Learners with

Developmental Disabilities
MENTAL RETARDATION (MENTAL
DEVELOPMENT)
AUTISM SPECTRUM DISORDER
(PSYCHOLOGICAL DEVELOPMENT)
 Introductio
nDevelopmental disabilities impose enormous
personal, social, and economic costs because of
their early onset and the lifetime of dependence
that often ensues. Children with disabilities often
have limited educational opportunities, and as
they grow older, limited employment options,
productivity, and quality of life.
Introductio
n Yet the costs of developmental disabilities are difficult to
quantify in settings where relevant data and services are
lacking. As a result, in low-income countries today, where
more than 80 percent of the world's children are born, the
magnitude of the impacts of developmental disabilities on
individuals, families, societies, and economic development
remains largely unrecognized and has yet to be addressed
from a policy perspective.
Objectives: At the end of this module
you should be able to:
1. Describe developmental disabilities and differentiate
the different categories.
2. Enumerate and discuss the characteristics of children
with mental retardation and with autism spectrum
disorder. 3. Discuss the assessment procedures,
curricular programs and instructional systems for
children with mental retardation and with autism
spectrum disorder.
I. Definition:
• Developmental disabilities are severe,
long-term problems. They may be
physical, such as blindness. They may
affect mental ability, such as learning
disabilities. Or the problem can be both
physical and mental, such as Down
syndrome.
Developmental disabilities
The problems are usually life-long, and can affect
everyday living. These limitations manifest during
infancy or childhood as delays in reaching
developmental milestones or as lack of function in one
or multiple domains, including cognition, motor
performance, vision, hearing and speech, and
behaviour.
Developmental disabilities
• It may be noted that children with developmental
disabilities are often affected extent of brain
in multiple domains of function because of the nature and

impairment or increased susceptibility to other causes of

disability (e.g., malnutrition,trauma, infection) among
children with a single disability.
• Often there is no cure, but treatment can help the
symptoms. Treatments include physical, speech, and
occupational therapy. Special education classes and
psychological counseling can also help.
Developmental disabilities
• Causes of developmental disabilities include damage to or

anomalies in the developing nervous system. The human

nervous system is especially vulnerable during the period of its

most rapid growth, which begins during gestation and extends

into early childhood. These include:

⮚ Genetic or chromosome abnormalities. These cause conditions

such as Down syndrome.

⮚ Prenatal exposure to substances. For example, drinking alcohol
when pregnant can cause fetal alcohol spectrum disorders.
Developmental disabilities
⮚ Certain infections in pregnancy like rubella,
syphilis and HIV.
⮚ Nutritional Deficiencies like iodine deficiency
(cretinism) and folate deficiency (spina bifida).
⮚ Environmental Toxins like lead
⮚ Preterm birth
⮚ Poverty
II. Categories of Developmental Disabilities
• Cognitive disabilities in children include mental retardation
as well as specific learning disabilities in children of normal
intelligence. Mental retardation is defined as subnormal
intelligence (intelligence quotient [IQ] more than two
standard deviations below that of the population mean),
accompanied by deficits in adaptive behavior. Grades of
mental retardation are typically defined in terms of IQ.
Cognitive Disabilities
Children with mild mental retardation, the most common form,
are limited in academic performance and consequently have
somewhat limited vocational opportunities. Adults with mild
mental retardation typically lead independent lives. Children
with more severe grades of mental retardation (moderate,
severe, and profound) are more likely to have multiple
disabilities (e.g., vision, hearing, motor, and/or seizure in
addition to cognitive disability) and to be dependent on others
for basic needs throughout their lives.
 SPECIFIC LEARNING DISABILITIES

• Specific learning disabilities result not from global intellectual deficit,

but from impairments in one or more of the specific “processes of speech,

language, reading, spelling, writing or arithmetic resulting from possible

cerebral dysfunction.” Children with specific learning disabilities are usually

identified as such only after entering

school, where a significant discrepancy is noted between their achievements in

specific domains and their overall abilities. These include

dyscalculia and dyslexia.

 MOTOR DISABILITIES
• Motor disabilities include limitations in walking and in use of
the upper extremities (arms and/or hands).
Some motor disabilities also affect speech and swallowing. Severity
can range from mild to profound. Motor disabilities diagnosed in
infancy or childhood include cerebral palsy, which results from
damage to motor tracts of the developing brain; paralysis following
conditions such as poliomyelitis and spinal cord injuries; congenital
and acquired limb abnormalities; and progressive disorders, such as
the muscular dystrophies and spinal muscular atrophies. Cerebral
palsy results from a permanent, nonprogressive damage or insult to
the developing brain. Affected children therefore may manifest a
variety of motor dysfunctions, depending on the specific location of
the damage.
 Vision, Hearing and Speech Disabilities

The prevalence of low vision, blindness, and hearing

loss increases with age, making these disabilities
conditions that affect primarily adults. A number of
important causes of vision as well as hearing disability
have their onset early in life, however, and may be
considered neurodevelopmental. Refractive errors, the
most common form of vision impairment, are especially
problematic for children in low-income countries
because eyeglasses and basic vision care services are
unavailable to many.
 Vision, Hearing and Speech Disabilities

Learning to speak depends on the ability to hear and

repeat sounds. The optimal period for speech
acquisition is the first 2 years of life; a child who does
not speak by the age of 5–6 will have difficulty
developing intelligible speech thereafter. It is therefore
important to screen young children for hearing
impairment and to evaluate the hearing of a child who
is suspected of having mental retardation or delay in
speech development.
 Behavioral Disorders

• Behavioral disorders not necessarily linked to psychosocial precursors

include autism and attention-deficit and hyperactivity disorders. These

disorders can have profound effects on academic achievement and on families.

Behavioral disorders typically develop in childhood or adolescence. While some

behavioral issues may be normal in children, those who have behavioral

disorders develop chronic patterns of aggression, defiance, disruption and

hostility. Their behaviors cause problems at home, school or work, and can

interfere with relationships.

 A. Mental Retardation
• Mental retardation currently is defined by the American
Association on Mental Retardation (AAMR) as “significantly
sub-average general intellectual functioning resulting in or
associated with concurrent impairments in adaptive
behavior and manifested during the developmental period.
⮚ significantly subaverage – an IQ of 70 or below but permits
clinical judgment to extend this as far as 75.
⮚ general intellectual functioning – means one’s ability to
reason, to understand the consequences of one’s actions, to make
generalizations, to deal with abstractions, and other related abilities
thought to reflect “intelligence.”
A. Mental Retardation
⮚ impairments in adaptive behavior – means the degree
to which an individual meets “the standards of maturation,
learning, personal independence and/or social
responsibility” expected for his/her age level and cultural
group.
⮚ adaptive behavior – refers to the extent to which a
person adapts successfully to various environments, takes
care of personal needs, and reflects age-appropriate
communication, social and situational competencies.
⮚ developmental period – means the time between
conception and 18th birthday.
Mental Retardation
Categories of Mental Retardation
 Learning Characteristics
General ∙ Apparent slowness in learning related to the delayed rate of
Cognition development (Wehman, 1997)
∙ Tend to perform more poorly than comparative normal group. ∙
They score significantly below average on intelligence tests. ∙
They have impaired capacities to learn, do not know how to
learn or are not efficient or effective in the learning process
including attention, memory, linguistic and generalization
skills.
Attention ∙ Have difficulty attending to a learning task for a required
length of time.
∙ They tend to perseverate or can’t shift attention to a new
material.
Memory ∙ They have problems with long-term and short-term memory
and the rehearsal processes necessary for placing
information in memory.
∙ The more severe the retardation, the greater the memory
deficit.
Language ∙ Individuals with mental retardation (depending on the degree
of retardation) usually have language comprehension and
formulation difficulties.
∙ They experience delayed language development and often
exhibit less fluent and less articulate speech than their peers. ∙
There may be expressive and receptive language problems,
problems in conversational skills, giving and receiving
directions, determining central or essential issues and telling
 Learning Characteristics
Academic ∙ Cognitive inefficiencies may lead to
Achieveme persistent problems in academic
achievement.
nt ∙ They lag behind in reading, reading
comprehension, computation and general
mathematics.
Metacogniti ∙ They have difficulty in metacognitive skills
on such as planning how to solve a problem,
monitoring their own solution strategy,
proceeding with the strategy implementation
and evaluating the outcome.
∙ The lack or underdevelopment of these skills
affects memory, rehearsal skills,
organizational ability and being in control of
the process of learning.

Motivation ∙ They may approach the learning situation

with significant anxiety.
Identification
Process Identification
The first and most important step in the
diagnosis of mental retardation is to conduct a
comprehensive study of the patient and his family
history. Assessment of maternal health status
during pregnancy with the involved child should
include questions regarding utilization of tobacco,
alcohol and drugs; lifestyle or other risks for
sexually transmitted diseases; weight gain or loss;
indications of contamination; serious illness or
injury; and surgery or hospitalization (Reiss, 1994;
Szymanski, 1994).
Process Identification
NIMH in 1998 developed a systematic method for
identification and screening of mentally retarted children. .
(1) Prenatal procedure for identification of Mentally
Retarted children .
⮚ Blood tests should be carried out for detecting anemia,
diabetes, syphilis and neural tube defects.
⮚ Ultra Sonography should be carried out in the second
trimester of the pregnancy for detecting certain disorders
such as hydrocephaly, microcephaly, holoprocencephaly,
prosencephaly and some celebral lesions.
⮚ Foetoscopy should be carried out during the second

trimester of pregnancy for diagnosing physical anomalies,

metabolic disorders or biochemical abnormalities
Process Identification
(2) Perinatal or Natal identification.
⮚ Peri-natal infections have long-term cognitive effects such
as neonatal herpes simplex (HSV) and group B
Streptococcus infection. HSV (Herpes Simplex Virus) often
has long term neurological impairment such as MR.
⮚ Group B streptococcus has meningitis which may display
neurosensory impairment and is acquired in utero at the time
of delivery or during the first 7 days of life.
⮚ Low birth weight (<2500 gm) and preterm delivery < 37
weeks is also associated with an increased risk of MR.
⮚ LBW/PRE (Low birth weight or Pretem delivery) infants who
were growth retarted at birth tend to have lower mean IQs
than appropriate growth LBW/PRE (Sung et al. 1993).
Process Identification

(3) Postnatal identification

Post natal causes of mentally retarted are
easily detectable than pre-natal and peri-natal
causes.
⮚ Exposure of the child to contaminated
environment (such as lead, methyl- mercury,
polychlorinated biphenyls etc.) can lead to
neurological damage.
⮚ A severe accident which lead to head injury
can also impair cognition.
Process Identification
(4) Assessment Methods
⮚ Intelligence Tests/ IQ Tests - There are various types of
IQ tests. Because of their accuracy and predictive
capabilities practitioner prefer individually administered
tests to group tests. Stanford-Binet and the Wechsler
Intelligence Scale for Children-Revised(WISCR-R) are the
most common individual IQ tests for children. Both tests are
verbal.
⮚ Adaptive Skills – operationally, this means that there are
clear deficits in the effectiveness or degree to which the
individual meets the societal standards of personal
independence and social responsibility that are expected of
his/her age and social group.
 Curricular Priorities
General education. It’s important that students with
intellectual disabilities be involved in, and make progress in,
the general education curriculum. That’s the same curriculum
that’s learned by those without disabilities. Be aware that
IDEA does not permit a student to be removed from education
in age-appropriate general education classrooms solely
because he or she needs modifications to be made in the
general education curriculum.
Curricular Priorities
Supplementary aids and services. Given that intellectual
disabilities affect learning, it’s often crucial to provide support to
students with ID in the classroom. This includes making
accommodations appropriate to the needs of the student. It also
includes providing what IDEA calls “supplementary aids and
services.” Supplementary aids and services are supports that may
include instruction, personnel, equipment, or other accommodations
that enable children with disabilities to be educated with nondisabled
children to the maximum extent appropriate. Thus, for families and
teachers alike, it’s important to know what changes and
accommodations are helpful to students with intellectual disabilities.
These need to be discussed by the IEP team and included in the IEP, if
appropriate.
Curricular Priorities
Adaptive skills. Many children with intellectual disabilities
need help with adaptive skills, which are skills needed to live,
work, and play in the community. Teachers and parents can
help a child work on these skills at both school and home.
Some of these skills include:
⮚ communicating with others;
⮚ taking care of personal needs (dressing, bathing, going to
the bathroom); ⮚ health and safety;
⮚ home living (helping to set the table, cleaning the house, or
cooking dinner); ⮚ social skills (manners, knowing the rules of
conversation, getting along in a group, playing a game);
⮚ reading, writing, and basic math; and
⮚ as they get older, skills that will help them in the workplace.
Curricular Priorities
Transition planning. It’s extremely important for
families and schools to begin planning early for
the student’s transition into the world of
adulthood. Because intellectual disability affects
how quickly and how well an individual learns new
information and skills, the sooner transition
planning begins, the more can be accomplished
before the student leaves secondary school.
Educational
Placement
• Mainstream (many people refer to this as
General Education): Many students receive
special education and related services in a
general education classroom where peers
without disabilities also spend their days. This
is called inclusion. Some services that a
student might receive in a mainstream
setting include: direct instruction, a helping
teacher, team teaching, co-teaching, an
interpreter, education aides, modifications or
accommodations in lessons or instruction, or
more teachers per student
Educational
Placement
• Resource: This is a class for students
who receive special education services
and need intensive help to keep up with
grade-level work. The class may have 1
or 2 students, or may have many
students. However, students receive
instruction or support based on their
unique needs. The number of minutes
your child spends in a resource class
must be written into the IEP.
Educational
Placement
• Self-Contained Programs: This is a
general term for placements for
which the student needs to receive
services outside of the general
education classroom for half of the
school day or more. Placement in a
self-contained classroom has to be
based on a student’s unique needs,
not on the disability alone.
Teaching Strategies
∙ To fully address the limitations in intellectual functioning
and adaptive behavior often experienced by individuals with
intellectual disabilities, 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.
Additional skill areas include money concepts, time
concepts, independent living skills, self-care and hygiene,
community access, leisure activities, and vocational training.
Students with intellectual disabilities learn these skills most
effectively in the settings or activities in which they will be
asked to apply these skills. Once the skills are mastered,
then additional environments can be added to work towards
generalization
Teaching Strategies
∙ Useful strategies for teaching students with intellectual
disabilities include, but are not limited to, the following
techniques:
⮚ Teach one concept or activity component at a time
⮚ Teach one step at a time to help support memorization and
sequencing
⮚ Teach students in small groups, or one-on-one, if possible
⮚ Always provide multiple opportunities to practice skills in a
number of different settings
⮚ Use physical and verbal prompting to guide correct
responses, and provide specific verbal praise to reinforce
these responses
B. Autism Spectrum Disorder

Autism is a wide range or

spectrum of brain disorders that
is usually noticed in young
children. Autism is also referred
to as Autism Spectrum Disorder
or ASD. Autism decreases the
individual's ability to
communicate and relate
emotionally to others. This
disability may range from mild to
severe. Autism occurs about four
to five times more often in boys
than girls
Is Autism a Disorder?

Autism is a disorder, not a disease. There

are many brain disorders that fall into the
autism category such as autistic disorder,
childhood disintegrative disorder, pervasive
developmental disorder-not otherwise
specified, and Asperger syndrome.
What Does “Spectrum” Mean?
“Spectrum” in autism spectrum disorder refers to
the wide range of symptoms, skills, and severity
of the disorder. The three most common disorders
on the autism spectrum are autism, Asperger’s
syndrome, and pervasive developmental
disorder- not otherwise specified.
Autism spectrum disorder (ASD) is a complex developmental
condition that involves persistent challenges in social interaction,
speech and nonverbal communication, and restricted/repetitive
behaviors. The effects of ASD and the severity of symptoms are
different in each person. ASD is usually first diagnosed in
childhood with many of the most-obvious signs presenting around
2-3 years old, but some children with autism develop normally
until toddlerhood when they stop acquiring or lose previously
gained skills. Autism is a lifelong condition. However, many
children diagnosed with ASD go on to live independent,
productive, and fulfilling lives.
 Categories of ASD
• PDD ( Pervasive Developmental Disorder)
Category is a general category of disorders
which are characterized by severe pervasive
impairment in several areas of development.
Individuals who fall under this category exhibit
commonalities in communication and social
deficits but differ in terms of severity. The
following are the main classifications of PDD:
 Categories of ASD
⮚ Autistic Disorder – impairments in social
interaction, communication, imaginative play prior to
age 3 years, stereotypes behaviors, interests and
activities.
⮚ Asperger’s Disorder - impairments in social
interactions and the presence of restricted interests
and activities with no clinically significant general
delay in language and testing in the range of average
to above average intelligence; high functioning autism.
 Categories of ASD
⮚ Pervasive Developmental Disorder/ not otherwise
specified (PDD NOS) – the child does not meet the criteria
for a specific diagnosis but there is a severe and pervasive
impairment in specified behaviors; atypical autism.
⮚ Rett’s Disorder – a progressive disorder which occurs
only to girls; period to normal development and then loss of
previously acquired skills, loss of purposeful use of hands
replaced with repetitive hand movements beginning at the
age of 1 to 4 years.
⮚ Childhood Disintegrative Disorder – characterized by
normal development for at least the first 2 years followed by
a significant loss of previously acquired skills; regressive
autism.
 Learning Characteristics
Interaction/ ∙ May prefer to be on their own
social ∙ Poor awareness of personal space
relationshi ∙ Try to be sociable, but is clumsy
ps/ ∙ Don’t look at others, or may give wrong signals
emotions (facial expressions)
∙ Difficulty adjusting behavior to specific
persons/situations ∙ May try to dominate games or
activities of others ∙ Little interest in competitive
sports/activities
∙ Indifferent to peer pressure
∙ Doesn’t seem to understand other’s feelings
(make inappropriate comments, lack empathy)
∙ Doesn’t seem to know how to play with other
children ∙ Difficulty controlling emotions
appropriately(inappropriate laughter, overly
distressed over small things)

Communicati ∙ Delayed language development

on ∙ May have good vocabulary and grammar but poor
pragmatic use of language (Asperger’s syndrome)
∙ Difficulty understanding jokes, idiom or metaphor
 Learning Characteristics
∙ Quality of communication may be worse if under stress or
excited
∙ Difficulties with non verbal communication
⮚ Lack of facial expression
⮚ Limited or inappropriate gesture
⮚ Poor judgment of other people’s body language

Inflexibility/ ∙ Lack of flexibility in thinking, resisting change

rigidity of ∙ Preferences for sameness and development of routines ∙
behavior Strong interests which are quite narrow
∙ Repetitive questioning eventhough the question has been
answered
∙ Repetitive motor movements(esp.if under stressed or
excited)

Sensory issue/ ∙ Unusual response to sensory stimuli such as loud noises,

others certain objects
∙ Unusual reaction to pain
∙ Preference for certain foods
∙ Difficulty concentrating/ over active
∙ Fine motor difficulties (poor handwriting)
∙ Gross motor clumsiness
 Identification
∙ There is no single medical test for diagnosing autism.
∙ Children with Autism (CWA) must be evaluated along the
developmental areas because autism consists of a cluster of
symptoms along these areas. ∙ Evaluation must include the
following (or most of):
⮚ Clinical interview (developmental, medical,family, behavioral history)
⮚ A measure of cognitive ability (IQ test)
⮚ A measure of receptive/ expressive language
⮚ A measure of academic ability
⮚ Observations of the children/ interactions with the child
⮚ A measure of adaptive behavior
⮚ A general behavior rating scale
⮚ A rating scale specific to autism
⮚ Interviews and rating scales from school (if appropriate)
 Curricular Priorities

∙ Communication development – expressive skills

through speech and/or augmentative systems;
development of receptive language; development of
pragmatic skills.
∙ Increase understanding of the environment.
∙ Socialization – with emphasis on appreciating and
communicating feelings, managing frustration, impulse
control and relaxation
 Curricular Priorities
∙ Development of social skills and behaviors appropriate to a
variety of contexts and situations.
∙ Use academic instruction appropriate to the developmental
level of the student.
∙ Developing and increasing self-control and self-
management – self-monitoring, self-evaluation and self-
reinforcement.
∙ Sensory integration Vocational and community-living skills
including self-help skills.
 Educational Placement
∙ Children with autism spectrum disorders (ASD) are
often educated in general education settings. As such,
it is important to understand the variables that might
affect a student's placement in inclusive education
settings, simultaneously considering student variables
(e.g., disability label) and teacher variables (e.g.,
knowledge of autism).
∙ Resource
∙ Self-Contained Programs
∙ One-on-one basis
Teaching Strategies

∙ Teachers must structure and organize the

classroom life in order for students to expand
their strong areas as well as grow in their
weak areas.
∙ The features of structure are physical
organization, scheduling and teaching
methods.
∙ The key to effectively using each of these
features is individualization.
Teaching Strategies

⮚ Physical organization – physical lay out of the

classroom is an important consideration when
planning learning experiences for students with autism.
⮚ Scheduling – a purposeful, clear and consistent
schedule - a framework that outlines who, what, where
and when – can help a student organize and predict
daily and weekly events. This lessens anxiety about
not knowing what will happen next. It can also aid
students in transitioning independently between
activities. There are 2 types of schedules used
simultaneously in the classroom:
Teaching Strategies

There are 2 types of schedules used simultaneously in

the classroom:
✔ General Overall Classroom Schedule –
outlines the events of the day; it does not specify work
activities for students but shows general work times,
break times, etc.
✔ Individual Student Schedule – helps the
student understand what to do during activities listed
in the general schedule; it can take in a variety of
forms but must be individually oriented i.e., age
appropriate, based on the level of comprehension or
endurance.
Teaching Strategies
⮚ Teaching Methods
✔ Teacher gives directions to students verbally or non-
verbally but at the student’s level of understanding.
✔ Verbal directions mean using minimum amount of
language needed which are accompanied with
gestures to help students understand.
✔ Nonverbal directions – mean using contextual and
visual clues like systematically presenting and
positioning materials and using written instructions.
✔ Reinforcements and fixations of studenrs can be
used as motivations for learning.
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