other neurological functions. While the symptoms and behaviors of
neurodevelopmental disabilities often change or evolve as a child grows older, some
disabilities are permanent. Diagnosis and treatment of these disorders can be difficult;
treatment often involves a combination of professional therapy, pharmaceuticals, and
home- and school-based programs.

9. Personality Disorder
Personality disorders are longstanding, ingrained distortions of personality that interfere
with the ability to make and sustain relationships. Impairment inrelational functioning is
an enduring feature of personality disorder (Skodol etal. 2005).

10. Sleep-Wake Disorders

Circadian Rhythms Physiological and behavioral changes in the body that occur on
roughly a 24 hour cycle, sometimes called the body clock Circadian Rhythm Sleep
Disorders (CRSDs) or Circadian Sleep Disorders (CSDs) Abnormalities in length,
timing, and/or rigidity of the sleep-wake cycle relative to the day-night cycle

Symptoms
 Difficulty initiating sleep.
 Difficulty maintaining sleep.
 Nonrestorative sleep.
 Daytime sleepiness.
 Poor concentration.
 Impaired performance, including a decrease in cognitive skills.

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11. Substance Related and Addictive Disorders
Addictive disorders, such as substance abuse and dependence, are commondisorders that
involve the overuse of alcohol or drugs. Addiction develops over time and is a chronic
and relapsing illness. (Wolery, M., Ault, M., & Doyle, P.M. (1992). There are three
different terms used todefine substance-related addictivedisorders: Substance abuse.

12. Trauma and Stressor-Related Disorder

Disturbing pattern of behavior demonstrated by someone who has experienced,
witnessed, or been confronted with a traumatic event. It was exposed to an event that
posed actual or threatened death or serious injury and responded with intense fear,
helplessness, or terror

Examples of traumatic events

Natural disaster, fire/explosion, serious accident, exposure to toxic substance, physical
assault, assault with a weapon, sexual assault or an unwanted sexual experience,
combat/exposure to war zone, captivity, life threatening illness or injury, sever human
suffering, sudden violent or unexpected death of someone close, serious harm, injury or
death caused by them to another person, or any other very stressful experience.

b. BehavioralDisabilities
Behavioral disabilities are identified in children whose behavior prevents them from
functioning successfully in educational settings, putting either themselves or their peers
in danger, and preventing them from participating fully in the general education program.
Children with behavioral disabilities engage in conduct which is disruptive to classroom
functioning and/or harmful to themselves and others. There are two categories of
behavioral disabilities:
i. Oppositional defiant disorder
ii. Conduct disorder

i. Oppositional defiant disorder is characterized by extreme non-compliance,

negativity, and an unwillingness to cooperate or follow directions. Children with this
condition are not violent or aggressive; they simply refuse to cooperate with adults or
peers.

The typology consists of three types:

 Stimulus Dependent ODD,
 Cognitive Overload ODD and
 Fearful ODD.

Youth with Stimulus Dependent type ODD have noticeably impairing attention
deficit/hyperactivity disorder (ADHD) and have ODD behaviors in multiple settings.
Oppositionality improves when ADHD is treated (Connor, Steeber&McBurnett, 2010).

The second group Cognitive Overload ODD, struggles with learning, language and
social processing difficulties far in excess of ADHD, and usually meets criteria for

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learning disability and anxiety disorder not otherwise specified. This group has poor
executive functioning skills even under low demand conditions and their oppositionality
appears for no clear reason beyond resistance to change. They have poor social
perspective taking abilities, and are socially awkward. These challenging youth require
multimodal, staged treatments targeting anxiety and attention, but success is limited
without psychoeducational testing to direct supports at home and school. They would
have high levels of all types of oppositional symptoms. Finally, the Fearful type
constitute highly aroused and stress reactive children, who can do well in many contexts,
but present with ODD symptoms when threat of loss or shame is present, typically with
caregivers. Often these children have histories of trauma and mistrust authority; indeed
their behaviours reflect a profile of anxious/ambivalent attachment.

ii. Conduct disorder It is much more severe. This disorder is characterized by

aggression, violence, and harm inflicted on self and others. Conduct disorder is a
group of behavioral and emotional problems that usually begins during childhood
or adolescence. Children and adolescents with the disorder have a difficult time
following rules and behaving in a socially acceptable way. They may display
aggressive, destructive, and deceitful behaviors that can violate the rights of others.
Adults and other children may perceive them as “bad” or delinquent, rather than as
having a mental illness.

Types of Conduct Disorder

There are three types of conduct disorder. These are categorized according to the age at
which symptoms of the disorder first occur:
 Childhood onset occurs when the signs of conduct disorder appear before age 10.
 Adolescent onset occurs when the signs of conduct disorder appear during the
teenage years.
 Unspecified onset means the age at which conduct disorder first occurs is
unknown.

Symptoms of Conduct Disorder

Children who have conduct disorder are often hard to control and unwilling to follow
rules. They act impulsively without considering the consequences of their actions. They
also don’t take other people’s feelings into consideration. Your child may have conduct
disorder if they persistently display one or more of the following behaviors:
 aggressive conduct
 deceitful behavior
 destructive behavior
 violation of rules

Aggressive conduct may include:

 intimidating or bullying others
 physically harming people or animals on purpose
 committing rape
 using a weapon

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Deceitful behavior may include:
 lying
 stealing
 forgery

Violation of rules may include:

 skipping school
 running away from home
 drug and alcohol use
 sexual behavior at a very young age

Additionally, the symptoms of conduct disorder can be mild, moderate, or severe.

Students with conduct disorder typically need to be taught in special education
classrooms until their behavior has improved enough to allow contact with the general
education population.

3.2.2 Characteristics of Behaviour

Children and youth with emotional and behavioral disorders are considered the most
underidentified and underserved of all the disability groups (Forness&Kavale, 2001;
Gresham, 2005, 2007; Merrell & Walker, 2004). The issue of underidentificationcause
substantial challenges to their teachers, administrators and peers. Unless teachers
understand the reasons and the appropriate strategies for coping with the issue, such
children in the classroom are a constant source of disruptions and stress for the teachers.

Traditional approaches for addressing students with emotional behavioral disorders

primarily focus on behavior. Although fundamental component of the education plan is
the behavior for such population, the academics may not be ignored. For the purpose
multifaceted support is to be incorporated. Lewis, Hudson, Richter and Johnson (2004)
states “Much of the Disruptive behavior observed in the classroom is due to a disconnect
between the demands of the lesson and students achievements levels”.

3.2.3 Strategies for Teaching Students with Emotional and Behavioral Disorders
As with other conditions, students with emotional and behavioral disorders need a
positive, structured environment which supports growth, fosters self-esteem, and rewards
desirable behavior.

Rules and Routines

For encouraging and developing good behavior in children Rules should be established
and strictly followed by the teachers. These should be written in a very simple and
straight language which is understandable by the students.

The wording of rules should be positive: "Respect yourself and others" is a better rule
than "Don't hurt anyone." Keep it simple.

Consequences for breaking rules should also be established at the beginning of the school

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year, and applied consistently and firmly whenever the rules are broken. When
administering consequences, provide feedback to the student in a calm, clear manner.
That way, the student understands why the consequence is necessary.

Try to avoid becoming emotionally reactive when rules are broken. Emotional reactivity
gives the student negative attention, which many children find very rewarding. Remain
calm and detached, be firm yet kind. It's a difficult balance to achieve, but crucially
important for positive results.

Routines are very important for classroom management. Students with emotional and
behavioral disorders tend to struggle with transitions and unexpected change. Going over
a visual schedule of the day's activities is an effective way to start the day, and helps the
students feel grounded.

3.2.4 Educational Implications and Interventions Techniques for Supporting

Positive Behavior
Students with emotional and behavioral disorders often need to receive instruction in a
special education setting because their behavior is too maladaptive for a general
education classroom. Here are a few ideas to guide and support growth towards more
positive, adaptive behavior:

 Token Economy - Students earn points, or tokens, for every instance of positive
behavior. These tokens can then be used to purchase rewards at the token store. In
order for a token economy to be effective, positive behavior must be rewarded
consistently, and items in the token store must be genuinely motivating for the
student. This takes a fair amount of preparation and organization, but has proven to
be quite effective.

 Classroom Behavior Chart - A chart which visually plots the level of behavior of
every student in the classroom. Students who are behaving positively progress
upwards on the chart; those who are behaving negatively fall downwards. This
makes every student accountable, and helps you monitor and reward progress. This
won't work if difficult students perpetually stay on the bottom of the chart. Focus
on the positive to the fullest degree possible, and keep them motivated.

 Lottery System - Similar to the token economy, students who behave in positive
ways are given a ticket with their name on it. These tickets are placed in a jar, and
once or twice a week you draw one out. The winner of the lottery is rewarded with
a prize.

 Positive Peer Review - Students are asked to watch their peers, and identify
positive behavior. Both the student who is behaving positively and the student who
does the identifying are rewarded. This is the exact opposite of "tattle-telling," and
fosters a sense of teamwork and social support in the classroom.

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Teaching children with emotional and behavioral disorders is extremely challenging.
Remember: fostering and rewarding positive behavior has proven to be vastly more
effective than attempting to eliminate negative behavior. Punishment and negative
consequences tend to lead to power struggles, which only make the problem behaviors
worse. It is not easy to remain positive in the face of such emotionally trying behaviors,
but don't give up. Your influence could mean a world of difference to these students who
are struggling with an incredibly difficult condition.

3.2.5 Challenges and Issues

From a teacher's perspective, psychiatric disorders present a profound challenge for a
number of reasons. For one, schools are not hospitals, and teachers cannot be expected to
"treat" these disorders. Students who struggle with these sorts of challenges are often
undergoing treatment and may be receiving medication. Medication can affect people in
unexpected ways and, because medical information is confidential, teachers may be
unaware why students are acting the way they are. This makes it difficult to respond
appropriately to certain behaviors. Additionally, students suffering from these conditions
may be simply unable to meet academic and behavioral expectations. In such cases,
students need to receive special education interventions of some sort, and may need to be
moved into a special education classroom.

3.3 Self-Assessment Questions

1. Define Physical Disability and what are their causes.

2. Diffrienciate between the types of Osteogenesis Imperfecta.

3. What are the causes of Muscular Dystrophy?

4. Define Neuro-skeletal disability with examples. How topographical distribution

effects on the body parts of the patients?

5. How classification of Cerebral palsy is done on motor functions?

6. Write different types of muscle tones?

7. Write on different types of Spina bifida?

8. What are the Signs and symptoms of Polio?

9. Discuss the causes of Paralysis.

10. What are the frequent educational needs of Special children having physical
disabilities?

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11. What are the instructional strategies for students with physical disability?

12. What are Emotional and Behavior Disorders?

13. What are the categories for emotional and Behavior?

14. Define Anxiety. Discuss the general symptoms of Anxiety.

15. How are Anxiety Disorder Treated?

16. Explain the types of eating disorders.

17. What cause obsessive-compulsive Disorder?

18. What is Neuro-cognitive Disorders?

19. What are the Behavioral Disabilities and there characteristics?

20. Discuss about the types and symptoms of conduct disorder.

21. Give the strategy for teaching supporting positive behaviour.

22. Discuss the issues and challenges of Special children having physical disabilities.

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3.4 References
Abbs, S., Roberts, R.G., Mathew, C.G., Bentley, D.R., and Bobrow, M. (1990). Accurate
assessment of intragenic recombination frequency within the Duchenne muscular
dystrophy gene. Genomics 7:602-606.

Brown, W. H., Odom, S. L., & McConnell, S. R. (2008). Social competence of young
children, risk, disability, and intervention. Baltimore, MD: Paul H. Brookes.

Connor DF, Steeber J, McBurnett K. A review of attention deficit/hyperactivity disorder

complicated by symptoms of oppositional defiant disorder or conduct
disorder. Journal of Developmental and Behavioural Pediatrics. 2010;31:427–
440.[PubMed]

Connor, Steeber&McBurnett, 2010. A review of attention-deficit/hyperactivity disorder

complicated by symptoms of oppositional defiant disorder or conduct disorder.

DiGennaro et al., 2005, 2007.levels of problem behavior are associated with high levels
of treatment integrity.

Eriksson, Lilly, Granlund, Mats, & Welunder, Jonas. (2007). Participation in everyday
school activities for children with and without disabilities. Childhood, 18, 485-502.

Gresham, 2005, 2007. Deconstructing a Definition: Social Maladjustment versus

Emotional Disturbance and Moving the EBD Field Forward Kenneth W.

Holtz, Kristin, &Tessman, Greta. (2006). Journal of developmental & physical

disabilities. Childhood, 531-542.

Jillian Pizzi, (2008). Rivier Academic Journal, Volume 4, Number 1, Spring

2008,Challenges of Children With Physical Disabilities.

Kroenke K , Spitzer RL , Williams JB , Linzer M , Hahn SR , deGruy FV 3rd , Brody

D Archives of Family Medicine, Physical symptoms in primary care. Predictors of
psychiatric disorders and functional impairment. Sep. 1994, 3(9):774-779]

Lewis, T. J., Hudson, S., Richter, M., &Johnson,N. (2004). Scientifically supported
practices in emotional and behavioral disorders: A pro-posed approach and brief
review of current practices.

Sandall, S., Schwartz, I., & Joseph, G. (2001). A building blocks model for effective
instruction in inclusive early intervention settings.

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Skodol AE, Pagano ME, Bender DS, et al. Stability of functional impairment inpatients
with schizotypal, borderline, avoidant, or obsessive-compulsivepersonality disorder
over two years. Psychol Med, 2005; 35(3): 443–51.

Steven R. Forness and Kenneth A. Kavale. Education and Treatment of Children

Wolery, M., Ault, M., & Doyle, P.M. (1992). Teaching students with moderate and
severe disabilities: Use of response prompting strategies

Wolery, M. and Wilburs, J. S. (1994) Introduction to the inclusion of young children with
special needs in early childhood programs. In M. Wolery and J. S. Wilbers (eds),
Including Children with Special Needs in Early Childhood Programs, pp. 1–22.
Washington, DC: National Association for the Education of Young Children.

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Unit: 4

TYPES OF EXCEPTIONALITIES-III

Written By:
Hina Noor

Reviewed By:
Mrs. Sadaf Noveen
&
Dr. Zahid Majeed
 INTRODUCTION
This chapter presents a systematic review of exceptional children with communication
disorders and specific learning disabilities in separate sections. Both communication
disorders and learning disabilities that individuals/children may experience are explained
with special reference to educational interventions for these individual/children. It is
important to realize that communication is a system with many reciprocal relationships.
A problem with one aspect of the communication process often affects many of the other
processes that are related to it. Children’s progress in other academic areas is directly
linked with their speech and language competence and performance. For this reason,
there is a need to identify children with language disorders as early as possible and to
provide them with the interventions that appear to be the prerequisite for success in
school life.

Learning disability (LD) is a general term that describes specific kinds of learning
problems. LD is a group of disorders that affects people’s ability to either interpret what
they see and hear or to link information from different parts of the brain. These
limitations can show up in many ways: as specific difficulties with spoken and written
language, coordination, self-control, or attention. Such difficulties extend to schoolwork
and can impede learning to read, write, or do math. Learning disabilities vary from
person to person. The skills most often affected are reading, writing, listening, speaking,
reasoning, and doing math. There is also evidence that Specific Learning Disabilities stay
with students into adulthood and remain with them for life. Therefore, it is paramount for
the students to understand the nature of this disability as well as strategies they can be use
when faced with such a situation in classroom.

OBJECTIVES
After reading the unit, you would be able to:
1. to discriminate between speech, language and communication.

2. to know about language form, content, and use.

3. to learn about the major processes in communication and systems that underlie
speech and language development.

4. to learn about important changes in language development that occur during four
major periods of development: infancy, the preschool years, the school-age years,
and adulthood.

5. to understand the nature and consequences of language disorders in school-age

children.

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6. to learn aspects of language development which are especially difficult for school-
age children with language disorders in the primary and secondary grades.

7. to understand the concept of learning disability and its possible causes.

8. to differentiate between the terms of 'learning disabilities', 'learning difficulties' and

'intellectual disabilities’.

9. to know about the characteristics of an individual learning disability.

10. to know the difference between profound, severe, moderate and mild learning
disability.

11. to get insight about possible educational adaptations required for the children with
learning disabilities.

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4.1 Type-5 Communication Disorders
4.1.1 Normal Human Communication Process and Language Development

Communication, Speech and Language

Communication is any exchange of meaning between a sender and a receiver. This
seemingly simple exchange is important because it is the primary means by which
humans share their thoughts and feelings, express their identity, build relationships, pass
on traditions, teach, and learn etc. Some communication is intentional, and some
communication is unintentional, as when your friend interprets your facial expressions or
your body language that indicate how you are feeling. Most of the time, meaning is
exchanged via a code, called language. Language is best defined as a standardized set of
symbols and the knowledge about how to combine those symbols into words, sentences,
and texts to convey ideas and feelings. Language can be written or signed, but that is
most often spoken. A simple way to differentiate between language and speech is to
remember that language is what you say (i.e., the meanings of words and sentences) and
speech is how you say it (i.e., the sounds that make up the words and sentences).

4.1.1.1 The Building Blocks of Speech

Speech production depends on two critical components: phonemes and syllables.

Phonemes
Languages have two basic types of sounds: consonants and vowels. Consonants and
vowels differ in their basic manner of production. Vowels are produced with no
constriction in the vocal tract, whereas consonants are produced with a significant
blockage in the vocal tract. Consonants are produced by altering the manner and place of
articulation or by voicing. Manner of articulation refers to the different ways that
speakers can block airflow through the oral cavity using different types of constrictions.
Another way of modifying speech sounds is to produce blockages at different places in
the oral cavity. This is referred to as place of articulation.

Syllables
Syllables are units of speech that consist of consonants and vowels. Vowels are the
central component or the nucleus around which the rest of the syllable is constructed. A
syllable may consist of a single vowel, although syllables usually contain combinations
of consonants and vowels. The most common and easy to produce combination is a
consonant and a vowel (e.g., ba, si), but syllabic complexity can be increased by adding
consonants before the vowel (e.g., ri, tri, stri) or after it (i.e., am, amp). Change in pitch,
stress, intensity, and duration of sounds in connected speech production is called
prosody. Falling pitch and intensity are associated with statements, whereas rising pitch
is associated with question forms. Stress patterns distinguish between the multiple
meanings of some words.

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4.1.1.2 The Building Blocks of Language
Language is often characterized as having three interrelated components: content, form,
and use. Content refers to the meaning of language, form refers to the structure of
language, and use refers to the way speakers select different forms that best fit the
communication context. Any sentence requires an interaction of all three components of
language.

Language Content
Language content is the component of language that relates to meaning. Speakers
express ideas about objects and actions, as well as ideas about relationships such as
possession or cause and effect. Sometimes, these meanings can be expressed by a single
word. Other times, these meanings are expressed through groups of words. The linguistic
representation of objects, ideas, feelings, events, as well as the relations between these
phenomena, is called semantics. Children develop a lexicon, which is a mental
dictionary of words. Word learning is a lifelong process primarily because there are so
many words that make up a language, but also because new words are being added all the
time. What makes word learning even harder is that most words have multiple meanings.

Language Form
Language form, or the structure of language, involves three linguistic systems:
phonology, morphology, and syntax. We introduced the concept of phonology when we
discussed writing about the sounds of speech. Phonology is the study of the sounds we
use to make words. For example, /b/, /r/, and /l/ are English as well as Urdu language
sounds. A phoneme is the smallest meaningful unit of speech. Morphology has to do
with the internal organization of words. A morpheme is the smallest grammatical unit
that has meaning. The word bird is a morpheme. It cannot be divided into parts that have
any meaning in and of themselves. Bird is an example of a free morpheme because it
can stand alone as a word. There are also bound morphemes, which are grammatical
tags or markers in English. An example of a bound morpheme is the final -s in birds,
which adds grammatical meaning. In this case, -s marks plurality, meaning that there is
more than one bird. Syntax refers to the linguistic conventions for organizing word order.
Basically, syntax is the formal term for grammar and the rules governing word order are
different for different languages. Sentences that are ungrammatical may still make sense.

Language Use
Words are combined into sentences to express complex ideas. Language use concerns
the goals of language and the means by which we choose between alternative
combinations of words and sentences. There are sociolinguistic conventions, called
pragmatics, that help us decide what to say to whom, how to say it, and when to say it.
We choose different sets of words that we believe will best communicate our meanings to
the audience we are addressing.

Effective language requires an interaction of content (semantics), form (phonology,

morphology, syntax), and use (pragmatics). Speakers think of something to say and the
best words to say it (content) and put those words in sentences (form) that address their

107
goal (use) given the nature of the speaking situation (use). Similarly, listeners interpret
the words (content) and sentences (form) they hear with reference to what they already
know about the language being spoken (content and form) and the situation they are in
(use).

Figure 1: Communication Process

Figure 1 depicts the primary processes that are involved in communication. In language
production, senders encode their thoughts into some form of a language code. This code
is usually spoken or written, but it can also be signed. In speech, which is the most
common means of expressing language, the sounds, words, and sentences that express the
speaker’s thoughts are formed by sending commands to the muscles responsible for
respiration (primarily the diaphragm), phonation (primarily the larynx), and articulation
(primarily the tongue, lips, and jaw). Sequences of spoken sounds leave the oral cavity in
the form of sound waves.

In listening and comprehension, the sound waves enter the receiver’s ear, where they are
turned into electrical impulses. These impulses are carried to the brain, where they are
recognized as speech and then decoded into words and sentences. Listeners interpret the
words and sentences based on their understanding of the meaning of the words in
relationship to the other words that were spoken and the speaking context.

Activity: Make a min recording of informal communication between two students of

your class and write down the contents of it, while listening it again. Then prepare

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separate lists of phonemes, morphemes, syntax, semantics and pragmatic elements of the
communication sample.

Suggested additional readings

Bloom, L., & Lahey, M. (1978). Language development and language disorders. New
York: John Wiley & Sons.

4.1.1.2 The Development of Speech and Language

By the time most children are 3 or 4 years old, they can integrate language content, form,
and use to understand and produce basic messages. By the time they reach the age of 9
years, most children are capable of understanding and expressing quite complex
messages. Communication ability continues to change into adulthood, where it plateaus
around age 50. Late in life, communication skills often decline as a result of hearing loss
and the loss of mental functions. To assist children and adults with communication
disorders, you must be able to determine what their communication abilities are. These
skills require a solid grounding in speech and language development. To identify atypical
development, you must know what is typical.

Individual Differences
It is important for you to understand that there is a fair amount of variation in the rate of
communication development. That is, some children develop language faster than others
do, and some adults’ language skills decline faster than others’ do. There is also some
variation in the way language develops. Some children are risk-takers; they will try to say
words that are difficult for them to produce even if the words are not pronounced
correctly. Other children prefer not to produce words that may be difficult for them to say
until they are sure they can say them correctly. Some children learn lots of nouns (50 or
more) before they start producing two-word utterances; other children learn and use
social phrases (e.g., thank you, see ya later, hi daddy) some time before they have 50-
word vocabularies. Finally, there is variation in communication style. Some children and
adults are relatively reserved; they tend not to say a whole lot about anything. Other
children and adults are quite social; they tend to say too much about everything! As a
result it is difficult, if not impossible to pinpoint what is “normal.” Neither can we
pinpoint what exactly happens in language development at a particular developmental
age. Because there is so much individual variation, we talk about typical development
instead of normal development, and we provide age ranges for the first appearance of the
speech and language behaviours that we discuss, given in table 1, However, we also
know that some children have developmental difficulties that place them at significant
risk for social, educational, and vocational difficulties later in life. The well-informed
TEACHER knows how to tell when language development is so far outside the typical
range that it can result in negative social, educational, or vocational consequences.

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Table 1: Basic Milestones of Speech and Language Development and the Typical
Age Range at Which They First Appear

Speech and Language Milestones Age Range of First

Appearance
Understands simple words (mommy, daddy, dog) 6–8 months
Reduplicated babbling (ba-ba) 6–8 months
Variegated babbling (ba-do-ke-ga-do) 6–8 months
First word 10–14 months
Two-word utterances 16–20 months
First grammatical morphemes 1;10–2;2 years
Multiword sentences 2;2–2;6 years
Combinations of sentences that describe events 3;2–3;6 years
Understood by unfamiliar listeners (95% of 3;10–4;2 years
consonants produced in adult-like manner)
Identifies beginning sounds in spoken words 5;0–5;8 years
Decodes words 6;0–6;6 years
Tells complex stories 8–10 years
Written stories are more complex than spoken 11–13 years
stories
Combines information from multiple sources into 14–15 years
research papers
Refines personal speaking and writing styles 15–20 years
Uses vocation-specific vocabulary 21–24 years
Consistent difficulty recalling names and content 45–47 years
words
Footnote: Children’s ages are represented by the convention years;months. So, 1;10
indicates the age, 1 year, 10 months.

4.1.2 Disorders of Speech, Voice and Language

The term communication disorder is sometimes used as a synonym for impairment and
other times as a synonym for disability. Communication disorder refers to any
communication structure or function that is diminished to a significant degree.
Unfortunately, many people with communication disorders experience communication
disabilities and handicaps, although this is not necessarily so.

Communication Differences
Some people communicate in ways that differ from that of the mainstream culture.

We use the term communication difference to mean communication abilities that differ
from those usually encountered in the mainstream culture even though there is no
evidence of impairment. For example, when they begin school, children who have spoken
Punjabi or Pashto for most of their lives will not communicate like their monolingual
Urdu-speaking classmates. Children who learn Punjabi or Pashto etc. without any

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difficulty do not have a communication disorder. Unfortunately, these children’s
communication differences may contribute to periodic social and educational
disadvantages within the school environment. These children may need extra assistance
in learning Urdu as a second language. Communication disorders typically are
categorized into speech disorders, language disorders, and hearing disorders. When the
disorder occurs is also an important consideration. Developmental disorders, such as
delays in speech and language development, occur early in the maturation of the
individual but may continue into adulthood. Acquired disorders, such as speech and
language disorders resulting from brain trauma following an accident, occur after
communication skills have been fully developed.

4.1.2.1 Speech Disorders

Speech disorders result from an interruption in the process of speech production. This
process starts with the programming of motor movements and ends with the acoustic
signal that carries the sound to the listener. By historical convention, speech disorders are
categorized on the basis of the aspect of speech production (articulation, fluency, voice,
etc.) that is affected.

Articulation and Phonological Disorders

Individuals with articulation and phonological disorders have problems with the
production of speech sounds. Such problems result from deviations in anatomic
structures, physiological functions, and learning. When the problem is thought to be
related to the way sounds are represented in the brain, it is commonly referred to as a
phonological disorder. The problem may be minimal at one extreme (interfering with the
way that one or two speech sounds, like /s/ or /r/ are produced) or severe, rendering
speech unintelligible. Included in this category are developmental speech disorders,
neuromuscular speech disorders in children, and articulation disorders resulting from
orofacial anomalies such as cleft palate. Approximately 10% of preschool and school-age
children present articulatory or phonological disorders (National Institute on Deafness
and Other Communication Disorders, 2007).

Fluency Disorders
A fluency disorder is an unusual interruption in the flow of speaking. Individuals with
fluency disorders have an atypical rhythm and rate and an unusual number of sound and
syllable repetitions. Their disruptions in fluency are often accompanied by excessive
tension, and they may struggle visibly to produce the words they want to say. The most
common fluency disorder is stuttering. Approximately 1% of the general population
stutters, but as many as 5% of all adults report they stuttered at some point in their lives.

Voice Disorders
The category of voice disorders is usually divided into two parts: phonation and
resonation.

Phonatory disorders result from abnormalities in vocal fold vibrations that yield changes
in loudness, pitch, or quality (e.g., breathiness, harshness, or hoarseness). Problems

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closing the opening between the nose and the mouth during production of speech sounds
are termed resonance disorders. It has been estimated that between 3% and 9% of the
total population of the United States has some type of a voice disorder (National Institute
on Deafness and Other Communication Disorders, 2007).

4.1.2.2 Language Disorders

Language refers to the words and sentences that are used to represent objects, thoughts,
and feelings. A language disorder is a significant deficiency in understanding or in
creating messages. There are three main types of language disorders: developmental (or
functional) language disorders that occur during childhood, acquired language disorders
that can occur during childhood but most often occur in older adults, and dementia, which
nearly always occurs in older adults. It has been estimated that between 6 million and 8
million individuals in the United States have some form of language disorder (National
Institute on Deafness and Other Communication Disorders, 2007).

Language Delay
During the preschool years, some children have delayed language development that is not
associated with a known etiology. That is, children have difficulties using and
understanding language for no apparent reason. These children have smaller
vocabularies, shorter sentences, and they may not say as much as most other children
their age. Approximately half of the children who have significant early language delays
(i.e., vocabularies less than 50 words) at 2 years of age will have language growth spurts
that enable them to catch up to their same-age peers by the time they are 5 years old
(Paul, Hernandez, Taylor, & Johnson, 1996).

Developmental Language Disorder

Some children have impaired language comprehension and/or production problems that
significantly interfere with socialization and educational success. These children might
have a variety of problems including difficulty formulating sentences that express what
they want to say, an unusual number of grammatical errors, difficulties thinking of words
they know at the moment they need them, and/or difficulties with the social use of
language (they tend to say the wrong thing at the wrong time). As with language delay,
language disorder is not associated with a specific cause. Until children are in the late
preschool and early school-age years, it is difficult to distinguish a language delay from a
language disorder. A language disorder may be differentiated from language delay when
the impairment persists beyond age 5 and children do not catch up with their peers.
Between 6% and 8% of all children have language disorders.

Acquired Language Disorders

Acquired language disorders are caused by brain lesions, which are specific areas of
damage to the brain. Traumatic injury to the brain results in a syndrome of cognitive and
language disturbance. The communication deficits associated with the injury are
primarily a consequence of impaired cognitive processes related to memory, orientation,
and organization and include problems more apparent in communication than in speech

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and language functioning. Most cases of brain trauma are caused by motor vehicle
accidents with an incidence of approximately 7 million new cases each year.

Hearing Disorders
People with hearing disorders have a deficiency in their ability to detect sounds. This
deficiency can vary in terms of how loud sounds need to be presented before they can be
heard. Hearing can also vary with respect to the pitch level of the sounds that are heard.
Some individuals can hear low-frequency sounds such as the notes from a bass guitar
better than they can hear high-frequency sounds such as a small bell. Other individuals do
not hear sounds at any frequency very well. According to the ASHA (ASHA, 2000), of
the estimated 46 million citizens with a communication disorder, more than 28 million
have some kind of hearing disorder. Hearing loss can have a large or small effect on
communication depending on the degree of loss and the type of sounds that are affected.
People with mild degrees of hearing loss that affect only their ability to hear high pitched
sounds will miss out on final sounds of words like bath, but they will hear most other
sounds reasonably well enough so that they can usually fill in the missing pieces.
However, people with a hearing loss that affects their ability to hear high- and low-
pitched sounds produced at conversational speech levels will be at a significant
disadvantage in communication.

Other important factors that influence the degree of the impact that a hearing loss has on
communication include whether the hearing loss is unilateral (one ear) or bilateral (two
ears), the kind of amplification that is provided, the length of time the individual has had
amplification, and the attitudes of the individual and his or her family members. The age
of the person with a hearing loss also plays an important role in the degree of impact that
a hearing loss has on communication. A moderate hearing loss that is present from birth
is much more problematic than a moderate hearing loss that is contracted when an
individual is 40 years old. That is because good hearing is critical for communicative
development. Children who do not hear well have considerable difficulties understanding
language that is spoken to them, learning to produce speech sounds clearly, and
developing the words and sentence structures necessary for expressing complex ideas.
Early detection of hearing loss is absolutely critical so that children can receive
intervention as soon as possible. Some children can profit a great deal from being fitted
with a hearing aid. The sooner they receive appropriate amplification, the better it is for
speech and language development. Other children are able to not hear much even with
amplification. These children need to be exposed to sign language or specialized speech
training to develop language.

Suggested reading
Bishop, D. V. M. (1997). Uncommon understanding: Development and disorders of
language comprehension in children. Hove, England: Psychology Press/Erlbaum (UK),
Taylor & Francis.
Semel, E., Wiig, E., & Secord, W. (1996). Clinical evaluation of language fundamentals
(3rd ed.). San Antonio, TX: Psychological Corporation.

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4.1.3 Language Diversity in Classroom and Remedial Teaching
Approximately 7% of all school-age children have unusual difficulties learning and using
language, and more than 1 million children receive language intervention services in
public schools each year (U.S. Department of Education, 2005). There are numerous
causes of language disorders in school-age children including intellectual and cognitive
impairments, problems processing information (deficits in attention, perception, and
memory), hearing loss, emotional disorders, and neglect. Recall that in most cases of
language disorders, the cause or causes of the child’s language-learning difficulties are
not known.

Language Disorders
Many preschool-age children have significant limitations in their ability to learn and use
language. These children’s development in areas of language form (morphology and
syntax), content (size of the lexicon and semantic relations), and/or use (pragmatics and
socialization) lags behind that of their same-age peers. Some of these children benefit
from early intervention and have language growth spurts that enable them to develop
language skills that appear to be similar to their age peers by the time they are 5 years old
(Paul, Hernandez, Taylor, & Johnson, 1996). However, these same late talking children
who seem to catch up by age 5 often continue to have lower language and reading skills
into their teenage years (Rescorla, 2002, 2005). Those children whose language disorders
are more severe and who do not seem to improve by an early age frequently have
significant difficulties with social and academic language during the elementary school
years (Aram & Hall, 1989; Paul, Murray, Clancy, & Andrews, 1997). Often, these same
children continue to exhibit social, academic, and vocational difficulties well into the
secondary grades (Bishop, 1997; Stothard, Snowling, Bishop, Chipchase, & Kaplan,
1998) and even into adulthood (Records, Tomblin, & Buckwalter, 1995). For this reason,
professionals need to be diligent in their efforts to identify children with language
disorders as early as possible and to provide them with the kinds of intervention they
need to succeed. Children are diagnosed as language disordered when they have
difficulties with language form, content, and use that are unexpected given their
chronological age. That is, they are significantly poorer at comprehending or producing
language than are other children their same age. Clinicians make this determination by
comparing children’s performance on standardized tests to the norms for children who
are their same age. They also make this determination by analyzing the level of language
and the patterns of form, content, and use errors in conversational and narrative language
samples.

Comparing a child’s language abilities to the abilities of typically achieving children the
same age is referred to as chronological age referencing. That is, the expected language
ability for a particular age is the reference on which a determination of a language
disorder is based.

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4.1.3.1 Areas of Language Development during School-Age Years

a. Primary Grades
Many aspects of language form, content, and use continue to develop during the school-
age years. There are three critical aspects of language development during the primary
grades as described below.

i. Complex Sentences
Most children use more complex sentences and a greater variety of complex sentence
forms during the school-age years. As children have more complex things to talk about,
they need to have a command of various kinds of complex language forms that can
express their ideas.

Children experiment with the kinds of syntactic devices that are required for “literate”
language, and they discover when and how to use these complex structures.
Unfortunately, complex sentences pose unusual difficulties for many children with
language disorders, and these difficulties are especially evident when children are reading
and writing (Gillam & Carlile, 1997; Gillam & Johnston, 1992). Often, children with
language disorders use more mazes when they are producing complex sentences. A maze
is a repetition, a false start, or a reformulation of a sentence. These are not unusual
problems for many school-age children with language disorders.

ii. Narration
Narration (storytelling) is a critical aspect of language development during the school age
years. Children socialize by telling each other stories about their lives, they use stories as
mental tools for remembering events, and they learn to read and write stories. Children’s
narratives become longer and more complex during the primary grades as they learn how
to create more elaborate episodes. They also develop the ability to weave multiple
episodes into their stories. If children with language disorders have trouble creating
complex sentences, it should not be surprising that they also have trouble combining
groups of sentences into stories. Studies of the narrative abilities of children with
language disorders have shown they routinely tell shorter stories that contain fewer story
grammar elements and that are less coherent than the stories of typically developing
children. As you might imagine, difficulties with narration interfere with socialization
and with the development of literacy.

iii. Literacy
Learning how to read is probably the most important achievement during the primary
grade years. Children are taught how to decode words in kindergarten and first grade.
Instruction in second grade is usually designed to make decoding skills more automatic.
Beginning in third grade, the primary emphasis of instruction changes to the ability to use
reading as a tool for learning. As noted earlier, reading and writing are language tasks,
and many school-age children with language disorders have literacy learning problems.
Reading is composed of two components: language comprehension and word
recognition. Children who have difficulty with language comprehension are likely to

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have problems understanding both verbal language and written language. The
relationship between language and reading comprehension can be viewed in the reverse
manner as well. That is, children who have a deficit in reading comprehension will likely
have difficulty with language comprehension (Catts, Adlof, & Weismer, 2006). Children
with reading comprehension difficulty are sometimes able to decode and recognize words
well, but they are unable to understand those words’ individual or collective meaning. On
the other hand, there are those children who have reasonably good language
comprehension, but poor word recognition. Word recognition has two important
subskills: the development of mental graphemic representations (MGRs), and word
decoding. MGRs (also referred to as visual or mental orthographic images) allow readers
to identify words almost instantaneously without the need to decode or “sound them out.”
Fluent readers use MGRs most of the time when reading. Only when a new or uncommon
word is presented will a fluent reader need to use decoding. Using MGRs is often referred
to as “sight word reading,”

Although being able to rapidly identify words is an extremely important reading skill, the
ability to decode words is equally important. Recall that children begin to think about
their own language at about the time they enter kindergarten. This ability is called
metalinguistic awareness. Decoding, or the ability to “break the code” of letter– sound
combinations, requires one aspect of metalinguistic awareness called phonological
awareness. Phonological awareness is the ability to identify the phoneme structure of
words.

Phonological awareness has been shown to be extremely important in the development of

reading, especially for the word learning skill of decoding. Unfortunately, many children
with language disorders have difficulties with phonological awareness (Gillon, 2005).

b. Secondary Grades
For children who are in the secondary grades, there is focus on vocabulary that is
associated with specific subject areas (e.g., geometry, world history or biology),
comprehension and production of expository texts (discourse for teaching or explaining
something), and/or metacognitive strategies for learning.

i. Subject-Specific Vocabulary
As mentioned in Chapter 2, children’s vocabularies expand dramatically during the
school-age years. Much of this expansion relates to the acquisition of subject-specific
vocabulary in subject areas such as mathematics, social studies, and the sciences. Many
students with language disorders have difficulty understanding and remembering subject-
specific vocabulary, and this difficulty contributes to school failure. Therefore, teacher
often helpS these children acquire the vocabulary they need to succeed in their courses.

ii. Expository Texts

Adolescents become adept at the rhetorical conventions of argument and persuasion.
These skills require them to present information about persons, facts, and dates and to
provide specific details, generalizations, and conclusions. Children encounter these same

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forms of discourse, called expository texts, in their academic textbooks. Students with
language disorders frequently have difficulties understanding the expository texts they
must read for their courses (Gillam & St. Clair, 2007). They may not understand cause-
and-effect relationships that are expressed in their science or history textbooks. They also
have difficulties creating the kinds of expository texts that are needed to complete
assignments for class such as book reports, essays, and term papers. These difficulties can
contribute to school failure.

iii. Metacognitive Strategies

Adolescents learn to employ strategies for learning school subjects. Throughout the
elementary school years, teachers support students as they learn the fundamentals of
reading, writing, and mathematical computation. During the middle and high school
years, there is a greater expectation for independence in academic learning. To be
academically successful, adolescents must know how to acquire, store, recall, and use
knowledge from assignments they complete outside of class.

Metacognitive strategies are effortful actions that students use to accomplish specific
learning goals. For example, students may reread passages they do not understand
completely, take extra notes, memorize their notes by saying them out loud, or create
their own practice tests. Adolescents with language disorders often demonstrate
inefficiency or even reluctance in applying these kinds of effortful learning strategies.

4.1.3.2 Alternative Strategies for Classroom Teachers

i. Simplify teacher questions.
ii. Shorten teacher directions.
iii. Require the child to restate teacher directions.
iv. Give the child extra time to organize thoughts.
v. Give cues to assist the child in word retrieval.
vi. Explain questions and instructions in greater detail.
vii. Repeat the child’s statements, adding grammatical markers to make them complete.
viii. Ask questions that encourage the child to explain his or her answers in more detail.
ix. Explain concepts in greater detail.
x. Respond positively to any verbal output from the child.
xi. Provide a “buddy” to assist the child when he or she is confused.
xii. Show the child how to ask for assistance and/or clarification.
xiii. Provide mini lessons on using descriptive language.
xiv. Ask questions that encourage the child to make connections between new and
previously taught information.
xv. Teach the child to make semantic maps of stories and expository texts he or she
reads.
xvi. Use pictures and objects while you are giving directions or explaining concepts.

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4.1.3.3 Intervention Principles
Gillam and van Kleeck (1996) suggest that intervention should primarily focus on social-
interactive and academic uses of language in pragmatically relevant situations. Many
intervention activities benefit both memory and language. New teachers should keep the
and following language intervention principles in mind as they plan and conduct
activities.

Promote Attention
Individuals with various kinds of language disorders evidence difficulties with attention.
Learners process information more quickly after they have activated relevant information
in long-term memory. Second, language learning is enhanced when learners selectively
attend to the most critical information. Teachers can mediate preparatory attention in
adolescents by explaining what they plan to work on and why it is important. Teachers
can mediate selective attention by making the intervention models as clear as possible
and by limiting distractions.

Speak Clearly and Slowly

Speech perception and speed of cognitive processing contribute to learning language.
Some children with developmental language disorders have difficulties perceiving and
understanding rapidly produced speech. It is noted that when teachers slow their rates of
speech, they provide learners with more time for processing, encoding, storage, and
retrieval.

Plan Activities Around Topics or Concepts That Are Familiar to the Learner
Greater prior knowledge enables learners to attend more carefully to new information,
which leads to better language learning. Teachers who want to teach new language forms
or new communicative functions should make optimal use of the learner’s prior
knowledge.

Help Learners Organize New Knowledge

Learners can remember much more information when they have organized their
knowledge meaningfully. For example, people struggle to recall 20 randomly presented
letters, but they can easily remember 60 or 80 letters when the letters are part of words
that comprise sentences. Following the same logic, it makes sense to help learners
organize new knowledge in ways that facilitate recall. Practice with paraphrasing
sentences and paragraphs from expository texts can help learners in the elementary
grades use their own prior knowledge, vocabulary, and language structures to organize
new information. Adolescents can be taught learning strategies that help them organize
and recall information contained in their textbooks (Gillam, 2007).

Provide Learners with Retention Cues

Teachers need to build bridges between what they are teaching and learners’ knowledge
and expectations. Learners can internalize clinician questions, summaries, drawings, and
pictures as recall cues. Recall cues provided by clinicians, parents, or teachers can be

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powerful. Children who are given retention cues during language intervention activities
learn more than children who do not receive extra cues.

Suggested Readings
Gillam, R. B., McFadden, T., & van Kleeck, A. (1995). Improving the narrative
abilities of children with language disorders: Whole language and language skills
approaches. In M. Fey, J. Windsor, & J. Reichle (Eds.), Communication intervention
for school-age children (pp. 145–182). Baltimore, MD: Brookes.

Van Kleeck, A., Gillam, R., & McFadden, T. U. (1998). A study of classroom-based
phonological awareness training for preschoolers with speech and/or language
disorders. American Journal of Speech-Language Pathology, 7, 66–77.

4.2 Type 6- Specific Learning Disabilities

People with learning disabilities are generally of average or above average intelligence,
and struggle in one or two areas where they need remedial educational help. Learning
disabilities, by definition, mean that a person's skills in a particular area (reading, math,
visual/auditory processing, etc.) are lower than would be expected by looking at the
person's overall IQ.

The Kass and Maddux (2005) defined learning disability as: Learning disability
(dyssymbolia) is characterized by extreme deviance in the acquisition and use of symbols
in reading, writing, computing, listening, reasoning, talking, or social skills; which
deviance is due to an interaction between significant defects in developmental functions
and environmental conditions that make the individual vulnerable to those dysfunctions.
If the extreme deviance in dealing with symbols is noted within a critical age range,
developmental remedial instruction should be sufficient, but if such deviance is not
corrected within a critical age range, specialized treatment methods are required.

A learning disability (LD) is a permanent condition which affects the manner in which
individuals with at least average intelligence receive, retain and express information.
Deficits in reading comprehension, spelling, written expression, math computation and
problem solving are commonly exhibited. Less frequent are problems in organizational
skills, time management and social skills. A learning disability is inconsistent and may
manifest itself in one specific academic area, such as a foreign language. It may also be
frustrating, since it is an invisible or hidden disability. Thus a significant learning
disability exists when the individual’s actual performance or achievement in any given
ability is found to be far below his actual capacity or potential

When a child has a learning disability, he or she may exhibit the following
characteristics:
 Have trouble learning the alphabet, rhyming words, or matching letters to their
sounds

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 Make many mistakes when reading aloud, and repeat and pause often
 Not understand what he or she reads
 Have real trouble with spelling
 Have very messy handwriting or hold a pencil awkwardly
 Struggle to express ideas in writing
 Learn language late and have a limited vocabulary
 Have trouble remembering the sounds that letters make, or in hearing slight
differences between words
 Have trouble understanding jokes, comic strips, and sarcasm
 Have trouble following directions
 Mispronounce words or use a wrong word that sounds similar
 Have trouble organizing what he or she wants to say or not be able to think of the
word needed for writing or conversation
 Not follow the social rules of conversation, such as taking turns, and may stand too
close to the listener
 Confuse math symbols and misread numbers
 Not be able to retell a story in order (what happened first, second, third)
 Not know where to begin a task or how to go on from there

When describing learning problems, two frameworks are most commonly used by the
education, community and government sectors. These are the learning difficulties
framework, and the learning disability framework.

Learning difficulty framework

Learning difficulty is a non-categorical definition, including all those who have
difficulties learning one or more of the basic academic skills. Learning difficulties are
viewed as responsive to intensive educational intervention. Effective educational
intervention will improve basic academic skills such as reading and writing, and will
result in an improvement in the individual's academic achievement levels. Learning
difficulties are not recognised as disabilities under the Disability Discrimination Act and
under state disability legislation. Learning difficulties arising from physical, emotional or
environmental causes are not covered by the legislation because they are not assumed to
be underlying disorders or malfunctions (Puplick, 1995).

Learning disability framework

Learning disability is a categorical definition based on diagnosis. The National Health
and Medical Research Council estimates 2-4% of the population have learning
disabilities. Learning disabilities are lifelong and pervasive, and do not respond readily to
intensive education intervention. Intensive educational intervention alone will assist
individuals with learning difficulties, but will provide minimal results for individuals
with learning disabilities. Academic adjustments and accommodations, and
individualised learning strategies are necessary to enable individuals with learning
disabilities to achieve at their ability level.

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Intellectual Disability
Intellectual disability is a disability characterized by significant limitations both in
intellectual functioning (reasoning, learning, problem solving) and in adaptive behavior,
which covers a range of everyday social and practical skills. This disability originates
before the age of 18. Intellectual disability or general learning disability, also known
as mental retardation (MR) is a generalized neuro-developmental disorder characterized
by significantly impaired intellectual and adaptive functioning. It is defined by
an IQ score under 70 in addition to deficits in two or more adaptive behaviors that affect
everyday general living.

4.2.1 Types of Learning Disabilities

A general learning disability can range from borderline mild, mild, moderate, to
severe/profound. Children with general learning disabilities find it more difficult to learn,
understand and do things than other children of the same age. They can continue to learn
and to make progress all through their lives but at a slower pace than other children. A
child with borderline mild or mild general learning disability has very different learning
abilities and needs than a child with a moderate or a severe/profound learning disability.

Children with mild general learning disabilities mature and develop certain skills at a
slower rate than other children. They may have difficulties with speech and language,
developing concepts, and later have difficulty with reading, writing, numeracy and
comprehension. They may find it difficult to adapt to school life and may show signs of
inappropriate or what might be considered immature behaviour. Sometimes it is the class
teacher who may be the first to notice these things.

Children with moderate general learning disabilities show significant delays in reaching
developmental milestones, such as walking, talking, reading, writing and so on. The
school curriculum will need to be adapted to meet their learning needs.

Children with severe/profound general learning disabilities show very significant delays
in reaching developmental milestones. Their basic awareness and understanding of
themselves and the world around them is limited by their level of disability. Children
with this level of difficulty may depend on others throughout their lives to help them with
basic needs such as mobility, communication, feeding and toileting.

Additional Disabilities
Children with general learning disabilities can sometimes have additional disabilities or
conditions (multiple disabilities) such as autism spectrum disorders, medical conditions,
physical and/or sensory disabilities and emotional/behavioural difficulties.

Assessed Syndromes
Children with an assessed syndrome may also have a general learning disability. A wide
range of syndromes that can have associated learning disabilities include: Down
syndrome, Fragile X syndrome, Prader-Willi syndrome, Rett syndrome, Turner syndrome
and Williams syndrome.

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4.2.1.1 Common Types of Learning Disabilities
Dyslexia – Difficulty with reading
 Problems reading, writing, spelling, speaking
Dyscalculia – Difficulty with math
 Problems doing math problems, understanding time, using money
Dysgraphia – Difficulty with writing
 Problems with handwriting, spelling, organizing ideas
Dyspraxia (Sensory Integration Disorder) – Difficulty with fine motor skills
 Problems with hand-eye coordination, balance, manual dexterity
Dysphasia/Aphasia – Difficulty with language
 Problems understanding spoken language, poor reading comprehension
Auditory Processing Disorder – Difficulty hearing differences between sounds
 Problems with reaiding, comprehension, language
Visual Processing Disorder – Difficulty interpreting visual information
 Problems with reading, math, maps, charts, symbols, pictures

Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder (ADHD) are

not strictly learning disabilities, but often pose as barriers to learning, particularly in the
classroom setting. Children with ADD/ADHD may be inattentive, hyperactive, and
impulsive or have trouble paying attention and controlling their behavior. Whilst not an
LD, both disorders usually require additional learning support and alternative teaching
methods to help the child focus, stay calm and be attentive.

4.2.2 Causes, Diagnosis and Assessment Techniques

a. Causes
The causes for learning disabilities are not well understood, and sometimes there is no
apparent cause for a learning disability. However, some causes of neurological
impairments include:

Heredity and Genetics

Learning disabilities often run in the family. Children with learning disabilities are likely
to have parents or other relatives with similar difficulties. Some children have
spontaneous mutations (i.e. not present in either parent) which can cause developmental
disorders including learning disabilities. One study estimated that about one in 300
children had such spontaneous mutations, for example a fault in the CDK13 gene which
is associated with learning and communication difficulties in the children affected.

Problems during Pregnancy and Birth

Learning disabilities can result from anomalies in the developing brain, illness or injury,
fetal exposure to alcohol or drugs, low birth weight, oxygen deprivation, or
by premature or prolonged labor.

Accidents After Birth

Learning disabilities can also be caused by head injuries, malnutrition, or by toxic
exposure (such as heavy metals or pesticides)

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In short, learning disability may result from parental factors, birth trauma, developmental
anomalies, environmental deprivation, psychological frustration and failure experiences
and inadequate instruction-to name a few.

LD’s can be discovered at any age, but are usually diagnosed between the ages of three
and thirteen. Symptoms are varied and contingent on the age of the child. In early
childhood, children may have difficulty pronouncing words and rhyming. Between the
ages of five and nine years old, they may have difficulty with spelling, telling the time
and remembering sequences. In the early teen years their difficulties may be with reading
comprehension, handwriting or organizational skills.

b. Diagnosis and Assessment

Four criteria are used to identify learning disability: (1) the individual must show normal
achievement potential, (2) the individual must show significantly low achievement for
age and grade, (3) the individual must show behavioral characteristics commonly
associated with learning disability, and (4) the individual must show component deficits
indicative of learning disability within age-related stages. All four criteria must be met
for an individual to be identified as learning disabled.

Criterion I: Normal Achievement Expectation

Generally, definitions of learning disabilities exclude mental retardation along with other
handicaps. This means that there should be no overlap in intellectual ability. The
American Association on Mental Retardation defines significantly low intellectual
functioning as approximately 70–75 IQ on an individually administered intelligence test.
Although the range of normal intelligence is between 90–100 IQ, we think that the cut-
off for normal achievement expectation should start where retardation ends—roughly, 75
IQ. This is particularly true for young children, since instruction plays such an important
role in the improvement of earned IQ (Kirk, 1958). Normal achievement is best predicted
by individual verbal intelligence tests such as the Stanford Binet Intelligence Scale and
the verbal or full scale scores of the Wechsler Intelligence Scale for Children,

Criterion II: Low Achievement

When compared with others of the same age and grade, students with learning disabilities
are significantly behind in some aspects of the curriculum. Since the disability is in the
acquisition and use of symbols, learning the three Rs (Reading, Writing, Arithmatic) is
generally impaired unless remediation is initiated during a critical period. Low
achievement can be measured by standardized or criterion referenced tests.. Learning
disability is usually discovered through difficulties in school achievement.

Criterion III: Behavioral Characteristics Associated with Learning Disabilities

The literature is replete with characteristics of learning disabilities with behaviour noted
by parents and teachers of not focusing on tasks. Some obvious signs of learning
disability indicate to the teacher that a student should be referred for evaluation. When a
student consistently does not pay attention or is constantly distracted, the teacher wonders
what is wrong. When these behaviors go along with low achievement, the teacher should

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initiate a diagnostic request. A set of answers to questions about obvious behaviors in
home, school, and community can best indicate typical behavioral characteristics. If three
or four questions in each range are answered affirmatively, the teacher should suspect
learning disabilities. A set of questions for each stage follows.

Sensory Orientation (birth through 17 months)—readiness to respond to the

environment (Task Requirement—Attending)
i. Was the child born prematurely?
ii. Does the child appear to have difficulty focusing on a moving target by four
months?
iii. Does the child appear to be hypersensitive to stimulation?
iv. Does the child have periodic ear infections (often resulting in temporary hearing
losses)?
v. Does the child make excessive demands for attention?
vi. Does the child insist on regularity of environment and schedule (rigidity or
repetition)?
vii. Does the child have difficulty paying attention to stimuli?

Memory (18 months through seven years)—rote imitation of the environment (Task
Requirement—Labeling)
i. Does the child have poor articulation or use jargon?
ii. Does the child have difficulty paying attention through one or more of the sensory
channels?
iii. Does the child require constant adult supervision or excessive discipline?
iv. Does the child have difficulty sitting still for a reasonable amount of time?
v. Does the child appear immature?
vi. Does the child have jerky, uncoordinated movements on the playground or in
learning to write?
vii. Does the child have difficulty repeating nursery rhymes, songs, stories, and simple
sentences by three years?
viii. Is the child undergoing treatment for any condition requiring medication or special
diet?
ix. Does the child show lack of suitable caution with strangers; i.e., being too fearful,
too friendly, too manipulative?
x. Does the child have difficulty repeating directions by age five?
xi. Does the child have difficulty responding to teachers’ directions in proper ways of
behaving in school?
xii. Does the child have difficulty following the example of adults close to him or her?
xiii. Does the child have difficulty sitting still to listen to the parent or teacher read
stories?
xiv. Does the child have difficulty remembering the names of letters and numbers?
xv. Does the child demonstrate consistent confusion in printing individual symbols and
in left-to-right progression?
xvi. Does the child have difficulty remembering simple arithmetic combinations?

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Re-Cognition (eight through 11 years)—understanding of semantic and structural
meanings (Task Requirement—Understanding)
i. Does the child still have difficulty paying attention?
ii. Does the child have difficulty explaining how things are alike and different?
iii. Does the child have difficulty selecting a particular word out of similar-looking
words?
iv. Does the child have difficulty using phonics in reading?
v. Is the child a discipline problem?
vi. Does the child have difficulty working independently?
vii. Does the child guess at words in reading?
viii. Does the child have difficulty using arithmetic operations appropriately
(understanding signs, number relationships, and story problems)?
ix. Does the child have difficulty spelling?
x. Does the child have difficulty learning cursive writing (particularly in strokes
where direction must be reversed as “c,” “a,” “p,” etc.)?
xi. Does the child have difficulty recognizing tenses, prefixes, suffixes, and syllables?
xii. Does the child have difficulty following written directions by ten years?
xiii. Does the child have difficulty keeping friends?

Synthesis (12 through 13 years)—automatization of previouslylearned responses to

the environment (Task Requirement— Integrating)
i. Does the youth have poor habits of responding to oral and written material (i.e., no
response, excessive errors, or inappropriate responses)?
ii. Does the youth seem to be oblivious to inaccuracies?
iii. Does the youth have difficulty correcting errors when these are pointed out?
iv. Does the youth have difficulty completing tasks within a time limit?
v. Does the youth have difficulty writing from dictation (showing motor tension)?
vi. Does the youth have difficulty organizing and estimating the time and sequence
necessary to complete a given task?
vii. Does the youth have difficulty relating to peers in general?
viii. Does the youth have difficulty making up for a mistake in social judgment?
ix. Does the youth have difficulty meeting obligations toward others, either in the
sense of over- or under-involvement?

Communication (14 years and up)—process by which meaning is received from and
expressed to others (Task Requirement—Expressing)
i. Has the youth had a history of problems in learning the tools for communication
(speaking, writing, gestures, and reading)/
ii. Does the youth have difficulty interpreting content meaning (specialized
vocabulary)?
iii. Does the youth have difficulty taking responsibility for interpreting what is
communicated and for the consequences of communicating in all school subjects?
iv. Does the youth have difficulty in making social judgments?
v. Does the youth try to cover up or refuse to face handicap?
vi. Does the youth frequently disappoint those who care about him or her?

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vii. Does the youth have difficulty discussing pros and cons of a particular issue?
viii. Does the youth frequently succumb to negative influence?
ix. Does the youth have difficulty evaluating situations, i.e., estimating the time to do
an assignment, estimating whether help is needed, being unrealistic in demands or
reaction, or being socially insensitive?

Criterion IV: Component Deficits within Five Developmental Stages

Figure 2: Developmental stages and critical learning disability defects

The developmental view of the human being shown in figure 2 assumes that those with
learning disabilities have common age-related deficits. The five developmental stages
are: (1) Sensory Orientation, from birth through 17 months, is the physiological or
functional readiness of the human to respond to the environment; (2) Memory, from 18
months through seven years, is the imitation of stimuli when these are no longer present;
(3) Re-Cognition, from eight through 11 years, is the internalization of, and flexibility in,
semantic and structural meanings; (4) Synthesis, from 12 through 13 years, is the
habituation of previously-learned responses; and (5) Communication, 14 years and older,
is reception of another’s meanings and expression of one’s meanings to another.

While the four criteria (normal achievement potential, low achievement, behavioral
characteristics, and component developmental deficits) comprise the assessment system,
some intuitive, clinical judgment is required to put all of the results together. Once
identified, persons with learning disabilities should receive treatment.

4.2.3 Adaptations in Teaching

In describing the experimental teaching method, Cruickshank et al. (1961) stated that “the
first need of these children is a simple, quiet environment where they can relax, and a
structure of activities so designed that they know what is expected of them and what they
can expect to have happen to them”. The dysfunctions on which the researchers focused

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were: muscular control, eye-hand coordination, form perception, figure-background
relationships, left-right progression, and integration of behavioral responses.

Fortunately there are many strategies for each struggle a student with a Specific Learning
Disability may have. There are many books and even entire programs for things like
dyslexia. Carbon copies of notes for a student with a processing disorder; books on tape
for a student who struggles with visual processing and reading comprehension; use of a
laptop for students with dysgraphia and so on. The use of a laptop or word processor is a
great example of an assistive technology device that helps students with SLD cope with
their disability.

Rogan and Lukens have proposed the following recommendations:

a. Good developmental kindergarten-primary programs with well-balanced
curriculums providing for all aspects of early cognitive development (perceptual,
visuo-motor, language, concepts);
b. Expansion of readiness testing for kindergarten entrance as a basis for flexible
“maturity” groupings with specialized curriculums at the kindergarten level;
c. Transitional or extended readiness classes for children who show a lack of
readiness for first grade;
d. Nongraded or flexibly graded primary programs permitting passage of the child
from one level to another according to his developed capacity to deal with the
instructional demands rather than chronological age; transitional classes leading
into second or third grade as a partial solution for the school which retains its grade
structure; specific, nonrepetitive curriculum in the transitional classes;
e. Regrouping within classes or within several classes for instruction in skills
according to preferred learning modes, e.g., primarily auditory emphasis in reading
(phonics) or visual (sight-word reading) for children with strengths in these areas;
f. Provision in later elementary grades (through regrouping) for teaching basic
scholastic skills to children who for various reasons (illness, absence, immaturity,
family mobility) have not mastered them at the normative age; teaching of phonics
beyond the second and third grades;
g. Utilization of existing specialists through expansion of competencies for individual
or small group help to children with learning disabilities; for example, extension of
techniques and knowledge of remedial reading therapists and speech correctionists
to include work with children of minimal brain dysfunction;
h. Development of learning laboratories for special skills such as library reference,
study approaches, organization of material, especially in the upper elementary and
high school levels.

Further the following techniques for varying the approach to learning difficulties have
been found helpful in breaking up patterns of rigidity and perseveration:
i. Practice on such things as number combinations may help to develop meaningful
automatization. If perseveration persists in spite of the use of varied drill
techniques, it is well to substitute another activity for a time and then return to the
subject later.

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ii. When dealing with a short attention span it is helpful to give short assignments. For
example: only the number of arithmetic problems that a child can handle is put on
his paper; thus he is able to finish the entire assignment because it is within the
range of his attention span.
iii. Utilize all of the senses in the approach to learning. The child learns through using
his whole body and self.
iv. Motor dis-inhibition can be used to the child’s advantage by providing materials of
learning which involve muscular movement, such as the abacus and peg boards. (p.
148)

4.2.3.1 Adapting Assessment/Evaluation Process

Each and every student with learning disabilities (LDs) is unique, as are their strengths
and needs; because of the diversity of LDs, it is essential that educators know the
particular strengths and needs of their students in order to select appropriate
accommodations. It should be noted as well that each student will respond differently to
the accommodations offered to them.

Similarly, each assessment is different, so a technique that is effective for one evaluation
may not be the best for another. The student’s IEP will list the environmental,
instructional, and assessment accommodations to which the student should have access at
all times. That being said, educators may wish to put in place other accommodation
strategies not listed in the student’s IEP; if these strategies prove effective, they may later
be added to the IEP. Here are some examples of accommodations that can effectively
support students with LDs, during assessment:

a. For students with reading difficulties

The student can listen to the assessment questions using text-to-speech technology. If the
student does not have access to technology, someone can read the questions out loud.

b. For students with writing difficulties

The student can:
 have access to a scribe or speech-to-text technology;
 use spell-checker software;
 use word prediction software to help with spelling, and to ease the process of
generating idea;,
 use a method of demonstrating their learning, other than pen and paper;
 videos, mind maps, comics, bristol boards, models;
 complete the evaluation orally, and/or
 complete the evaluation as a fill-in-the-blank style page, so they only need to add
the basic information being assessed.

c. For students with difficulties organizing their ideas and their time
 Chunk the evaluation into smaller sections that a student can complete over a
number of different class periods.
 Chunk the questions into smaller steps, and in a logical order for the work required.
 Use a countdown timer to help students manage their time.

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d. For students with memory difficulties
Provide:
 a word bank related to the assessment;
 a formula list related to a math assessment;
 a glossary (either with images or written definitions, depending on the students’
strengths), and/or
 a reference page for calculation processes (division, multiplication, how to use a
protractor).

Allow students access to devices, such as calculators for math computations; the student
will still be required to justify their answer on paper.

For problem-solving, have students read the problem aloud.

We can conclude by saying that it is important to remember that the techniques chosen by
educators must allow students with LDs to demonstrate their learning effectively during
the evaluation. These techniques should play off the students’ strengths and minimize the
impact of their weaknesses, so that they can achieve to their greatest potential.

4.2.3.2 Remedial Instruction within Curriculum

The notion of individualized instruction has a special connotation when it comes to
dealing with the idiosyncratic deficits of students with learning disabilities. The farther
the deviations are from the normal, the more adaptations must be made in methods and
materials. It is first of all imperative that the teacher of students with learning disabilities
know the developmental curriculum. This provides the standard against which the
remedial instruction can be measured. The traditional treatments that prospective teachers
of students with learning disabilities learned about reflected a variety of schools of
thought, each with a heavy emphasis on treatment relating to its particular orientation.
These schools of thought may be labeled as follows: medical, clinical process,
behavioristic, academic, and meta-cognitive approaches. Medical and clinical process
approach is out of scope of this unit. The following sections briefly describe some
representative treatments relating other three approaches.

1. Behavioral Treatment Approach

The behavioristic remedial instruction approach assumes that the most important aspect
of the teaching-learning situation is the actual behavior of the child in that situation.
Treatment is aimed directly at arranging the contingencies of the situation in such a way
that the behavior of the child is changed. Behavior modification, precision teaching, and
direct instruction are outgrowths of the practical application of behavioristic principles.

Behavior Modification
Behavior modification includes principles of reinforcement, response measurement, and
cueing, with the result that appropriate re-sponses occur and inappropriate responses are
extinguished.

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Precision Teaching
The precision teaching language emphasizes precise description of behaviours and events
which are directly observable and countable, thus greatly reducing connotative confusion.
The format of the precision teaching language also guides the teacher in identifying those
events in the environment which have the highest probability of effecting the behavior.
Three phases are included in precision teaching: (1) the before phase: pinpointing the
behavior and its environment, (2) the during phase: intervention, and (3) the after phase:
termination of intervention.

Direct Instruction
This approach, like behavior modification and precision teaching, assumes highly
structured instruction, reinforcement of appropriate responses, and continuous assessment
of student performance. In addition, direct instruction requires that teachers (1) explicitly
teach general case problem-solving strategies, (2) provide small group instruction, (3)
systematically correct errors and reinforce correct responses, (4) provide for cumulative
review of previously learned material, and (5) insist on mastery of each step in the
learning process

2. Academic Treatment approach:

The academic approach focuses on academic tasks and processes as well as the
environmental situations that precipitate school failure. Remedial methods treat the
school subjects directly and are based on analysis of errors within the school task. Since
the least restrictive environment is a legal requirement, developmental curriculum is
usually the treatment of choice.

Current Academic Approaches

Most current textbooks in learning disabilities organize intervention according to
academic subjects. Reading is usually given the most attention since it appears to be the
most commonly referred disability for services in learning disabilities. In addition,
academic problems are noted in writing, spelling, and arithmetic.

3. Metacognitive Treatment Approach

One popular approach to remediation is the metacognitive approach, a mixture of process
and academic intervention. A metacognitive treatment requires the student to think about
the process by which he or she can learn subject matter. Students are taught to think
about their own learning through self-instruction and self monitoring. Self instruction
refers to “the use of self-verbalized directions designed to guide an individual through a
series of steps that will result in the solution of a problem”. Self-monitoring is the
assessment of what one has accomplished and the self-recording of that performance.

Learning Strategies Intervention Model

This conceptual framework was designed for adolescents with learning disabilities. It is
designed to teach students techniques for learning rather than specific content. Students
are taught both general and specific learning strategies. General strategies “enable the
student to assess a problem situation, determine its requirements, and select a specific

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strategy for its solution”. Specific strategies are those applied to skill areas. In addition,
students are taught to set and monitor their own goals and to generalize the skills across
situations.

Reciprocal Teaching Procedure

Another currently-popular approach to the teaching of reading comprehension is
reciprocal teaching that took place “in a cooperative learning group” and as featuring
“guided practice in applying simple concrete strategies to the task of text
comprehension”. “A teacher and a group of students take turns leading a discussion
concerning a segment of text they are jointly attempting to understand”. Four activities
foster comprehension: questioning, clarifying, summarizing, and predicting. The
discussion leader must begin with a question and end with a summary of the content.

4.3 Self-Assessment Questions

1. What is the critical difference between these terms: phonemes, syllables, and
morphemes?

2. What linguistic systems are involved in language form, language content, and
language use?

3. How can you differentiate between a communication disorder and a

communication difference?

4. How can you differentiate between language delay, developmental language

disorder, and acquired language disorder?

5. Why can’t we pinpoint the language abilities a child should have at 3 years and 9
months of age?

6. What are some examples of sounds that may be difficult for children to produce at
the time they enter kindergarten?

7. What is a difference between delay and disorder?

8. What is the difference between language production and comprehension?

9. Name one important development that occurs in each area of language (content,
form, and use) during each of the four major developmental periods (infancy, the
preschool years, the school-age years, and adulthood).

10. What are some common speech disorders in children?

11. What is the difference between learning difficulty and learning disability?

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12. What is the difference among a learning disability, a language disorder, and
dyslexia?

13. Define learning disability. What characteristics children may exhibit having
learning disability.

14. What are the different types of learning disabilities commonly found in children?

15. Describe the different possible causes of Learning disabilities.

16. What criterions are observed while diagnosing and assessing children for any
learning disability?

17. What do you understand by Remedial instruction within the curriculum?

18. What different approaches are available for adapting teaching and evaluation
process for the children with learning disabilities?

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4.4 References
Aram, D. M., & Hall, N. E. (1989). Longitudinal Follow-up of Children with Preschool
Communication Disorders: Treatment Implications. School Psychology Review,
18(4), 487–501.

Carrow-Woolfolk, E. (2004). Comprehensive assessment of spoken language. Circle

Pines, MN: American Guidance Service.

Catts, H. W., & Kamhi, A. G. (1999). Language and reading disabilities. Needham
Heights, MA: Allyn & Bacon.

Catts, H. W., Adlof, S. M., & Weismer, W. E. (2006). Language deficits in poor
comprehenders: A case for the simple view of reading. Journal of Speech,
Language, and Hearing Research, 49, 278–293.

Falk-Ross, F. (2002). Classroom-based language and literacy intervention: A programs

and case studies approach. Boston: Allyn & Bacon.

Gillam, R. B. (1995). Whole language principles at work in language intervention. In D.

Tibbits (Ed.), Language intervention: Beyond the primary grades (pp. 219–256).
Austin, TX: Pro-Ed.

Gillam, R. B., & Carlile, R. M. (1997). Oral reading and story retelling of students with
specific language impairment. Language, Speech, and Hearing Services in Schools,
28, 30–42.

Gillam, R. B., & Johnston, J. R. (1992). Spoken and written language relationships in
language/ learning-impaired and normally achieving school-age children. Journal
of Speech and Hearing Research, 35(6), 1303–1315.

Gillam, S. L. (2007). Understanding and remediating text comprehension deficits in

school-age children. In A. Kamhi, J. Masterson, & K. Apel (Eds.), Clinical
decision making in developmental language disorders (pp. 267–284). Baltimore,
MD: Brookes.

Gillam, S. L., & St. Clair, K. (2007). Comprehension of expository text: Insights gained
from think aloud data. Manuscript in preparation.

Gillon, G. (2005). The efficacy of phonological awareness intervention for children with
spoken language impairment. Language, Speech, and Hearing Services in Schools,
31, 126–141.

Gough, P. B., & Tunmer, W. E. (1986). Decoding, reading and reading disability.
Remedial and Special Education, 7(1), 6–10.

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Halliday, M. A. K. (1975). Learning how to mean. London: Arnold.

Jusczyk, P. W. (1997). The discovery of spoken language. Cambridge, MA: MIT Press.

Lyon, R. (1995). Toward a definition of dyslexia. Annals of Dyslexia, 4, 3–30. Mayer, M.

(1969). Frog, where are you? New York: Penguin Books.

Newcomer, P. L., & Hammill, D. D. (1997). Test of Language Development—Primary

(3rd ed.). Austin, TX: Pro-Ed.

Paul, R., Hernandez, R., Taylor, L., & Johnson, K. (1996). Narrative development in late
talkers: Early school age. Journal of Speech and Hearing Research, 39, 1295–
1303.

Rescorla, L. (2002). Language and reading outcomes to age 9 in late-talking toddlers.

Journal of Speech, Language, and Hearing Research, 45, 360–371.

Rescorla, L. (2005). Language and reading outcomes of late-talking toddlers at age 13.
Journal of Speech, Language, and Hearing Research, 48, 1–14.

Stothard, S. E., Snowling, M. J., Bishop, D. V. M., Chipchase, B. B., & Kaplan, C. A.
(1998). Language- impaired preschoolers: A follow-up into adolescence. Journal of
Speech, Language, and Hearing Research, 41, 407–418.

Waters, G., & Caplan, D. (2005). The relationship between age, processing speed,
working memory capacity, and language comprehension. Memory, 13, 403–413.

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Unit: 5

TYPES OF EXCEPTIONALITIES-IV

Written By:
Dr. Tanzila Nabeel

Reviewed By:
Dr. Shahida Sajjad
 INTRODUCTION
Dear Students, while starting working on this Unit let me introduce the contents of the
unit to you. This unit comprises the category of special needs which is related with
intellectual development, the shortcomings associated with intellect or cognition if not
done at norms, the identification process and the adaptations or accommodations a
teacher needs to work to handle such children in his/her class. Interestingly this unit
covers the two extremes of the pendulum of intellectual development. At one end there
are children who are deficient in their capacities and capabilities in terms of their
cognitive development and on the other end there are children who are much above the
general performance level when compared to their peers. Both types need special services
for their psychological, moral, social and academic development. The unit provides a
holistic approach in this regard. It is equipped with references used while writing it. It
suggests further readings if you need to enhance your information on the topics. It
provides you with opportunities to get yourself assessed on your understanding of the
topics by giving questions at the end of the unit.

Now let us start.

OBJECTIVES
To enable the students, to:
1. understand the classification of intellectual and developmental disabilities by
different classification systems.

2. screen and identify the children having intellectual and developmental disabilities.

3. learn implication and instructional approaches for children having intellectual and
developmental disabilities.

4. understand giftedness and be able to differentiate between intelligence and

giftedness.

5. comprehend the concept of multiple Intelligences.

6. be familiarize with Gagne’s Model of Giftedness and compare it with other models
formulated by educationists working in the field of gifted children.

7. learn teaching strategies to be used for intellectually, developmentally deficient and

giftedchildren and necessary adaptations to be made in curriculum.

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5.1 Type 7- Intellectual and Developmental Disabilities
Intellectual Disability refers to a group of disorders characterized by a limited mental
capacity and difficulty with adaptive behaviors such as managing money, schedules and
routines, or social interactions. Intellectual disability originates before the age of 18 and
may result from physical causes, such as autism or cerebral palsy, or from nonphysical
causes, such as lack of stimulation and adult responsiveness.

Developmental Disability is a severe, long term disability that can affect cognitive
ability, physical functioning, or both. These disabilities appear before age 22 and are
likely to be life-long. The term “developmental disability” encompasses intellectual
disability but also includes physical disabilities. Some developmental disabilities may be
solely physical, such as blindness from birth. Others involve both physical and
intellectual disabilities stemming from genetic or other causes, such as Down syndrome
and fetal alcohol syndrome.

(Classification in Mental Retardation: Chapter 3. American Association on Mental

Deficiency (AAMD), now American Association on Intellectual and Developmental
Disabilities (AAIDD) AUG, 28, 2014, Page 11 indicates that a "developmental period"
ends at age 18).

General intellectual functioning is operationally defined as the results obtained by

assessment with one or more of the individually administered standardized general
intelligence tests developed for that purpose.

Deficits in adaptive behavior which includes skills such as communicating, taking care of
him or herself, social and emotional skills,are defined as significant limitations in an
individual's effectiveness in meeting the standards of maturation, learning, personal
independence, and/or social responsibility that are expected for his or her age level and
cultural group, as determined by clinical assessment and, usually, standardized scales.
Intellectual disabilities affect three different types of learning. These are
i. academic learning,
ii. experiential learning, and
iii. social learning

i. Effect on Academic Learning: These are scholastic skills includes Reading,

Writing and Numeracy.

ii. Effects on Experiential learning:This type of learning occurs through Cause and
Effect. For example, if a child touches a hot heater. This experience causes the
child to learn to avoid touching a heater. He would always relate the presence of a
heater with heat and pain. A child with an ID does not learn from this painful
experience. He/She is unable to relate the heater (cause) with effect (pain).

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iii. Effects on Social Learning: This learning occurs by observing other people in
social situations. We learn social customs and rules by watching others. For
instance, we might notice it is customary to greet people by shaking hands or
offering a hug. Social learning enables us to learn social skills. These skills are
needed to get along well with other people. Moreover, social skills are critical to
life success. People with Intellectual disabilities are far behind in their social skills
when compared to their normal peers.

Now Let’s Read How This Process of LEARNING Takes Place

Learning can be defined as a change in behavior as a result of experience. This can be
physical and overt, or it may involve complex intellectual or attitudinal changes which
affect behavior in more subtle ways. For example, an individual's way of perceiving,
thinking, feeling, and doing may change as a result of a learning experience. Learning
brings about changes in the way we act, think and/or feel about ourselves, other people
and the world around us. Two basic processes are involved to create Learning i.e.
Perception- the way we take information and Processing – how we deal with that
information. Changes as a result of Learning may be permanent or temporary depending
on our own perceptions of the importance and relevance of the gained knowledge. The
individual learning capacity depends upon stimulus, motivation and learning style.

People with intellectual disability experience significant limitations in two main areas:
i) Intellectual functioning and
ii) Adaptive behavior

Intellectual Functioning
Intellectual functioning is determined by many factors. However, a primary source of this
capacity is mental ability or "intelligence." Intelligence refers to the ability to reason,
plan, think, and communicate. These abilities allow us to solve problems, to learn, and to
use good judgment. Intelligence refers to a general mental capability. It involves the
ability to reason, plan, solve problems, think abstractly, comprehend complex ideas, learn
quickly, and learn from experience.

What Is Adaptive Behavior?

Adaptive behavior is the collection of conceptual, social and practical skills which are
necessary to learn to function in every day’s life. Significant limitations in adaptive
behavior impact a person’s daily life and affect his or her ability to respond to a particular
situation or to the environment. Standardized testing aims to measure the following skills:
 Conceptual skills: receptive and expressive language, reading and writing, money
concepts, self-direction.
 Social skills: interpersonal, responsibility, self-esteem, follows rules, obeys laws.
 Practical skills: personal activities of daily living such as eating, dressing, mobility
and toileting; instrumental activities of daily living such as preparing meals taking
medication, using the telephone, managing money, using transportation and doing
housekeeping activities; occupational skills; maintaining a safe environment.

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A significant deficit in one area impacts individual functioning enough to constitute a
general deficit in adaptive behavior (AAIDD, 2011).

So if we summarize this, it is:

Intellectual disability starts any time before a child turns 18 and is characterized by
problems with both:
 Intellectual functioning or intelligence, which include the ability to learn, reason,
problem solve, and other skills; and
 Adaptive behavior, which includes everyday social and life skills.

Developmental disabilities: The term "developmental disabilities" is a broader category

of often lifelong disability that can be intellectual, physical, or both."IDD" is the term
often used to describe situations in which intellectual disability and other disabilities are
present.

According to the Developmental Disabilities Act (Pub. L. 106-402), the term

developmental disability means a severe, chronic disability that:
i. Is attributable to a mental or physical impairment or a combination of those
impairments.
ii. Occurs before the individual reaches age 22.
iii. Is likely to continue indefinitely.
iv. Results in substantial functional limitations in three or more of the following areas
of major life activity: (i) self-care, (ii) receptive and expressive language, (iii)
learning, (iv) mobility, (v) self-direction, (vi) capacity for independent living, and
(vii) economic self-sufficiency; and
v. Reflects the individual’s need for a combination and sequence of special,
interdisciplinary, or generic services, individualized supports, or other forms of
assistance that are of lifelong or extended duration and are individually planned
and coordinated.
vi. Developmental deficits may be manifested by slow, arrested, or incomplete
development resulting from brain damage, degenerative processes in the central
nervous system, or regression from previously normal states due to psychosocial
factors.

How Does the DD Definition Compare with the AAIDD Definition of Intellectual
Disability?
The major differences are in the age of onset, the severity of limitations, and the fact that
the developmental disability definition does not refer to an IQ requirement. Many
individuals with intellectual disability will also meet the definition of developmental
disability. However, it is estimated that at least half of individuals with intellectual
disability will not meet the functional limitation requirement in the DD definition.
Intellectual disability involves impairments of general mental abilities that impact
adaptive functioning in three domains, or areas. These domains determine how well an
individual copes with everyday tasks:

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The DD definition requires substantial functional limitations in three or more areas of
major life activity. The intellectual disability definition requires significant limitations in
one area of adaptive behavior.

Those with developmental disabilities include individuals with cerebral palsy, epilepsy,
developmental delay, autism and autism spectrum disorders, fetal alcohol spectrum
disorder (or FASD) or any of hundreds of specific syndromes and neurological conditions
that can result in impairment of general intellectual functioning or adaptive behavior
similar to that of a person with intellectual disability.

5.1.1 Classification and Assessment

Cognitive Impairments are divided into four categories:
i. Mild
ii. Moderate
iii. Severe and
iv. Profound

The category details are as follows:

Mild intellectual disability

 IQ 50 to 70
 Slower than typical in all developmental areas
 No unusual physical characteristics
 Able to learn practical life skills
 May attains reading and math skills up to grade levels 3 to 6
 Able to blend in socially
 Functions in daily life

Moderate intellectual disability

 IQ 35 to 49
 Noticeable developmental delays (i.e. speech, motor skills)
 May have physical signs of impairment (i.e. thick tongue)
 Can communicate in basic, simple ways
 Able to learn basic health and safety skills
 Can complete self-care activities
 Can travel alone to nearby, familiar places

People with moderate intellectual disability have fair communication skills, but cannot
typically communicate on complex levels. They may have difficulty in social situations
and problems with social cues and judgment. These people can care for themselves, but
might need more instruction and support than the typical person. Many can live in
independent situations, but some still need the support of a group home.

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Severe intellectual disability
 IQ 20 to 34
 Considerable delays in development
 Understands speech, but little ability to communicate
 Able to learn daily routines
 May learn very simple self-care
 Needs direct supervision in social situations

Only about 3 or 4 percent of those diagnosed with intellectual disability fall into the
severe category. These people can only communicate on the most basic levels. They
cannot perform all self-care activities independently and need daily supervision and
support. Most people in this category cannot successfully live an independent life and
will need to live in a group home setting.

Profound intellectual disability

 IQ less than 20
 Significant developmental delays in all areas
 Obvious physical and congenital abnormalities
 Requires close supervision
 Requires attendant to help in self-care activities
 May respond to physical and social activities
 Not capable of independent living

People with profound intellectual disability require round-the-clock support and care.
They depend on others for all aspects of day-to-day life and have extremely limited
communication ability. Frequently, people in this category have other physical limitations
as well. About 1 to 2 percent of people with intellectual disabilities fall into this category.
According to the new DSM-V, though, someone with severe social impairment (so severe
they would fall into the moderate category, for example) may be placed in the mild
category because they have an IQ of 80 or 85. So the changes in the DSM-V require
mental health professionals to assess the level of impairment by weighing the IQ score
against the person's ability to perform day-to-day life skills and activities.

Both formal and informal assessment approaches can be used. Informal testing may be
most useful to determine the child’s achievement of specific developmental milestones.
Intellectual disability is diagnosed through the use of standardized tests of intelligence
and adaptive behavior.The fifth edition of the Diagnostic and Statistical Manual of
Mental Disorders (DSM-5), emphasizes the need to use both clinical assessment and
standardized testing of intelligence when diagnosing intellectual disability, with the
severity of impairment based on adaptive functioning rather than IQ test scores alone.
Assessment focus on the impacts of deficits of cognitive abilities and practical skills
gives significant information.

The first indication of an intellectual disability (ID, formerly mental retardation) is

usually a child's physical and behavioral characteristics. Once an intellectual disability is

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suspected, a formal evaluation and assessment begins. The evaluation begins with a
complete physical examination.

Assessment for individuals with ID involves multiple professionals due to the varying
and far-reaching needs across developmental domains. Team models may be
multidisciplinary, interdisciplinary, or transdisciplinary.

A thorough assessment usually includes the following:

 comprehensive medical exam;
 possible genetic and neurological testing;
 social and familial history;
 educational history;
 psychological testing to assess intellectual functioning;
 testing of adaptive functioning;
 interviews with primary caregivers;
 interviews with teachers;
 Social and behavioral observations of the child in natural environments.

Assessment is the collection of data through the use of multiple measures, including
standardized and informal instruments and procedures. These measures collect
comprehensive quantitative and qualitative data about an individual student. The results
of continuous progress monitoring may be used as part of individual and classroom
assessments. Information from many of these sources of assessment data can and used to
help ensure that the comprehensive assessment and evaluation accurately reflects how an
individual student is performing.

Evaluation follows assessment and incorporates information from all data sources.
Evaluation is the process of integrating, interpreting, and summarizing the comprehensive
assessment data, including indirect and preexisting sources. The major goal of assessment
and evaluation is to enable team members to use data to create a profile of a student's
strengths and needs. The student profile informs decisions about identification, eligibility,
services, and instruction. Comprehensive assessment and evaluation procedures are both
critical for making an accurate diagnosis of students with learning disabilities.

 The conceptual domain includes skills in language, reading, writing, math,

reasoning, knowledge, and memory.

 The social domain refers to empathy, social judgment, interpersonal

communication skills, the ability to make and retain friendships, and similar
capacities.

 The practical domain centers on self-management in areas such as personal care,

job responsibilities, money management, recreation, and organizing school and
work tasks.

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5.1.2 Implications Of Intellectual And Developmental Disabilities
The development of learning process of children with an intellectual disability develop at
significantly slower rate and to a lower level than other children their age.

These children have significant deficits in their cognitive skills—that is, their ability
to think and reason, as well as their skills of independence, socialization and
language, compared with other children of their age.

Intellectual and developmental disabilities are best assessed by professionals. Such

disorders may co morbid with other disorders. A constructive way to look at intellectual
disability is to define it in terms of the support needs of people. This approach sees the
effect of the disability as something that will vary and can be increased or reduced by
external factors.Adjusting the environment and the support to meet the person’s needs
can increase the person’s capacity and reduce the effect of the disability.

Assessment Procedures
Procedures that are not comprehensive can result in identification of some individuals as
having disabilities when they do not, and conversely, exclude some individuals who do
have specific learning disabilities.Formal testing may be required if diagnosis or
eligibility have yet to be determined for a child at risk for, or suspected of, a DD. For that
purpose assessment tools, techniques, data sources are required.

Alternatively Dynamic assessment can also be carried out for the assessment of child’s
learning capacities and capabilities. Dynamic assessment identifies the skills that an
individual child possesses as well as their learning potential. The dynamic assessment
procedure emphasizes the learning process and accounts for the amount and nature of
examiner investment. It is highly interactive and process-oriented.

Comprehensive assessment of individual students requires the use of multiple data

sources. The term assessment is used in many different contexts for a variety of purposes
in educational settings including individual and group, standardized and informal, and
formative and summative. Some professionals use assessment broadly to include both
assessment and evaluation.

Learning Styles, Learning Capacity

For young children and the persons having limitations in adaptive skills teaching
methodology needs to be modified. Conventional method of lecturing or demonstration
may not be as helpful as the strategy of letting the person to practice the skill with hands
on material. Student’s existing skills and strengths are required to be used and further
strengthen up to provide him with the experience of success rather initiate the teaching
with new skills. It will help the child with intellectual deficiency if shorter or distributed
sessions are taken for the purpose.

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Personality Development
People with intellectual disability experience more failure, rejection and social deprivation
leading to personality traits that may impede their ability to learn and predispose them to
depression. Students with learning disabilities experience an imbalance in their own ability
levels. They are very good at some things, very poor at others, and feel the tension between
what they can and cannot do. Frustration is a hallmark of a student with learning
disabilities. Typically such students will either be failing in one or more academic areas or
be expending excessive amounts of energy to succeed. Also, they are also highly
inconsistent, able to do a task one day and unable the next.

5.1.3 Instructional Approaches

Students with intellectual and developmental disabilities require accommodations in
curriculum. The purpose is to setup a learning environment that helps students achieve
their educational goals. For such students the educational goals are more important than
academics. Students with developmental delays may show signs of inattentiveness,
aggression and an inability to socialize with others. For them the instructional strategies
must be such which effectively address their special needs.

Break down learning tasks into small steps

Each learning task is introduced, one step at a time. This avoids overwhelming the
student. Once the student has mastered one step, the next step is introduced. This is a
progressive, step-wise, learning approach. It is characteristic of many learning models.
The only difference is the number and size of the sequential steps.

Hands – On Practice
Lengthy verbal directions or conventional lecturing is mostly ineffective teaching
methods for most of the students with intellectual and developmental disabilities.
Generally such people are kinesthetic learners i.e. they learn best by performing a task
"hands-on." They learn best when information is concrete, observed and practiced.

Visual Cues and Use of Concrete Teaching-Learning Aids

People with ID do best in learning environments where visual and concrete aids are used.
The use of real materials or actual tools in natural environments is an essential
component in the effective instruction of students with intellectual disabilities. For
example teaching students the concept of BIG and SMALL if two balloons of same
colour and visibly differentiated big and small sizes are shown and let them feel would
leave lasting learning effects on them.

Immediate Feedback
Provision of direct and immediate feedback on performance enables them to make a
connection between their behavior and the teacher's response. A delay in providing
feedback makes it difficult to form connection between cause and effect. As a result, the
learning point may be missed.

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Teaching in Small Groups or Individualized Instructions
Students learn best when taught in small groups.

Such grouping formats include:

 Peer (same-age) tutoring
 Cross-age tutoring
 Small learning groups
 Combined grouping formats
 Sometimes appointing a group leader

Direct Instructions
To fully address the limitations in intellectual functioning and adaptive behavior, teachers
need to provide direct instruction in a number of skill areas outside of the general
curriculum. These skills are more functional in nature but are absolutely essential for the
future independence of the individual. Useful strategies for teaching students with
intellectual disabilities include, but are not limited to, the following techniques:

Assistive Technology
There are a number of existing software packages designed to support students with
intellectual disabilities in the classroom. One promising approach in literacy software
utilizes universal design for learning principles. This approach combines reading for
meaning with direct instruction for decoding and understanding. The resulting software
consists of an audio and video based curriculum that can be adjusted by the teacher to
meet the specific academic capacities of the student.

Ultimately, any learning software that can tailor content to address the interests of the
student can be useful in supporting learning with individuals with intellectual disabilities,
given that the instruction can be adapted to meet the needs of the individual.

5.2 Type 8- Gifted and Talented

Gifted people are the ones who possess and perform higher levels of capacities and
capabilities than average in areas such as cognitive intellect, creativity, art, leadership and
require special interventions which are not required generally by others in the same
circumstances(Renzulli 1978, 1984, Renzulli& Reis, 1985, Gagne, 2003, 2008).

There is a biological difference between the gifted child and the typical child. The gifted
child seems to have an increased cell production that also increases synaptic activity. This
all adds up to an increased thought process. The neurons in the brain of the gifted child
seem to be bio-chemically more abundant and, as a result, the brain patterns that develop
are able to process more complex thought. There seems to be more prefrontal cortex
activity in the brain, which leads to insightful and intuitive thinking.Gifted children have
more alpha wave activity in the brain. Alpha brainwaves are dominant during quietly
flowing thoughts, and in some meditative states. Alpha is ‘the power of now’, being here,
in the present. Alpha is the resting state for the brain. Alpha waves aid overall mental

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coordination, calmness, alertness, mind/body integration and learning. They not only get
more alpha wave activity faster than the typical child, but they also sustain it longer. This
allows for more relaxed and focused learning with greater retention and integration. The
brain rhythms of the gifted child occur more often, and this allows for concentration,
attention, investigation, and inquiry (Clark, 2012).

5.2.1 Defining Multiple Intelligences

The theory of multiple intelligences was developed in 1983 by Dr. Howard Gardner,
professor of education at Harvard University. It suggests that the
traditional notion of intelligence, based on I.Q. testing, is far too limited. The theory of
multipleintelligences differentiates intelligence into specific (primarily sensory)
'modalities', rather than seeing intelligence as dominated by a single general
ability. Multiple intelligences represents different intellectual abilities.Howard
Gardner proposed this model in his 1983 book Frames of Mind: The Theory of Multiple
Intelligences.

According to this theory, "we are all able to know the world through language, logical-
mathematical analysis, spatial representation, musical thinking and the use of the body to
solve problems or to make things, an understanding of other individuals and an
understanding of ourselves. Where individuals differ is in the strength of these
intelligences - the so-called profile of intelligences -and in the ways in which such
intelligences are invoked and combined to carry out different tasks, solve diverse
problems, and progress in various domains."

The intelligences are:

Visual-Spatial - think in terms of physical space. They like to draw, do jigsaw puzzles,
read maps, and daydream. They can be taught through drawings, verbal and physical
imagery. Tools include models, graphics, charts, photographs, drawings, 3-D modeling,
television, multimedia, texts with pictures/charts/graphs.

Bodily-kinesthetic - use the body effectively like a dancer or a surgeon. Have keen sense
of body awareness. They like movement, making things, touching. They communicate
well through body language and be taught through physical activity, hands-on learning
and acting out, role playing. Tools include equipment and real objects.

Musical - show sensitivity to rhythm and sound. They love music, but they are also sensitive
to sounds in their environments. They may study better with music in the background. They
can be taught by turning lessons into lyrics, speaking rhythmically and tapping out time.
Tools include musical instruments, music, radio, stereo, CD-ROM, multimedia.

Interpersonal - understanding, interacting with others. These students learn through

interaction. They have many friends, empathy for others, street smarts. They can be
taught through group activities, seminars and dialogues. Tools include the telephone,
audio conferencing, time and attention from the instructor, video conferencing, writing,
computer conferencing, E-mail.

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Intrapersonal - understanding one's own interests, goals. These learners tend to shy
away from others. They're in tune with their inner feelings; they have wisdom, intuition
and motivation, as well as a strong will, confidence and opinions. They can be taught
through independent study and introspection. Tools include books, creative materials,
diaries, privacy and time. They are the most independent of the learners.

Linguistic - using words effectively. These learners have highly developed auditory
skills and often think in words. They like reading, playing word games, making up poetry
or stories. They can be taught by encouraging them to say and see words, read books
together. Tools include computers, games, multimedia, books, tape recorders, and lecture.

Logical -Mathematical - reasoning, calculating. Think conceptually, abstractly and are

able to see and explore patterns and relationships. They like to experiment, solve puzzles,
and ask cosmic questions. They can be taught through logic games, investigations, and
mysteries. They need to learn and form concepts before they can deal with details. (Taken
from: "The Distance Learning Technology Resource Guide," by Carla Lane,
https://www.gse.harvard.edu/faculty/howard-gardner).

5.2.2 Identification and Accommodation of Diversity

Gifted people exhibit different traits and characteristics. Giftedness is dynamic and is
expressed without any identity of socio-economic levels, creed, color or race. For
identification, professionals must seek ways to gather information across various
domains. Giftedness may be exhibited within a specific interest or a category. Early
identification carries the chances for converting the giftedness into talent. A systematic,
multi-phased process for identifying gifted students is to be followed which would screen
the students who need special services beyond the general education program.

In any identification process:

 Educators and parents matter in identifying and nurturing giftedness.
 Evidence-based characteristics are a guide to recognizing and understanding
giftedness.
 We should be alert to factors that can mask a child’s abilities, including our beliefs.
 Informal identification is necessary to ‘recognize’ (possible) giftedness in order for
formal identification to occur(Kerry Hodge, 2013).

Consistent indicators of giftedness

 “Good” thinking – e.g. reasoning, conceptual understanding, abstract thinking,
problem solving, generalizing;
 Ease or speed of learning – may learn from being told/shown just once; quick to
see errors as learning opportunities;
 Advanced verbal abilities – early/sophisticated expressive language development,
sophisticated vocabulary and/or complex sentences (although some gifted children
actually begin to talk later than usual, then progress swiftly); advanced receptive
language that can be observed (advanced ability to comprehend concepts,
vocabulary, directions and questions);
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 Exceptional memory – e.g. can retain information after brief exposure; able to
recall early life events in complete detail; Exceptional concentration or attention
span – a long attention span when interested; children in the upper levels of
giftedness may be able to concentrate on more than one thing at a time;
 Perseverance or motivation – e.g. greater goal-directedness and persistence to
completion, an appetite for learning;
 Wide ranging interests and knowledge – interests may be intense and outside
what is expected for young children;
 Preference for older companions – prefer older children/adults to age peers,
which may reflect advanced language levels, preferences for complexity in play,
mature views of friendships;
 Keen observation – an eye for detail; notes subtle changes;
 Quantitative ability andinterests – interest and skill in numbers; greater interest
in time, calculators, money;
 Exceptional spatial ability – interest and skill in puzzles, maps, diagrams;
advanced sense of place and direction;
 Early use of symbolic representation – early or sophisticated drawing or writing
(depends on fine motor development).

Possible indicators of giftedness

 Early development – e.g. begins to sit and walk earlier than other children; begins
to speak, read, write or use numbers earlier than other children;
 Intense curiosity – shows intense curiosity/deeper knowledge than other children;
e.g. insatiable need to know/explore;
 Wide range of temperaments – e.g. perfectionism (concern with precision,
especially in area of interest), sensitivity (easily hurt, empathetic), intensity,
concern with moral or social issues;
 Often exhibits imagination and creativity – e.g. finds imaginative ways to get
out of doing things they don’t want to do;
 Has an advanced sense of humor – is humorous in speech, social interactions, art
or story telling; makes jokes, puns, or plays on words (Kerry Hodge, 2013).

Instrument for Identification

 Parents comments / Opinions - particularly in early identification of gifted and
talented students.
 IQ tests (verbal and non-verbal).
 Standardized tests.
 School records, achievement tests (e.g. reading, mathematics).
 Anecdotal records - Interviews (parent/child/community members/previous
teacher/school psychologist).
 Identification checklists.
 Rating scales.
 Interpreters, translators (for students from culturally and linguistically diverse
backgrounds).

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Gifts are developed into talents through the developmental process. The developmental
process, designed to nurture and develop gifts into talents, has six main elements:
i. Enriched curriculum or training program
ii. A clear and challenging excellence goal
iii. Selective access criteria
iv. Systemic and regular practice
v. Regular and objective assessment of progress
vi. Personalized accelerated pacing (Gagné, 2008).

Gifted and talented students vary in terms of the nature and level of their abilities; there is
no single homogeneous group of gifted and talented students. Gifted and talented students:
 vary in abilities and aptitudes — they may demonstrate gifts and talents in a single
area or across a variety of domains; they may also have a disability
 vary in their level of giftedness — this means that two students who have gifts in
the same field will not necessarily have the same abilities in that field
 vary in achievement — while having gifts is often associated with high
achievement, achievement can and does vary across high-potential students and
over time, and some gifted students underachieve and experience difficulty
translating their gifts into talents
 are not always visible and easy to identify, and their visibility can be impacted by
cultural and linguistic background, gender, language and learning difficulties,
socio-economic circumstance, location, and lack of engagement in curriculum that
is not matched to their abilities
 Exhibit an almost unlimited range of personal characteristics in temperament,
personality, motivation and behavior — no standard pattern of talent exists among
gifted individuals.

Identification – who exactly is it we are looking to identify and how should we find
them?
 Schools should consider the following principles in creating, adapting, or adopting
their definitions of giftedness and talent. A school-based definition needs to:
 Recognize both performance and potential;
 Acknowledge that gifted and talented students demonstrate exceptionality in
relation to their peers of the same age, culture, or circumstances;
 Reflect a multi-categorical approach which includes an array of special abilities;
 Recognize multicultural values, beliefs, attitudes, and customs;
 Provide for differentiated educational opportunities for gifted and talented students,
including social and emotional support;
 Acknowledge that giftedness is evidenced in all societal groups, regardless of
culture, ethnicity, socioeconomic status, gender, or disability (learning, physical, or
behavioral); and
 Recognize that a student may be gifted in one or more areas.
(Riley, Bevan-Brown, Bicknell, Carroll-Lind & Kearney, 2004, p.15)

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5.2.3 Gagne’s Model of Gifted
Gagne has designed a developmental theory titled the Differentiated Model of Giftedness
and Talent (DMGT) (Gagne, 1985, 1991, 1995, 1997, 2000, 2003, 2009) with the aim of
describing how “excellence” within any field comes to be. This article describes the
components of his model and also discusses the interaction between them. Gagne’s basic
premise is to make a distinction between “outstanding natural abilities” to which he
assigns the term “aptitudes” and “specific expert skills” he terms “competencies”. His
model focuses on describing the process these basic building blocks go through as they
transform into systematically developed abilities. In this way then, he differentiates
between giftedness as raw capacity and talent as developed ability.

This distinction gives rise to some important implications for schools as they wrestle with
the understandings needed to design and implement policies and practices for the
education of their gifted and talented students.

The article by Sharon Mansfield, TEACHERS AS TRANSFORMERS: WITHIN THE

DIFFERENTIATED MODEL OF GIFTEDNESS AND TALENT discusses the issues of
central importance in this respect, namely:
i. Identification – who exactly is it we are looking to identify and how should we find
them?
ii. How can we respond to gifted and talented learners in ways that are appropriate for
all the sub-groups of gifted and talented learners?
iii. The Equity vs. Excellence debate – what are the goals of gifted education? What
are some of the barriers that stand in the way of their realization?

Although Sharon Mansfield discusses the model within the context of New Zealand, but
if go through this can be analytically refer for Pakistani context as well.

Differentiated Model of Giftedness and Talent

The Differentiated Model of Giftedness and Talent (DMGT) comprise six components,
each being assigned an identifying acronym. As described in the diagram below, (Gagne,
2009) the components demonstrate the progression from Natural Abilities or Gifts (G) to
Competencies or Talents (T). This progression is facilitated through the Developmental

GIFTEDNESS designates the possession and use of outstanding natural abilities,

called aptitudes, in at least one ability domain, to a degree that places an
individual at least among the top 10% of age peers.

TALENT designates the outstanding mastery of systematically developed

abilities, called competencies (knowledge and skills), in at least one field of
human activity to a degree that places an individual at least among the top 10% of
age peers who are or have been active in that field.

(Gagne, 2009)

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Process (D), which is either assisted or hindered by factors that Gagne describes as
catalysts. He groups these into Environmental (E) or Intrapersonal (I) and also includes
the Chance component (C) as a factor that can impact on all of the contributing
components of the model. This model is one that is being continuously refined with the
diagram below being the latest version.

Gagne (1995) noted and discussed a “plethora of definitions” with very little consensus
over the meaning of the terms gifted and talented. He recognised that ambiguity over
exactly what constitutes gifted and talented was not helpful in advancing the spec special
educational needs of Gifted students. Gagne proposed that, despite the two terms being
often used synonymously, there was a clear and appropriate distinction to be gainfully
made. Whereas both terms define an above average level of human ability, he ssaw that a
useful differentiation could be applied to account for the beginning and end points of the
developmental process that human abilities go through as they are transformed from basic
ability into systematically developed skills. While acknowledging the genetic origin of
these natural abilities, Gagne also recognised the impact that environmental stimulation,
daily use as well as informal and formal training has on their development (Gagne, 1995).

Differentiated Model of Giftedness and Talent

Gagne, 2009

He initially identified four “domains”, namely intellectual, physical, creativity and socio
socio-
affective abilities, as being separate areas of ability that can be observed at an early age,
with such large variance from the norm that could not be accounted for by any form of

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external teaching. In subsequent years Gagne has continued to refine his model and now
includes a perceptual domain, along with a division in the physical domain to
differentiate between muscular and motor control facilities. He recognised that along with
areas of natural ability were genetically determined temperamental dispositions or
personality traits such as will power, resilience and ethical behaviour and that these,
along with environmental factors, i.e. the places, the people and the educational processes
that a student is exposed to, would have an impact on the development of skills.

Gagne considers undeveloped natural abilities to be the “constituent elements” of

systematically developed skills and thus defines talents as the skills that develop as these
“building blocks” are applied to a particular context or field (Gagne, 1995).

One very important outcome of viewing the concept of giftedness and talent through the
lens that Gagne presents is the implication that a child can, by virtue of having naturally
high abilities, be recognised as gifted from a very early age. As the child matures these
abilities will develop however the course such development takes is dependent upon the
impact of what Gagne describes in his model as “catalysts”, that is to say, the influences
of environmental and intrapersonal factors. He also includes the chance factor as
influential in the eventual successful or otherwise outcome of the developmental process.
The outcome of a successful developmental process is the maturing of these basic
abilities into exceptional competencies or talents. Thus, a person is described as gifted to
highlight that they have exceptional abilities and, when they have favourably developed
these abilities they may be described as gifted and talented, however to be described as
talented necessarily implies giftedness as a prerequisite. A further implication is
therefore that while such a child will always (barring exceptional mishap) remain gifted,
only when a high level of performance has been attained can they be described as
talented. This is important because it alludes to the common phenomenon in our schools,
and in life, of gifted underachievement, and points us in the direction of beginning to
understand and therefore remedy this (Gagne, 2000). It supports the important
understandings that if, through unfavourable catalytic circumstances, a child’s abilities
fail to manifest into talents, the basic constituents of their giftedness do not disappear and
therefore neither do their special educational needs; in fact, they are likely to be even
more in need of intervention and support.

Gagne’s Differentiated Model of Giftedness and Talent is based upon the precept that
giftedness is descriptive of natural abilities that place an individual in the top 10% of
ability range in relation to their peers, which then translates, if met with optimal
conditions within a developmental process, into talents or competencies, again placed at
the top 10% of performance. Thus this model meets well the first two principles outlined
above.

Gagne’s model is an effective device in supporting a broadening of conception from the

historically narrow recognition of giftedness as a measure of academic ability, to one
where exceptional abilities in any of six distinct domains of natural ability are recognised,
and where identification is aimed towards individuals who exhibit aptitudes or natural

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abilities, as well as those have developed skills in a particular field of human activity.
The need for gifted and talented students to be provided with differentiated programmes
is likewise acknowledged as an Environmental catalytic factor that will impact upon the
success or otherwise of the transformation process of gifts into talents.

When we recognise that the scope of giftedness and talent lies in a much broader range
than intellectual aptitude alone, we also see that the methods used to identify individuals
within these categories consequently need to be broad ranging as well. Different
measures will yield information of differing value depending upon exactly what it is that
one is seeking to assess. In line with his model of differentiation between giftedness and
talent, Gagne noted the different types of assessment available to determine levels of
natural ability or giftedness, and for fields of talent, although he points out some aptitudes
are more easily measured than others (Gagne 1995).

An advantage to be capitalised on by adopting this thinking into the identification process

is in avoiding the common but somewhat superficial practice of identifying high
achieving academic students who have successfully negotiated and benefited from a
systematic program of training and practice, but failing to account for gifted students who
are in need of programme modifications and/or extra support with any of the catalytic
aspects of Gagne’s model in order to reach their potential. In fact Gagne has gone so far
as to give students in the former group an acronym of their own – IGAT as in
intellectually gifted and academically talented – and points out himself that this group are
those most often and most likely to be targeted by current gifted and talented educational
provisions (Gagne, 1995).

The three questions given in this section had been addressed by Sharon Mansfield in the
perspective of New Zealand., which is given as follows:

How can we respond to gifted and talented learners in ways that are appropriate for
all the sub-groups of gifted and talented learners?
Gifted and talented learners, as a group in general, require differentiated educational
opportunities. It is common in New Zealand also to see IGAT students provided for, but
less often students whose gifts and talents fall outside this arena. Also minority groups
are less likely to be identified and consequently provided appropriate programmes. This
means the principle for schools to “acknowledge that giftedness is evidenced in all
societal groups, regardless of culture, ethnicity, socioeconomic status, gender, or
disability (learning, physical, or behavioural) is one that must be accounted for within
whatever programme is implemented. (Riley, Bevan-Brown, Bicknell, Carroll-Lind &
Kearney, 2004, pg. 10)

The Differentiated Model of Giftedness and Talent provide an appropriate avenue

through which to fulfil these criteria.

Firstly, it assists us to recognise that there are base-line characteristics that will be found
in gifted children; i.e. those that fit around what are described by Gagne as the Natural

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Abilities which he reminds us are at least partly genetically endowed. These
characteristics are observable from a very early age and can be seen in all learning
situations a child is faced with, e.g. where the child learns new material and masters skills
much faster than their peers (Gagne, 2000).

From here however, the pathways travelled become significantly diverse, as the catalytic
factors influence the developmental course of individuals. Also children with similar sets
of natural abilities may choose to pursue different directions and apply their gifts in the
pursuit of any of a wide range of possible directions. It therefore becomes significant to
consider each of these factors and how schools can work to maximise benefits and/or
minimise damage that can occur through each one. Some are of course much more open
to modification than others, however most could well be noted as part of a profiling
exercise and taken into account when consideration is given to appropriate programming
(Gagne, 1995).

Gagne has worked on trying to prioritise the relative importance of each component in an
attempt to answer “What makes a difference?” (Gagne, 2003). Again, he has formulated
an acronym to spell out this hierarchy of causal impacts – C.GIPE which places Chance
at the top and Environmental Catalysts at the lowest level. The importance he places on
Chance is interesting when we reflect that Chance is the one factor that, by its very
nature, we have little control over. Gagne’s position is that Chance has significant
influence over every other aspect of the talent development process, due to the role of
Chance in two of the most significant contributing factors of our lives; firstly, the random
assignment of our genetic make-up and secondly, the family and social background into
which we are born (Atkinson, 1978).

The hierarchy of importance could though, be usefully viewed in terms of identifying the
factors we do have influence over and where our efforts as educators might be best
directed in order to most effectively facilitate the talent development process. While we
cannot have any influence over the cards a child is dealt in terms of their genetic makeup,
or their family and social background, we are in the privileged position of being able to
facilitate the positive development of many of the causal factors. And while we cannot
change the Natural Abilities outlined in Gagne’s model, we can make sure we know what
to look for in order to identify these early in a child’s education, so that they can be given
scope and encouragement to blossom. In designing our gifted and talented policies and
programmes, we can be aware and make sure that we are correctly distinguishing the
characteristics of gifted children from those of talented children. We can know that our
place in Gagne’s Model is that of an Environmental Catalyst, and as such we are placed
to have either a positive or negative impact on the Natural Abilities of a child as these are
“processed”.

For example, we are able to influence the development of the child’s fluid reasoning
ability by allowing this process to be practised and validating its place in the learning
process, even when it may appear to conflict with more sequential and organised
reasoning. We can encourage verbal skills, even when they may appear excessive and

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beyond acceptable “norms”. We can value high ability within areas of imagination and
inventiveness and encourage their application and growth. And even with the all
important but mostly uncontrollable Chance factor, we can encourage the development of
intrapersonal factors such as autonomy, passion, perseverance and resilience, so that the
child will be best placed to recognise and take advantage of opportunity when it happens
along (Austin, 1978).

The Equity vs. Excellence debate – what are the goals of gifted education? What are
some of the barriers that stand in the way of their realization?
Within New Zealand, as is the case internationally, gifted education has struggled to be
recognised as a field with any valid substance to its claims of need. The education of
gifted students continues to be seen as low priority by most, fed by beliefs that gifted and
talented students are the cream that already has an advantage, and therefore gifted and
talented programmes are viewed as “extras” – the luxury items that are always the first to
go when budgets require to be trimmed.

There are two commonly used rebuttals to this argument, the first being that all students
are entitled to an education that engages and challenges them; they are entitled to learn
and achieve personal excellence, to have their abilities and talents recognised, affirmed
and their learning needs addressed (MOE, 2007). To withhold necessary educational
modifications from a group of students simply because their abilities and talents place
them at a higher level than most other students, to expect them to moulder away in an
environment that provides little positive stimulation and yet remain motivated, and to
expect them to achieve success in spite of an inappropriate curriculum, is in short,
inequitable.

The second imperative comes more from an economic position – that which considers the
provision of resources for gifted and talented students to be an investment in the national
future, and encourages the pursuit of excellence in terms of an outcome for the ultimate
benefit of all.

The New Zealand Government has in recent year’s mandated gifted education and
recognised both equity and excellence as valid in their reasoning for its importance
(MOE, 2004). However, recent research (Riley et al, 2004, ERO, 2008) has shown that
while some schools have made excellent progress with designing and implementing
policies and practices, there are still large gaps in provision for gifted and talented
students, particularly in relation to a lack of professional development, support and
resourcing for schools, and in the lack of inclusion of under-represented sub-groups of
gifted and talented students. A range of categories of giftedness and talent in which
students are identified and provided for is frequently overlooked, e.g. cultural, spiritual
and emotional giftedness, as are the social and emotional needs of gifted and talented
students (Riley et al, 2004).

So how does Gagne’s Differentiated Model of Giftedness and Talent sit within this
present situation?

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Firstly as stated earlier, Gagne has presented his work as a model of how excellence in
any field comes to be. Therefore, if our goal is to produce students who are capable of
top performance in any given career, then this model describes for us all the components
that we need to take account of in pursuing this.

Gagne (1995) professed the title of “gifted education” to in fact be a misnomer as he says
it is not usually development of the natural abilities that gifted children possess at the
beginning of their formal education process that are the aim of such programmes. He
suggests “talent development” as a more accurate descriptor, in terms of the definitions
within his model, of the common goals of current programmes.

It is certainly the case within New Zealand that certain specific talents are commonly
targeted within gifted education initiatives, and that these areas of ability are limited in
scope (MOE 2004). If we pay attention to the broader range of abilities that are
highlighted in the DMGT, then we will be more successful at identifying and providing
for a greater number of gifted and talented children.

Secondly, we can look at equitable outcomes as a goal of gifted and talented education
programmes. The suggestion that talent development may be a more accurate description
of current programmes also implies that excellence is the goal. If however we place
equal emphasis on the value of successful outcomes judged from a more individual and
personal viewpoint, then we should move our focus from Gagne’s competencies as the
end result and the inherent benefit to society gained, and balance this with the need for
development from the beginning point – the natural abilities. In this way, identified gaps
in provision – the narrow range of abilities and also the lack of appropriate attention to
the special social and emotional needs of gifted students can be addressed. In identifying
the “building blocks” and then accounting for the environmental and inter-personal
factors that impact upon them, we can create a more balanced and holistic view of the
child and their needs and respond appropriately. The goal of excellence is not discounted
but its attainment is more likely to be reached for a wider range of gifted students with
enhanced results both for them personally and for society also.

Summary
The major point of difference in Gagne’s Differentiated Model of Giftedness and Talent
is his contention that there is, and should be, a clear distinction to be made between the
concepts of giftedness and talent. This difference is the basis upon which he has
designed a description of the process by which the Natural Abilities or Gifts possessed by
young children are transformed (or not) into Competencies or Talents. It also provides
the means to satisfy the required principles of gifted and talented education in New
Zealand to recognise both performance (talents) and potential (gifts).

Gagne’s DMGT clearly distinguishes both separate domains of ability and fields of
talent, and specifies gifted and talented children to be those whose gifts or talents place
them within the top 10% ability-wise of their age peers. This aspect of his model meets

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the requirement for New Zealand schools to ensure their definitions are multi-categorical
and acknowledge children who demonstrate exceptionality in relation to their peers.

Requirements within New Zealand for school-based definitions to recognise multicultural

values, beliefs, attitudes, and customs is met within the DMGT with Culture specifically
noted under the sub-heading of Mileu as an Environmental Catalyst, whereby it has, in a
conjunctive relationship with all other catalysts, a direct impact upon the developmental
process, and subsequently on resultant talents. Similarly, Provisions describe the range
of programming options that are necessary for successful transformation of gifts into
talents, providing satisfaction of the requirement in New Zealand for provision of
differentiated educational opportunities.

Gagne has identified a common tendency which has been borne out by research within
the New Zealand context, towards identifying a group that he has termed IGAT students
(Intellectually Gifted and Academically Talented). This highlights a “gap” in the way we
are currently providing for our gifted and talented students that the DMGT is well placed
to remedy, through firstly providing for early identification of a broad range of natural
abilities and then awareness and specific targeting of the catalytic factors required for
optimum progression through the developmental process to facilitate transformation of
these abilities into competencies.

In New Zealand, gifted education fights an uphill battle for survival, despite that there are
very sound reasons to support its existence. Recent research has highlighted substantive
gaps in provision and identified many of the causes of these deficits. Utilisation of the
DMGT as a guiding model for definition of gifted and talented learners and then for
responding to their needs in ways that will enhance the likelihood of successful
outcomes, is definitely a plausible solution. It is by no means a simple process, but then
with all the complexities inherent in the concept of giftedness and talent, one would not
expect that it should be so! However, it can be seen that for each guiding principle
advanced by the researchers, a satisfactory approach can be drawn from within the
DMGT with which to meet it. Moreover, application of the DMGT has the potential to
remedy identified gaps in current provision, if used in conjunction with necessary
resourcing including professional development and support, to help New Zealand
teachers take their places as significantly positive influences in the development process
of our gifted children.

5.3 Teaching Strategies for Academic Skills, Functional Skills

and Social Competencies
In the following paragraphs general instructions are given (taken from
do2learn.com/.../CharacteristicsAndStrategies/DevelopmentalDelay_Strategies.html) for
the teachers of students with intellectual and developmental delays for effective teaching.

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Physical Development
 Plan physical activities for times when the student has the most energy.
 Provide simple, fun obstacle courses that the student is capable of completing.
 Provide daily opportunities and activities for children to use handheld tools and
objects.
 Use songs with finger plays to develop fine motor skills.
 Use materials such as a non-slip mat under drawing paper, thick crayons, and thick
handled paint brushes that are easy to grasp.
 Incorporate singing and dancing into many activities.
 Place objects in student’s hand to hold and feel.
 Let students practice swinging and hitting.
 When eating, let student make a mess to practice the motions of feeding and
cleaning up.
 Give students blocks, clay, paper, pencils, crayons, safety scissors, play dough, and
manipulative to use.
 Plan daily physical activities, and take students outside to run, climb and jump
around.
 Have students practice buttoning and unbuttoning, zipping clothes, and opening
and closing a door.
 Use activities that involve cutting, pasting, drawing and writing.
 Model and use activities with drawing and writing tools.
 Use child-size tables and chairs in the classroom.
 Have a schedule for active and quiet times.
 Model and talk about healthy eating habits with students.
 Provide nutritious snacks and meals.
 Make parents aware of health concerns that could affect a child’s development
(changes in growth, hearing, vision).
 Provide parents with information about health, medical, and dental resources.
 Use visual discrimination games such as “I spy”.
 Take “listening walks.”

Cognitive Development
 Use the student’s preferences and interests to build lessons (get input from parents).
 Allow student time to complete tasks and practice skills at own pace.
 Acknowledge level of achievement by being specific.
 Be specific when giving praise and feedback.
 Break down tasks into smaller steps.
 Demonstrate steps, and then have student repeat the steps, one at a time.
 Be as concrete as possible.
 Demonstrate what you mean rather than giving directions verbally.
 Show a picture when presenting new information verbally.
 Provide hands-on materials and experiences.
 Share information about how things work.
 Pair student with a buddy who can assist with keeping the student on track.
 Be consistent with classroom routines.

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 Set a routine so student knows what to expect.
 Provide a visual schedule of activities that can be understood by the student (using
photos, icons).
 Use a visual timer so student knows when an activity will be over and they can
transition to the next task.
 Use age appropriate materials.
 Use short and simple sentences to ensure understanding.
 Repeat instructions or directions frequently.
 Ask student if further clarification is necessary.
 Keep distractions and transitions to a minimum.
 Teach specific skills whenever necessary.
 Provide an encouraging and supportive learning environment.
 Do not overwhelm a student with multiple or complex instructions.
 Speak more slowly and leave pauses for student to process your words.
 Speak directly to the student.
 Speak in clear short sentences. Ask one question at a time and provide adequate
time for student to reply.

Communication Development
 Use large clear pictures to reinforce what you are saying.
 Speak slowly and deliberately.
 Paraphrase back what the student has said.
 Clarify types of communication methods the student may use.
 Identify and establish functional communication systems for students who are non-
verbal.
 Reinforce communication attempts (e.g. their gestures, partial verbalizations) when
the student is non-verbal or emerging verbal.
 Label areas in the room with words and pictures.
 Use sequencing cards to teach order of events.
 Provide puppets/pictures as props when using finger plays and songs.
 Develop a procedure for the student to ask for help.
 Speak directly to the student.
 Be a good speech model.
 Have easy and good interactive communication in classroom.
 Consult a speech language pathologist concerning your class.
 Be aware that students may require another form of communication.
 Encourage participation in classroom activities and discussions.
 Model acceptance and understanding in classroom.
 Provide assistance and positive reinforcement as the student shows the ability to do
something with increased independence.
 Use gestures that support understanding.
 Model correct speech patterns and avoid correcting speech difficulties.
 Be patient when student is speaking, since rushing may result in frustration.
 Focus on interactive communication.
 Use active listening.

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 Incorporates the student’s interests into speech.
 Use storybook sharing in which a story is read to student and responses are elicited
(praise is given for appropriate comments about the content).

Social and Emotional Development

 Use strategies to assist student in separating from parent.
 Set a routine in saying goodbye (such as finding a book to read).
 Value and acknowledge student’s efforts.
 Provide opportunities for students to play in proximity to one another.
 Provide opportunities for students to interact directly with each other.
 Work to expand the child’s repertoire of socially mediated reinforcers (e.g. tickling,
peek-a-boo, chase, etc.).
 Explore feelings through use of play.
 Teach students to express their feelings in age-appropriate ways.
 Provide play activities that don’t require sharing such as art projects, making music
(students have own instrument), and sand or water play.
 Ask students to imagine how their behavior might affect others.
 Have students make a “friend book” with students from the class.
 Comment on and describe what student is doing (be specific).
 When dealing with conflict, explain what happened in as few words as possible and
use a calm, not-angry voice.
 Point out consequences of the student’s behavior.
 Brainstorm better choice(s) with students.
 Use language to describe feelings and experiences.
 Put student’s feelings into words.
 Read books about feelings.
 Explain your reasons for limits and rules in language that students can understand.
 Model the benefits involved in cooperating.
 Use natural consequences when possible to reinforce cause and effect involved in a
rule, request, or limit.
 Teach students words for important people and things.

Adaptive Behavior / Functional Skills
 Explicitly teach life skills related to daily living and self-care.
 Break down each skill into steps.
 Use visual schedules with pictures / icons to demonstrate each step.
 Plan experiences that are relevant to the child’s world.
 Find ways to apply skills to other settings (field trips).
 Minimize distractions and the possibility for over-stimulation.
 Teach and model personal hygiene habits such as washing hands, covering mouth
and nose when sneezing or coughing, and dental care.
 Find ways to practice personal care and self-help skills (using centers in the
classroom).
 Provide opportunities for students to practice asking for help, feeding themselves,
dressing, washing hands, toileting, and locating personal items.

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 Provide materials that support self-care such as child-size sink, toilet, coat rack,
and toothbrushes.
 Teach and model rules and practices for bus safety, playground safety, staying with
the group, and safety in the classroom.
 Teach students to provide personal identification information when asked.
 Teach and model procedures for dealing with potentially dangerous situations,
including fire, severe weather, and strangers.

5.4 Self-Assessment Questions

1. What is meant by intellectual disability?

2. Define developmental disability?

3. Differentiate between intellectual and developmental disabilities with examples.

4. How the Intellectual and developmental disabilities are determined?

5. What role has AAIDD has played in defining Intellectual and developmental
disabilities?

6. What health issues do people with developmental disabilities face?

7. What educational supports are required by people with developmental disabilities?

8. What are the strategies to communicate effectively with individuals having a

Developmental Disability (DD)?

9. Write the purpose of educating children with Developmental disability.

10. What are the expected outcomes of teaching – learning process for children with
Intellectual and Developmental disabilities?

11. How can it be assessed if a classroom is equipped to address the special needs of
the students?

12. Why is early identification of special education students so important?

13. How do parents and teachers measure learning progress for special education
students?

14. What are the specific characteristics of Gagne’s Model of Giftedness?

15. What is the difference between Gagne’s and Renzulli’s models of Giftedness?

161
16. Analyze the role of environmental factors in sharpening natural abilities as
competencies.

17. What are the different ways gifted students are served in the classroom?

18. What kind of training does a teacher need to work with gifted students?

19. How students who are Gifted& Talented learn, learning characteristics and how
these are displayed in the classroom.

20. How would you give feedback to Gifted& Talented students that avoids peer
comparisons, targets what they know and that challenges further learning through
open-ended questions.

21. How would you advice and counsel parents of Gifted& Talented students.

22. Explain, how do gifted students differ in their thinking process. Evidence that they
think faster, in greater depth, in larger steps at once. Are they able to change that
they know more easily?

23. What are the appropriate strategies for a teacher to develop academic skills in
intellectually and developmentally delayed children?

24. How children with intellectual and developmental delays are affected in their
physical development?

25. What are the Functional skills?

26. How Functional skills are developed in intellectually deficient children?

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5.5 References
Atkinson, J.W. (1978). Motivational determinants of intellective performance and
cumulative achievement. In J.W. Atkinson & J.O. Raynor (Eds.). Personality,
motivation, and achievement. (pp. 221-242). New York: Wiley.

Austin, J.H. (1978). Chase, chance, and creativity. New York: Columbia University
Press.

Clark,Barbara, (2012), Growing Up Gifted: Developing the Potential of Children at

School and at Home. (8th Edition; April 2012, Pearson)

Gagne, F. (1985). Giftedness and talent: Reexamining a reexamination of the definitions.

Gifted Child Quarterly, 29, 103-112.

Gagne, F. (1991). Toward a differentiated model of giftedness and talent. In N. Colangelo

& G. A. Davis (Eds.) Handbook of gifted education (pp. 65-80). Boston: Allyn and
Bacon.

Gagne, F. (1995). From giftedness to talent: a developmental model and its impact on the
language of the field. Roeper Review, 18(2), 103-111.

Gagne, F. (1997). Critique of Morelock’s (1996) definitions of giftedness and talent [a].
Roeper Review, 20(2), 76.

Gagne, F. (2000) A differentiated model of giftedness and talent. Year 2000 update.
[Online] Retrieved from the World Wide Web June 16, 2009 from:
http://www.eric.ed.gov.ezproxy.massey.ac.nz/ERICDocs/data/ericdocs2sql/content
_storage_01/0000019b/80/16/bf/70.pdf

Gagné, F., 2003, transforming gifts into talents: e DMGT as a developmental theory. In
N. Colangelo & G.A. Davis (Eds.), Handbook of gifted education (3rd ed., pp. 60–
74). Boston: Allyn & Bacon.

Gagné, F. (2008) Building gifts into talents: Overview of the DMGT. Keynote address,
10th Asia-Pacific Conference for Giftedness, Asia-Pacific Federation of the World
Council for Gifted and Talented Children, Singapore, 14-17 July.

Gross, M., MacLeod, B., Drummond, D. & Merrick, C., 2001, Gifted Students in Primary
Schools: Differentiating the Curriculum, GERRIC, University of NSW.

Gross, M., MacLeod, B. & Pretorius, M., 2001, Gifted Students in Secondary Schools:
Differentiating the Curriculum (2nd edition), GERRIC, University of NSW.

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Kerry Hodge Macquarie University Special Education Centre 2013 (for references
beyond those) you can email at: [email protected]

MacLean, P. (1978). A mind of three minds: Educating the triune brain.

Ministry of Education. (2000). Gifted and talented students: meeting their needs in New
Zealand

Renzulli, J.S. (1978). What Makes Giftedness? Reexamining a Definition. Phi Delta
Kappan, 60(3), 180-184, 261.

Renzulli, J.S., & Reis, S.M. (1985). The school wide enrichment model: A comprehensive
plan for educational excellence. Mansfield Center, CT: Creative Learning Press.

Renzulli, J. S. & Reis S.M., (1985), The Schoolwide Enrichment Model: A

comprehensive plan for educational excellence: Mansfield Center, CT: Creative
Learning Press

Renzulli, J. S., (1986). The Three Ring conception of Giftedness: A developmental

Model of creative productivity. In R.J. Sterberg & J.E. Davidson (Eds.),
Conception of Giftedness (pp. 332-357). New York; Cambridge University Press.

Renzulli, J.S. (1994). Schools for talent development: A practical plan for total school
improvement. Mansfield Center, CT: Creative Learning Press.

Renzulli, J.S., gentry M. & Reis S.M., (2004), A time and Place for authentic learning
and Educational Leadership, 62 (1), 73-77.

Thompson, R., Berger,T. and Berry, S. (1980). An introduction to the anatomy,

physiology, and chemistry of the brain. In M. Wittrock, (Ed.) The brain and
psychology, New York: Academic.

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Unit: 6

EARLY IDENTIFICATION
ASSESSMENT AND EARLY
INTERVENTION OF SPECIAL
CHILDERN

Written By:
Anila Inam

Reviewed By:
Dr. Shaista Majid
 INTRODUCTION
Every child is unique having their own strengths and weaknesses. Their development
progresses according to certain sequences, but the pace may vary. It is natural that some
children may excel in certain areas but have deficiencies in other areas. However, if
children display
play marked problems or difficulties in one (or more) developmental area(s),
and their performance shows significant discrepancies compared with other children of
the same age, it is advisable to refer the children for professional assessment, as these
problems
blems may become a disorder if not detected and identified at an early age shown in
figure 1.

Figure: 1

Early
arly years of childhood plays an important role in any child’s life. These years can
provide tremendous opportunities for considerable growth, and conversely for
vulnerability and harm. The experiences and opportunities children are provided in the
early years set the foundations for future learning and development, and influence factors
such as academic success, relationship building, health, and wellbeing.
wellbeing. The early years
represent a unique opportunity for practitioners and families to scaffold children from
factors and positively influence children’s developmental trajectories.

Recent years have seen the advent of a strong evidence base around the benefits of early
identification and intervention for children with disability and developmental delay.

It is our belief that all students can and will learn and have a right to education. But
Children learn at different rates and in different ways while
while developing knowledge and
skills in different areas.in addition, the diverse backgrounds of students contribute to
variations in the knowledge, skills, and attitudes that they bring to school.Educating
children is a partnership that reflects the shared responsibility
responsibility between home, school and
community. Establishing effective communication processes between the home and
school is crucial to developing a learning program that best fits the student’s needs and
capitalizes on the student’s strengths. To promote
promote success for students with varying
abilities, a collaborative effort must be made by all partners to develop a needs
needs-based
plan. Identifying learning issues and intervening as early as possible in a student’s career
is critical to his/her educational success.
succ

Early childhood intervention constitutes all the experiences and opportunities afforded to
the infants and toddlers with disabilities by the children’s parents and other primary
caregivers (including service providers) that are intended to promote the the children’s

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acquisition and use of behavioural competence to shape and influence their pro-social
interactions with people and objects. The earlier a child is identified as having a
developmental delay or disability, the more likely they are to benefit from strategies
targeted towards their needs. The success of early intervention strategies not only assists
families through the provision of extra support for their child, but also decreases costs to
schools and communities in the later years as children transition to school. Early
identification isn’t just about the early years though. Obviously, it’s vitally important that
children’s needs are identified as early as possible, and the more children identified
before they start school, the better. However, many children slip through the net.

Currently, we know that there has been an increase in identifying children with some of
the educational special needs, this is not as big an increase as for those with other special
educational needs and many children are still being missed. For example, we would
expect 5-7% of all children to have specific speech, language and communication needs.
However, we know primary schools only identify 2.3% of their population as having
primary SLCN overall, and secondary schools identify a worrying 0.7%. So, at every
stage of schooling, there are opportunities to continue to identify those pupils whose
SLCN are likely to affect their outcomes.So, if children with SLCN(specific speech and
language communication needs) identified in early years and with the right early
intervention, children make better progress, the longer-term impacts are minimised and
many children can even catch up.Early intervention may occur at any point in a child or
young person’s life. Early intervention is a system of coordinated services that promotes
the child's age-appropriate growth and development and supports families during the
critical early years. Early intervention is a force for transforming the lives of children,
families and communities, particularly the most disadvantaged. Its importance today in
terms of policy and practice owes as much to its economic sense, as well as the social and
personal benefits that it can generate.

OBJECTIVES
After reading this unit, the students will be able to:
1. To understand the importance of early detection, identification, and intervention.

2. To outline early intervention, how services are tailored to meet the needs of the
children.

3. To compare and analyze variety of assessment tools used to identify special need
children.

4. To critically examine different research findings related to early identification,

assessment, and intervention.

5. To state importance of parental involvement in the process of early identification,

assessment, and intervention.

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6.1 Basic Assumptions and Principles of Intervention
The awareness about disability, its identification, intervention and inclusion is relatively
new concepts in the history or evolution and the whole world is still searching for more,
finding evidences or doing research. These concepts are still in a teething process. Let’s
take an example. If a head of an institution, like a school principal or a policy maker, or a
founder director assumes that special needs children should be sent to ‘specialists’ and
only people with ‘special training’ or ‘super power’ can teach them, then
these assumptionscan become dangerous, because whoever these people will interact
with, will be passed on this personal judgement in the form of truth or a policy. Also,
since this is the person who is ‘educated’ ‘experienced’ and is supposed to know ‘better’,
people take such information on face value.

Parents and doctors both can also be guilty on many accounts about assumptions. These
people believe that their version of reality is the gospel truth, even though the new-found
research or evidence proves them wrong. Their narrative remains mostly unchanged.As a
parent or a new parent, if you don’t question such mindsets, you are bound to
compromise on the potential of your child because you’d never push him beyond what
you have been told he can achieve because you are ‘assuming the incompetence’ which
was mostly the prevailing narrative of those time. If one is led to believe the in
capabilities of a child based on the achievements of people with similar disabilities in last
few decades, one should argue and question the same because a popular narrative is more
important than is believed.

What is early intervention?

Early intervention is a system of services that helps babies and toddlers with
developmental delays or disabilities. Early intervention focuses on helping eligible babies
and toddlers learn the basic and brand-new skills that typically develop during the first
three years of life, such as:
physical (reaching, rolling, crawling, and walking);
cognitive (thinking, learning, solving problems);
communication (talking, listening, understanding);
social/emotional (playing, feeling secure and happy); and
self-help (eating, dressing).

Examples of early intervention services | If an infant or toddler has a disability or a

developmental delay in one or more of these developmental areas, that child will likely
be eligible for early intervention services. Those services will be tailored to meet the
child’s individual needs and may include:
Assistive technology (devices a child might need)
Audiology or hearing services
Speech and language services
Counseling and training for a family
Medical services
Nursing services

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Nutrition services
Occupational therapy
Physical therapy
Psychological services

Services may also be provided to address the needs and priorities of the child’s family.
Family-directed services are meant to help family members understand the special needs
of their child and how to enhance his or her development.

The Individuals with Disabilities Education Act(IDEA) requires it–Part C of IDEA, to be

precise. That’s why you’ll sometimes hear early intervention referred to as Part C.

Early Intervention in the childhood years caters to children in the 0-6-year age range.
During this period, three big opportunities for early identification of developmental
disabilities arise. The first instance arises at the hospital when infants with birth defects
are detected and intervention started right away. The second instance is when children
show delays in speech and language development usually emerging in the second year of
life and the third arises in preschool when children’s play behaviours are expanding to
include playmates. Preschool teachers should be considered a part of the early
intervention team, who can support a therapist’s program, through activities designed for
the natural environment of the classroom. Do you remember the day when you took your
first step? Chances are you don’t. Early childhood is a blur: our earliest memories only go
back to about age 3. When you think about it, growth and development in the early years
is a miracle. In the first three years of life, 90 percent of brain development is complete.
By six years, we have learnt to walk, talk, feed ourselves, join friends in play,
demonstrate curiosity and express emotions.

Early intervention assumes that the earlier services and supports are provided, the better.
Intervention is likely to be more effective if it begins early in the life of a child or soon
after the onset of the factors that place their development at risk. Also, very early support
may increase the chance that a family at risk is able to engage or re-engage with
mainstream services, such as education and health.it leads to an open-ended question,
how early is early? Current technology allows it as early as before conception for some
of the disorders. Two such disorders are fragile X syndrome and tay-sachs disease. The
carriers of the disease may be identified by the blood test. New born screening and
postnatal tests are also available.

Risk is a statistical concept that says a person is likely to have a condition. When risk is
assigned it is more often relative risk.it may be based on group status or performance.
Establishing a treatment program based on relative risk is destined to be successful as
most of the children do not demonstrate that they at risk of developing. Therefore, we
sometimes say treatment strategies have treated for something that is not present.

Risk registries identify children as at risk when exhibit characteristics of the disorder of
the interest. Mostly historic risk is used to identify children who require evaluation to
confirm diagnoses. Risk factors are easily identified as low birth weight or prematurity in
some cases. Sometimes risk registries prove challenging as some of the risk factors are

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difficult to define as some factors may have poor classification abilities (sensitivity and
specificity) or some risk factors may not exert their effect directly for example low
socioeconomic condition is associated with developmental disability, but the mechanism
by which it cause developmental disability is still to be defined.so risk registries
established on performance are more likely to better classify children who are at risk for
developmental disabilities because performance based classification is more specific than
risk assigned by historic risk.it require more initial effort as larger number of children
need evaluation of their performance. Assigning risk based on performance is the
foundation of screening.it is the first step in diagnostic process. Screening does not yield
diagnosis; confirmatory test is required before treatment is initiated. Screening is justified
if the condition will benefit from early diagnosis and treatment and the cost benefit ratio
is positive. Developmental milestones are compared with normal developing child as
mothers used to compare their babies talking and walking. Some of the screening tools
are mentioned below prescribed by American Academy of Pediatrics.

General Developmental Screening Tools

Ages and Stages Questionnaires
Battles Developmental Inventory Screening Tool, 2nd ed.
Bayley Infant Neurodevelopmental Screener
Brigance Screens-II
Child Development Inventory
Chid Development Review-Parent Questionnaire
Denver-II Developmental Screening Test
Infant Development Inventory
Parents’ Evaluation of Developmental Status
Language and Cognitive Screening Tools
The Capute Scales
Communication and Symbolic Behaviour Scales-Developmental Profile
Early Language Milestone Scale
Motor Screening Tools
Early Motor Pattern Profile
Motor Quotient
Autism Screening Tools
Communication and Symbolic Behavior Scales-Developmental Pro
Early Language Milestone Scale
Motor Screening Tools
Early Motor Pattern Profile
Motor Quotient
Autism Screening Tools
The Checklist Autism in Toddlers
Modified Checklist for Autism in Toddlers
Pervasive Developmental Disorders Screening Test-II
1.Primary Care Screener
2.Developmental Clinic Screener
Screening Tool for Autism in Two-Year-Olds
Social Communication Questionnaire
Source: AAP Council on Children with Disabilities et al., 2006.

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The early childhood educators welcome children with additional needs and their families.
These service providers often work with children who have identified special needs.
Working with children who have special needs can be very rewarding if they understand
the child and his special need and make appropriate accommodations to support his
learning and development. For them it is important to remember that children with
special needs are children first. They have the same needs as all children -- a place where
they feel physically comfortable, loved and secure; opportunities to play and learn;
people who care about them; and activities that allow them to be successful. Children
with special needs often are not so different from typically-developing children. They
may need more time to learn and practice certain skills. They may need more praise and
encouragement to gain the skills typical for their age group. They may need specific
adaptations to help them succeed at certain activities. But it's important to remember
that in many, many ways these children have lots in common with other children. Many
child care professionals and child advocates emphasize this point by using "children first"
language, referring to "a child with special needs" rather than "a special needs child."

When working with children who have special needs, child care providers need to realize
that each child and each disability is unique. A child with visual impairments has
different needs than a child with behavioral challenges. A 2-year-old with a physical
disability has different abilities and challenges than a 4-year-old with the same type of
disability. Some children have more than one type of disability. The severity of the
challenges that each disability presents is also different for each child. Early
identification and intervention works - providing best outcomes for children, families and
early childhood settings. The use of individualized planning in the assessment process is
a key component of inclusive practice in early intervention in the jurisdictions discussed
in this review, and in many European jurisdictions.

Recommended practices in assessment are the following:

Professionals and families collaborate in planning and implementing assessment.
Assessment is individualised and appropriate for the child and family.
Assessment provides useful information for intervention.
Professionals share information in respectful and useful ways.

Other key principles identified in the literature include the need for multiple measures
and multiple sources when assessing young children, developmental appropriateness, and
viewing the child from a framework of competency embedded within a cultural context.
Research on using a learning stories approach to assessment identifies that this can
empower parents and early childhood educators to participate more fully in the process,
particularly as they are already familiar with this approach to assessment, and the
language used is more fully in the process, particularly as they are already familiar with
this approach to assessment, and the language used is more inclusive, reducing the
“expert” model.

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The learning stories approach may also contribute to the enhancement and strengthening
of team relationships, through an increased knowledge of the perspectives of other team
members, a shared language and a climate of support amongst team members.

All children benefit from inclusive practice. Collaboration and cross-agency work is vital
– parents, settings and government agencies. Supports and resources that are accessible
and timely provide a foundation for inclusive practice. Early childhood professionals
have a unique non-problem focused relationship with the child and family and have a
valuable contribution to make in understanding the whole child.

The Critical Features to Include in Early Intervention

While there have been too few attempts to determine critical features of effective early
intervention programs, there are a few factors which are present in most studies that
report the greatest effectiveness. These program features include: (a) the age of the child
at the time of intervention; (b) parent involvement ; and (c) the intensity and/or the
amount of structure of the program model.

 Many studies and literature reviews report that the earlier the intervention, the more
effective it is. With intervention at birth or soon after the diagnosis of a disability
or high risk factors, the developmental gains are greater and the likelihood of
developing problems is reduced
 The involvement of parents in their child's treatment is also important. The data
show that parents of both handicapped and gifted preschool-aged children need the
support and skills necessary to cope with their child's special needs. Outcomes of
family intervention include: (a) the parent's ability to implement the child's
program at home; and (b) reduced stress that facilitates the health of the family.
Both of these factors appear to play an important role in the success of the program
with the child.

6.2 Review of Research on Early Identification, Early Assessment

and Early Intervention

The effects of neglect begin early and remain throughout a child’s life even into
adulthood. For an Early Interventionist, these early years of neurological development are
fascinating and humbling too. It is the time to actively partner with families to support
children whose development patterns are disordered, disrupted or delayed. In a broader
sense, every one of us is an Early Interventionist in a child’s life. All it takes are good
observation skills and a deep understanding of developmental goals and milestones.

Nature always throws up challenges that force us to rethink our ideas of normalcy and
development. One such challenge is being able to respond to the needs of children with
genetic disorders. Today, there is a wealth of information and parent support networks for
children diagnosed with rare genetic disorders like Prader-Willi Syndrome, Cri-du-chat,
Rubinstein-Taybi Syndrome, mitochondrial diseases, to name a few that are identified at

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birth. The initial years present parents with the struggle of handling grief, disappointment
and anger. When mothers are unable to get started with stimulation programs at home,
they sometimes slide into depression.

Many researchers in the field have documented about autism spectrum disorder, case
examples of children who have eliminated their symptoms to the point where the
individuals fit within the typical range and almost half can eventually function without
the need for special support. However, without early intervention this is unlikely. Most
parents and professionals have the goal of alleviating symptoms that could negatively
affect the child’s ability to engage in leisure activities and gain employment. Early
intervention increases the likelihood of improved long-term outcomes.

According to Hart and Risley 1992, developmental trajectories are well established by
the pre-school years, and delays in potential positive outcome of early detection and
intervention is not something that should be denied to any child or family, and will
ultimately have a positive impact on society.

Research on RTI response to intervention allows us to change, modify, discontinue, or

continue a intervention. As Lovaas (1987) showed, if a child is responding to
intervention, a larger “dose” may result in the ability of a child to be indistinguishable
from his or her peers. The potential positive outcome of early detection and intervention
is not something that should be denied to any child or family, and will ultimately have a
positive impact on society.

Recent research suggests that co-morbidity may be reduced if the core social area is treated.
Reed, (2002). Alternatively, failing to provide intervention for these symptoms due to
inaccurate or lack of diagnosis may result in grave consequences. Early intervention
techniques to address core symptoms any problem may prevent secondary symptoms and
reduce the need for more substantial and expensive interventions later in life.

Munro review importance of early identification and early help Implications for: Society.
Early damage requires further support from social care, education, health, housing, police,
and other services. Individual – reduced life chances.The evidence suggests that "children
whose cognitive and behavioural characteristics are poorly developed in their early years
have difficulty succeeding in the school system" and that "research has documented that
early intervention is a critical factor contributing to the success of such children.

Why Intervene Early?

There are three primary reasons for intervening early with an exceptional child: to
enhance the child's development, to provide support and assistance to the family, and to
maximize the child's and family's benefit to society.

Child development research has established that the rate of human learning and
development is most rapid in the preschool years. Timing of intervention becomes
particularly important when a child runs the risk of missing an opportunity to learn during

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a state of maximum readiness. If the most teachable moments or stages of greatest
readiness are not taken advantage of, a child may have difficulty learning a particular
skill at a later time.

Early intervention services also have a significant impact on the parents and siblings of
an exceptional infant or young child. The family of a young exceptional child often feels
disappointment, social isolation, added stress, frustration, and helplessness. The
compounded stress of the presence of an exceptional child may affect the family's well-
being and interfere with the child's development. Families of handicapped children are
found to experience increased instances of divorce and suicide, and the handicapped child
is more likely to be abused than is a nonhandicapped child. Early intervention can result
in parents having improved attitudes about themselves and their child, improved
information and skills for teaching their child, and more release time for leisure and
employment. Parents of gifted preschoolers also need early services so that they may
better provide the supportive and nourishing environment needed by the child.

A third reason for intervening early is that society will reap maximum benefits. The
child's increased developmental and educational gains and decreased dependence upon
social institutions, the family's increased ability to cope with the presence of an
exceptional child, and perhaps the child's increased eligibility for employment, all
provide economic as well as social benefits.

Is Early Intervention Really Effective?

After nearly 50 years of research, there is evidence--both quantitative (data-based) and
qualitative (reports of parents and teachers) that early intervention increases the
developmental and educational gains for the child, improves the functioning of the
family, and reaps long-term benefits for society. Early intervention has been shown to
result in the child: (a) needing fewer special education and other habilitative services later
in life; (b) being retained in grade less often; and (c) in some cases being
indistinguishable from nonhandicapped classmates years after intervention.

Disadvantaged and gifted preschool-aged children benefit from early intervention as well.
Longitudinal data on disadvantaged children who had participated in the Ypsilanti Perry
Preschool Project showed that they had maintained significant gains at age 19 These
children were more committed to schooling and more of them finished high school and
went on to postsecondary programs and employment than children who did not attend
preschool. They scored higher on reading, arithmetic, and language achievement tests at
all grade levels; showed a 50% reduction in the need for special education services
through the end of high school; and showed fewer anti-social or delinquent behaviors
outside of school. that underachievement in the gifted child may be prevented by early
identification and appropriate programming.

Here are some of the many challenges that exist in the early identification of young
children with disabilities.which are identified through findings of different studies.

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 Many children in need of prevention/intervention services are not identified in their
early childhood years.

Child Find efforts are non-existent in many places. If a Child Find system does exist, it
often has little accountability built into monitoring its impact.

Public awareness initiatives are often ineffective and/or non-existent.

Access to services is a limitation in many areas .

Referrals and service coordination are often fragmented and/or difficult for the child’s
family to navigate.

A lack of consistent and comprehensive developmental-behavioral screening is evident.

In order to identify children with developmental concerns, screening assessment needs to
be coordinated with better referral and public awareness procedures and policies
implemented. The use of research-based developmental screening tools is recommended
Once a child is identified as needing early intervention supports and services, the use of
appropriate assessment practices and performance monitoring can help determine the
level of progress a child is making. This special issue highlights important research,
practices, and models underway to aid in the early identification and assessment of young
children at risk or who have delay/disability.

Early Assessment Researches

Lee, Bagnato, and Pretti-Frontzcak compare conventional and authentic assessment
practices in their study on utility and validity. Their findings are applicable to practitioners
in search of authentic methods for observing and understanding a child’s development.
Results have implications for improving assessment practices on a global scale.

A qualitative study was conducted to validate an assessment used to observe and monitor
the development of young children. Macy, Bricker, Dionne, Grisham-Brown, Johnson,
Slentz, Waddell, Behm, and Shrestha describe how an expert panel was used to
investigate properties of third edition of the Assessment, Evaluation, and Programming
System for Infants and Children (AEPS™).

Bricker, Squires, Franz, and Xie present a conceptual framework for early identification
with a comprehensive and additive system. The authors show strategies for incorporating
best practices used to identify young children through parent collaboration. The vignettes
give the reader concrete examples of how this framework could be used in practice settings.
Steed and Banerjee present a conceptual framework for the early identification of young
children with social emotional and behavioral issues. A linked system to help with early
detection efforts of young children with emotional difficulties and challenging behaviors is
provided. Practitioners working with young children and families can incorporate cohesive
and aligned early detection practices so that resources are used efficiently.

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An article written by Yockelson, Linder, and Asman focuses on practices used in the
early identification process. The authors show how screening assessments can be used to
address the unique needs of children and their teen parents. Examples are offered in their
cross sector collaboration that could be applied in communities of practice around the
world. Horiguchi and Akiyama present a study conducted in their pediatric assessment
unit in Tokyo, Japan. They examined the costs related to early identification of
delay/disability. Results of their study showed differential costs were found based on the
child’s diagnosis. Implications for an in-clinic consultation system were found for early
identification and resource utilization.

Keilty, Blasco, and Acar present a model of executive function (EF) to inform
developmental and behavioral screening, eligibility assessment, and program planning in
early childhood. Their article stresses the importance of EF for school success, as well as
the limitations measuring EF in early childhood (e.g., lack of measures to assess EF). The
EF model can be used to make decisions about early intervention assessment. Haglund,
Dahlgren, Källén, Gustafsson and Råstam examined the psychometric properties of a
measure called the Observation Scale for Autism (OSA) to screen for early markers of
Autism Spectrum Disorders (ASD). Young children in Sweden with ASD, Down
syndrome, and typical development participated in the study. Results of their study have
implications for using the OSA for early detection of ASD in children under the age of
three. Tzouridadou, Vouyoukas, and Anagnostopoulou explored the use of response to
intervention (RtI) in an inclusive Kindergarten setting as a form of early identification in
Thessaloniki, Greece. Researchers and undergraduate students at Aristotle University
worked with Kindergarten teachers to implement RtI. A description of the Greek early
identification paradigm is presented. Busillo-Aguayo, Murawski, and Weiner describe an
innovative mobile screening van used in Los Angeles, California to locate hard to reach
children and families. Results of their screening project are reported. Their research has
implications for Child Find programs in low income and diverse urban areas. These
articles in this special issue strive to improve practices, assessment methods, and system
of early detection. Professionals may be able to improve early identification efforts by
using some of the models/frameworks, suggestions, or outcomes from these articles.
Young children and their families will benefit from an effective system designed to
promptly and accurately respond to concerns about child development

Main Findings of the Research

A clear need has been identified for more research into the effectiveness and the relative
cost-effectiveness of early intervention strategies, but several characteristics emerge as
common to a number of the successful examples described. These are reflected. Where
possible, these golden threads need to be taken together, when they constitute a coherent
strategy for systemic change.

Five Golden Threads

The best start in life

The best start in life Far more is known now than even a few years ago about the extent
to which a child’s early development, including before birth, lays the foundation for their
future life. But little of this knowledge is applied systematically to ensure that all children

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get off to the best start; too much is still left to what is often referred to as the ‘accident of
birth’. Most parents are largely unaware of the conditions that promote early brain
development and some members of the workforce know less than they might.

Key messages
 There is now compelling evidence to show that what a experience during the early
years (starting in the womb) lays down a foundation for the whole of their life,
which needs to be reflected in policy and practice, both at a national and local
level.
 Children’s centres lie at the ‘hub’ of a continuum of support for children, families
and communities with additional needs, but require an effective outreach strategy
to ensure that interventions target and support the most vulnerable in the
community.
 Despite the significant benefits of breastfeeding having been clearly illustrated,
breastfeeding rates in England are among the lowest in Europe. Effective local
initiatives, such as in Blackpool, are needed to achieve and sustain significant
improvements.
 Complementary action is needed to dramatically increase the current low
proportion of hospitals in England (less than one in 10) accredited under the Baby
Friendly Hospital Initiative, a set of standards developed by UNICEF and the
WHO (World Health Organisation) to promote breastfeeding.
 More needs to be done to promote the use of peer support: volunteers from the
community (including local parents) who are trained to work alongside
professionals, but whose similar life experiences bridge the ‘approachability gap’.

Language for life

The ability to communicate is an essential life skill which underpins a child’s future
development, but more children struggle than is commonly recognised. Yet awareness of
the importance of language and communication skills and the creation of language rich
environments for young children remains generally inadequate – not only with many
parents, but also amongst policy-makers, commissioners of services and service
providers. The practice examples describe a range of approaches for improving this and it
is encouraging that a high proportion of language difficulties can be remedied with the
right support – though for some it appears that this needs to be done by the age of 5½,1
and many early years staff and primary teachers report a lack of confidence in meeting
these needs.

Key message
The scale of children affected is considerable: up to 10% of children have a longterm,
persistent communication disability, and approximately 50% in socially disadvantaged
areas have significant language delay on entry to school. There is a strong correlation
between communication difficulties and low attainment, mental health issues, poor
employment or training prospects and youth crime.
 As there is insufficient understanding amongst policy-makers and commissioners
nationally and locally, and sometimes parents and families themselves, raising

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 awareness of the importance of language and communication skills and creating
language rich environments is urgently needed.
 With the right support, many children with language delay go on to catch up with
their peers, and those with a pre-school history of persistent disorders that can be
resolved by the age of 5½ (which appears to be a critical age). Effective support or
intervention in the early years is vital to improving persistent disorders and
speeding up the resolution of difficulties linked to social disadvantage.
 A skilled and confident workforce is critical, with the ability to identify
communication problems at an early age, and distinguish between transient and
persistent difficulties so that appropriate interventions can be put in place. Yet
many early years staff feel inadequately equipped to help these children and over
60% of primary teachers lack confidence in their ability to meet children’s
language needs.
 Effective local practice was characterised by a large scale training programme and
dissemination of information to equip staff and parents alike in successfully
targeting early intervention and support, resulting in marked improvements in
children’s learning and achievement, practitioners’ confidence and parental
feedback. Other key characteristics included the effective use of data, not least to
track progress, building capacity through sharing the knowledge of specialist staff,
and strong parental engagement.

Engaging parents
We know how important good parenting is to successful outcomes, from a child’s early
development through to them achieving independence – including the crucial acquisition
of language and communication skills. But, again, our national approach to parenting
support is far from systematic, with the inevitable consequence that many children and
young people experience problems that are largely avoidable, and which blight their lives
– and those of their parents and families – often escalating into more serious situations
that may require expensive intervention. Effective intervention with children depends not
only on the fact of involving their parents, and sometimes wider family, but also on the
way of doing so. The examples in this publication repeatedly demonstrate the importance
of engaging parents in a collaborative approach, building on their strengths and taking
account of their views and experiences. They highlight the need to recognise the
problems that families themselves often face and to develop strategies that build
confidence and capacity to enable parents to properly fulfil the crucial role they play.
They illustrate the vital part that outreach work often plays in contacting families who
would otherwise miss out on services, but who can often be successfully drawn into both
universal or specialist (targeted) provision. A key feature of several examples is the use
of peer support: volunteers from the community who are trained to work alongside
professionals, but whose similar life experiences bridge the ‘approachability gap’ that
often prevents the take up of support. To some extent, this is also a way of addressing an
issue identified previously in the Narrowing the Gap guidance,2 that many professionals
still lack confidence in working with parents, and receive inadequate training to help
them. Most parents need support of some kind at some time, and ‘normalising’ parenting
support would greatly widen the reach of the benefits it brings.

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Key message
Parents are the most significant influence on children, and parenting has profound
consequences for their future lives, so it is important to persuade parents that engaging in
their child’s development can make a difference, and to build positively on their existing
strengths and actively involve them in decisions. Disadvantage is not a block to good
parenting but low levels of literacy and numeracy and confidence are obstacles, and self-
perception contributes to parents’ motivation to change – so it is particularly important to
persuade such parents to engage with support services by convincing them that they can
bring real and lasting benefits to their children.
 As most parents need support of some kind at some time and effective parenting
support does help improve parenting; systematic parenting support should be rolled
out across the UK.
 A whole society attitude shift to parenting is needed: parenting should be
celebrated as a matter where achieving high standards is in everyone’s interest, and
it is socially acceptable for everyone to recognise they are able to learn, rather than
being a private matter which must not be invaded.

Smarter working, better services

The quality of leadership will be key in determining both how far there is a shift of
emphasis towards early intervention, and how effective it will be. There needs to be a
clarity of purpose, and a determination to make improvements, because it’s the right
thing to do. Commissioning provides a robust, credible and objective way of making
decisions about the use of scarce public resources so that that they have maximum
positive impact on the lives of children and families. Effective commissioning starts with
a strategic understanding of how the whole system works and how the total resource is
being used. A key to success is understanding that early intervention requires a
reorientation of the system at all levels. The importance of agencies working in
partnership to meet the needs of children and families lies at the heart of recent changes
in approach to service development and delivery. Many of the examples of effective early
intervention arise explicitly from such practice, either in the form of multi-disciplinary
teams working with children and families – often making use of the CAF (common
assessment framework) to determine the action to be taken – or, in some cases, through
one group of highly trained professionals supporting colleagues from other disciplines in
the identification of need, facilitating a joint approach to resolving them. Staff in all
settings need to have an increased understanding of the principles of early intervention, of
how they can identify early difficulties, of how they should respond, and of the role of
others. Some interventions, particularly those involving outreach or intensive support,
require changes of practice to enable services to be offered out of ‘normal’ hours in order
to meet families’ needs. These often involve specialist staff working closely with
colleagues from other agencies, with a lead professional or key worker providing
consistent support. The problems experienced by some children and families will respond
to a single intervention, others will require longer term support; some will be complex
and may even cross generations. It is, therefore, essential that a continuum of support is
available with the capacity to meet specific needs at a particular time. Creating and

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sustaining such provision requires a high level of interagency collaboration, as well as
good communication with families.

Key message
When resources are scarce, and the workforce feels under pressure, there is a tendency to
defend (or at least cling to) the status quo which can make innovation and change harder
to implement; but it is only by doing things differently that better outcomes will be
achieved. Energetic and visionary leadership, combined with effective joint
commissioning, is therefore critical in delivering whole system change.
 Effective commissioning applies evidence of what works to improve outcomes for
local people and will become increasingly important as budgets are constrained. It
provides a robust, credible and objective way of making decisions about the use of
scarce public resources so that they have maximum positive impact on the lives of
children and families.
 As some children and families need ongoing support, while others may have their
needs met sufficiently by an ‘earlier’ intervention to prevent later interventions, a
continuum of services is needed to identify the most appropriate intervention to
match specific needs at a particular point.3
 Considerable progress has been made in inter-agency working, but there is still
much more to do. Key characteristics of effective integrated working that need to
be in place everywhere include having a shared vision, clear understanding of
needs and identification of gaps, sharp focus on improving outcomes for children,
young people and families, clear and consistent messages communicated to staff
and families, and an underpinning integrated workforce development strategy.
Time needs to be invested to build trust, strong relationships and, ultimately, to
secure buy-in from all agencies.
 To overcome the inconsistencies and confusion about the CAF (Common
Assessment Framework) process, it should be developed into the standardised tool
for conducting assessments for children’s additional needs, and for developing and
agreeing on a process through which agencies work together to meet those needs. •
Evidence suggests that professionals in all kinds of settings may lack confidence
and experience in working directly with parents and families, particularly if they
are disadvantaged. Continuing investment in developing workforce skills and
capacity is essential to effectively engage with parents.

Knowledge is power
Many have observed that we frequently fail to make effective use of the data we already
gather, let alone gather and use systematically what would help us to make real progress.
Existing data, well used and interrogated, would often highlight needs earlier. And asking
the right questions would often lead to more effective forms of intervention. The recent
Ofsted review of Special Education Needs and Disability observed that, “What
consistently worked well was rigorous monitoring of the progress of individual children
and young people, with quick intervention and thorough evaluation of its impact” (p 6). 4
It is the progress, or lack of it, being made by children that often signifies the existence of
a problem. Whilst the practice examples in this publication illustrate data being used

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effectively, the international examples show how much we have to learn from other
countries. It is vital that staff at all levels are able to recognise objectively the value of
their work, and to both measure and question their practice against objective criteria
assessing its impact.

Key message
Evidence suggests that the use of data is a systemic weakness. In short, if we cannot
provide evidence to show that an intervention is having a positive impact, how can we
justify funding it? Evidence should be used as an integral part of the process and as an aid
to innovation. We can learn much from international experience in this area.
 International research suggests that the most successful programmes tend to share
common characteristics: they target specific populations; they are intensive; they
focus on behaviour; they include both parents and children; and they stay faithful to
the programme.
 Effective local practice is characterised by clarity of purpose; interventions are
informed by a comprehensive evidence base; there is a clear analysis of local
needs, including feedback from children, families and practitioners; and, critically,
there is a baseline to enable the intervention to be tracked at key stages following
its implementation to measure impact on outcomes.
 Sufficient analytical capacity within children’s services needs to be addressed as a
workforce development priority (both nationally and locally).

Where is it best to invest?

When resources are scarce, priorities must be clearly established, as it is particularly
important to allocate them where there can be confidence of achieving significant impact
and good value from the investment. Some of the examples described achieve impact
through a targeted focus on specific areas of need across population groups, others target
specific groups and achieve broader benefits. Both approaches can deliver excellent value.

Key message
 The temptation to cut back on investment in early intervention in times of austerity
needs to be resisted, for short term financial gains can lead to long term costs. The
challenge is not, therefore, deciding whether to maintain spending on early
intervention, but working out how to get better value out of the money already
being invested.
 The powerful body of research (home and abroad) showing that what a child
experiences during the early years (starting in the womb) lays the foundation for the
whole of their life, makes a compelling case for prioritising investment in this area.
 In general, targeted approaches tend to be judged more cost effective than universal
approaches. Yet there is little comparative evidence to determine which approach
might be most ‘cost effective’. The evidence suggests that it is unlikely to be a
question of one or the other. What is needed is a range of interventions able to
provide support at different levels of need.
 Spending should be prioritised on children’s centres and early years (in particular
breastfeeding initiatives and the Nurse Family Partnership); speech, language and

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 communication needs; parenting programmes; targeted family support; and young
people on the edge of care.
 Three of the recommended interventions – Nurse Family Partnership, Incredible
Years and Multi-Systemic Therapy – are among the 11 ‘Blueprint’ programmes
identified by the Center for the Study and Prevention of Violence at the University
of Colorado which meet high standards of effectiveness, as part of a review of 800
early intervention programmes.
 The OECD suggestion that expenditure on children should be regarded as if it were
an investment portfolio, and be subjected to a continuous iterative process of
evaluation, reallocation and further evaluation to ensure child well-being is actually
improved, poses a formidable but necessary challenge to this nation. Learning from
international experience in particular can be invaluable in helping us to move
forward, though, ultimately, tough decisions need to be taken at a national and
local level in the best interests of children, families and, indeed, the long-term
prosperity of the country.

6.3 Models of Early Interventions

All children have a right to grow and develop to reach their optimal potential. Young
children who show signs of a delay or disability need an effective system that can
identify them early so that prevention and/or early intervention can begin as soon as
possible. Communities worldwide are in dire need for systems change. Research has
found significant strengths in early interventionists. A strong predictor of outcomes of
early intervention is the relationship of a primary service provider with the family

Parents need to play an important role in early intervention services to have a significant
effect on children's developmental and social-emotional well-being. Interventions such as
parent support, education, training, strengthening family networks, peer support, etc. can
help build parents’ self-esteem and skills, improve parents’ long-term employability, and
enhance children’s well-being and development. The idea of prevention and early
intervention is to support parents and families before problems arise. Only in this way
can we avoid huge long-term costs associated with family breakdown, poor mental health
and social exclusion

An important challenge ahead for the early intervention field is to understand the relative
effects of different approaches for children with different developmental needs. There is
debate in the literature about the role of parent education and training in early
intervention. On the one hand, parents appear to want parent education, and studies show
a relationship between mother-child interactions and early intervention effectiveness. On
the other, there is concern about the potential of parent education to alter the nature of the
home, changing it from a natural environment to an unnatural one, and disrupting family
relationships. One meta-analysis found that children receiving direct educational
experiences showed larger and more enduring benefits than those in programmes relying
on intermediary routes, such as parent training.

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Another mediating view is that parent education be a particular kind of parenting support –
one of a number required by parents - and that professionals’ interactions with families should
emphasise support as well as education, when this is identified as a priority for parents.

Model of Support
Portage is a model of support for children and families which can be adapted and used
effectively both in the home and in early years settings. Portage is a home-visiting
educational service for pre-school children with special needs and their families.

Portage aims to;work with families to help them develop a quality of life and
experience, for themselves and their young children, in which they can learn together,
play together, participate and be included in their community in their own right play a
part in minimising the disabling barriers that confront young children and their families
support the national and local development of inclusive services for children.

The specific components of the original Portage Model included child assessmentusing
formal standardized tools and informal curriculum assessment. Using thisassessment
information, the home teacher and parent target skills and behaviors to betaught. Typically,
three to five specific behaviors are selected during each weekly homevisit. This is how it
works. A family that has a child, suspected of having a disability, isreferred to a program
that uses the Portage model. In Japan, for example, the family isreferred to the Japan
Portage Association (JPA). The parents bring the child to the JPA forassessment. If the JPA
determines the child has an intellectual disability it will recommendthe family use the
Portage kit. The Portage kit is an Activity Card File that consists of 580developmentally
sequenced behaviors from birth to age six in five areas: Socialization,Self-Help, Language,
Cognition, & Motor. The parents are taught how to use the cards tohelp their child develop.
The parents keep a checklist to track the child’s’ progress. Incase of the JPA, the
rehabilitation worker never goes out to the home, the clients alwayscome to the JPA. In this
case Portage may be institution based - hence contributing to thecontroversy of Portage as a
CBR tool. See CBR NEWS No. 10, January 1992.

However, contrary to institutional rehabilitation, therapy takes place in the home while
thechild is functioning and adjusting in the community.

At one time, the field of early intervention was organized as though it were about
professional support (e.g., therapy sessions) leading directly to child outcomes.
Caregiver
Competence &
Confidence

Professional Child
support Outcomes
Figure: 3 Pattern of Influence

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Unfortunately, perhaps, this did not lead to large effects on developmental trajectories
(Dunst, 1985). Caregivers, however, can exert much influence on how children turn out,
because they spend many hours with the child every week. We in turn can have a
profound pressure on caregivers’ competence and confidence, because adults can learn in
small time spans and can generalize. Our best route t child outcomes, therefore, is
through caregivers. Specifically related to home visits, it is the family-child interactions
and other learning opportunities occurring between home visits that lead to child
learning.Effective home visits are one of the components of the model. The following
table shows each component alongside the corresponding specific practice:

Table: 1 components of the model

Ecomap
Various needs converge to result in developing ecomaps with families in order to show
our interest in the family, not just the child. The reason we know the family is because of
the child, but the child lives in a family, not a vacuum. A friendly, interested relationship
is established with the family. Developing an ecomap during intake visits or at some
early point of acquaintance with a family can therefore be beneficial.

Figure: 4

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The first people to determine are those living with the child, are placed in the middle box
and no questions are asked about intrafamilial relationships. So, commonly, questions are
asked about the mother’s family, the father’s family, neighborhood and family friends,
the mother’s friends, and the father’s friends. Intermediate supports include worship
friends and work friends. Formal supports include doctors, teachers, therapists, and
financial agencies. To determine the approximate amount of support provided by each of
these agents, one can ask such questions as ·“How often do you see or talk to them?”
·“How do you get along with them?” ·“If something cool happened with one of your
children, who would you call?” The thicknesses of lines represent three levels of support.
The fattest lines represent very supportive agents, the slightly thinner lines represent
moderately supportive agents, and the thinnest lines represent agents who are present but
do not provide much extra support. We use dotted lines to represent sources of stress. It is
possible to have a solid and a dotted line. See paternal grandparents in the example
ecomap, where they babysat Michelle (quite a lot of support) but Sarah’s mother-in-law
also told her how she should be raising Michelle (stress). The ecomap is a valuable
method for understanding the family ecology.

The Routines-Based Interview

The needs for a routines-based assessment, of which the interview is the main practice, are
numerous. A method is needed to produce functional goals or outcomes—also known as
target behaviors. Functional child outcomes are those that address participation or
engagement needs, that address independence needs, and that address social-relationship
needs. Outcomes need to be broad enough yet specific enough. Strategies are needed to aim
directly at the function problem (i.e., teach first). Finally, caregivers other than the family
(e.g., teachers) need to be invested in the IFSP. The routines-based interview (RBI) can
meet these needs. The RBI evolved through two models, the currently described one for
EINE and the Individualizing Inclusion model. The latter consists of three components: (a)
functional intervention planning through the RBI, (b) therapy and consultative special
education integrated into classroom routines, and (c) embedded interventions.

The RBI therefore is central to both homeand classroom-based interventions. In this

model, routines are not activities the professional sets up with the family. Instead, they
are naturally occurring activities happening with some regularity. They include both
caregiving events and hanging out times. Although we are reminded constantly that a
good RBI will produce information far beyond a listing of daily events, it is true that not
everything happens in routines. Hence, at the time of the interview, we ask first about
major concerns the family has. At the end of the interview, we ask if there’s anything else
to be talked about. The RBI as we have defined it was first described in Family-Centered
Intervention Planning:

A Routines-Based Approach
Five stages were delineated:
i. Family and staff preparation for the interview;
ii. The routines-based interview itself;
iii. Outcome selection by the family;

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iv. Writing of objectives and strategies by professionals with family input;
v. Review in subsequent months.

Preparation for the interview simply consists of asking the family and any child care staff
to think about their daily activities and events and to consider how well the child
functions in each of those “routines.” They are alerted that the structure of the planning
meeting will be routines. Forms are available in the book for those who like them!
Another dimension of the preparation is who will be there and where the interview will
take place. The family should be given free choice or a broad array of choices. The
interview itself begins with families reporting on their routines first. This sets the stage
for respecting families’ points of view. Child care staff report on “classroom” routines
second, if the team is lucky enough to be able to interview both the family and the child
care staff at the same meeting. One or two people can conduct the interview; it is helpful
to have a second person to take notes; perhaps score a developmental tool, based on the
reports of child functioning in routines; keep children occupied; and help ask questions.
Any questions should be asked during discussions of routines; specialists do not have a
time when they ask all the questions pertaining to their discipline. Professionals withhold
giving advice, so they do not become the expert and change the balance of listening.
Because once the family starts getting advice, they are less likely to be forthcoming
confidently about what goes on during their routines. For each routine, the interviewer
indirectly asks six questions:
i. What does everyone else do? For home routines, this means other family members;
for classroom routines, it means other children.
ii. What does the child do?
iii. More specifically, what is his or her engagement like—how and how much does
the child participate in the routine?
iv. What is his or her independence like—how much can the child do by him- or
herself?
v. What are his or her social relationships like—how does the child communicate and
get along with others?
vi. How satisfied is the caregiver with the routine? This is the big question. If desired,
the interviewer can get a score for this satisfaction with the routine.

The RBI leads to more functional outcomes than do other methods, especially the well-
meaning question. What are your concerns? That question usually yields a couple of
vague statements about walking and talking. The other common method is to pick failed
items from a test or curriculum, which might have little meaning in the child’s and
family’s life.

By producing 6-10 outcomes, the RBI tends to be more specific than many IFSPs and
tends to have more family-level outcomes. Here is one real list from an RBI:

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 Original words from notes Stated in outcome from
1. Moving on stuff outside & inside (e.g., Elliott will play with movement on three
going up stairs pieces of equipment for 5 minutes each so
he participates more.
2. Texture outside Elliott will play in the sandbox or move
on the grass for 10 minutes 3 times in a
row so he participates more
3. Why not eating more? Family will find out from a qualified
professional why Elliott does not eat more
than the does
4. Eating Variety of foods Elliot will eat a balanced diet as
determined appropriate by the family and
a nutritionist so he will be healthy.
5. Picking up food Elliott will use a fine pincer grasp to
finger feed so he can eat more efficiently.
6. Making church easier Mary will have 7 activities she can give
Elliott or Katie to keep them occupied
during church so church participation is
easier for Mary.
7. Making choices Elliott will choose one of two objects
presented at meals, dressing, or hanging-
out time, daily for 5 days, to begin
functional communication.
Table: 2

Where does on fit in the ecomap and the RBI? This is a “local question” meaning the
early interventionists or programs need to decide this, based on their systems. Most
systems have a process involving a referral, an intake visit, a multidisciplinary
evaluation, and IFSP completion. So professionals need to ask who does what, when. The
answers might differ for children entering the system with established conditions (who
therefore do not need to be tested, even though they need a multidisciplinary evaluation),
with obvious delays (who therefore will definitely meet eligibility criteria for delays), and
with suspected delays (who should probably be deemed eligible before proceeding with
an RBI).

As we conclude the section on the RBI, we should state the four principles needed to
understand this model: 1. It’s the regular caregivers who influence the child, and
professionals can influence the family; 2. Children learn throughout the day; 3. All the
intervention for the child occurs between professionals’ visits; and 4. It is maximal
intervention the child needs, not maximal services.

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Figure: 5

To explain this last distinction, intervention is learning opportunities afforded the child
and these naturally come from those who spend time with the child, such as parents, other
family members, and child care providers. Services are the professional supports,
provided intermittently (e.g., weekly) for short (e.g., 30-60 minutes) durations. As
discussed earlier, early intervention was founded on a belief that professional supports
would lead directly to child outcomes. Note that professional supports in the form of
classroom teaching can still lead directly to child outcomes. But, in home settings, the
path to impact on child outcomes is through caregiver competence—their knowing what
to do—and confidence.

This model uses transdisciplinary home visits as the best approach to achieve caregiver
competence and confidence, as will be described in the next section. For children
spending considerable time during the week in classrooms (e.g., child care settings),
professionals supports are best provided, according to this model, through integrated
services, which will be described in the Collaborative Consultation section of this article.
Integrated therapy and special instruction lead to embedded interventions, which is what
can have an impact on positive child outcomes. The model therefore shows that
professional supports are most effectively used in working with the adults who can make
a difference in the child’s life.

Primary Service Provider Approach

In the EINE model, one professional provides weekly support to the family, backed up by
a team of other professionals who provide services to the child and family through joint
home visits with the primary service provider. The intensity of joint home visits depends

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on child, family, and primary service-provider needs. It is designed to address some of
the problems with the multidisciplinary approach, in which different professionals work
directly with the child and family and rarely communicate with each other.

First, the multidisciplinary approach implies that interventions for the child occur during
the home visits, rather than between visits. Second, it implies that the family needs
massive doses of demonstration, since that is a common rationale for all those visits.
Third, it separates child functioning into domains related to disciplines, such as OT for
fine motor, PT for gross motor, and speech-language therapy for communication. Fourth,
it requires much family time, which is known as an “opportunity cost”—one rarely
considered when programs talk about the cost of services. Fifth, it allocates scarce
resources inappropriately, when most children receive multiple visits by multiple
providers in a month or even in one week.

The transdisciplinary approach, which is synonymous with PSP, is needed because (a) we
need a method that emphasizes how children really learn, (b) we need a plan that is
unified around the family’s functional needs, (c) we need to capitalize on families’
forming close relationships with a primary service provider, (d) we need to use specialists
as efficiently as possible, and (e) we need to use our limited resources most effectively.
The primary-service-provider (PSP) approach works with the PSP alone, making most of
the home visits, with occasional visits with a colleague—a team member representing
another service. It works best if an RBI has been used to develop the IFSP, because the
resulting list of outcomes is not driven by justification for a service but by family
priorities. Either a generalist such as an educator or a child development professional or a
specialist such as an OT, a PT, or a speechlanguage pathologist can be a PSP. When a
combination of generalists and specialists is used, which will be the frequent case;
generalists will spend most of their time on their caseload families, making occasional
consults with others’ families. Specialists, on the other hand, will spend most of their
time consulting but being the PSP for a few families.

To decide who on the team should be a particular family’s PSP, the team can consider at
least three factors. First, they might consider geography, giving the family to a PSP who
is already seeing families in that region. Second, they might consider caseload size,
giving the family to a team member who has relatively fewer cases. Third, they might
consider matching the PSP’s interest or expertise. Aligning PSPs to families can occur in
early intervention programs but is difficult to do in states using a vendor approach, where
individual providers are contracted to serve Part C families. In those states, providers are
extremely concerned about who gets the business; in fact, they might derail the approach
because of this concern. The PSP approach is not without its skeptics; in fact, some
people are terrified of it! As Oscar Wilde said, however, “the basis of optimism is sheer
terror.” And Helen Keller said, “No pessimist ever discovered the secret of the stars, or
sailed to an uncharted land, or opened a new doorway for the human spirit.” Therefore,
once specialists have recovered from their terror and become optimistic, not pessimistic,
they will see the impact of this approach.

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The approach is consistent with the principles articulated earlier that all the intervention
occurs between specialists’ visits (that’s when children learn), that therapy and
instruction are not golf lessons (young children cannot process massed trials and cannot
transfer skills effectively), and regular caregivers (not specialists working directly with
the child need to own the goals.

Support-Based Home
Visits Many home visits are little more than a clinic-based model dumped on the living
room floor. Many involve a toy bag. Many ignore the complex, interrelated needs of
developing children and their families. An alternative is based on the view of support as
the goals of services. Three types of support have been identified as a basis for family-
centered home-based early intervention emotional, material, and informational. In a study
of familycentered service providers, five characteristics were identified: positiveness,
responsiveness, orientation to the whole family, friendliness, and sensitivity.These
characteristics define both how to behave with families and what to talk to them about.
They can be considered the distillation of emotional support.

Material support consists of two general categories:

i. equipment and materials and
ii. financial support.

Informational support consists of four kinds of information most families want:

i. child development,
ii. the child’s disability,
iii. services and resources, and
iv. what to do with the child.

6.4 Concept and Significance of Multi-Disciplinary Approach

Timely and periodic assessment of young children’s development makes it possible to
identify and treat developmental disabilities at the earliest possible point of manifestation
and to prevent loss of developmental potential. It can also help to identify developmental
risk factors and target effective anticipatory guidance to provide parents with strategies
for promoting optimal developmental outcomes. Accurate early recognition and
management of neuro-developmental delay present with unique challenges for several
practitioner at several different levels, but is critical to the well-being of children and
their families and is a central precondition to their correct evaluation and management.
Clinicians should encourage parents to participate in early intervention programs,
because high-quality maternal interactive behaviors are known to be correlated with
improved developmental outcomes in developmentally delayed children.

A common approach to early identiϐication is to ensure optimal intervention and

limitation of secondary disabilities is developmental surveillance. Screening as part of
surveillance programme takes place at different specified times and in different places
including delivery points, home visits by accredited professionals, special children

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centers and at schools. In the United Kingdom, every child from birth to the age of 5
years beneϐits from the Healthy Child Programme (HCP), which incorporates preventative
and health promotion strategies for ensuring the health and wellbeing of children in
England. One of the HCP’s core functions is to recognize disability and developmental
delay, to ensure that children receive appropriate referral to specialist services, and families
are signposted to wider support services. It provides an invaluable opportunity for
screening tests and developmental surveillance, assessing growth, identifying social and
emotional risk factors, providing additional ongoing support to families that are in need of
emotional and social support and to children who are at risk of poor outcomes

Developmental assessment programs benefit from the involvement of a wide variety of

professionals who are part of a multi-disciplinary team, each suitably skilled and prepared
to meet the needs of the children and their families. Multidisciplinary and inter-professional
approach has been documented to be effective in the management of many childhood
situations spanning from healthy child surveillance to inpatient mental health care.

The primary care provides a unique area of potential ample opportunities for training and
promotion of high-quality developmental surveillance. Developmental or neuro-
behavioral Pediatricians constitute the lead professionals involved in the care and
management of children and adolescents with neurodevelopmental disorders.
Assessment, investigation, and consultation with the family are part of the prime
responsibility of the Pediatricians, in collaboration with a multidisciplinary team,
including a thoughtful assessment of the child and family needs. Neuro-behavioral
Pediatricians (NBP) with care of children who have problems of biological origin,
presumed if not demonstrated, that impact on the child’s development and/or behavior. It
involves a complex interplay of not only individual child but also their social systems and
context, involvement of multidisciplinary services including physical and mental health,
social and justice services

There is wide variation in the timing of developmental milestones from child to child,
but every child develops continuously according to his or her own pattern. Specific
developmental disorders such as dyslexia, attention-deficit hyperactivity disorder, autistic
spectrum disorder and auditory processing disorders (APD) often co-occurs with
impairments of language, literacy, and attention. Each child often requires a multi-
professional approach to the diagnosis and management. It is essential to ensure that
children have access to the most appropriate range of support and intervention. Many
categories of professionals are often involved, including therapists (Speech and language,
Occupational therapists), psychology and mental health professionals, Pediatricians,
primary care professionals including nurses, social care professionals, allied healthcare
professionals (e.g. Audiology/Vestibuloauditory), educational staff including Educational
Psychologist, Early-years practitioners, and nursery nurses

Speech and language delay is one of the commonest NDD in preschool children in most
populations. The outpatient consultation for a child with speech and language delay often
requires a multidisciplinary approach and should consist of a structured history,

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examination, and relevant targeted investigations with the aim of identifying whether the
delay is primary or secondary in nature,. lead to a correct diagnosis of the delay and
enable appropriate treatment. It also requires full cooperation from the child’s parents.
Preschool neurodevelopmental disorders often affect multiple inter-related areas and co-
morbid or co-occurring disabilities are often the norm rather that the exemption. The need
for effective and comprehensive services and efficiency within interdisciplinary teams is
therefore oftentimes paramount. Autistic Spectrum Disorder (ASD) is one of the other
common and significantly debilitating neuro-behavioral disorders manifesting from
preschool age.

The combination of symptoms of Attention Deficit Disorder (ADHD) and ASD in the
same children is common and a number of overlapping co-morbidities have been
reported. Children with the combined symptoms tend to have a lower IQ mean, a higher
autistic symptoms severity and will tend to present very early in preschool age. Most of
the parents and the teachers of children with suspected ASD, have their first concern
about the child’s development before the child’s second birthday. Improved long-term
outcome in children with ASD has been related to earlier parental concern, earlier
referrals to specialists, and earlier and more intensive interventions. Surgical
professionals including the Otolaryngologist play a key role in the multidisciplinary
management of individuals with ND disorders such as ASD, Auditory processing
disorder (APD) and Downs Syndrome, due to the high prevalence of otological pathology
amongst these patients. ASD patients have a higher incidence of profound sensorineural
hearing loss, middle ear infections, and abnormalities of the cochlear nerve and brainstem
auditory pathways. There are cortical and brainstem neurodevelopmental abnormalities in
the way auditory information is interpreted and processed in the ASD patient. Early
intervention has moved from a traditionally multidisciplinary approach towards
interdisciplinary and transdisciplinary practice. An interdisciplinary model is one where
members of a team employ their own perspectives, assessing and working with children
separately, but then discussing their finding and reaching decisions collaboratively. A
transdisciplinary model requires early intervention professionals involved in a team to
provide integrated interventions. One person, in collaboration with team members, accepts
the primary responsibility for implementing a child’s individualised plan. An “exchange of
competencies” between team members is usually achieved through role release.

Advantages of a transdisciplinary model include the fact that it is less of an intrusion into
family systems, and encourages increased communication among team members and
consistency in the implementation of the intervention plan.

In many cases, early intervention professionals will also collaborate closely with early
childhood education staff to deliver an intervention. However, early intervention
professionals must be aware of the possibility of excluding early childhood teachers by
adopting the role of the “expert” in their interactions with both children and teachers.
Effective collaboration requires the establishment of positive relationships among early
intervention professionals, early childhood education teachers, and parents (or other
caregivers).

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Key principles for interdisciplinary models are that:
i. teams, including family members, make decisions and work together
ii. professionals cross disciplinary boundaries
iii. intervention is focused on function, not services

Multidisciplinary teams with interdisciplinary approach and holistic integrated services

for assessment of developmental delays have been established in a number of countries
including India, Finland, Sweden and the UK. This approach ensures a healthy dynamic
future for all children. Multidisciplinary professional team (MDT) approaches are already
the standard mechanism for delivering mental health care and other chronic diseases such
as cancer in several settings, including health care professionals, policy-makers and
patient representatives

The aim of integrated working was to ensure that no children fell through the gaps
between services, and to reduce duplication of work by multiple services in a culture of
increasingly high stakes accountability. A number of tools were mandated that apparently
facilitated integrated working such as the ‘common assessment framework’, the role of
the ‘lead professional’, a data base of information available to all services called ‘contact
point’ and ‘information sharing’ protocols. Preschool developmental surveillance
programs need to be holistically structured in order to be effective. Inter-professional
collaboration is an important aspect of successful developmental intervention therapies.
Advantages of a transdisciplinary model include the fact that it is less of an intrusion into
family systems, and encourages increased communication among team members and
consistency in the implementation of the intervention planthe justification for early
identification is that it leads to better outcomes of the child as it,
i. Help prevent child abuse and neglect
ii. Mitigate the effects of abuse and neglect
iii. Improve parenting skills
iv. Strengthen families
v. Improve the child's developmental, social, and educational gains;
vi. Reduce the future costs of special education, rehabilitation and health care needs;
vii. Reduce feelings of isolation, stress and frustration that families may experience;
viii. Help alleviate and reduce behaviors by using positive behavior strategies and
interventions;
ix. Help children with disabilities grow up to become productive, independ
independent individuals
x. Assistance with technological devices, counseling, and family training.

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6.5 Self-Assessment Questions
Answer the following questions;
1. Define early identification and assessment.

2. What are different services included in early intervention system?

3. What are the benefits of early identification and intervention? Also quote research
findings?

4. Briefly outline part C of The Individuals with Disabilities Education Act(IDEA).

5. How current technology is helpful in finding special children, and how much early
special needs can be identified?

6. What do you know about risk registries, and how do one can identify special needs
through risk registry.

7. Describe some of the assessment tools recommended by American Academy of

Pediatrics?

8. What are these? RTI, ECOMAP, RBI, and Parenting shops.

9. Describe five golden threads brought together in order to develop a coherent

strategy for systemic change.

10. Discuss in detail about multi-disciplinary approach for early intervention.

6.6 Web Links

Visit the following web sites for the in depth study.
http://www.floridahealth.gov/alternatesites/cms-
kids/providers/early_steps/training/documents/early_intervention.pdf

http://www.parentcenterhub.org/ei-overview/#

http://teachersofindia.org/en/article/special-needs-identification-and-intervention-early-
childhood-years

http://www.family-friendly-fun.com/special-needs/early-intervention.htm

https://www.educationcounts.govt.nz/publications/special_education/22575

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4538781/

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Unit: 7

ATTITUDES TOWARDS HANDICAPPED:

INDIVIDUAL, FAMILY AND COMMUNITY

Written By:
Dr. Tanzila Nabeel

Reviewed By:
Dr. Shaista Majid
 INTRODUCTION
An attitude is a disposition based as a positive or negative evaluation of people, objects,
event, activities, ideas, or just about anything in your environment. They encompass, or
are closely related to, our opinions and beliefs and are based upon our experiences. Since
attitudes often relate in some way to interaction with others, they represent an important
link between cognitive and social psychology. Attitudes are expected to change as a
function of experience.

Structure of Attitudes
According to Saul McLeod, (2009) Attitudes structure can be described in terms of three
components.

Affective component: this involves a person’s feelings / emotions about the object which
are positive, neutral, or negative. For example: “I am scared of snakes”.

behavioral (or conative) component: the way the attitude influences our act. The
behavioral component consists of a person’s tendencies to behave in a particular way
toward an object. For example: “I will scream if I see a snake”.

Cognitive component: this involves a person’s belief and information about an object.
For example: “I believe snakes are dangerous”.

This model is known as the ABC model of attitudes. The three components are usually
linked. However, there is evidence that the cognitive and affective components of
behavior do not always match with behavior.

The Function of Attitudes

Attitudes can serve functions for the individual. Daniel Katz (1960) outlines four
functional areas:
 Knowledge
Attitudes provide meaning (knowledge) for life. The knowledge function refers to
our need for a world which is consistent and relatively stable. This allows us to
predict what is likely to happen, and so gives us a sense of control. Attitudes can
help us organize and structure our experience. Knowing a person’s attitude helps
us predict their behavior. For example, knowing that a person is religious we can
predict he/she would be very particular in praying regularly.

 Self / Ego-expressive
The attitudes we express help communicate who we are and may make us feel good
because we have asserted our identity. Self-expression of attitudes can be non-
verbal too. Therefore, our attitudes are part of our identity and help us to be aware
through expression of our feelings, beliefs and values.

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 Adaptive
If a person holds and/or expresses socially acceptable attitudes, other people will
reward them with approval and social acceptance. For example, when people
flatter their bosses or instructors (and believe it) or keep silent if they think an
attitude is unpopular. Again, expression can be nonverbal. Attitudes then, are to
do with being apart of a social group and the adaptive functions helps us fit in with
a social group. People seek out others who share their attitudes, and develop similar
attitudes to those they like.

 The ego-defensive function

Refers to holding attitudes that protect our self-esteem or that justify actions that
make us feel guilty. For example, People whose pride has suffered following a
defeat adopt a defensive attitude.This function has psychiatric overtones. Positive
attitudes towards ourselves, for example, have a protective function (i.e. an ego-
defensive role) in helping us reserve our self-image.

The basic idea behind the functional approach is that attitudes help a person to
mediate between their own inner needs (expression, defense) and the outside world
(adaptive and knowledge).

OBJECTIVES
The objectives of the unit are to enable the students to;
1. differentiate between positivity and negativity from which the corresponding
attitudes arise.

2. know the underlying dynamics of positive and negative attitudes are.

3. understand the social psychology of the handicapped and relate it attitudes of

people and surroundings.

4. comprehend the Goffman’s theory of Stigma.

5. know the cognitive and social characteristics of people with disabilities.

6. relate the effects of disabilities on the family and its social relationships in the
community.

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7.1 Positive and Negative Attitudes
Each of us is made up of various physical, vital and mental parts. There is our physical
body and its organs, muscles, etc; the vital being with its sensations, emotions and
feelings, and the mental part with its thoughts, memories, reasoning power, beliefs, etc.
Somewhere between our emotions and our thought processing lie our attitudes -- our
emotional perceptions about ourselves, others, and life itself.

It can be said that attitude is a psychological tendency that is expressed by evaluating a

particular entity with some degree of favor or disfavor" (Eagly & Chaiken, 1993, p. 1). It
is nothing but a point of view one holds for other people, situations, event, object, places,
phenomena, or beings. Basically, there are three components of attitude namely,
emotional, cognitive, and behavioral that relate to feelings, information or thought
process, and the course of action, respectively.

Being humans, we tend to have different types of attitudes that may or may not change
with time. Positive attitude is an optimistic approach of a person to achieve good results.

Resourcefulness and determination are leading attributes to look for options or other
alternatives when confronted with problems that need remedial measures. Whereas,
Negative attitude is a pessimistic mind-set of a person who is not capable of handling
critical issues as he easily gives up and does not bother to explore available means that
lead to the resolution to an issue or problem.

It is essentially like an evaluative statement that is either positive or negative depending

on the degree of like or dislike for the matter in question. e.g., when I have good feelings
towards my work or co-workers, my attitude is positive. When I feel reluctant to do
certain things that are necessary, or show hostility towards certain individuals, then my
attitude is negative. As humans we are all the time thinking, feeling or doing something.
These three things make the baseline for developing attitudes reinforced with beliefs and
expressed through behaviors. Beliefs represent what we have learned or come to know
through experience and behavior represents what think about that particular entity.

Differences Between People Having Positive and Negative Attitudes

People with Positive Attitude People with Negative Attitude

 Would say 'I can'.  Would say 'I can't',
 focuses on solutions of the problem  remains in trouble
 pays attention to the virtues of  pays attention to other peoples
others. shortcomings
 will find only positive things at  will find a complaint at anyone
others.
 always see opportunities.  see only limitations

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Activity
Dear students; let’s do some brainstorming for the ways how we can keep ourselves away
from negativity. Before you move on to the next part of the chapter,

Step 1: Evaluate yourself for your attitude

Close your eyes and concentrate how do you respond towards people around you? (Make
a sketch in your mind about your own responses towards people, things and
surroundings.

Step 2: Analysis
Bifurcate your findings about yourself into Good/ Bad, Right / Wrong, Acceptable / not
Acceptable, Positive / Negative.

Step 3: Result
Now place yourself about your mental tendency weather
a. you take your surroundings positively or negatively.
b. What proportion of your thought process is inclined towards positivity and how
much is inclined towards negativity.

Now let’s try to improve the negativity. We can use following guidelines:

10 ways how to protect yourself from negativity

i. Don't take other people's negativity too personal,
ii. Spend your time as much as possible with positive people,
iii. Show others that it's possible to be successful if you think positive. Protect your
own visions from negative influence of others,
iv. Control the way you think. No one can control your mind and you have the power
to create your own vision,
v. Always be focused on solving of existing problems,
vi. Talk to people from your heart. Give them compliments. Be the best you can be, in
that way you will awake a positive attitude in them,
vii. Always support people around you,
viii. Keep on mind that the life is full of ups and downs,
ix. Focus yourself on what's happening today and don't waste your energy on things
that has passed,
x. Stay away from negativity, in that way you will leave space to positive things in life.

“Don't forget that life is a crazy ride. Learn the rules of driving and don't drive with
a high speed on curves and narrow roads”.

Positive and Negative Attitudes

Attitude is a state of mind that involves beliefs and feelings that influence our behavior
and the decision we make.

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A positive attitude enables people to be in a very optimistic state of mind. A positive
attitude helps to avoid worries and negative thinking. Positive attitude brings constructive
changes into the life. With a positive attitude one sees the bright side of life. A person
with a positive mindset is able to write negative events off as an incident and take the
chance to learn from their mistakes to avoid these bad happenings in the future.

Positive attitude manifests in the following ways

 Positive thinking.
 Constructive thinking.
 Creative thinking.
 Optimism.k2
 Motivation and energy to do things and accomplish goals.
 An attitude of happiness.

Positive Thinking
Hara Estroff Marano, editor in chief of "Psychology Today" magazine, reports that the
average person generates 25,000 to 50,000 thoughts per day. Beginning in 1952 with
Norman Vincent Peale's book, "The Power of Positive Thinking," a large school of
thought has developed around the idea that happiness and unhappiness are largely
byproducts of thoughts and that "negative thinking" results in a variety of psychological
and physiological disorders. The remedy, according to these thinkers, is to exercise
control over your thoughts to achieve health, serenity, an enhanced sense of well-being
and increased personal effectiveness at work and at home.

Creating a Positive Attitude

It can take a little time and effort to create the habit of a positive attitude if it is not
something you are accustomed to doing. One way is to catch yourself when you are
having a negative thought and form a new positive script in response. Dr. Ronald
Rubenzer of the Midwest Center for Stress and Anxiety suggests that you can convert bad
stress into good stress through your thoughts. Instead of feeling "stressed out," turn the
situation into an exciting opportunity for growth and achievement. Learning the power of
a positive attitude can make your life more manageable and fulfilling.

Negative Thinking
Attitudes are organized collections of thoughts about a particular issue. To think positively,
you need to eliminate certain negative thinking patterns that nearly everyone indulges in at
least some of the time. These include the four major types of negative thinking:
 Filtering,
 Personalizing,
 Catastrophizing and
 Polarizing.

Filtering refers to psychologically screening out the encouraging aspects of complex

scenarios. Personalizing means automatically blaming yourself every time something bad
happens. Catastrophizing is expecting the worst possible outcome in any situation, and

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polarizing is a type of black-and-white thinking that defines failure as any result short of
perfection.

What Lies Underneath?

Negative attitude is developed for a variety of reasons. Sometimes it appears in response to
the unliked and unwanted circumstances which are not acceptable or out of control for the
person. The uncontrollable circumstances develops defiance behavior to express the disliking.
Sometimes parents’ unnecessary disciplinary rules produces such feelings in children.

A positive frame of mind can help you in many ways, such as

 Expecting success and not failure.
 Making you feel inspired.
 It gives you the strength not to give up, if you encounter obstacles on your way.
 It makes you look at failure and problems as blessings in disguise.
 Believing in yourself and in your abilities.
 Enables you to show self-esteem and confidence.
 You look for solutions, instead of dwelling on problems.
 You see and recognize opportunities.
 It helps you achieve goals and attain success.
 It brings more happiness into your life.
 It produces more energy.
 Positive attitude increases your faith in your abilities, and brings hope for a brighter
future.
 You become able to inspire and motivate yourself and others.
 You encounter fewer obstacles and difficulties in your daily life.
 You get more respect and love from people.
 Life smiles at you.

Negative attitude says: you cannot achieve success.

Positive attitude says: You can achieve success.

A positive attitude creates belief and determination. One can handle life’s hurdles and
obstacles with confidence and determination. Positive attitude rears thoughts and actions
in positive way. When we interact with other people we broadcast our attitude. The way
we approach others can have a huge impact on our relationship. A positive attitude is one
of the core components of self - confidence. If you struggle with your self-confidence.
Developing a positive attitude is about making everything in your life positive. That
means associating with positive people, keeping yourself in positive situations and
surrounding yourself with positive things. You have to get rid of negativity. You have to
start being positive about everything. You are paving your road with the positive and this
will lead you to positive results.

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Steps to Develop Positive Attitude
a. Tell yourself “you can change”:
When something is done with conviction it does emerge into reality. Write down
the three greatest moments of change in your life that have brought you to being
the person you like being today. Hang your list in your bathroom or above your
desk to encourage you to adapt your attitude and stay positive.
b. Change the Environment:
New environment can change your perspective for the better. If you're stuck,
expose your brain to a new environment—physically go to another place, or read or
look elsewhere—to gain a positive change of attitude.
c. Re-Energise Yourself
Lower energies express lower morale. Energies need to be rejuvenated. The brain
interprets lack of sleep as a threat to the central nervous system. Missing one night
of sleep can cause you to remember 59 percent fewer positive words, which could
make you overly focus on the negative. If you are well rested and just fed, it will be
easier to see the broader range of valuable details, information, and possibilities.
d. Demarcation of Positive and Negative
There are always two sides of the picture. No matter how bleak a situation appears
it always has a silver lining - Why not take the positivity out of it. For instance
think of a situation which is not liked by you, then try to find at least three positive
things from there. You would certainly come up with it.
e. Talking to the Right people
Continually talking to like-minded people could mean you hear the same
perspective on repeat, which discourages problem solving. To get a positive
attitude, seek out different viewpoints to recognize all aspects of the issue.
f. Channel your stress
Stress makes every bad situation worse. Hormones released during stress can boost
memory and reasoning ability. Teaching yourself to think about the positive
aspects of stress can actually improve performance as well as physical and mental
health. Aim to direct the stress into a more confident delivery.

7.2 Attitude and Social Psychology of the Handicapped

Social psychology studies how people act, think, and feel in the context of society. That
is, how people's behaviors, thoughts, and feelings change because of other people.
Social psychologists therefore deal with the factors that lead us to behave in a given way
in the presence of others, and look at the conditions under which certain behavior/actions
and feelings occur. Social psychology is to do with the way these feelings, thoughts,
beliefs, intentions and goals are constructed and how such psychological factors, in turn,
influence our interactions with others.

Baron, Byrne & Suls (1989) define social psychology as ....

'the scientific field that seeks to understand the nature and causes of individual behavior
in social situations' (p. 6). It therefore looks at human behavior as influenced by other

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people and the social context in which this occurs. Social psychology bridges the interest
of psychology (with its emphasis on the individual) with sociology (with its emphasis
on social structures).

Social psychology attempts to understand the complex relationship between minds,

groups, and behaviors in three general ways. First, it aims to describe how the thoughts,
feelings, and behaviors of individuals are influenced by the actual, imagined, or implied
presence of others. This includes areas like social perception, social interaction, and
social influence (including trust, power, and persuasion). There is a strong interest in how
perceptions and thoughts, as well as social cues, affect individual behavior in this area.
Second, social psychology attempts to describe the influence that individual perceptions
and behaviors have on the behavior of groups. This includes research on areas such as
group productivity and decision making. Third, social psychology explains the dynamics
of groups as behavioral entities. Research in this area investigates the relationships that
one group has with another group, and/or the influence one group has on another group.
Some of the topics of focus within social psychology are listed below:
 attribution
 persuasion
 prejudice
 social perception
 conformity
 social influence
 group dynamics
 interpersonal attraction

Stages of Adjusting to Disability

The stages of adjusting to disability include four basic ones. These stages include shock,
denial, anger/depression, and adjustment/acceptance. People progress through these
stages at their own pace.

 Shock
Shock involves a state of both emotional and physical numbness that can last from
a few hours to several days.
 Denial
Denial may last anywhere from three weeks to two months and is a defense
mechanism that allows the implications of the new disability the person has
experienced to be gradually introduced. Denial only becomes an issue when it
interferes with the person's life, forms of treatment, or rehabilitation efforts.
 Anger/Depression
Anger and depression are reactions to loss and the person's change in social
treatment and status. The person may experience a number of different emotions
during this stage and grieve for the changes in their body image, function, loss of
future expectations, or former satisfaction based upon any function that has been
lost.

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 Adjustment/Acceptance
The stage of adjustment and acceptance mean the person has accepted disability
with its realistic potentials and limitations. The person might benefit from
interactions with others who experience forms of disabilities, and becomes
comfortable with who they are.

Attitude Towards Disability

Emotional aspects associated with disability are many times a major factor in determining
the person's outcome. Many people experience more than four stages of adjustment to a
physical disability; in fact - people might experience as many as twelve stages that include:
 Shock
 Anxiety
 Bargaining
 Denial
 Mourning
 Depression
 Withdrawal
 Internalized anger
 Externalized aggression
 Acknowledgment
 Acceptance
 Adjustment

There may be two reasons for the scarcity of contact between disabled and non-disabled
people: lack of opportunity to mix with disabled people, or apprehension and anxiety in
non-disabled people about mixing with the disabled.

This lack of contact between the disabled and non-disabled, whether through lack of
opportunity or through choice, may compound the negative relationship between disabled
and non-disabled people.

Psychological research suggests that one way to reduce prejudice towards other groups
such as ethnic minorities, is through contact with members of other groups in the form of
neighbours, work colleagues, friends or classmates. Indeed psychological research does
suggest that if disabled children are not given these opportunities this may result in long-
term delays in social development. However, evidence regarding the positive effects of
inclusion is mixed. Inclusion does not always lead to a positive change in non-disabled
children's attitudes towards the disabled. Furthermore, inclusion has been shown to have
negative consequences for the self-concept and emotional security of disabled children
attending mainstream schools. Also, inclusion does not always mean inclusion. Often
inclusion occurs in word alone, and not in deed. Disabled children often attend the same
classes as non- disabled children, play in the same playgrounds and have lunch in the
same dining hall, but they are still excluded by their peers in a kind of elective exclusion.
There may be little actual interaction between the two groups, which can lead to feelings
of isolation and anxiety in ‘included’ children.

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7.3 Labelling
It is a term used to describe or categorize people on the bases of certain characteristics they
possess. Labeling is a process of creating descriptors to identify persons who differ from
the norm. Normal is a broad relative term. Everyone is different in some way from others.

Disability Related Labelling

Many people use disability-related labels to describe a person. A disability should not be
used as the primary adjective used to identify an individual, such as ‘the autistic student
in my class.’ A disability is not the most important descriptor of any individual. It is best
to focus on the person first and not the disability. Defining persons by their disability, as
if the disability comprises the entirety of the person, often isolates or segregates people
and more importantly, fails to recognize their humanness that goes well beyond the
disability “The nature of descriptors and how they are used often infer negative
implications about persons with disabilities.

Three grossly different types of stigma may be mentioned. First there are abominations of
the body—the various physical deformities. Next there are blemishes of individual
character perceived as weak will, domineering or unnatural passions, treacherous and
rigid beliefs, and dishonesty, these being inferred from a known record of, for example,
mental disorder, imprisonment, addiction, alcoholism, unemployment, suicidal attempts,
and radical political behavior. Finally there are the tribal stigma of race, nation, and
religion, these being stigma that can be transmitted through lineages and equally
contaminate all members of a family.

In all of these various instances of stigma, however, including those the Greeks had in
mind, the same sociological features are found: an individual who might have been
received easily in ordinary social intercourse possesses a trait that can obtrude itself upon
attention and turn those of us whom he meets away from him, breaking the claim that his
other attributes have on us. He possesses a stigma, an undesired differentness from what
we had anticipated. We and those who do not depart negatively from the particular
expectations at issue, shall call the normals.

The attitudes we normals have toward a person with a stigma and the actions in regard to
him, are well known, since these responses are what benevolent social action is designed
to soften and ameliorate. By definition, of course, we believe the person with a stigma is
not quite human. On this assumption we exercise varieties of discrimination, through
which we effectively, if often unthinkingly, reduce his life chances. We construct a
stigma-theory, an ideology to explain his inferiority and account for the danger he
represents, sometimes rationalizing an animosity based on other differences, such as
those of social class. We use specific stigma terms such as cripple, blind, moron in our
daily discourse as a source of metaphor and imagery, typically without giving thought to
the original meaning. We tend to impute a wide range of imperfections on the basis of the
original one, and at the same time to impute some desirable but undesired attributes, often
of a supernatural cast, such as "sixth sense," or "understanding":

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Labeling isn't always a cause for concern, and it's often very useful. It would be impossible
to catalogue the information we process during our lives without the aid of labels like
"friendly," "deceitful," "tasty," and "harmful." But it's important to recognize that the
people we label as "black," "white," "rich," poor," smart," and "simple," seem blacker,
whiter, richer, poorer, smarter, and simpler merely because we've labeled them so.

Impacts of Labelling
Labelling may seem trivial but it effects are long lasting and sometimes harmful.
Labelling may cause following for the labeled person specially when is on the students
with special needs.

Low Self-Esteem
Labeling students can create a sense of learned helplessness. The students may feel that
since they are labeled they just cannot do well or that they are stupid. This can also cause
the student’s self-esteem to be very low.

Lower Expectations and Motivation

Labeling can also lead to others having lower expectations for the student and student
with low motivation. Adults, including teachers and parents, may think the student cannot
do what is required and lower their expectations. If the teachers and parents do not
believe in the student’s ability, then the student will not either. It can create a vicious
cycle, which ultimately sets the student up for failure.

Peer Issues
A student who is labeled may experience peer issues. The student may be made fun of for
being learned disabled. This can cause trouble with making friends and can cause
bullying as well. The student then may become very isolated and withdrawn in the school
setting and may begin to skip school.

7.4 Goffman’s Theory of Stigma

The Greeks, who were apparently strong on visual aids, originated the term stigma to
refer to bodily signs designed to expose something unusual and bad about the moral
status of the signifier. The signs were cut or burnt into the body and advertised that the
bearer was a slave, a criminal, or a traitor – a blemished person, ritually polluted, to be
avoided, especially in public places.

Stigma is a social disapproval of a person because of a particular trait that indicates their
deviance from social norms. It is a degrading attitude of the society due to which the
person is discredited to be in the mainstream of society. The dignity and self esteem of
the stigmatized person is destroyed because of the marginalization. Such persons do not
have social acceptance and are constantly striving to adjust their social identities.

Erving Goffman an American Sociologist’s book on Stigma was published in 1963.

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Following paragraphs are taken from the article by Ashley Crossman which was updated
on March 02, 2017

Stigma: Notes on the Management of Spoiled Identity is a book written

by sociologist Erving Goffman in 1963 about the idea of stigma and what it is like to be a
stigmatized person. It is a look into the world of people considered abnormal by society.
Stigmatized people are those that do not have full social acceptance and are constantly
striving to adjust their social identities: physically deformed people, mental patients, drug
addicts, prostitutes, etc.

Goffman relies extensively on autobiographies and case studies to analyze stigmatized

persons’ feelings about themselves and their relationships to “normal” people. He looks
at the variety of strategies that stigmatized individuals use to deal with the rejection of
others and the complex images of themselves that they project to others.

Three Types of Stigma

In the first chapter of the book, Goffman identifies three types of stigma: stigma of
character traits, physical stigma, and stigma of group identity. Stigma of character traits
are “blemishes of individual character perceived as weak will, domineering, or unnatural
passions, treacherous and rigid beliefs, and dishonesty, these being inferred from a
known record of, for example, mental disorder, imprisonment, addiction, alcoholism,
homosexuality, unemployment, suicidal attempts, and radical political behavior.”

Physical stigma refers to physical deformities of the body, while stigma of group
identity is a stigma that comes from being of a particular race, nation, religion, etc.

These stigmas are transmitted through lineages and contaminate all members of a family.
What all of these types of stigma have in common is that they each have the same
sociological features: “an individual who might have been received easily in normal
social intercourse possesses a trait that can obtrude itself upon attention and turn those of
us whom he meets away from him, breaking the claim that his other attributes have on
us.” When Goffman refers to “us,” he is referring to the non-stigmatized, which he calls
the “normals.”

Stigma Responses
Goffman discusses a number of responses that stigmatized people can take. For example,
they could undergo plastic surgery, however they still risk being exposed as someone
who was formerly stigmatized. They can also make special efforts to compensate for their
stigma, such as drawing attention to another area of the body or to an impressive skill.
They can also use their stigma as an excuse for their lack of success, they can see it as a
learning experience, or they can use it to criticize “normals.” Hiding, however, can lead
to further isolation, depression, and anxiety and when they do go out in public, they can
in turn feel more self-conscious and afraid to display anger or other negative emotions.

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Stigmatized individuals can also turn to other stigmatized people or sympathetic others
for support and coping. They can form or join self-help groups, clubs, national
associations, or other groups to feel a sense of belonging. They might also produce their
own conferences or magazines to raise their morale.

Stigma Symbols
In chapter two of the book Goffman discusses the role of “stigma symbols.” Symbols are
a part of information control – they are used to understand others.

For example, a wedding ring is a symbol that shows others that someone is married.
Stigma symbols are similar. Skin color is a stigma symbol, as is a hearing aid, cane,
shaved head, or wheelchair.

Stigmatized people often use symbols as “disidentifiers” in order to try to pass as a

“normal.” For instance, if an illiterate person is wearing ‘intellectual’ glasses, they might
be trying to pass as a literate person; or, a homosexual person who tells ‘queer jokes’
might be trying to pass as a heterosexual person. These covering attempts, however, can
also be problematic. If a stigmatized person tries to cover their stigma or pass as a
“normal,” they have to avoid close relationships, and passing can often lead to self-
contempt. They also need to constantly be alert and always checking their houses or
bodies for signs of stigmatization.

Rules for Handling Normals

In chapter three of this book, Goffman discusses the rules that stigmatized people follow
when handling “normals.”
i. One must assume that “normals” are ignorant rather than malicious.
ii. No response is needed to snubs or insults, and the stigmatized should either ignore
or patiently refute the offence and views behind it.
iii. The stigmatized should try to help reduce the tension by breaking the ice and using
humor or even self-mockery.
iv. The stigmatized should treat “normals” as if they are honorary wise.
v. The stigmatized should follow disclosure etiquette by using disability as a topic for
serious conversation, for example.
vi. The stigmatized should use tactful pauses during conversations to allow recovery
from shock over something that was said.
vii. The stigmatized should allow intrusive questions and agree to be helped.
viii. The stigmatized should see oneself as “normal” in order to put “normals” at easy.

Deviance
In the final two chapters of the book, Goffman discusses the underlying social functions
of stigmatization, such as social control, as well as the implications that stigma has for
theories of deviance. For instance, stigma and deviance can be functional and acceptable
in society if it is within limits and boundaries.(Updated by Nicki Lisa Cole, Ph.D.)

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7.5 Handicapped Persons in the family and Community
Family life is changed, often in major ways. Giving care to a disabled or special needs
family member bring stress into the family. It changes the family system and family
roles. It changes the family responsibilities – who will be taking care of the special needs
of the disability. Family relationships and family pattern all change. When a family
member begins requiring daily care, “tried and true” family roles often used as a first step
to cope with the situation and stress it has brought along.

Other traditional family practices may also appear. A permanent role and responsibility is
given to one person to look after this member with special needs. Brothers, sisters,
children and other family members may be frightened by the illness, or feel
uncomfortable around the care receiver. Some may not want to "interfere" with what
you've already planned or decided. Family members need to decide how to share
responsibility for meeting these needs. There are many ways to divide tasks: by specific
need, by interval of time, by ability to provide the service. A written chart may be
developed for needs and responsibilities. Assigning each person the responsibility for
meeting one specific care need can be an effective way to divide responsibilities.

Over the period of time there is a shift in thinking about the effects of disability on the
family, and the family's effects on the person with a disability. This shift has occurred
because of the increased sophistication of models used to understand family functioning,
over the past 30 years. Other factors have contributed to this widening perspective:
 the move away from institutional models of care
 the acknowledgement of the rights and value of people with disabilities within
society
 changes in family structure generally
 the recognition of the importance of family care in providing support well into
adulthood.

Historical Perspectives
The birth of a child with a disability was seen as a tragedy for the family, without hope of
resolution or adaptation, a view that stigmatized the child, the mother and the family.
Within this context, institutional care was seen as a way of preventing the child disabling
the family. Such views are unacceptable now, but they illustrate that the early research
into family functioning was based on a pathological model of adaptation, and that
inferred maternal psychological reactions were equated to family functioning. Mitigating
or mediating factors within the family or society were not felt to be relevant given the
tragic nature of the birth, thus ignoring the positive adaptations that families made.

The development of family systems theory

In the 1970s, family research moved away from models of individual pathology with the
development of family systems theory. The family was seen as an interacting set of
relationships, both between the members of the family and with the wider society. This
changed the focus to an interactional, and subsequently more complex, model of family

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functioning. It also allowed for the development of ideas about family life-cycle in
relation to disability and changes over time as opposed to the static individual pathology
model. Early applications of family systems theory were criticized, however, for
assuming that dysfunctional communication within the family was the cause of
conditions such as autism and schizophrenia.

Research developed into areas such as stress, coping mechanisms, support networks,
effects on siblings, other family members and the families of adults with a disability.
Research has now moved away from looking at family dysfunction and increasingly
recognizes the successful, resourceful ways in which families adapt and provide care.

Effects of the nature of the disability

These have been examined with varying results. Comparisons between diagnostic groups
such as Down's syndrome and autism have been studied. While differences in
methodology make it difficult to reach conclusions, it appears that factors such as
communication difficulties and behavioural problems - rather than particular diagnostic
groups - predict stress. Providing physical care may be less stressful than supporting a
person with behavioural problems. Comparisons between families with and without a
person with a disability indicate that families of people with a disability have a higher
degree of stress, but less so than had been assumed. The difference in levels of stress was
correlated with a range of variables rather than just the person with the disability.

Coping complementary to the research on stress is the work that has been undertaken on
coping mechanisms. These mechanisms take a number of forms but seem to cluster into
two main areas.

Problem-focused coping relates to conduct aimed at reducing the effect of the stressor
event or changing it. It predominantly involves cognitive and behavioural strategies.

Emotion-focused coping seeks to regulate the feelings aroused by a stress and aims to
produce or maintain an emotional equilibrium.

Although both coping mechanisms may be required at times, families that predominantly
use problem-focused coping have lower stress levels.

Limitations the limitation of the stress model is that it focuses on dysfunction rather than
how families adapt to or function with complex demands and range of resources. This
realization has stimulated research on the positive aspects for the family of a person with
a intellectual disability, and the rewards and gratifications that it may bring.

Rewards and gratifications

Identifying family stress alone does not give a complete picture of the effects of disability
on the family. Researchers have recognized that the care-giving role is associated with its
own rewards as well as benefits for the beneficiary of care and the family as a whole. The
rewards seem to be more than coping mechanisms to mitigate the stresses upon the

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family and are associated with positive benefits that the person with a disability has
brought to the family. Researchers have attempted to identify core themes (Figure 1).
The concept of rewards does not mean that families do not experience stresses and there
is some evidence that there is an association between the prevalence of stresses and
rewards. The implication that overcoming adversity is a major source of reward is a
recurrent theme in interviews with carers.

The ecocultural model

The importance of this model, which is derived from the 'social ecology' model
developed by Bonfenbrenner (1979), is that it proposes that individuals and families exist
not in isolation but in the context of wider relationships within society. The functioning
of an individual or family depends on how they relate to the wider context, which exerts
influence upon them, and how they influence the wider context. Examples of such
relationships include workplace flexibility, which may facilitate the balancing of work
and care-giving responsibilities, and how specialist intellectual disability services support
a person with an intellectual disability living with his or her family.

Accommodations: the ecocultural model suggests that families create a meaningful and
daily routine of family life. To create this routine families must respond in various ways to
the often conflicting pressures placed upon them. These responses are referred to as
'accommodations'. The accommodations are not only within the family but within the wider
social context, the family forming an ecocultural 'niche'. The importance of the concept is
that it regards families' behaviour as adaptive. By emphasizing extrafamilial aspects it
allows the exploration of the effects of services and society on family adaptation.

The process of accommodation is common to all families, and particular accommodation

variables have been identified in relation to families of a person with intellectual
disability:
 family subsistence and financial base
 access to health or educational services
 home and community safety and convenience
 domestic tasks and chore workload for the family
 caring tasks
 socialization
 marital role relationships
 social support
 father's role
 sources of information and advice.

Social Ecological Model

The parent of a child with a disability may change jobs and even move the family home
to improve access to healthcare or schools. Siblings may take on domestic tasks and
families may leave or develop new social-support networks, join advocacy groups or
develop links with other careers. The accommodations they make depend on the
ecocultural constraints/resources available to them.

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Families of people with intellectual disabilities usually make many accommodations,
which alter in intensity and frequency over time, in order to maintain the family routine.
This has important implications for services, which often increase the number and
intensity of accommodations families will need to make; for example, behavioural
interventions at home may involve a considerable amount of accommodation.
The ecocultural model also takes into account the other aspects of family life that have to
be maintained in addition to the care-giving responsibilities. The overall impact of this
research has been to show the sophistication of the accommodations that families make
and also points to preparatory adaptations they make to prepare for future care-giving
demands - often years in advance - that may be placed on them.

(This article was first published in Psychiatry; Volume 2:9, September 2003 and
reprinted with the kind permission of the Medicine Publishing Company).

Impacts
Care-taking responsibilities may lead to changed or abandoned career plans for the
person who has taken or been given this responsibility. Female family members are more
likely to take on caregiving roles and thus give up or change their work roles.

The day-to-day strain of providing care and assistance leads to exhaustion and fatigue,
taxing the physical and emotional energy of family members. There are a whole set of
issues that create emotional strain, including worry, guilt, anxiety, anger, and uncertainty
about the cause of the disability, about the future, about the needs of other family
members, about whether one is providing enough assistance, and so on. Grieving over the
loss of function of the person with the disability is experienced at the time of onset, and
often repeatedly at other stages in the person's life.

The disability can consume a disproportionate share of a family's resources of time,

energy, and money, so that other individual and family needs go unmet. Families often
talk about living "one day at a time." The family's lifestyle and leisure activities are
altered. A family's dreams and plans for the future may be given up.

Friends, neighbors, and people in the community may react negatively to the disability by
avoidance, disparaging remarks or looks, or overt efforts to exclude people with
disabilities and their families.

Disabilities vary along several dimensions, including the degree and type of
incapacitation (sensory, motor, or cognitive); the degree of visibility of the disability;
whether the course of the condition is constant, relapsing, or progressive; the prognosis or
life expectancy of the person; the amount of pain or other symptoms experienced; and the
amount of care or treatment required.

The family is faced with increasing caretaking demands, uncertainty about the degree of
dependency and what living arrangement is best, as well as grieving continuous loss.

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These families need to readjust continuously to the increasing strain and must be willing
to find and utilize outside resources.

poverty is more frequently a characteristic of families with disabilities compared to the

general population. Economic hardship is more evident among racial and ethnic minority
households, single-parent families, and households that have multiple members with
disabilities. Poverty is a major social determinant of health and quality of life.

In a special issue of Introduction: Special Issue on Families and Disabilities

By Jennifer Haskin & Heather Dillaway , WAYNE STATE UNIVERSITY
Volume 17, Issue 1, 2013, pp. i-iv
Permalink: http://hdl.handle.net/2027/spo.4919087.0017.101
papers were published on the Family attitudes and patterns having disabled members.
( Excerpts from the papers published in the issue….)

Shildrick (2002) and other disability scholars suggest that we should think of a
“disability” as an “impairment.” That is, broadly defined, a disability is typically
something that impedes one’s ability to navigate their social world and relationships, or
participate fully in society. This impairment or impediment could be physical, cognitive,
or emotional. Typically we think of disability as related to the physical body first and
foremost but disability scholars remind us that cognitive and/or mental disabilities affect
individuals as much as any physical impairment can.

When there are barriers to disabled individuals’ health care, paid work, or mobility, it is
also often family members who are expected to pick up the slack. When disabled
individuals experience barriers or constraints to their participation in society in any form,
or any difficulty at all in living their daily lives, they may also take out their frustrations
on or share these feelings with family members. Thus, families deal with the
consequences of the barriers and constraints that disabled individuals may face.

Community
Families often report that the person with the disability is not a major burden for them.
The burden comes from dealing with people in the community whose attitudes and
behaviors are judgmental, stigmatizing, and rejecting of the disabled individual and his or
her family (Knoll 1992; Turnbull et al. 1993). Family members report that these negative
attitudes and behaviors often are characteristic of their friends, relatives, and service
providers as well as strangers (Patterson and Leonard 1994).

As children with disabilities move into school environments where they interact with
teachers and peers, they may experience difficulties mastering tasks and developing
social skills and competencies. Although schools are mandated to provide special
education programs for children in the least restrictive environment and to maximize
integration, there is still considerable variability in how effectively schools do this.
Barriers include inadequate financing for special education; inadequately trained school
personnel; and, very often, attitudinal barriers of other children and staff that compromise

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full inclusion for students with disabilities. Parents of children with disabilities may
experience a whole set of added challenges in assuring their children's educational rights.
In some instances, conflict with schools and other service providers can become a major
source of strain for families (Walker and Singer 1993). In other cases, school programs
are a major resource for families.

Poverty is more frequently a characteristic of families with disabilities compared to the

general population. Economic hardship is more evident among racial and ethnic minority
households, single-parent families, and households that have multiple members with
disabilities. Poverty is a major social determinant of health and quality of life.

7.6 Self-Assessment Questions

1. What are the components of Attitde?

2. Write the functions of Attitude?

3. What are the characteristics of people having positive and negative thinking?

4. Describe the factors which pace the development of positive and negative thinking?

5. How does stigma describe the characteristics of the person?

6. How a negative attitude be changed into positive?

7. What images or feelings do labels create?

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7.7 References
Baron, R. A., Byrne, D., & Suls, J. (1989). Attitudes: Evaluating the Social World. Baron
et al, Social Psychology. 3rd edn. MA: Allyn and Bacon, 79-101.

Eagly and Chaiken, (1993). The Psychology of Attitudes, Fort Worth, TX: Harcourt
Brace Jovanovich.

Hogg, M., & Vaughan, G. (2005). Social Psychology (4th edition). London: Prentice-Hall
K8
How to cite this article: McLeod, S. A. (2009). Simply Psychology; . Retrieved 24
February 2012, from http://www.simplypsychology.org/attitudes.html

Barnes C, Mercer G, Shakespeare T. Exploring Disability: A Sociological Introduction.

London: Polity Press, 1999.

Bonfenbrenner U. The Ecology of Human Development. Cambridge, MA: Harvard

University Press, 1979.

Gallimore R, Weisner T S, Bernheimer L P, Guthrie D, Nihira K. Family responses to

young children with developmental delays: accommodation activity in ecological
and cultural context. Am J Ment Retard 1993; 98: 185-206.

Glidden L M, Kiphart M J, Willoughby J C Bush B A. Family Functioning when Rearing

children with developmental disabilities. In: Turnbull A P et al., eds. Cognitive
Coping, Families and Disability: Participatory Research in Action. Baltimore, MD:
Paul H Brookes, 1993.

Grant G, Ramcharan P, McGrath M, Nolan M, Keady J. Rewards and gratifications

among family caregivers: towards a refined model of caring and coping. J Intellect
Disabil Res 1998; 42: 58-71.

Hill R. Genetic features of families under stress. Social Casework 1958; 49: 139-50.

Kazak A E. Families with physically handicapped children: social ecology and family
systems. Fam Process 1986; 25: 265-81.

Nolan M, Grant G, Keady J. Understanding Family Care: A Multidimensional Model of

Caring and Coping. Buckingham: Open University Press, 1996.

Olshansky S. Chronic sorrow: a response to having a mentally defective child. Social

Casework 1962; 43: 190-3.

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Seligman M, Darling R B. Ordinary Families, Special Children: A Systems Approach to
Childhood Disability. New York: Guilford, 1989.

Shearn J, Todd S, Parental work: an account of the day-to-day activities of parents of

adults with learning disabilities. J Intellect Disabil Res 1997; 41: 285-301.

Stainton T, Besser H. The positive impact of children with an intellectual disability on the
family. J Intellect Dev Disabil 1998; 23: 55-70.

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Unit: 8

ORGANIZING AND MANAGEMENT

SPECIAL NEEDS IN SCHOOL

Written By:
Dr. Hina Noor

Reviewed By:
Dr. Zahid Majeed
 INTRODUCTION
According to J.B. Sears an organization is “a machine for doing work. It may be
composed primarily of persons of materials of ideas, of concepts, symbols, forms, rules,
principles or more often of a combination of these. The machine may work automatically
or its operation may be subject to human judgment and will”.

Management is an art and a science; it is an art as it involves application of skills and it is

a science as it is a body of systematic body of knowledge developed through
experimentation and observation. School management is a process of leading the school
towards development through not only the optimum use of the human resources, physical
sources, principles and concepts that help in achieving all the objectives of the school but
also the proper coordination and adjustment among all of them.

A school's organizational structures can go a long way toward promoting student

learning. At all instructional levels, the school's organizational pattern can materially
affect the manner in which students and teachers interact. All of these school wide
structures should be designed to maximize teacher and student flexibility, encourage in-
depth teaching and learning, and integrate as many different resources as possible.

A special school is a school catering for students who have special educational needs due
to severe learning difficulties, physical disabilities or behavioural problems. Special
schools may be specifically designed, staffed and resourced to provide appropriate
special education for children with additional needs. Students attending special schools
generally do not attend any classes in mainstream schools. The major purpose of the
special education administrative organization is to provide and maintain those
environmental conditions in schools that are most conducive to the growth and learning
of children with special needs. A special education program should be customised to
address each individual student's unique needs. Special educators provide a continuum of
services, in which students with special needs receives varying degrees of support based
on their individual needs. Special education programs need to be individualised so that
they address the unique combination of needs in a given student.

Like all children, children with exceptionalities need environmental stability, emotional
nurturance, and social acceptance. Decisions about the delivery of special education to
children with exceptionalities should be made after careful consideration of their home,
school, and community relationships, their personal preferences, and effects on self-
concept, in addition to other sound educational considerations. There must exist for all
children, youth, and young adults a rich variety of early intervention, educational, and
vocational program options and experiences. Access to these programs and experiences
should be based on individual educational need and desired outcomes. Furthermore,
students and their families or guardians, as members of the planning team, may

218
recommend the placement, curriculum option, and the exit document to be pursued. The
career potentials of children with exceptionalities range from sheltered to competitive
work and living arrangements. Children with exceptionalities require career education
experiences which will develop to the fullest extent possible their wide range of abilities,
needs, and interests.

OBJECTIVES
After reading this unit, you will be able to understand:
1. The objectives of the processes involved in the school organization and the
management.

2. The requirements of a system of co-ordinated activities for classroom processes.

3. The quality index for the processes involved in the school.

4. The use of different plans and organizing skills required as a teacher/head of the
institution.

5. The responsibilities and the leader in professional growth, commitment,

competencies, attitudes, school development plan, physical and human resource
management, time management and community relations.

6. The needs of alternative education and integrate it into the curriculum.

7. The varied and effective classroom management skills.

8. The need of different tools and techniques for continuous and comprehensive
evaluation.

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8.1 Special Education Needs
"Special needs" is a broad term. Special educational needs are defined in as “a restriction
in the capacity of the person to participate in and benefit from education on account of an
enduring physical, sensory, mental health or learning disability, or any other condition
which results in a person learning differently from a person without that condition. The
special educational needs may arise from four different areas of disability:
 physical
 sensory
 mental health
 learning disability

Or from any other condition that results in the child learning differently from a child
without that condition. It is also important to understand that a child can have a disability
but not have any special educational needs arising from that disability which require
additional supports in school.

A child or young person has special educational needs (SEN) if he or she has learning
difficulties or disabilities that make it harder for him or her to learn than most other
children and young people of about the same age. So special educational needs could
mean that a child or young person has:
 learning difficulties - in acquiring basic skills in an early years setting, school or
college
 social, emotional or mental health difficulties - making friends or relating to adults
or behaving properly in an early years setting, school or college
 specific learning difficulty - with reading, writing, number work or understanding
information
 sensory or physical needs - such as hearing impairment, visual impairment or
physical difficulties which might affect them in an early years setting, school or
college
 communication problems - in expressing themselves or understanding what others
are saying
 medical or health conditions - which may slow down a child’s or young person's
progress and/or involves treatment that affects his or her education.

Children with special educational needs are children first and have much in common with
other children of the same age. There are many aspects to a child’s development that
make up the whole child, including personality, the ability to communicate (verbal and
non-verbal), resilience and strength, the ability to appreciate and enjoy life and the desire
to learn. Each child has individual strengths, personality and experiences so particular
disabilities will impact differently on individual children. A child’s special educational
need should not define the whole child. Special education is defined as any educational
provision which is designed to cater for pupils with special educational needs, and is
additional to or different from the provision which is generally made in ordinary classes
for pupils of the same age.

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8.2 Curriculum Design for Special Education Needs
The curriculum consists of all the learning experiences designed or encouraged by the
school as its programme to promote the educational aims and objectives of the school for
its pupils. It encompasses the content, structure and processes of teaching and learning,
which the school provides in accordance with its educational objectives and values.

The broad aims of education for students with special educational needs include
 Enabling the student to live a full life and to realise his or her potential as a unique
individual through access to an appropriate broad and balanced curriculum
 Enabling the student to function as independently as possible in society through the
provision of such educational supports as are necessary to realise that potential.

The student’s environment is a powerful factor in his or her learning. This begins in the
home; and the skills and knowledge that all students bring with them to school are of vital
importance to their future development. Close co-operation between home and school is
essential if the student is to experience the full benefit of his or her education.

Here, we will discuss how to design curriculum for students with special needs, with a focus
on catering to the multiple needs of a student group and finding a balance between student
needs and school / staff availability. While designing a curriculum for these children it is
important to consider that some basic student’s needs fall into some simple categories:
Physical needs - this can include the need for meal assistance, eating, drinking skills,
physical mobility, gross and fine motor skill development, game playing, operating in an
indoor or outdoor physical environment, and toileting support.

Cognitive needs - this can include developing thinking processes such as critical
thinking, reasoning, using judgment and making decisions and choices (with a wide
variety of levels depending on your students and their level of intellectual disability).

Emotional needs - this can include the ability to express oneself to describe emotions,
using emotion based language, showing thoughts and feelings through facial expression
and gesture etc.
Social needs - this can include interacting with others, making friendships, clear social
expression, asking and responding to questions, taking turns and listening to others in a
group situation.

Communication needs - there is some cross over with communication into many of the
other areas, as it is such a vital and wide ranging topic. Communication needs can include
giving a yes / no response, using a reliable communication system (such as a
communication board, gesture, sign or a voice output device), interacting with others
outside the school environment and sharing and expressing views in an appropriate way
at school and in public.

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Independence needs - this can include using public transport, organizing belongings,
taking out the correct tools and equipment for a task, assisting others when needed, taking
initiative, showing leadership, dealing with unexpected events and taking responsibility
for activities of daily living.

Finding a Balance
It is important to balance your curriculum so that there is a focus on all the important
areas required for student success, and so that student Iindividualized Education Plan
goals are able to be worked upon and hopefully met. As a guide, when you try to design
curriculum for special students, work on having a blend of activity types from the list
above spread throughout each day and each week. This ensures that students are
achieving across all the learning areas (such as meeting literacy and numeracy needs
related to special education), and not spending too much time on a single one whilst
neglecting others. For some students, beginning each day in a predictable way (such as
with a morning greeting circle and then a movement activity) allows for a communication
need and then a gross motor physical need to be consistently met each day.

A range of professionals, such as psychologists, speech and language therapists, nurses,

occupational therapists, physiotherapists etc as well as the caregivers have an overlapping
and interdependent role to play in the education and management of students with special
educational needs. Students will often need support from such agencies as health boards,
voluntary organisations, religious orders, and training and employment agencies.
These guidelines will enable teachers and schools to establish significant and flexible
connections between the key skills and knowledge and the content of curricula.

Flexibility of provision
The curriculum the student experiences will allow for both age and stage of development.
However, flexibility is required if it is to be mediated in the most effective way. This must
allow for a full-time curriculum experience in mainstream education or in special education
but also for a combination of part time experience in both where this is appropriate. It must
also take account of the practicalities involved in providing both group and individual
experiences for students who may have multiple and complex needs.

In particular, co-operative and group work that encourages peer learning is very
important. Students should increasingly begin to take control of, and responsibility for,
their own learning. Students with special educational needs should be enabled to make
choices and decisions, and this can be achieved only through an accepting environment
that celebrates diversity and individuality while acknowledging the importance of peer
learning and group interaction.

Whole-school approaches
Instead of treating the individual student with special needs in isolation, it is necessary to
plan for the class or group as a whole and to identify the learning opportunities that exist
for all children. Whole-school approaches to planning could maximise the educational
opportunities available for students. These opportunities should be based on learning
need, not learning difficulty, and the student should be involved in identifying those

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needs where appropriate. Flexible multi-disciplinary and interdisciplinary approaches
involving teachers, parents and other professionals must keep the student at the centre of
the educational process. Where all students are striving to realise their own potential, age-
related and ability-related levels of attainment become a reality, and curriculum-based
assessment becomes meaningful.

The structure of the curriculum design for children with special needs includes:
 broad principles and aims of education for students with general learning
disabilities
 the identification of realistic, time-referenced targets
 the use of individualised education programmes
 the use of a variety of assessment tools
 lines of development in the skills areas, with short exemplars illustrating how they
can be developed
 new content and linkage points to national curricula at both primary and post-
primary levels where appropriate
 whole-school and classroom planning approaches that will facilitate schools and
teachers in developing and implementing an appropriate education policy for
students with special educational needs
 a range of multi-disciplinary approaches in the education of students with special
educational needs.

For those who require more specialised provision it is suggested that appropriate structure
of the areas of experience could be referred to as a framework.

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8.3 Placement and Management
A variety of placements options available to the children with special needs are shown
below in the form of continuum of educational services ranging from least to full
additional support required.

Regular Class includes students who receive the majority of their education program in a
regular classroom and receive special education and related services outside the regular
classroom for less than 21% of the school day.

Resource Room includes students who receive special education and related services
outside the regular classroom for at least 21% but no more than 60% of the school day.
Separate Class includes students who receive special education and related services
outside the regular classroom for more than 60% of the school day.

Separate School includes students who receive special education and related services in
separate day schools for students with disabilities.

Residential Facility includes students who receive education in a public or private

residential facility at public expense.

Home/Hospital Environment includes students placed in and receiving special

education in hospital or homebound programs.

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8.3.1 Residential Schools / Day School
In some cases, when there is a need for access to care, instruction, and consistency of
interventions during all waking hours it indicates the requirement for a residential school
as an appropriate option. It can even save families from disintegrating under the pressure
of providing for needs when resources are simply not at hand. The main characteristics
and advantages of residential school placement are as follows:
A continuum of consistency: A residential school setting and its staff are uniquely
qualified to give your child access to educational opportunities and the chance to practice
skills he or she has learned 24 hours a day. The professional staff and faculty provide
support and reinforcement during all waking hours of your child’s day. The same
prompts and cues are used whether your child is in class, in the cafeteria, engaging in
leisure activities, or in the residence. Some schools also offer training to parents so that
they may continue these prompts and cues at home during vacations and breaks. Round-
the-clock nursing care, where available and appropriate, is a vital aspect of a residential
school’s continuum of care as well.

A chance to practice safely – and learn flexibility: Opportunities to safely practice

skills in controlled environments in a residential school flow into chances to practice in
natural environments both before and after school hours Again, the professional staff and
faculty are standing by to support and reinforce skills learned at school and help your
child see how they apply in the larger surrounding community.

A peer group of his or her own: A residential school setting provides children with
special needs with peer group interaction opportunities both during and after school. It
also allows more time for leisure with peers both during and after school, giving each
child many opportunities to learn critical socialization skills as well as how to effectively
manage leisure time—an often-overlooked ability that is vital to his or her quality of life.

Learning for a lifetime: Developmental disabilities and other special needs can affect all
aspects of a child’s life, far beyond the classroom. Self-care, self-esteem, interpersonal
relationships, vocational skills, and many other critical life-skills are areas that must be
addressed. A residential school’s programs are designed to educate the whole child –
academically, socially, vocationally and more – so that he or she can live life as fully as
possible.

Constant social interaction: Students are always around their peers: in class,
extracurricular and in their living arrangements. As such, they have many opportunities to
be themselves and express their individuality outside of formal class time. This
sociability is extremely important for students with special needs, as they may lack
confidence or communications skills. Always being with their classmates may make them
feel more comfortable than they would in a day school.

Taking care of yourself: Many parents cannot resist pampering their kids or, at least,
providing them with an environment in which most things are taken care of. In contrast,
at boarding school, children with special needs will learn independence. For example, he

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or she may have to do cook or clean. Indeed, at a young age, your kid could live both
independently and safely.

Closeness: Students with special needs often need extra/out of class attention. If you send
your child to a day school, especially one that is not close to your home, you may have
difficulty dropping him or her off early in the morning or picking him or her after hours.
At a boarding school, your kid will live close to, if not on, the campus. Therefore,
seeking help, a vital part of special education, will always be convenient and possible.

Extra-curricular activities: After or before school programs are a great way to socialize
and to hone a particular skill. Such a well-rounded education is a wonderful way in which
to build the confidence of a child with special needs and to make school more enjoyable
and less stressful.

Despite all these positive influences for which residential schools are selected, there are
challenges too that a child has to face.

Growing up away from family, friends, and home: Like any residential school setting,
your child will pass many milestones and reach many benchmarks while living away
from his/her family. While many families find that a residential school experience
actually enriches and enhances the relationships between each family member, the fact is
that the child simply won’t be in his or her home community as often.

Less integration with non-disabled peers: Having a peer group of his or her own
naturally means less time spent around non-disabled peers. For some children, integration
with non-disabled peers can be demoralizing, while for others, it is not only appropriate,
but recommended. The peer group may affect the child’s ability to discover and explore
his or her full potential. Thus effects on self esteem and expectations from oneself may be
evident from the children studying in residential schools.

Keep in mind these advantages and challenges, still one cannot deny the necessity of
residential schools for the children with residential schools as an only option.

8.3.2 Itinerant teacher/peripatetic teacher

Itinerant teachers are usually qualified school teachers who have had some formal
training in the education of children with special. These teachers travel around local
mainstream schools and communities to offer advice, resources, and support to children
with special needs, their teachers, and their parents. Itinerant teacher programmes can be
established in partnership with public and non-governmental organizations.

An itinerant teacher normally works under the direction of a full-time coordinator

Itinerant teachers travel to provide services to students with disabilities. Instead of
functioning as traditional classroom teachers, itinerants visit children on their caseloads
in a variety of settings including homes, early childhood centers, schools, community-
based programs, and hospitals. They provide direct services and supports to children with

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special needs as specified by the goals and objectives in their Individual Education Plans
(IEP). Academic skills, communication skills, cognitive development, social
development, adaptive skills, motor skills, and behavioral support are some of the
categories addressed. They also may provide consultation services to the student’s
primary teacher or caregiver.

A certified special education teacher provides direct services and support to children, and
consultation to parents and early childhood professionals. The certified special education
teacher provides a written report with goals and remediation strategies, designed to
maximize the child’s independence in the classroom. Special education itinerant teacher’s
services are individualized to the needs of the child, and may include:
 Direct assistance to the child through therapeutic interventions.
 Implementation of the child’s Individualized Education Program
 Implementation, coordination, and monitoring of the child’s behaviour
management program.
 Collaboration with nursery school directors and teachers.
 Participation in Committee on Preschool Special Education meetings;
 Coordination of the child’s educational program with teachers, therapists, and
parents’
 Opportunities for parents to partner in their child’s education.

Those Teachers of the children with disability who are employed as peripatetic teachers
fulfil many roles, To be effective such teachers need to be trained, experienced and have
adequate time to carry out their duties, The peripatetic teacher must be a teacher, adviser,
counsellor, diplomat, learner, technician and manager.

As a Teacher
Peripatetic Teachers may work with children from pre-school age to college age. They
will have to work in a variety of environments which may have different levels of
resourcing available. Peripatetic Teachers need to have a variety of teaching strategies at
their disposal to meet the needs of children effectively. Strategies are most effective when
they have been grounded and developed in practical teaching situations. Working in other
people's homes, with pre-school children, is a public form of teaching, if teaching is not
done to a high standard and parents lose confidence in their peripatetic teacher, then the
reputation of the teaching profession in general may be adversely affected.

As Advisor
Advice offered to parents should be based on understanding and experience of managing
the effect of IMPAIRMENT or Disability. Without this understanding and experience, it
is possible that advice offered would not be appropriate to the situation. The trained
itinerant/peripatetic Teacher, therefore, is in the best position to ensure that realistic
understandings of those consequences are established in parents and mainstream teachers.

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As Counsellor
All adults who support the children with special needs experience times of self-doubt.
These teachers are trained for social and emotional development so, they are often in a
better position to help those adults. They will have experienced difficulties in the past and
will be able to use that experience as they counsel. The children attending mainstream
schools are more exposed to social interactions than their peers who attend special
schools. Therefore there is a greater opportunity for misunderstanding. Peripatetic
Teachers, because of the training they have received, are able to explain social
misunderstandings to these children and can contribute significantly to the successful
integration of the children with special needs into mainstream schools.

As a Diplomat
Working with other professionals in their establishments requires tact. It is important that
the peripatetic Teacher should be aware of the constraints placed on mainstream teachers
and be in a position to offer advice that can be applied successfully. The peripatetic
teacher has to know what advice to offer and when.

As a Learner
It is important that the itinerant/peripatetic teacher keeps abreast of current changes if
s/he is to serve the needs children and young people with special needs. There is a danger
that without appropriate training and experience of the learning needs of these children
and young people, innovations could be adopted in ways that are inappropriate. The
itinerant Teacher as a learner can use his/her training and experience to evaluate and
apply innovations to the benefit of the child.

As Technician
Some children with special needs may be equipped with assistive technology. If this
equipment is to be of value to child it has to be appropriate and maintained to a high
standard. To do this the teacher must have considerable technical knowledge that must be
updated regularly. This skill is essential if inappropriate decisions are to be avoided.

As Manager
As the peripatetic Teacher’s role is wide ranging and requires them to work
independently it is essential they are trained and experienced as Teachers of the
Disability they are dealing mainly with. Where this is the case, parents, schools and
teachers of the Deaf will have greater confidence in the recommendations and decisions
the manager makes. To go back to the analogy with the mainstream school, it is unlikely
that a parent would have confidence in the recommendations of a teacher they knew not
to be experienced in teaching. Likewise parents of hearing-impaired children and
mainstream teachers are entitled to be guided by, and have regular and direct access to
the trained teachers.

8.3.3 Special Education Consultants

To assure the free, appropriate, public education for all students with special needs,
education Consultants are necessary to:

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i. Serve as advocates for the formation and implementation of appropriate laws,
regulations, and program standards affecting the educational well-being of all
students with special needs.
ii. Provide leadership to teachers and related service providers in local, regional, and
residential education programs and to function as advocates for these personnel
with local administrators;
iii. Provide an on-going program of professional development in order to raise the
level of technical expertise for local teachers certified in the area of special
education and certified specialists who are responsible for providing student-
specific instruction, adapting materials, order needed equipment, providing travel
training, etc.;
iv. Serve as consultants and provide guidance on available resources to local school
district personnel and residential school staff as they conduct appropriately
designed program evaluation and improvement practices;
v. Design and administer systematic child find plans which will effectively identify
students needing specialized educational services including providing guidance to
state-level screening programs;
vi. Act as analysts of census data in order to recommend and enforce the establishment
of a continuum of appropriate program models to serve all identified students with
special needs in the least restrictive settings;
vii. Assure that adequate federal, state/provincial, and local funding programs are
provided to support state wide special education delivery systems;
viii. Serve as advocates for the development and maintenance of comprehensive
delivery systems for specialized educational instruction, materials, and equipment
for students with special needs in the least restrictive and most appropriate settings;
ix. Assure that appropriate related services are provided as necessary within the
special education delivery systems;
x. Design and administer public communication systems which will clearly describe
all programs and services potentially necessary for students with special needs to
receive a free, appropriate, public education;
xi. Serve to foster interagency and medical community cooperation to ensure the
smooth provision of other necessary social, vocational, rehabilitation, and medical
services to students with special needs in concert with the total education system;
xii. Serve as information channels in the long-range development of appropriate
programs, services, and technology to state / provincial and national agencies;
xiii. Serve as advocates for existing personnel-preparation programs in the fields of
educating students with special needs and/or orientation and mobility or working to
establish such programs;
xiv. Advise institutions of higher education of evolving competencies needed for
teachers of the special student and certified orientation and mobility specialists; and
xv. Maintain regular communication with national professional organizations and
consumer groups to ensure uniformity of service delivery patterns, to keep abreast
of the latest policy, curricular, technological, and program developments, and to
collaborate on state / provincial level initiatives;

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To perform these tasks, and to function adequately as leaders, a Special Education
Consultant must have a background of knowledge, understanding, and experience with
the general and special educational needs of students with special needs including those
learners who are Gifted, at-risk and/or who have additional disabilities, and must possess
skill in administration and consultation. The following competencies are considered to
be essential:
i. Ability to design and implement an appropriate special education service delivery
system for the students;
ii. Ability to supervise, advocate for, coordinate, and support certified teachers who
work with these students;
iii. Skill to assess educational and adaptive skill needs of these students, determine
priorities of work responsibilities, and manage time and resources;
iv. Ability to secure funds and manage fiscal matters;
v. Ability to utilize skills of a change agent to establish appropriate service delivery
systems;
vi. Ability to plan and implement on-going professional development;
vii. Ability to work effectively with other professionals such as local and state /
provincial education officials, instructional materials center personnel, legislators,
college/university personnel, residential school personnel, parents, and community
volunteers;
viii. Ability to engage in meaningful problem solving;
ix. Skill in analyzing and utilizing the political communications, school reform, and
state / provincial initiative systems;
x. Ability to serve in an advocacy role to ensure that all students are included in state /
provincial level educational initiatives;
xi. Ability to apply research skills to the solution of educational problems;
xii. Ability to select and manage appropriate evaluation procedures for students and
their educational programs; and
xiii. Skill in facilitation and consultation.

In order that children and youth with impairment or disability including those who are
gifted, at-risk and/or who have additional disabilities, may be assured of receiving a free,
appropriate, public education of consistently high quality, state / provincial departments
of education must maintain at least one full-time Education Consultant specifically
trained and experienced in education of the students with special needs.

8.3.4 Resource Room

A resource room is a separate, remedial classroom in a school where students with
educational disabilities, are given direct, specialized instruction and academic
remediation and assistance with homework and related assignments as individuals or in
groups. Resource rooms are learning spaces where a special education teacher instructs
and assists students identified with a disability. These classrooms are staffed by special
education teachers and sometimes paraprofessionals. The number of students in a
resource room at a specific time varies, but typically consists of at most five students per

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instructor. Mainstreaming and inclusive education typically includes this service to
students with special needs.

These students receive special instruction in an individualized or group setting for a

portion of the day. Individual needs are supported in resource rooms as defined by the
student's Individualized Education Program (IEP). The student getting this type of
support will receive some time in the resource room, which is referred to as a
"removal/withdrawl from the regular education environment" portion of the day and
sometime in the regular classroom with modifications and/or accommodations which
may include specialized instruction with their non-impaired peers. Special education
support within the regular education setting is part of the "inclusion model."

Often, a child may receive services in a combination of environments, for example, when
a child attends a regular education classroom for a part of the day, and a special education
classroom for certain subjects. Some students may benefit from being outside of the
regular education classroom for a portion of the day, for example for academic subjects
where the student may need more assistance than can be provided in the regular
education classroom. These students may attend a Resource Room or Academic Support
Classroom for whatever percentage of the day is determined necessary by the IEP team
and attend a regular education classroom for the remainder of the day. Services and
supports will follow the student in both settings, as needed. The teacher in the Resource
Room or Academic Support Classroom will have specialized training in working with
students who need more specialized accommodations, modifications, or adaptations. The
teacher in the regular education setting typically has not received specialized training that
would be required for students with complex support needs.

Special education instructors in a resource room focus on particular goals as mandated by

an IEP and remedial general education curriculum. Some programs emphasize the
development of executive skills, including homework completion and behavior.
Depending on individual needs, students usually attend resource rooms three to five times
per week for about forty five minutes per day. Some research has suggested these
classrooms are of particular benefit to students with language-based learning disabilities
such as dyslexia. Other research has indicated that students show growth in visuo-motor
perception, arithmetic, spelling and overall self-perception through time in the resource
room classroom. Students using these services are typically considered included—rather
than segregated or mainstreamed because they attend other classes with their peers,
especially at the secondary level. At least one study has suggested students with learning
disabilities in resource rooms have higher expectations regarding their academic success
when they are in the class. This may be due to the familiarity with the resource room
teacher, small group Direct Instruction or confidence within an area they are comfortable
in. Researchers believe that explicit instruction that breaks tasks down into smaller
segments is an important tool for learning for students with learning disabilities. Students
often benefit from "re-teaching" of core concepts taught initially general education
classroom and reinforced in resource rooms via the small-group instructional model,
which has been shown to lead to achievement in students with a multitude of educational
disabilities

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8.4 Competencies of Special Education Teacher
The Special education teacher shall demonstrate knowledge and/or competencies in the
following areas:
1. Learner Development and Individual Learning Differences
 Ability to understand how language, culture, and family background influence the
learning of individuals with exceptionalities.
 Ability to uses an understanding of human development and individual differences
to respond to the needs of individuals with exceptionalities.

2. Learning environment
 Ability through collaboration with general educators and other colleagues, to create
safe, inclusive, culturally responsive learning environments to engage individuals
with exceptionalities in meaningful learning activities and social interactions.
 Ability to use motivational and instructional interventions to teach individuals with
exceptionalities how to adapt to different environments.
 Knowledge of how to intervene safely and appropriately with individuals with
exceptionalities in crisis.

3. Curricular Content Knowledge

 Ability to understand the central concepts, structures of the discipline, and tools of
inquiry of the content areas that are taught, and can organize this knowledge,
integrate cross-disciplinary skills, and develop meaningful learning progressions
for individuals with exceptionalities
 Ability to understand and use general and specialized content knowledge for
teaching across curricular content areas to individualize learning for individuals
with exceptionalities
 Ability to modify general and specialized curricula to make them accessible to
individuals with exceptionalities.
 Knowledge of Language Arts/Literacy for learners with exceptionalities including
teaching reading, using literacy assessment and intervention, teaching literature,
teaching integrated language arts etc.
 Knowledge of Math for learners with exceptionalities including mathematical
processes, number sense and numeration, algebraic concepts, geometry and
measurement, data organization and management etc.
 Knowledge of Science for learners with exceptionalities e.g.
a) Understands and uses fundamental concepts of physical, life, and earth/space
sciences
b) Understands and models key concepts of science, technology, engineering
and mathematics etc
 Knowledge of Social Science for learners with exceptionalities with an aim to
Creates learning environments that encourage social interaction, active engagement
in learning, and self-motivation.

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 Knowledge of mental and emotional health, diet, exercise, drug education,
sexuality, diseases and safety concepts as they relate to quality and longevity of
life.
 Knowledge of Physical Education for learners with exceptionalities.

4. Assessment
 Ability to select and use technically sound formal and informal assessments that
minimize bias.
 Ability to use knowledge of measurement principles and practices to interpret
assessment results and guide educational decisions for individuals with
exceptionalities.
 Ability in collaboration with colleagues and families, to use multiple types of
assessment information in making decisions about individuals with
exceptionalities.
 Ability to engage individuals with exceptionalities to work toward quality learning
and performance and provides feedback to guide them
 Ability to follow legal/ national guidelines.

5. Instructional Planning and Strategies

 Ability to consider an individual’s abilities, interests, learning environments, and
cultural and linguistic factors in the selection, development, and adaptation of
learning experiences for individual with exceptionalities.
 Ability to uses technologies to support instructional assessment, planning, and
delivery for individuals with exceptionalities.
 Knowledge of augmentative and alternative communication systems and a variety
of assistive technologies to support the communication and learning of individuals
with exceptionalities.
 Ability to use strategies to enhance language development and communication
skills of individuals with exceptionalities.
 Ability to develop and implement a variety of education and transition plans for
individuals with exceptionalities across a wide range of settings and different
learning experiences in collaboration with individuals, families, and teams.
 Ability to teach to mastery and promote generalization of learning.
 Ability to teach cross-disciplinary knowledge and skills such as critical
thinking/problem solving to individuals with exceptionalities.

6. Professional Learning and Ethical Practice

 Use professional Ethical Principles and Professional Practice Standards to guide
teaching.
 Understand how foundational knowledge and current issues influence professional
practice.
 Understand that diversity is a part of families, cultures, and schools, and that
complex human issues can interact with the delivery of special education services.

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 Understand the significance of lifelong learning and participate in professional
activities and learning communities.
 Advance the profession by engaging in activities such as advocacy and mentoring.
 Provide guidance and direction to parents, tutors, volunteers etc.

7. Collaboration
 Ability to use the theory and elements of effective collaboration.
 Ability to serve as a collaborative resource to colleagues.
 Ability to use collaboration to promote the well-being of individuals with
exceptionalities across a wide range of settings and collaborators.

8.5 Classroom Organization and Management

Classroom Organization focuses on the physical environment. Effective teachers
organize a safe classroom environment. They strategically place furniture, learning
centers, and materials in order to optimize student learning and reduce distractions.

Classroom Management is “the actions and strategies teachers use to solve the problem
of order in classrooms”. Effective teachers also use rules, procedures, and routines to
ensure that students are actively involved in learning. In essence, they use management
not to control student behavior, but to influence and direct it in a constructive manner to
set the stage for instruction.

The classroom environment is influenced by the guidelines established for its operation,
its users, and its physical elements. Teachers often have little control over issues such as
temperature and leaky ceilings, but they greatly influence the operation of their
classrooms. Effective teachers expertly manage and organize the classroom and expect
their students to contribute in a positive and productive manner. It seems prudent to pay
careful attention to classroom climate, given that it can have as much impact on student
learning as student aptitude. Effective teachers take time in the beginning of the year and
especially on the first day of school to establish classroom management, classroom
organization, and expectations for student behaviour.

8.5.1 Classroom Organization

Classroom management and organization are intertwined. While rules and routines
influence student behavior, classroom organization affects the physical elements of the
classroom, making it a more productive environment for its users. How the classroom
environment is organized influences the behavior in it. For example, actions as simple as
color-coding folders, establishing fixed locations for lab supplies, maintaining folders for
students to pick up missed work after being absent, keeping extra copies of “Back to
School Night” items to share with new students, and designating specific places for other
classroom supplies can have a dramatic effect on classroom organization and,
consequently, on student learning. While these procedures and a multitude like them are

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simple matters, they nonetheless can be essential components for a smoothly operating
classroom.

Classroom organization is evident in a room even if no one is present. Furniture

arrangements, location of materials, displays, and fixed elements are all part of
organization. Effective teachers decorate the room with student work, they arrange the
furniture to promote interaction as appropriate, and they have comfortable areas for
working. They also consider student needs in arranging the room by leaving space for
wheelchairs to maneuver; having walkways so students can access materials, pencil
sharpeners, and the trashcan with minimal disturbance to others; and organizing in such a
way as to allow the teacher to freely move around the room to monitor student progress.

Teachers are observers of behavior and understand the rhythm of the classroom. Placing
materials near the pencil sharpener may seem like a good idea, until one considers that at
the start of a lesson this area may become congested with some students retrieving
materials for their group and others waiting to use the pencil sharpener. However, the
pencil sharpener and the trashcan may be a good pairing if the pencil sharpener tends to
break regularly, spilling its contents on the floor; this way shavings fall into the trash
instead. Effective teachers think about the little details that enhance the use of available
space in the classroom as well as the big issues.

Below is the list of few organization tips that an effective teacher can think of.
Material
If students commonly work in the same group, assign each group a container (dish
tubs, baskets, and trays work well) that they can send one member to retrieve and
return for each activity. It gives the students an incentive to treat the common supplies
well.
Place scissors, tape, stapler, hole punch, calculators, rulers, and other commonly
needed items in a common place that students can access on their own.
Have a can of sharpened pencils near the pencil sharpener. If the lead breaks during
class, a student can place the pencil in the can and retrieve a sharpened one. At a more
appropriate time (e.g., end of the lesson) the student can return the borrowed pencil
and sharpen the one that was left. HINT: The teacher may not have to buy the initial
pencils, since pencils frequently can be found on the floor when they have rolled away
under another desk. Just tell your custodian where retrieved pencils can be placed for
student use.
Keep extra school supplies on hand for students who forget or run out of their own.
Also, this is helpful when a new student arrives in class who may not have all the
supplies needed.
Set up numbered work stations with necessary supplies and assign students to
matching work groups. This works well when students must go to the equipment (e.g.,
science lab) versus taking the equipment to their desks.

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Classroom Displays
Have a board for “works in progress” where students can post work on which they
want constructive criticism from their peers. Students wind up keeping this board ever
changing.
Use a blend of student-made and commercial products to display on the walls. An art
portfolio works well to keep posters flat and poster board can be tabbed with headings
of different units, so the teacher can pull out new material as appropriate for display.

Work Assignments
Set up collection trays for finished work labeled with either the subject for elementary
classrooms or periods for secondary classrooms.
Create wall organizers with identified bins for class assignments so that students can
pick up missed work after a late arrival or an absence.

Lesson plan
At the secondary level when there are multiple preps separated by brief breaks, it can
be helpful to have a plastic file folder holder affixed to the wall so the teacher can pull
the necessary folder.
Keep plans in a binder that has divider pages for the different subjects/periods. Use
plastic page protectors to hold copies of handouts and transparencies (make sure to
have the “crystal clear” sleeves or else the transparency will have to be removed from
the sleeve).
Organize lesson plans electronically. If the room is equipped with a monitor for
PowerPoint presentations, use the first slide to identify the title and the second slide
the goals; this not only organizes the students, but also reminds the teacher as well.

Emergency procedures
Post fire and tornado information in the room. Include labeled maps of where to go
when exiting the classroom for tornado and fire drills/emergencies.
Know the location of the nearest fire extinguisher and fire alarm pull.
Train students to know what to do in an emergency situation.
Clearly label the office call button so substitute teachers can immediately identify it if
an emergency occurs.
Keep a list of all students who may require medical attention in your grade book.
Know the protocol for what to do, for example, diabetics, bee stings, epileptic
seizures, etc. As appropriate, alert substitute teachers.
If in a specific-use classroom, such as science, know how to operate the eyewash
station and shower, the location of the emergency shut-off valves in the room, and
where safety equipment is stored.

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Schedules
Display a poster with the basic flow of the day (i.e., bell changes in secondary school
or in elementary school when reading, math, resource classes, lunch, science, social
studies, etc. occur).
Write a daily agenda for students to know what to expect in terms of the day's
objective, activities, and homework. Note any changes in the regular daily schedule in
this location.
Create a Web page with weekly assignments listed and hyperlinks to possible
resources.

Activity 1:
Fill in the tables given below as per the instructions to get deeper insight into the possible
avenues of reflection about Classroom Arrangement

1) Take an inventory of the movable furniture/items in the class room. There is space
provided for additional items.
_____ Student Desks w/chairs
_____ Teacher's Desk w/chair
_____ Overhead Projector
_____ Computer(s)
_____ File Cabinet
_____ Work table(s)
_____ Bookcase(s)
______________________________________________
______________________________________________
______________________________________________
2) Make a sketch of the classroom's fixed elements in the space provided. If the room
is not rectangular, shade off areas to reflect the classroom space. In your sketch,
include
 Door(s)
 Window(s)
 Chalkboards/whiteboards
 Mounted TV monitors
 Computer stations
 Bookcases
 Storage cabinets
 Lab stations
 Sinks
 Pencil sharpener
3) Determine how the room will be primarily used (e.g., lecture, discussion, group
work).
4) Use dotted lines to show key walkways or spaces that need to stay open.
5) The biggest grouping of furniture is the student desks and chairs. Place them on the

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 layout first. They can be moved about later on the diagram as needed, but they do
encompass the largest area in most classrooms.
6) Sketch in the other furniture items.

8.5.2 Classroom Management

Effective teachers create focused and nurturing classrooms that result in increased student
learning. These teachers teach and rehearse rules and procedures with students, anticipate
students' needs, possess a plan to orient new students, and offer clear instructions to
students. They use a minimum number of rules to ensure safety and productive
interaction in the classroom, and they rely on routines to maintain a smoothly running
classroom. In fact, it has been noted that classroom management skills are essential in a
classroom for a teacher to get anything done. In some ways, classroom management is
like salt in a recipe; when it is present it is not noticed, but when it is missing, diners will
ask for it.

Rules
Virtually everything that involves interactions among people requires rules. Webster's
dictionary defines a rule as “a fixed principle that determines conduct”. Nonetheless,
rules establish the boundaries for behavior, and consistency in their implementation is
essential to effective classroom management. Effective teachers have a minimum number
of classroom rules, which tend to focus on expectations of how to act toward one another,
maintain a safe environment, and participate in learning. These teachers offer clear
explanations of the rules, model the rules, rehearse the expectations with students, and
offer students opportunities to be successful in meeting the expectations. There is no
magic number of rules that govern a classroom; rather, it is the clear establishment of
fair, reasonable, enforceable, and consistently applied rules that makes a difference in
classrooms. There are four criteria that a rule needs to meet to stay on the list. The rule
must be all of the following:
1. clearly stated so students know what is expected of them.
2. reasonable so students can realistically follow it.
3. enforceable such that Mandrel will take the time and effort to address any
violations. If he is not willing to invest the effort, then the item may be too trivial
or there may be a better solution.
4. general so that the rule addresses several behaviors as opposed to one specific
misdeed.

Effective educators have a sense of classroom tempo and student harmony such that they
are aware of when an intervention may be needed to prevent a problem. Often, teachers
use nonverbal cues, proximity, and redirection to prevent misbehaviour. These techniques
typically allow the momentum of the instruction to continue and refocus the student;
however, there are times when a stronger intervention is necessary. When a rule is
broken, an effective teacher is prepared to address the problem. Effective teachers tend to
react in several ways, including the following: positive reinforcement that points to the

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desired behaviour, consequences that punish the negative behaviour, a combination of
reinforcement and consequences, or indirectly responding to the behaviour such that the
student is reminded of why a rule is important. What an effective teacher does not do is
react to an entire class for a rule infraction by a single student.

Activity 2:
Write down the list of rules, you normally enforce in your class and analyze them for
their effectiveness with the help of the following table.

Classroom Rules Criteria

Proposed Clearly Stated
Rule stated Reasonable Enforceable General Positively

Routines
While they are more flexible than rules, routines or procedures are specific ways of doing
things that, for the most part, vary little during the course of the day or the year.
Classrooms typically require many routines to operate efficiently and effectively. For
example, routines commonly include how to enter and leave the classroom, take
attendance, indicate lunch selection, secure materials, dispose of trash, label work, turn in
assignments, make a transition during or between instructional activities, get to safety
during drills and actual emergencies, and change from one activity or location to another.
In essence, routines shape the classroom climate.

Effective teachers use routines for daily tasks more than their ineffective counterparts.
They invest the time at the start of the school year to teach the routines. By establishing
and practicing routines that require little monitoring, teachers ensure that the focus of the
classroom is more squarely on instruction. Effective teachers frequently provide students
with cues to remind them of acceptable behavior, and effective teachers are good at
organizing and maintaining a positive classroom environment. Following is a small list of
normally occurring phenomenon about which, an effective teacher always plans and
prepares beforehand.

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Common Classroom Occurrences
Attendance Morning work
Lunch counts Make up work
Collecting work Afternoon dismissal
Returning work Settling students down
Distributing supplies Changing activities
Returning supplies What to do when you finish your
Walking to specials (PE, art, music, library, work
computers) Drills: Fire, Tornado, Lock-down

The establishment of routines allows for flexibility. For example, the teacher may not
rehearse with students what should occur if a new student joins the class, but might adapt
the routine used for greeting classroom guests. Additionally, routines empower students
to be more responsible for their own behavior and learning in the classroom. When
classroom management issues arise, the teacher has procedures to address the concern in
an efficient, fair, and consistent way. Thus, the result of established procedures is more
time for teaching and learning.

Activity 3:
Observe the teaching-learning environment of any special school nearby and evaluate the
management skills with the help of the following indicators. Mark ‘Yes’ or ‘No’ against
each item.

Indicators Yes/No
1. The classroom entry and exit doors are separate
2. At-least 35 minutes is allocated for learning (out of 40 mins)
3. The time spent on each activity in classroom is even for all.
4. Resources for teaching-learning process are well utilized.
5. There is good involvement of pupils in learning activities/process
6. Sufficient time is spent on planning for the lesson.
7. Provision is made to meet the needs of children with special abilities.
8. Teacher has allocated time to check pupils’ performances.
9. Provision is made for assessing students learning.
10. Time allotment for all activities is made.
11. Activities are planned to retain students’ interest throughout the lesson.
12. There is provision for clarifying and articulating the performance of expected
outcomes of students.
13. Different strategies are planned to meet the needs of all children in the class.
14. Provision to identify the gains and difficulties of students in learning and
performing is made.
15. Different techniques are planned to analyze the assessment of students’ progress.
16. Planning to evaluate the effectiveness of teaching-learning and materials used is done.
17. There is sufficient provision for follow up activities and other related concerns.

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18. The plan is flexible for change following the innovations during the course of
action.
19. There is provision for continuous review and feedback during the course of action.
20. The plan allows to meet in-discipline if any by suitable measures.

8.6 Transition and Vocational Rehabilitation Services

The Transition Planning Programs are aimed at developing special education students as
a contributing member of the society. Transition Services means a coordinated set of
activities for a student with a disability, designed within an outcome-oriented process,
that promotes movement from school to post-school activities, including, but not limited
to, post-secondary education, vocational training, integrated competitive employment
(including supported employment), continuing and adult education, adult services,
independent living, or community participation. The coordinated set of activities must be
based on an individual student’s needs, taking into account the student’s preferences and
interests. Transition services are integrated into academic, vocational, and work
experience programs on an individual basis.

Vocational Rehabilitation program provides any necessary support and training to ensure
that individuals with disabilities are able to obtain and maintain meaningful employment.
Vocational Rehabilitation Services are typically offered as a part of the Transitioning
Process, although they may take other forms. Vocational Rehabilitation is designed to
help people with disabilities meet career goals, from entry-level to professional. It helps
people with disabilities get jobs, whether the person is born with a disability, develops a
disability or becomes a person with a disability while working.

Transition and vocational rehabilitation services shall include activities in the following
areas:
i. Instruction
ii. Related services
iii. Community experiences
iv. Development of employment and other post-school adult living objectives
v. Acquisition of daily living skills (when appropriate)
vi. Functional vocational evaluation

The individualized education program (IEP), developed under the Individuals with
Disabilities Education Act (IDEA), for each student with a disability must address
transition services requirements and includes:
i. Appropriate measurable postsecondary goals based upon age-appropriate transition
assessments related to training, education, employment, and, where appropriate,
independent living skills; and
ii. The transition services (including courses of study) needed to assist the student
with a disability in reaching those goals).
iii. Age-appropriate transition assessments based on the individual needs of the student
to be used to determine appropriate measurable postsecondary goals.

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Parental and student input is also vital in determining postsecondary goals related to
needed postsecondary education and training services for post-school activities, including
independent living and employment. Students with disabilities and their parents should be
knowledgeable about the range of transition services available, and how to access those
services at the local level. School should encourage both the student and their parents to
be fully engaged in discussions regarding the need for and availability of other services,
including application and eligibility for vocational rehabilitation services and supports to
ensure formal connections with agencies and adult services, as appropriate.

“Pre-employment transition services” are offered as an early start at job exploration

and are designed to help students with disabilities to identify their career interests. These
services include:
 Job exploration counselling;
 Work-based learning experiences, which may include in-school or after school
opportunities, or experience outside the traditional school setting (including
internships) provided in an integrated environment to the maximum extent possible;
 Counselling on opportunities for enrollment in comprehensive transition or
postsecondary educational programs at institutions of higher education;
 Workplace readiness training to develop social skills and independent living; and
 Instruction in self-advocacy.

The Vocatonal Rehabilitation services depending on the student’s or youth’s individual

needs include, but are not limited to:
 An assessment for determining eligibility and VR needs by qualified personnel,
including, if appropriate, an assessment by personnel skilled in rehabilitation
technology;
 Counselling and guidance, including information and support services to assist an
individual in exercising informed choices.
 Referral and other services to secure needed services from other agencies
 Job-related services, including job search and placement assistance, job retention
services, follow-up services, and follow-along services;
 Transition services for students with disabilities, that facilitate the achievement of
the employment outcome identified in the IPE;
 Supported employment services for individuals with the most significant
disabilities; and
 Services to the family of an individual with a disability necessary to assist the
individual to achieve an employment outcome.

Vocational Rehabilitation agencies provide a variety of community-based work

experiences and on-the-job training services to students and youth with disabilities on a
case-by-case basis. The Vocational Rehabilitation counselor and the student or youth
with a disability will identify a specific vocational goal to determine whether a
community-based work experience is a necessary service for the student or youth with
disability to achieve an employment outcome in competitive integrated employment or

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supported employment. “Competitive integrated employment” is employment with
earnings comparable to those paid to individuals without disabilities in a setting that
allows them to interact with individuals who do not have disabilities. “Supported
employment” is competitive integrated employment or employment in an integrated work
setting in which individuals with the most significant disabilities are working on a short-
term basis toward competitive integrated employment, while receiving ongoing support
services in order to support and maintain those individuals in employment.

Community-based work experiences allow the student or youth with a disability to

explore potential careers related to the specific vocational goal, potential workplace
environments and demands, and other aspects of the work. These experiences offer the
student opportunities to gain firsthand knowledge of a particular job skill, or to learn the
culture of day-to-day employment. These experiences can be offered in lieu of, or to
supplement, vocational training or educational programs, or as a stand- alone service. To
ensure the success of community-based work experiences, Vocational Rehabilitation
agencies normally have agreements with employers and the student or youth with a
disability that describe the training objectives, services to be provided, timelines, and
financial responsibilities necessary for a successful community-based work experience.

To sum up, we conclude by saying that Postsecondary education is one of the most
important post-school goals; and research has demonstrated that it is the primary goal for
most students with disabilities. As students with disabilities transition from secondary
school to postsecondary education, training, and employment, it is critical that they are
prepared academically and financially. Postsecondary options, with the help of the
Vocational Rehabilitation program, include two- and four-year colleges and universities,
trade and vocational schools, adult education programs, and employment outcomes in
competitive integrated employment or supported employment.

8.7 Self-Assessment Questions

1. Define special education needs. What different options are available to the teachers
to meet such needs of the students?

2. Explain the concept of School organization and management with the help of
suitable examples.

3. How classroom Management can facilitate the teaching-learning process?

4. What different placement options are available to suit the needs of each individual
with special needs?

5. How the itinerant teacher can compensate the shortage of trained professionals in
special schools?

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6. How the planning of instruction, teaching and evaluation in special schools may
vary when compared with normal schools?

7. What characteristics a special education consultant holds to direct the provision of

different support services to children with special needs?

8. How the principles of curriculum planning, organizing curricular and co- curricular
activities coincide with the concept of time management?

9. How would you evaluate the skillful use of different techniques of classroom
management by a teacher?

10. Explain the role and responsibilities of teachers in the light of special education
management.

11. How transition services are planned and provided to children with special needs?

12. Explain the different concepts associated with the term “vocational rehabilitation”
with the help of suitable examples.

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Unit: 9

CURRENT TRENDS AND ISSUES IN

SPECIAL EDUCAITON

Written By:
Muhammad Imran Nazir

Reviewed By:
Dr. Shaista Majid
 INTRODUCTION
Special Education has the vital role to make the PWDs independent and confident person
in the society. A special person has to face so many problems in his life since his/her
birth. If parents and all the related persons to the child accept and face the challenge for
the child then they will be able to make him/her an self-sufficient person. So many
factors can be involved in this matter.

Right Assessment of the child is key to the success. Once the assessment is correct then
parents has the clear disrection and plan for their child. Special education provides the
occasions to make the PWDs aware about their basic needs and how they can be the part
of our society and play their role for their family & nation as well.

OBJECTIVES
After studying this unit, student will be able to understand the following points:
1. to distinguish between identification, diagnosis, assessment and placement

2. to differentiate among Segregation, Integration and Inclusive Education

3. to identify discriminate between the Special Education and Regular Education

4. to separate among Special and normal curriculum

5. to make a difference stuck between Adaptation in Curriculum

6. role of IEP

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9.1 Issues in Identification, Diagnosis, Assessment and Placement
Identification of disability is the basic element for the rehabilitation of PWDs. If the level
of disability is diagnosed initially then it is easier to cope & make the rehabilitation
process better for the special needs children. Right assessment about the level of
disability describers the direction of placement of the child in the right direction. For
example if a child is identified or diagnosed as visually impaired then he/she may refer to
the special school for the visually impaired children. Moreover he/she may require
Braille, large print books or other aids/devices for the learning process in the school.

The two main purposes of identification and assessment of students with disabilities are
to determine whether they are eligible for special education services and, if they are
eligible, to determine what those services will be. Eligibility for special education
services requires two findings: first, the student must meet the criteria for at least one of
the thirteen disabilities recognized in the federal Individuals with Disabilities Education
Act (IDEA) and second, special education and/or related services must be required for the
student to receive an appropriate education. It is true that some students are eligible for
special education and/or related services but do not need them, while other students need
the services but are not eligible according to federal or state classification criteria. If the
disability diagnosis and special education need are confirmed, the student then has certain
important rights to individualized programming designed to improve educational
performance and expand opportunities. These rights are established through several
layers of legal requirements based on federal and state statutes, federal regulations, state
rules, and state and federal litigation.

Families of young disabled children can play a critical role in the early development of
their children but for this to happen they need to receive support, understanding and
useful information on how they can help their children (Dash, 2006). This information
needs to be available from birth or as soon as the disability becomes evident. The type of
support needed is both professional and personal. The health and educational needs of
children play an important role, particularly in the beginning developmental stage of life;
therefore, early intervention program is equally important to support organizations of
people with disabilities and other training centres. Children qualify for inclusion in an
Early Intervention program either because they are on the state’s list of automatically
eligible conditions or after being assessed by a specialist. In most jurisdictions, because it
is a genetic condition, it automatically qualifies the child for services. Programs are
designed to provide support for the child’s strengths and therapy to improve the child’s
weaknesses. In some areas, services are offered at your home, while other localities may
require going to a centre. A comprehensive early intervention program addresses five
areas of development, with specific services customized to meet each child’s particular
need: Cognitive development: how a child thinks/learns, Physical development, including
vision and hearing: usually involves physical therapy, Language, speech, and
communication, Social-emotional development, and Adaptive/self-help skills
development (UNESCO, 2009). The early years of childhood represent a crucial window
of opportunity for investments in skills or capabilities that can place children on the path

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to well-being in adulthood. Many recent studies in the last decade have focused on the
importance of early human capital investments in academic and social skills for
promoting long-term educational and economic success (Reynolds, Rolnick and Temple,
2014).Early identification and intervention of children with special educational needs is
absolutely key: the earlier a problem is identified, the better the outcomes of intervention.
Because learning is a cumulative process, difficulties found earlier on if not attended to,
can have a cascading effect on the rest of a child’s life. As stipulated by Reynolds,
Rolnick and Temple (2014), early identification and intervention usually refer to finding
emotional, intellectual, behavioural and mental health concerns at the earliest age they
appear.These problems can emerge early in childhood and become progressively worse if
not treated. Hence, identifying the above problems early can pave the way for children to
get the support they need to experience successful futures both in and out of school.
Knowing the early warning signs that put young children at risk for learning disabilities
and understanding normal developmental milestones helps with early diagnosis and
intervention. As of date, early intervention is considered to be the most important factor
influencing long-term outcome in these children. Along with paediatricians and parents,
it is the teachers and other educators, who can and must play a role in early identification.

Assessment and Placement Professionals, who make decisions about student assessment
on a regular basis, have the arena of early childhood assessment that can be difficult to
navigate (Yell, 2006). It is not enough to simply assess earlier content using the same
approaches as those used in older grades, or to take decisions about tools and purposes
that were made with older students in mind and extend them to younger children. Instead,
professional standards and guidelines for early childhood assessment must begin with
attention to the important reality that young children are continuously and rapidly
developing, both academically and across a wide range of other domains. The context
that informs assessment decisions for early learners is qualitatively different from the
context for older students. Across the nation; school districts are selecting from among
standardized measures, designed group-administered measures, and open-ended
subjectively scored tests to make decisions about school or teacher accountability and
student placement. These tests are part of accountability systems that have been designed
differently in each state in an attempt to ensure that student learning has occurred of
which Ghana is no exemption. In many cases, test results and accompanying
consequences are neither clearly understood by parents nor policy makers. Often in an
effort to design an accountability system, the developmental level of the child seems lost.
What arethe assessment systems used for and what should well-designed assessment
systems consider? An assessment system should include a variety of instruments for
various categories or purposes; clarifying the main purpose of the assessment,
determining what should be measured, establishing procedures for data collection, and
selecting data sources, m (child work, standardized tests, teacher report, and parent
report) are all components in an assessment process. Safeguards, however, should be in
place to protect against harmful or questionable assessment-based decisions with the
consequences or use of the results spelled out to the parents. According to Robbins,
(2011), assessment of individual children is currently used

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 To determine progression on meaningful developmental achievements.
 To place or promote
 To detect special needs, learning, and teaching problems,
 To assist with curriculum and instruction decisions,
 To help a child assess his or her own progress,
 To boost learning,
 To evaluate programs,
 To monitor trends, and
 For "high-stakes" accountability.

Assessments should benefit children by improving the quality of educational programs or

in providing direct services to children. It should link to the specific purpose and must be
valid, fair, and reliable for that purpose. When designing assessment policies, policy
makers should consider that reliability and validity increase with children's age, and that
the method of data collection and content through any data collection method selected
should be age appropriate (suit the pre-schooler). It is critical to consider language
development as well as special learning needs when determining both appropriate
methods and in interpreting the meaning of assessment results. Multiple sources of
evidence is key to presenting a clear picture of the child's learning needs. This means
collecting information from the child's portfolio of work as well as from reports of
parents and teachers (Banta, Jones & Black, 2009) These assessments should still be
balanced with informal methods such as direct observations which may include looking
at samples of work and drawings, asking other adults about the child, and asking
questions of the child either orally or in writing is crucial.

9.2 Segregation vs. Integration vs. Inclusive Education Segregation

The Individual with Disabilities Act (IDEA) involves that the students having disabilities
be given education on the maximum possible level that is adopted for educating those
students who have no disabilities. However, a considerable number of students within our
constituency remain isolated in the classrooms of separate schools, where a very limited
or almost no opportunities are offered to display their participation in terms of academics
and social aspects in general education classroom as well as school activities.

It was a time when the special needs children were not allowed to fully participate in the
school activities as other normal children had. These special needs children were being
segregated for their race, color sex and disability. There were small numbers of chances
for them to perform such tasks academically or social participation. People thought that
these children couldn’t do anything. They considered them as burden on the families and
society. But with the passage of times these ideas were changed and special needs
children became the active member of the society and they proved worthy of every task
either academics or social.

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Now a days this method of teaching is disliked and is considered against the justice &
discrimination. In America special children are being taught in special class or resource
room instead of special schools. According to Meyer (1988) only 10% students are
getting education in special schools whereas remaining special needs children are getting
education from special class or resource room.

The question arises that despite the new adaptations who are those children who what to
learn only in special education system and what is the reason of this purpose? Laberman
(1992) explains that these are special students who want a specific program for them
which is different from the regular school system.

Why do parents choose special school?

Despite the inclination of integration still many parents want the separate school for their
special children. Concept of integration could not get on in the developing countries yet
even in Pakistan. Mostly parents in Pakistan select and they fell better to send their
children in special schools for their special children as they don’t like to send them in the
regular education system. Following are some of the reasons in favor of special schools
or special education institutes:
 Adaptable facilities/services
 Low cost
 Architectural Environment
 Curriculum
 Individualized Educational Programs
 Ratio among the teacher and students
 Social attachment

There are also some disadvantages of special schools. Some of them are as follows:
 According to particular category
 Artificial Environment
 Separation from normal people
 Limited Curriculum
 Loss for minor disabled students

Integration
Integrated education means to carry the special or outstanding children in the educational
institution delivering general education to study with their peers but having no extra
tools, devices, equipment and teaching faculty. The medical model of disability is
followed in integrated education that observes the child as a problem and demands that
the child is supposed to be changed or rehabilitated to make him fit for the system.

A report was published in Tesmania (1983) in which the right of education for all the
students in local schools was accepted but existence of special schools was also
considered compulsory simultaneously for who could not get the benefit from the regular
schools. Although it is the legal right of every special child to get education in normal

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school but it is not possible without the extra measures. It is compulsory for the school
administration to provide such facilities according to the needs of special children and it
is also the duty of government to provide such resources.

The child with disabilities is integrated into the classroom such that they work with the
same content and materials (though not necessarily expected to learn the same level of
skills). Types of integration are as under:
 Physical Integration
 Social Integration
 Pedagogical Integration

Initially the integration was introduced as adding the special needs children into regular
classroom but without any other material which was required for the special children. It
was too difficult to get the successful results from all those special needs children
because their needs were not fulfilled. Anyhow integration had three types. First of all
they were physically integrated with the normal children with their race, color, sex and
disability. Secondly they were socially integrated in the society. They were allowed to
attend the parties and different functions like festivals & Fairs. Parents and relatives took
their children in the society without any discrimination. Thirdly they were pedagogically
integrated in the schools. Admissions to the special children were given in different levels
and they were the part of classes and were fully allowed to perform in the class.

Inclusive Education
An inclusive education is a place where every individual is expected to be supported by
his or her peers as well as other members of the institutional community in the process of
meeting his or her educational needs.

Inclusive Education is referred to be a learning environment that tends to promote the

personal, academic and professional development of all students regardless of gender,
creed, religion, race, ethnicity, culture, class, disability, learning, style and language.

Inclusive Education permits every individual to develop the feelings regarding respect,
confidence and the individual is safe to develop his/her potentials by availing equal
opportunities along with rights of education regardless his/her disability, race, color,
religion, social, cultural, ethnic or economic differences. Its purpose is to provide abilities
to the maximum and address the full potential.

Essentials of Inclusive Education

i. Adaptation
In Curriculum, physical and social environment of the school.
ii. Consultation
With the administrative and the teaching staff of the school, the parents, General
Education Teacher, Special Education Teacher and the Resource Teacher.
iii. Collaboration
School Administration and Management, parents and the Professionals.

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Activity
Visit your locality and find out the schools having segregation, integration and inclusive
education system. Make a list of such institutes and write a note on each type after
physically visiting these institutes.

9.3 Special Education vs. Regular Education

To provide the special children having disabilities that may keep them away from getting
full advantages out of traditional educational approaches is the basic goal of special
education. It offers them specialized instruction and intervention that is needed to make
them able to be benefited from the process of their education.

The term of Regular Education is frequently used for elaborating the educational experience
of those children who are typically developing. The content dedicated for this curriculum is
defined in terms of standards; the Common Core State Standards is one of those.

The difference between general and special education

Some students are found who have a need to be treated with exceptionally special
attention as compare to those who are defined as the typical ones. Generally they are
termed as less-intelligent or even abnormal students. This approach developed be certain
people is impolite and harsh. It is much better to term such children as special students.
These special students are not apparently like the normal ones – as they possess special
needs. The special children might be having problems or hurdles with learning or they
may feel it challenging to perform in the activity of communication. Some special
students might contain disorder in behavior or emotions while others may face physical
disabilities that hinder them to learn like those who undergo the typical study. Owing to
these special needs, it is essential to form a certain category of education that would outfit
to these types of individuals – special education. So, the question arises, how does special
education differ from the general education?

Special education uses quite a different approach from the general education, although
some areas overlap. General education involves presenting the standard curriculum set by
education authorities using standard teaching methods. General education involves the
typical classroom setting, wherein teachers address the needs of the class as whole.
Teachers in general education implements procedures and teaching methods regardless of
the differences between the students.

Special education is obviously contrary to the general education. Special curriculum that
fulfills the needs of a certain special type of student is used in Special education. For
instance, the procedures and teaching methodology brought in use for attending a special
student are different from those being implemented on another student. The students’
individual needs and differences are addressed specifically in special education. For that
purpose, various teaching methods, learning materials and support equipment are used.
Hence, a typical classroom environment and set up is not what a special education
teacher use. They have to take help of a special resource room with specific set up.

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Special education VS general education
The basic goal of special education is to provide exceptional children with disabilities
which will prevent them from fully benefiting from traditional educational approaches
with specialized instruction and intervention sufficient to enable them to benefit from
their education.

It is a common but wrong concept that special education is merely altered version of
regular education. This approach of thinking is not correct. In fact, special education in
various ways is more concentrated as well as thorough than a conventional way of
education.

Followings are the differences between special education and regular education:
 Both the systems use quite different instructional methods, and
 Additional specialists (specialized teachers, speech therapists, occupational
therapists, physical therapists, aides, social workers, etc.) are used. These
specialized skills are matched to the specialized requirements of identified children.

Intensive, individualized instructional methods are used in special education. Most

special education students will work on traditional academic content areas such as
reading, writing, math, social studies, and science. In addition to traditional academic
content, many exceptional students also benefit from a functional curriculum. A
Functional Curriculum is designed to help students learn basic daily living skills they
have not developed on their own such as toileting, eating, grooming, using money, filling
out forms, communicating basic needs, and following directions that a teacher or boss
gives them. Functional curriculums teach students the basic skills required for
independent living.

Traditional and functional curricula are improved on a child-by-child, as needed by

special services that assist individual children to administer or surmount obstacles to their
learning. Intervention services are received at school. These services include physical
therapy (PT), occupational therapy (OT), speech and language therapy, and other
services. There are different objectives behind these services: 1) to help in the prevention
of minor problems from turning into a disability, 2) to stop the effects of a disability that
can get worse, 3) to resolve problems related to a disability, or 4) to educate students
regarding completion of certain tasks without thinking about their disability.

For example, psychological and other specialists may collaborate to create a behavior
plan intended to help a child decrease acting-out behaviors, learn to meet their daily
living needs, and to focus their energy on learning. A behavior plan is a plan in black and
white that specifies what positive behaviors the student should be showing, such as
completing work in a timely manner, or sharing toys with other students during group
activities. The behavior plan also specifies what tools school staff can exercise to prompt
students to model those fitting behaviors. Some school staff and families consider that
behavior plans should chiefly form planned consequences for a student's misbehavior, but

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these punishment-oriented plans frequently do not get the full benefits that a more
inclusive behavior plan could offer. Both children in regular education and special
education can benefit from behavior plans, but often, children with special needs will
require a more detailed plan.

Exercise
Q: What is the main distinction between special and general education.

Activity:
Arrange a visit to the special education institute and regular education, at least one each.
Meet their teachers and write down the major differences. You must highlight the names
of the institutions.

9.4 Special Curriculum vs. Regular Curriculum

General Education Curriculum (When Congress passed amendments in 1997 to the
Individuals with Disabilities Education Act (IDEA), they made it clear that children with
disabilities were to progress in the general education curriculum. This was executed to
support learning outcomes for all students, including those with disabilities.

Some schools had to transform. How were they to expose children with major disabilities
to the general curriculum? The answer is they have to make changes in teaching
techniques, and think with some novelty.

The main aims to keep in mind: What is the rationale of the curriculum and what is the
focal point of the curriculum for the student? The teacher must be vigilant regarding the
vision of the child. The outcomes of education must always be the focus of the curriculum.

For example, a student with a disability needs a calculator for the multiplication tables in
a Math class as he cannot retain information of his multiplication facts. What if the
student fails to memorize his multiplication? He is not just taught division? He could still
continue to learn the concept of division by using calculator. This example reflects that if
calculator is used, the student still shows progress in the general education curriculum.

In another example, we discuss about a student who faces difficulties regarding prefixes
and suffixes as his disability creates hurdles in this process of learning. The student in
this case should keep on learning nouns and verbs and also the structure a sentence.
When the student finally starts reading, the teacher will not have to play catch up.

Regardless of the severity of the student’s disability, the curriculum must benefit the
student. Focus should be on the outcome of this process. It must be given a priority that this
curriculum fulfills the needs of the student for making is existence in the world of adults.

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All the students can learn! We must develop the students’ strengths. Diverse learners are
in fact resources and they must not be considered deficits to the classroom. For meeting
the diverse needs of all students, we need to be creative. We also need to teach them
compensatory skills and provide suitable space and adjustment to meet the needs of all
students. For these purposes, schools and parents must be:
 Challenging special students in the process of achieving at higher levels
 Ensuring students with disabilities access to and engage in the general education
curriculum
 Strengthening the parents’ role and nurturing partnership between schools and
families
 Ensuring accountability in learning of students with disabilities by their partaking
in state and local evaluation programs

Through access to the general curriculum, efficient instructional practices, and elevated
standards, many special education students will pick up their academic performance. This
will transform people’s viewpoint about what students with disabilities know and can
do.” (-McIntire)

Access To The General Education Curriculum

 Access to general education curriculum, the same standards, the same testing (with
or without modifications) is a basis of the new law. It is a swing in thinking for all.
 Access to the general education curriculum should not be confused with access to
general education. In the past, children with disabilities had had access to the
general education setting and might have been included in the classroom, but not
the class instruction.
 Furthermore, access to the general curriculum, expectations, and content can take
place in any setting. Intervention specialists offer instruction in diversity of settings
as per students’ needs, including special classes.
 The shift in thinking is that the foundation is the general education curriculum -
what everyone else gets. Then, the IEP addresses the specialized instruction
necessary for the child to access and progress in the general curriculum.
 Systemically, the law undoubtedly requires states and school districts to be
accountable for children with disabilities in compound areas - higher standards,
statewide testing, and graduation.

Activity:
Make a list of major differences among special education curriculum and general
education curriculum after discussing with at least two experts of both the types.

9.5 Adaptations in Curriculum, Instructions and Evaluation

Children with Special Needs are not of same types. They have different qualities and I.Q
levels. It is not possible for them to get the education with the same curriculum as general
education systems have. Although Physically Handicapped, Visually Impaired and

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Hearing Impaired students read the same syllabus as general education students have but
Adaptation in the curriculum is compulsory for them. Therefore many adaptations can be
made according to the disability of the children. For example selective topics in Science,
English and Mathematics may be included or excluded to meet the goals. Mostly Hearing
Impaired and Physically Handicapped children have adaptations in curriculum where as
Visually Impaired students follow the same syllabus and they are allowed the writer for
their exams. Moreover Intellectually Challenged students follow the IEP according to the
severity of their disability.

Adaptations and modifications that can be used in the general education curriculum are as
follows:

Volume of Work - Adapt the number of items that the learner is expected to gain
knowledge of or complete.
 Reduce or limit the exercise of scan sheets for test answers
 Reduce the number of items for assigned tasks
 Reduce the amount of copying
 Reduce the number of troubles
 Reduce the number of concepts and expectations introduced in any given time
 Reduce the number of terms the student must be taught at one time
 Coordinate assignments with other teachers for avoiding overwork
 Reduce volume of assignments
 Reduce assignments as home work, or the assignments should be modified by
parents for avoiding stress
 Have to make students learn two to three concepts/ideas from each chapter
 Minimize the number of concepts/ ideas given at any assigned time period

Time - Adapt the time allotted and allowed for learning, task completion, or
testing
 Make a timeline individualized for accomplishing a task
 Permit learner to take assignments home. Allow extra time in class or outside of
class for work completion
 give extra time on task with a general idea of the lesson before actual teaching
 Review repeatedly for test
 Allow additional time for preparation by giving a pre-test one or two days ahead of
the final test
 Allow additional time to complete a test
 Allow extra time to complete a project
 Allow the learner to get short breaks

Support - Increase the amount of personal assistance with a specific learner

 Grant frequent comprehension checks during a lesson
 Assign peer buddies, teacher assistants, peer tutors, or cross-age tutors

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 Study the tests loudly
 Use groups to write collective story or write summary together and\or to each other
 Assign peer tutor who has accelerated math skills
 Provide cooperative work in small groups
 Utilize peer tutors or pairs of students for projects, to study for test or to proofread
and correct each other’s assignments
 Allow students to take tests in pairs or small groups
 Allow student to dictate answers to a test to a peer or adult
 Provide self-evaluation conferences
 Copy notes from presentation so student who cannot write well or listen effectively
can have notes to study
 Have one student write while the student with writing difficulties dictates responses
 Have a peer proof student's work to provide assistance with prewriting activities
 Ask parent to provide extra practice for their child at home
 Clarify the goals of homework for the student and make adaptations accordingly
 Let learners Elgin homework in class to determine if they understand what is to be
done
 Prepare study packet so student can get assistance at home
 Encourage support between students (e.i., teach students to "ask three then me"
when they need help, ask peers for ideas on how
 their classmates with disabilities can participate more fully in an activity)

Difficulty - Adapt the skill level, problem type, or the rules on how the
learner may approach the work.
 Allow use of calculators to figure math problems
 Prepare an outline with blanks; student fills in the blanks as information is given
 Set up a Word Bank (3x5 file boxes) for weekly vocabulary words,
 spelling words, parts of speech, etc. They may be used later for other work such as
creative writing assignments.
 Provide page number and paragraph to help students find answers
 Number the handouts for reference during the lecture
 Simplify written directions by limiting words and numbering steps and page
 Provide highlighters for students to use in the classroom throughout the year
 Help students highlight or underline important information
 Review frequently for tests
 Supply a study guide with key concepts and vocabulary in advance for learners to
review at home
 When giving a test requiring A, B, C, D answers use capital letters and ask students
to use capital letters to avoid b,d reversals
 Eliminate the choices “All of the Above” and “None Of the above”on tests and quiz
 Provide a menu of options for students to demonstrate knowledge other than or in
addition to tests
 Avoid using double negatives in true-false questions

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 Give alternate test
 Vary format (i.e., true-false, multiple choice, short answers, demonstrating tests,
matching or essay questions)
 Give students choices for testing
 Encourage the students to select the method of writing which theyfind most
comfortable
 Have students repeat directions back to you
 Simplify task directions
 Change rules to accommodate learner's needs
 Use high interest how level books to motivate students to read
 Assign projects that allow students to be creative (shadowboxes, puppets, videos,
summaries on tape, role playing, etc.)
 Allow students to read extra books in place of a test or more difficult project such
as creative writing
 Provide opportunities for students to vary activities rather than to read all period
 Let learners choose assignment (i.e., odd or even questions)
 Make homework relevant to what has been covered in class

Activity
Which types of adaptations are being used in special education system in Pakistan? Enlist
them according to each disability separately.

9.6 Individualized Education Program

The Individualized Education Program (IEP) is a document that is developed for each
child from public school with needs of special education. Through a team effort, IEP is
formed and reviewed periodically.

An IEP is ...
 a written plan telling about the special education program and/or services required
by a particular student, based on a thorough assessment of the student’s strengths
and needs – that is, the strengths and needs that affect the student’s ability to learn
and to exhibit learning;
 a record of the particular accommodations2 needed to help the student achieve his
or her learning expectations, given the student’s identified learning strengths and
needs;
 a working document that identifies learning expectations that are modified from the
expectations for the age-appropriate grade level in a particular subject or course, as
outlined in the Ministry of Education’s curriculum policy documents;
 a working document that identifies alternative expectations, if required, in program
areas not represented in the Ontario curriculum; a record of the specific knowledge
and skills to be assessed and evaluated for the purpose of reporting student
achievement of modified and/or alternative expectations;

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 an accountability tool for the student, the student’s parents, and everyone who has
responsibilities under the plan for helping the student meet the stated goals and
learning expectations as the student progresses through the Ontario curriculum.
 a description of everything that will be taught to the student;
 a list of all the teaching strategies used in regular classroom instruction;
 a document that records all learning expectations, including those that are not
modified from the regular grade level curriculum expectations;
 a daily lesson plan.

An IEP is required when

 the school principal determines that a student’s achievement will be assessed on the
basis of modified expectations; and/or
 the student regularly requires accommodations for instructional or assessment
purposes.

Important Information to be Included in an IEP

 The strengths and needs that relate to the student’s learning. If the student has been
formally identified as exceptional, the IEP should include the strengths and needs
identified in the statement of decision received from the IPRC.
 Relevant assessment data that support the identification of an exceptionality or the
reasons that give rise to the need for special education programs and services
 Any specialized health support services needed to enable the student to attend
 school
 A list of all subjects/courses in which the student requires modified expectations
and/or accommodations, and all alternative programs
 A list of the accommodations the student requires to help him or her learn and
demonstrate learning
 The student’s current level of achievement in each modified subject or course
and/or alternative program area
 Annual program goals and learning expectations for each reporting period in each
subject or course in which modified expectations are required and/or in each
alternative program area
 The assessment methods that will be used to assess the student’s achievement of
the modified or alternative expectations
 A clear indication of the way in which student progress will be reported to parents
(i.e., on the Provincial Report Card and/or in an alternative report) and the dates on
which reports will be issued
 Documentation of consultations with parents and the student (if the student is 16 or
older) during the development of the IEP and any subsequent reviews, and a record
of the review and updating of learning expectations by school staff
 A transition plan (if required)

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9.7 Activity
Meet a special education teacher of any disability. Discuss with him/her and make at least
one IEP for the child with special needs and then observe its results. Was it helpful for
the child?

9.8 Self-Assessment Questions

1. Elucidate segregation in your own words.

2. Explain briefly the integration and its types.

3. Discuss the Inclusive Education and what are the essentials of IE?

4. Discriminate between special education curriculum and General education

curriculum.

5. Do you think that curriculum adaptation is must for the special children? Support
your answer with reasons.

6. Write down some adaptations made for the special needs children.

7. What is an IEP and why we make it?

8. Do you think an IEP play a vital role for the teaching to children with special
needs?

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9.9 References
Berkson, Gershon. (1993). Children with Handicaps: A Review of Behavioral
Research, New Jersey Hove and London, Lawrence Erlbaum Associates,

Butler, D. L. & Sllborm, M. (2013). Barriers to adopting technology for teaching

and learning Educause Quarterly. November 2002. 21-28.

Haring, Norris G. and McCormick Linda, (1986). Exceptional Children in Youth,

Charles E. Merrill Publishing Company, Columbus.

HORNE, MARCIA D. (1985) Attitudes Toward Handicapped Students:

Professional, Peer and Parent Reactions New Jersey London, Lawrence
Erlbaum Associates, Publishers

Kirk, Samuel A, (1972) Educating Exceptional Children, Haughton Mifflin

Company, Boston.

Paul M.A. Baker & Nathan W.M. (2008). Wireless Technologies and
Accessibility for People with Disabilities: Findings form a Policy
Research Instrument, Assistive Technology: The Official Journal of
RESNA, 2:3, 149-156, DOI: 10.1080/713662196.

Thomas David, (1982). The Experience of Handicap, Methuen & Co. Ltd.,
London.

World Health Organization, Disability Prevention and Rehabilitation, World

Health Organization, Geneva.

Yousafzai Fazal-e-Rabbi, A Study of the Education of Educationally Subnormal

Children in UK and Its Implementation for Pakistan.

Zais, Mick. (2011). Standards for Evaluation and Eligibility Determination

(SEED). Office of Exceptional Children: South Carolina, State
Department of Education.

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