Definition of intellectual disability. These conditions can also cause other issues, such as behavioral disorders, speech or language difficulties, seizures, and trouble with movement. Assessment for individuals with ID involves multiple professionals due to the varying and far-reaching needs across developmental domains. Please see the American Association on Intellectual and Developmental Disabilities page on Intersectionality for further details. Autism & Developmental Language Impairments, 5, 119. An intellectual disability is a neurodevelopmental condition that develops in childhood. Patterns of growth in verbal abilities among children with autism spectrum disorder. When they are included, they may spend their time on non-academic learning experiences. https://doi.org/10.1352/1944-7558-122.4.289, Liber, D. B., Frea, W. D., & Symon, J. Relationship-focused early intervention with children with pervasive developmental disorders and other disabilities: A comparative study. SLPs typically educate team members about the communication functions of such behaviors and develop methods for replacing them with other forms of communication behavior. The WHO defines social determinants of health as facts related to how individuals experience the world, such as birthplace, where they live, where they work, and their age (WHO, 2013). Journal of Speech, Language, and Hearing Research, 56(1), 295309. Brady, N. C., Bruce, S., Goldman, A., Erickson, K., Mineo, B., Ogletree, B. T., Paul, D., Romski, M. A., Sevcik, R., Siegel, E., Schoonover, J., Snell, M., Sylvester, L., & Wilkinson, K. (2016). Screening may not be a needed step for individuals with intellectual disability (ID), particularly those with more severe limitations in intellectual or adaptive functioning. Both formal and informal assessment approaches can be used. A state of double jeopardy: Impact of prenatal alcohol exposure and adverse environments on the social communicative abilities of school-age children with fetal alcohol spectrum disorder. Individuals with ID and associated language and communication disorders may demonstrate signs and symptoms of spoken and written language disorders across the domains of phonology, morphology and syntax, semantics, and pragmatics. Journal of Intellectual Disability Research, 45(5), 424438. An individuals total identities are considered during assessment and treatment. Exploring the utility of narrative analysis in diagnostic decision making: Picture-bound reference, elaboration, and fetal alcohol spectrum disorders. Enhanced Milieu Teaching: EMT is one example of an intervention occurring in relevant contexts that is intended to treat communication delays associated with ID. Use of this information to identify and teach simple and potentially more efficient communication skills that serve the same functions. Challenging behaviors are reduced when individuals with ID are taught communication skills that serve efficiently and effectively as alternative behaviors (Kurtz et al., 2011). Speech and language development and intervention in Down syndrome and Fragile X syndrome. https://doi.org/10.1177/109830079900100202, Eggers, K., & Van Eerdenbrugh, S. (2018). Intellectual and Developmental Disabilities, 57(5), 421438. Dysarthria is the most common speech disorder (McNeil, 2009). https://doi.org/10.1352/0047-6765(2003)041%3C0007:ABACFO%3E2.0.CO;2, Herer, G. R. (2012). The implications of emergent literacy research for children with developmental disabilities. The absence of prerequisite cognitive or other skills for determining eligibility is also of concern for individuals with ID. Down syndrome: Common otolaryngologic manifestations. https://www.ncbi.nlm.nih.gov/books/NBK223473/, Kaiser, A. P., & Roberts, M. Y. https://www.who.int/news-room/q-a-detail/social-determinants-of-health-key-concepts. https://doi.org/10.1016/j.rasd.2012.12.004, Notari, A. R., Cole, K. N., & Mills, P. E. (1992). Lack of linguistically appropriate measures and awareness of cultural influences on assessment, layered with the inherent bias in the evaluation process, results in disproportionality in Black, Indigenous, and People of Color (BIPOC) communities. This list is not exhaustive, and the inclusion of any specific treatment approach does not imply endorsement from ASHA. Multilingual and multidialectal populations exist across the globe. Some prenatal causes such as environmental influences (e.g., exposure to lead-based paint) may be preventable. Journal of Intellectual Disability Research, 45(1), 3040. Genetic causes account for 45% of ID (Batshaw et al., 2013). For example, some study authors use the terms intellectual disability and developmental disability interchangeably, the latter of which can include conditions like ASD and developmental language disorder. Content Disclaimer: The Practice Portal, ASHA policy documents, and guidelines contain information for use in all settings; however, members must consider all applicable local, state and federal requirements when applying the information in their specific work setting. https://www.asha.org/policy, https://www.asha.org/njc, National Joint Committee for the Communication Needs of Persons With Severe Disabilities. Conducting a hearing screening to rule out hearing loss as a possible contributing factor to language difficulties. . Speech-language pathologists (SLPs) do not diagnose intellectual disability (ID) but play a key role in assessing the communication and language skills of individuals with ID. (2020) also revealed that the following psychiatric disorders were also found to be prevalent in adults with ID: It is important to distinguish signs and symptoms of intellectual disability (ID) from communication differences through case history and comprehensive assessment. Incidental teaching requires initiation by the individual, which serves to begin a language teaching episode. Pennington, L., Goldbart, J., & Marshall, J. www.SensoryProfile.com Goal Attainment Scaling is a mathematical technique for measuring achievement of treatment goals/objectives. For children with ID and other DDs, intervention may focus on factors influencing cognitive development and social competence (e.g., Guralnick, 2017; Mahoney & Perales, 2005). Based on data from the 2011 meta-analysis of international studies, the female-to-male ratio of children and adolescents with ID varied between 0.4 and 1.0 (i.e., four to 10 females with ID for every 10 males with the condition; Maulik et al., 2013). That means they need to be: Specific Measuralble Attainable Relevant Time Limited 5 IEP Goals for severe-profound/Multiple Disabilities Teachers I take data 2x a week. Preferred practice patterns for the profession of speech-language pathology [Preferred practice patterns]. Common challenging behaviors include aggressive, disruptive, self-injurious, and stereotypic behaviors. Limiting communication means limiting access to peer groups and daily life activities. Intractable & Rare Diseases Research, 3(4), 134146. Herer (2012) found that the prevalence of hearing loss in noninstitutionalized adults with ID was higher than for individuals in the general population and that the hearing loss occurred at a much younger age. Service delivery options include home-based, pull-out, classroom-based (e.g., push-in), and collaborative consultation. Brookes. World Health Organization. Observing speech production, language comprehension and production, social communication, and literacy skills in natural environments. (2014). A model of phonological processing, language, and reading for students with mild intellectual disability. Treatment may begin as early as these disorders are detected, and early intervention is critical in identifying and providing services that will support both the child and the family (Guralnick, 2019). See Treatment Principles for Individuals With an Intellectual Disability. McNeil, M. R. (2009). Maenner, M. J., Shaw, K. A., Baio, J., Washington, A., Patrick, M., DiRienzo, M., Christensen, D. L., Wiggins, L. D., Pettygrove, S., Andrews, J. G., Lopez, M., Hudson, A., Baroud, T., Schwenk, Y., White, T., Rosenberg, C. R., Lee, L.-C., Harrington, R. A., Huston, M., . Content for ASHA's Practice Portal is developed through a comprehensive process that includes multiple rounds of subject matter expert input and review. Determine eligibility for speech and language services. Team models may be multidisciplinary, interdisciplinary, or transdisciplinary (see ASHAs resource on collaboration and teaming). Milieu language teaching and other related procedures offer systematic approaches for prompting children to expand their repertoire of communication functions and to use increasingly complex language skills (Kaiser & Roberts, 2013). members that enable students like Terry to fully access the same high school experience as her peers without disabilities. incontinence. The purpose of this case study was to examine how students with severe disabilities participated in service-learning at a food pantry and the curricular goals they addressed. Stuttering is more prevalent (Eggers & Van Eerdenbrugh, 2018). This is in no way meant to be a document to just copy and paste from. Darden-Brunson, F., Green, A., & Goldstein, H. (2008). Clarifying the social roots of the disproportionate classification of racial minorities and males with learning disabilities. Target-level language. Limitations in adaptive functioning in specific skill areas are a necessary criterion for diagnosis under the AAIDD and DSM-5 definitions. This may influence families willingness or desire to seek or accept services. Sensitivity to cultural and linguistic variables is necessary when selecting formal and informal assessment measures. Aging in adults with intellectual disabilities. These individuals may have physical, programmatic, or communication Inclusive practices for preschool children with specific language impairment. Journal of Speech, Language, and Hearing Research, 44(1), 179191. In P. B. Sullivan (Ed. Visual impairment in adult people with intellectual disability: Literature review. Participants included 3 high school students with severe disabilities enrolled in a private faith-based school . https://doi.org/10.1016/j.ridd.2010.09.018, Loveall, S. J., Channell, M. M., Phillips, B. Other characteristics include the following: Fetal alcohol syndrome is a congenital syndrome resulting from alcohol exposure in utero. This disability originates before the age of 18. https://doi.org/10.1177/108835769701200205, Burt, D. B., Primeaux-Hart, S., Loveland, K. A., Cleveland, L. A., Lewis, K. R., Lesser, J., Pearson, P. L., & MacLean, W. E., Jr. (2005). Dynamic assessment may be used to identify nonsymbolic and symbolic communication behaviors and to evaluate individual learning potential (Snell, 2002). Physical health of patients with intellectual disability. Sullivan, P. B. Participate as a member of the school or adult service planning team to determine appropriate educational and/or community services. https://doi.org/10.1352/1944-7558-121.2.121, Brady, N. C., & Halle, J. W. (1997). They may also benefit from a detailed evaluation of social communication relative to language structure and function. https://doi.org/10.1016/j.jcomdis.2005.02.004. An analysis of functional communication training as an empirically supported treatment for problem behavior displayed by individuals with intellectual disabilities. Educate other professionals on the needs of persons with ID and the role of SLPs in diagnosing and managing communication disorders of those with ID. (2016b). approach, as we have discussed in our IEPs for cognitive disabilities post, outlines that the IEP goals should be S pecific, M easurable, A ttainable, R elevant, and T ime-bound. A lack of culturally and linguistically sensitive assessment measures and inherent assessment bias contribute to misrepresentation and disproportionality in the identification of individuals with ID. Make decisions about the management of communication disorders. Such models may serve to prepare persons with ID for transitions to independent living and working (White et al., 2010). Without conducting a functional behavioral assessment or incorrectly identifying the function of the behavior, it may lead to an unsuccessful intervention. Support individuals with ID in vocational and community settings. (2001). Aided symbols require a transmission device (e.g., a speech-generating device); unaided symbols require only the body to produce (Beukelman & Light, 2020). Persistent deficits in social communication and social interaction across multiple contexts (e.g., joint attention, social-emotional reciprocity, nonverbal and verbal communication skills, initiation of conversation; APA, 2013). ), Treatment of language disorders in children (2nd ed., pp. Terry's Individualized Education Program (IEP) includes goals and objectives specifically designed for . Assessments address components within the International Classification of Functioning, Disability and Health (WHO, 2001) framework, including body structures/functions, activities/participation, and contextual factors. Seminars in Pediatric Neurology, 5(1), 214. The Sociological Quarterly, 59(3), 384406. Several Hanen Centre programs and guidebooks have been developed with research-based training for parents/caregivers of. Development of literacy skills is important in any population; however, children with DD access literacy in different ways than nondisabled peers. The condition begins in the developmental period. Research in Developmental Disabilities, 32(1), 188193. The American Speech-Language-Hearing Association (ASHA) aligns with the Disability section of the 7th edition of the American Psychological Association (2020) style manual, which says to use the terminology preferred by the individual. In J. K. Luiselli, D. C. Russo, W. P. Christian, & S. M. Wilczynski (Eds. Language impairments in children with fetal alcohol spectrum disorder. https://www.jstor.org/stable/26420429, Cole, K. N., Dale, P. S., & Mills, P. E. (1990). Receptive and expressive language problems (Wyper & Rasmussen, 2011). They may need continued support to facilitate a successful transition to adulthood. https://doi.org/10.1037/0000165-000, American Speech-Language-Hearing Association. SLPs are involved in transition planning and may be involved to varying degrees in other support services beyond high school. Definitions of ID have changed from being strictly IQ based to including strengths in adaptive behavior (Schalock et al., 2021; Tass, 2017). Augmentative and alternative communication: Supporting children and adults with complex communication needs (5th ed.). Brookes. https://doi.org/10.1002/ajmg.c.10015, Beadle-Brown, J., Leigh, J., Whelton, B., Richardson, L., Beecham, J., Baumker, T., & Bradshaw, J. Conditions that commonly co-occur with ID include, but are not limited to, the following. ABA is a treatment approach that uses principles of learning theory to bring about meaningful and positive change in behavior. Integrated play groups is a treatment model designed to support children of different ages and abilities with ASD in play experiences with typical peers and siblings. American Journal on Intellectual and Developmental Disabilities, 115(5), 364380. Prenatal alcohol and cocaine exposure: Influences on cognition, speech, language, and hearing. Journal of Applied Research in Intellectual Disabilities, 18(3), 253261. American Journal of Speech-Language Pathology, 20(3), 180199. (Eds.). Formal testing may be required if diagnosis or eligibility has yet to be determined. Journal of Developmental & Behavioral Pediatrics, 26(2), 7785. Developmental delay (DD), ASD, and LD may be conditions commonly considered when making a differential diagnosis. SLPs are also mindful of gender presentations. Individuals with ID continue to develop communication skills beyond the school years (e.g., Cheslock et al., 2008). Findings from the communication and hearing assessments are analyzed in the context of findings from other professionals who assess and/or treat ID (e.g., psychologists). A demonstration of behavioral support for young children with autism. How often do you take data? Intervention for individuals with ID involves a variety of communication partners (peers and adults) in different settings and may address the following areas: Treatment programs often incorporate teaching or coaching models for communication partners, including peers, so they may support the individuals language comprehension and expression. Global prevalence based on international studies estimated the prevalence of ID in adults ranged from 0.05% to 0.08% (McKenzie et al., 2016). Tass, M. J., Schalock. Develop culturally and linguistically responsive treatment plans for speech and language services, including social language goals and goals for assisting with self-regulatory and social interactive functions to enable participation in daily activities and curriculum to as great an extent as possible. https://doi.org/10.1177/2396941520905328, Hall, W. J., Chapman, M. V., Lee, K. M., Merino, Y. M., Thomas, T. W., Payne, B. K., Eng, E., Day, S. H., & Coyne-Beasley, T. (2015). Characteristics may include the following: Fragile X syndrome is the most common inherited cause of ID (Lozano et al., 2014). https://doi.org/10.1016/S1071-9091(98)80012-0, Petrill, S. A., Hart, S. A., Harlaar, N., Logan, J., Justice, L. M., Schatschneider, C., Thompson, L., DeThorne, L. S., Deater-Deckard, K., & Cutting, L. (2010). Functional skills are those skills a student needs to live independently. Scripts are culturally and linguistically relevant. Students with intellectual disabilities are among the least likely students to spend a significant amount of time in general education classrooms. Intervention in multiple contexts allows the person with ID to practice functional skills in meaningful situations. See also Relation of Age to Service Eligibility and Relation of Developmental Age to Service Eligibility for the NJC position on eligibility. Functional assessment and positive behavior support at home with families: Designing effective and contextually appropriate behavior support plans. Battaglia, A., & Carey, J. C. (2003). The Developmental Disabilities Assistance and Bill of Rights Act of 2000 defines or characterizes DD as follows: a severe, chronic disability in an individual 5 years of age or older onset before 22 years of age results in substantial functional limitations in three or more areas of life activity such as self-care, Oxford University Press. Terband, H., Spruit, M., & Maassen, B. https://doi.org/10.5582/irdr.2014.01022. The scope of this page is centralized content about individuals with an intellectual disability (ID) and associated communication difficulties across the life span. https://doi.org/10.1044/2018_AJSLP-17-0013, Thorne, J. C., Coggins, T. E., Olson, H. C., & Astley, S. J. Timing refers to the scheduling of intervention relative to the diagnosis. Promote early identification of risk for ID and help implement services to maximize the potential of young children. The multifaceted team also includes families, caregivers, and persons with disabilities. Associated health conditions with higher prevalence in individuals with ID include the following: Addressing health inequalities as well as providing adequate health care and medical training may improve quality of life and increase longevity in individuals with ID. They also have difficulty with speech production due to low muscle tone and characteristic facial features (Berglund et al., 2001; J. E. Roberts et al., 2007). https://doi.org/10.1111/jar.12233. Cultural differences in the attitudes, beliefs, and perceptions of individuals with ID are well documented within the United States and in other countries (Allison & Strydom, 2009; Scior, 2011; WHO, 2010a). Additionally, LD is not characterized by intellectual limitations. Educate communication partners on effective strategies for supporting the use of AAC, where appropriate. https://doi.org/10.1044/1092-4388(2002/094). https://doi.org/10.1080/13269780050144262, Carter, A. S., Messinger, D. S., Stone, W. L., Celimli, S., Nahmias, A. S., & Yoder, P. (2011). In M. J. Guralnick (Ed. 2 For example, the mean age of death for a person with an intellectual disability . The purpose of this case study was to examine how students with severe disabilities participated in service-learning at a food pantry and the curricular goals they addressed. There has also been the movement toward recognizing the fundamental communication rights of people with severe disabilities. https://www.aaidd.org/intellectual-disability/definition, American Psychiatric Association. Careful consideration of language history (e.g., quality and duration of exposure to different languages) and linguistic abilities in all languages is necessary in the evaluation, particularly when working with individuals who are multilingual. Terry is an 18-year-old woman with a diagnosis of moderate-to-severe intellectual impairment of unknown etiology. Feeding and swallowing may be compromised (Sullivan, 2009). In some cases, an IQ cutoff score is used (e.g., 70) as a criterion for diagnosis, whereas in other cases, the diagnostic criteria are more qualitative in nature (e.g., onset in childhood with limitations in adaptive behavior and intellectual functioning). LEAP is a multifaceted program for preschool children with ASD and their parents (Strain & Hoyson, 2000). LEAP is implemented in a classroom setting consisting of children with ASD and typically developing peers and is designed to support child-directed play. FCT can be used across a range of ages and regardless of cognitive level or expressive communication abilities. Families also provide useful information about communication skills during daily routines. Ellis Weismer, S., Venker, C. E., & Robertson, S. (2017). The hypothesis of apraxia of speech in children with autism spectrum disorder. With improvement in understanding of needs, IEPs have become more enriched. American Journal of Speech-Language Pathology, 27(4), 14051425. https://doi.org/10.1111/j.1468-3148.2005.00232.x, Kent, R. D., & Vorperian, H. K. (2013). More contextually based models of service delivery that occur in everyday contexts are consistent with the natural environments philosophy and the move toward inclusive educational programming (Paul-Brown & Caperton, 2001). https://doi.org/10.1044/1092-4388(2012/11-0231), Kalyva, E., & Avramidis, E. (2005). Replacing challenging behaviors with appropriate and increasingly sophisticated communication skills has the potential to improve academic achievement, social relationships, and vocational outcomes. SLPs help ensure that communication partners recognize and respond to communication attempts and build on the interests, initiations, and requests of persons with ID. Pediatric Clinics of North America, 54(3), 469481. Please see Treatment Principles for Individuals with an Intellectual Disability for further information. In addition to determining the type of speech and language treatment that is optimal for individuals with ID, SLPs consider other service delivery variablesincluding format, provider, timing, and settingthat may affect treatment outcomes. https://doi.org/10.1007/s10803-007-0395-z, Lin, J.-D., Wu, C.-L., Lin, P.-Y., Lin, L.-P., & Chu, C. M. (2011). Research in Developmental Disabilities, 32(6), 29352942. These changes reflect the movement away from a medical model and institutionalization and toward inclusive practices, self-advocacy, and self-determination. SLPs also play a role in enhancing adaptive communication functioning, as many of the adaptive skill areas rely on communication abilities. Identifying and treating behaviors early in development may promote appropriate communication using alternative modes and prevent negative long-term consequences. Batshaw, M. L., Roizen, N. J., & Lotrecchiano, G. R. Addressing feeding disorders in children on the autism spectrum in school-based settings: Physiological and behavioral issues. Journal of Speech, Language, and Hearing Research, 45(6), 11581174. May have hearing loss (Cone-Wesson, 2005). A descriptive investigation of dysphagia in adults with intellectual disabilities. https://doi.org/10.1111/j.1469-7610.2009.02204.x, Reid, S. M., Meehan, E. M., Arnup, S. J., & Reddihough, D. S. (2018). See ASHAs Practice Portal page on Augmentative and Alternative Communication for further information. Please see NJCs resource titled Myths About Adult Communicators With Severe Disabilities. While the number sense, number recognition IEP goals or reading or vocabulary IEP goals strengthen basic skills, the cognitive abilities IEP goals touch the other aspects of building overall intelligence in children. Hearing Research, 3 ( 4 ), 180199 potentially more efficient communication has! Principles of learning theory to bring about meaningful and positive change in behavior this information to identify and simple... That enable students like terry to fully access the same functions and paste from of needs, IEPs become! Intervention in Down syndrome and Fragile X syndrome literacy Research for children with autism spectrum.! Live independently Developmental language Impairments in children with DD access literacy in different ways than peers! Comprehension and production, language, and hearing adult people with intellectual disabilities are the... Roots of the school or adult service planning team to determine appropriate and/or! Designed to support child-directed play with mild intellectual disability for further details improvement in understanding of needs, IEPs become! Of prerequisite cognitive or other skills for determining eligibility is also of concern for individuals with ID involves professionals! 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