children with motor and intelectual disablities Flashcards
what are the 5 categories that describe mental retardation
1) limitations in the community and environment
2) differences in sensory and communication and motor factors
3) limitations often coexist with strengths
4) needed supports in his or her life like assistants
5) the life might improve
IQ is typically 70-75 or below
The greater the cognitive impairment the more likely the motor problems
Examination and intervention strategies must take into account child’s information processing ability
The greater the cognitive impairment the more likely the motor problems
Examination and intervention strategies must take into account child’s information processing ability
Cognitive impairments
The greater the cognitive impairment the more likely the motor problems
Examination and intervention strategies must take into account child’s information processing ability
What age does mental retardation set in before and how would you describe it. Do males or females get it more
Onset before age of 18 yrs
Significant subaverage intelligence
Limitations in adaptive function (activity & participation)
Examples: Communication, self-care, home living, social/interpersonal skills
Incidence : 3% of population
Only 1 to 1.5 % are diagnosed
80% of causes are unknown
4 x more men than women
Mild MR - 75% have
Moderate – 20%
Severe/Profound – 5%
Definition
Mental retardation- Shift in focus from IQ scores to functional ability
IQ of 70-75 or below
Eligibility criteria varies across states; prior to age 18
Identification of cognitive impairment is complicated
Culture & Language
Communication mode
Motor problems
Sensory problems
How would you classify mental retardation in terms of levels.
Diagnostic Categories - Classification System
AAMR Intelligence Education
Intelligence
Level Score Test Category Test Score
Mild 55 to 70 Educable 50 to 75
Moderate 40 to 55 Trainable 25 to 50
Severe 25 to 40
Profound Below 25
Current definition of “mental retardation or intellectual disability
Based on the supports needed for function,
MR is a disability – significant limitations BOTH in intellectual functioning, and adaptive behavior
Limitations in present functioning must be considered in context of community environments typical of individual’s age, peers, culture
Valid assessment should consider cultural & linguistic diversity, sensory, motor & behavioral factors
Etiology & Pathophysiology of Cognitive Impairment
Describe the prenatal, perinatal, and postnatal stages
In many cases the cause of mental retardation can’t be identified
Prenatal: chromosomal disorders, syndromes, inborn errors of metabolism, brain malformation, environmental factors
Perinatal: intrauterine, neonatal disorders
Postnatal: head trauma, infection, demyelinating disorders, degenerative disorders, toxic-metabolic, malnutrition, environmental deprivation
STORCH describe what this means and
Syphilis Toxoplasmosis Other Rubella Cytomeglia Herpes These are a group of diseases if at birth or prenatal stages can cause congenital infections
Name of prevention measures that can be taken to avoid mental retardation.
Some causes can be averted
Phenylketonuria (PKU)
Rubella
Lead poisoning
Prenatal testing and care
Ultrasound
Amniocentesis
Genetic counseling
C-section delivery for children with myelodysplagia
What are somethings that can cause impairments
4 major things
Complex interaction of causative factors and external events (environment) can alter the severity of cognitive impairment
Environmental factors that contribute to cognitive impairment
Malnutrition
Teratogens (drugs that can interact with the baby in the womb and cause harmful affects)
Accidents & injuries (ABI)
Poor psychological environment – deprivation
Assessment of intellectual function: Diagnosing a cognitive impairment
Standardized, norm-referenced test
Administered by psychologist, psychometrist
Standford-Binet
Weschler
WISC – IV
Leiter International Performance Scale – requires no oral communication
Kaufman Assessment Battery for Children (nonverbal subscale)
What is the first indication of mental retardation and the early diagnosiable signs
Varies greatly – depends on whether cause can be identified
Early diagnosis - Down syndrome vs later diagnosis after impaired function is noted
First indication often delay in achievement of developmental motor milestones (when cognitive impairment is due to prenatal or perinatal causes)
Children develop normally for a time – followed by regression or decline in function (Rett syndrome)
Looming ? what is this think motor delay
Is poor motor performance due to limited capacity to process information and rapid decay of information
Impede motor learning
Clumsy movement
Motor control problems have their bases in central nervous system pathology
Coordination
Force production
Postural control
Look at table 17-1
look at table 17-1
KEY POINT
Identify an individual’s limitations AND strengths
Describing limitations in order to develop a profile of supports
Use areas of strength
Life functioning of persons with MR will generally improve with personalized supports
FIGURE 17-1
Limiting Physical Impairments, Preventing Secondary Impairments, & Minimizing Activity Limitations & Participation Restrictions
Early identification of problems best opportunity to limit impairments & resultant problems
Specific intervention depends on identified problems and what is known about natural course of the condition
Motor impairments * may restrict active exploration of the environment and result in secondary delays in domains not primarily affected
are retards capable of being taught
Individuals with cognitive impairments ARE capable of learning
Important to understand how to modify/adapt approach to intervention
Treatment program must take into account child’s learning characteristics
Some common learning characteristics of children with cognitive impairments
Capable of learning a fewer number of skills
Need lots of repetition
Difficulty generalizing skills
Greater difficulty maintaining skills that aren’t practiced regularly
Slower response time
More limited repertoire of responses
Promoting Environmental Interaction
What are some way to help increase the childs attention???
Intervention strategies to enable child to engage in play, socialization and communication
PT Input
Positioning may affect arousal level and behavioral state
Increase attention
Improve oxygenation
Seating and other assistive positioning devices – places child at a height that encourages communication and socialization
Switch activated toys
Down Syndrome Box 17-1
explain a little bit about this and how many kids get it.
Most common cause of MR
4000 infants born annually
1 in 800 – 1000 live births
Syndrome results in neuromotor, musculoskeletal and cardiopulmonary pathologies
characteristics of down syndrome
Motor Balance Hypotonia Hyper reflexibility Oral motio Feeding delay
Delayed fine motor skills Slow reaction time Loss of strength
cognitive Intellectual disabilities Test scores decrease with age Early onset dementia Low motivation language Usually poor Impairment of verbal memory skills Language comprehension problems less than expressive language problems
medical CHD Vision deficits Hearing impairment Obesity Skin condition
compare boxes
17.1 and 17.3
Characteristics of Autism
Motor Poor balance and coordination Impaired motor imitation Unusual gait patterns (such as toe walking Delayed and gross and fine motor development Praxis Poor balance and coordination Lack of anticipation
Communication/ social Deficit of joint attention Difficulty learning meaning of symbols Limited ability to use speech for communication Low rates of interaction with others Less attention to others emotions
compare box 17-2 and 17-4
compare boxes 17-2 and 17-4
