(2009). Interprofessional collaborative practice consists of core ideals described by the WHO that include patient- and family-centered, community-oriented, and relationship-focused service delivery by a team of professionals working together with common goals for the individual with ID (WHO, 2010b). Setting refers to the location of treatment (e.g., home, community-based, work). Cerebral palsy is a motor disorder that may affect speech, language, and swallowing. ABA is a treatment approach that uses principles of learning theory to bring about meaningful and positive change in behavior. Prenatal alcohol and cocaine exposure: Influences on cognition, speech, language, and hearing. The Journal of Child Psychology and Psychiatry, 52(7), 741752. https://doi.org/10.1177/108835760101600404, Scior, K. (2011). The impact of aging on eating, drinking, and swallowing function in people with Downs syndrome. SLPs determine which options are appropriate by taking into consideration the individuals age, language profile, communication needs, factors related to language functioning, the presence of coexisting conditions, communicative opportunities and partner supports, linguistic needs, cultural background and values, and available research evidence. The Canadian Child and Adolescent Psychiatry Review, 12(3), 5763. Questions pertaining to gender and pronoun use must be relevant to that individual and their familial structures. https://doi.org/10.1177/1053451207310346, Hawkins, B. Environmental arrangement is a technique that involves arranging the environment to encourage communication by increasing interest in the environment and setting the occasion for communication. ASD is a neurologically based, heterogeneous condition, characterized by a range of social communication skills and the presence of restricted, repetitive behaviors, which are present in early childhood. https://doi.org/10.1111/dmcn.13773, Rimmer, J. H., Yamaki, K., Lowry, B. M. D., Wang, E., & Vogel, L. C. (2010). (2013). 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). Using a speech- generating device to enhance communicative abilities for an adult with moderate intellectual disability. Rosas Law, a federal law enacted in 2017, changed all prior references to mental retardation in federal law to intellectual disability or intellectual disabilities. Please see AAIDDs page on Historical Context for further details. Qualifications for providing ABA therapy may vary by state; check with your state, as this may affect reimbursement. https://doi.org/10.1044/2018_AJSLP-17-0013, Thorne, J. C., Coggins, T. E., Olson, H. C., & Astley, S. J. For example, a physical therapist and an SLP may work together to improve respiratory support, which can, in turn, enhance speech production and intelligibility. Provide treatment, document progress, and determine appropriate timelines for treatment and development of new treatment goals/targets for the individuals continued development. ASD commonly co-occurs with ID (see the Incidence and Prevalence section above). https://doi.org/10.1044/0161-1461(2008/025). https://doi.org/10.1007/s10803-007-0357-5, Cone-Wesson, B. Government Printing Office. Perspectives on Language Learning and Education, 18(3), 8797. (2001). https://doi.org/10.1016/j.jcomdis.2017.11.001. LEAP is a multifaceted program for preschool children with ASD and their parents (Strain & Hoyson, 2000). For example, the time delay between initial instruction and any additional instruction or prompting is gradually increased as the individual becomes more proficient at the skill being taught. Research in Developmental Disabilities, 32(6), 29352942. Descriptive terminology and philosophy concerning ID focuses on levels of support necessary to maximize an individuals ability, rather than strictly on functional limitations. (2005). They also ensure the rights of each communicator in accordance with the National Joint Committee for the Communication Needs of Persons With Severe Disabilities Communication Bill of Rights (Brady et al., 2016). Identification and evaluation of mental retardation. Additionally, the intellectual and adaptive deficit begin early in . https://doi.org/10.1080/00380253.2018.1479198, Shifrer, D., Muller, C., & Callahan, R. (2011). Video-based instruction for children with autism. Challenging behaviors are reduced when individuals with ID are taught communication skills that serve efficiently and effectively as alternative behaviors (Kurtz et al., 2011). The effect of instructional use of an iPad on challenging behavior and academic engagement for two students with autism. Adaptive behavior and cognitive function of adults with Down syndrome: Modeling change with age. People with this condition experience significant limitations with intellectual functioning and developing . Tager-Flusberg, H., & Caronna, E. (2007). Morphosyntax is more difficult than semantics (Fidler et al., 2009), with variability in vocabulary development compared to children with other intellectual disabilities or typical development (Loveall et al., 2016). 433463). professionals and individuals to measure and to profile the effect of sensory processing on functional performance." Most appropriate for individuals aged 11-65+. Down syndrome is the largest genetic cause of ID, and Fragile X syndrome is the largest inherited cause of ID. Developmental delay (DD), ASD, and LD may be conditions commonly considered when making a differential diagnosis. 108-446, 20 U.S.C. using telecommunications technologies (e.g., phone, Zoom). Collaborate with parents, teachers, caregivers, job coaches, peers, and others to promote communication development in individuals with ID. Delayed speech and language skills, particularly syntax, with relative strengths in vocabulary and language comprehension (J. E. Roberts et al., 2008). In R. J. McCauley, M. E. Fey, & R. B. Gillam (Eds. A randomized trial of longitudinal effects of low-intensity responsivity education/prelinguistic milieu teaching. https://www.asha.org/policy/, American Speech-Language-Hearing Association. Individuals with ID have limitations in intellectual functioning and adaptive behavior, whereas individuals with ASD have a wide range of intellectual abilities and adaptive behavior. https://doi.org/10.1097/00004703-200504000-00002, Martin, C. A., Drasgow, E., Halle, J. W., & Brucker, J. M. (2005). Weitzman, E., Girolametto, L., & Drake, L. (2017). Intervention in multiple contexts allows the person with ID to practice functional skills in meaningful situations. Common challenging behaviors include aggressive, disruptive, self-injurious, and stereotypic behaviors. Clinical issues: Language intervention considerations for children with mental retardation and developmental disabilities. Difficulties with articulation, fluency, and oral motor skills (J. E. Roberts et al., 2003). Genetic and environmental influences on the growth of early reading skills. Developmental disabilities. (2008). This paper presents goals to develop specific communication skills needed to function independently in the community. (2003). Milieu therapy is a range of methods (including incidental teaching, time delay, and mand-model procedures) that are integrated into a childs natural environment. Journal of Positive Behavior Interventions, 16(1), 4455. The determination of incidence and prevalence of intellectual disability (ID) is complicated because researchers of ID do not use a uniform operational definition when selecting and identifying individuals with ID. ASHA extends its gratitude to the following subject matter experts who were involved in the development of the Intellectual Disability page: In addition, ASHA thanks the members of the Ad Hoc Committee to Review/Revise Current Practice and Policy Documents Related to Mental Retardation/Developmental Disabilities, whose work was foundational to the development of this content. American Journal of Public Health, 105(12), e60e76. Target-level language. A model of phonological processing, language, and reading for students with mild intellectual disability. Intellectual disability: Definition, diagnosis, classification, and system of supports (12th ed.). This assumption is a concern when applied to individuals with disabilities in general and to individuals with ID in particular (Casby, 1992; Cole et al., 1990; Notari et al., 1992). Application of stimulus equivalence to language intervention for individuals with severe linguistic disabilities. Characteristics may include the following: Other conditions that may also co-occur with ID include the following: Individuals with ID may have more health problems than others in the general population, often because of inadequate health care, limited access to quality services (Krahn et al., 2006; van Schrojenstein Lantman-de Valk & Walsh, 2008), and communication limitations (Gentile et al., 2015). What are Functional Goals. Simply put, a functional goal is a target skill or behavior that can be measured in specific terms. American Journal of Speech-Language Pathology, 20(3), 180199. (2018). https://doi.org/10.1044/1092-4388(2012/11-0231), Kalyva, E., & Avramidis, E. (2005). https://www.asha.org/policy, https://www.asha.org/njc, National Joint Committee for the Communication Needs of Persons With Severe Disabilities. Intensive programs total from 25 to 40 hr per week for 13 years. Children with disabilities: A medical primer (7th ed.). Dynamic assessment may be used to identify nonsymbolic and symbolic communication behaviors and to evaluate individual learning potential (Snell, 2002). These methods are based on behavioral/operant principles of learning; they involve examining the antecedents that elicit a certain behavior, along with the consequences that follow that behavior, and then making adjustments in this chain to increase desired behaviors and/or decrease inappropriate ones. For many children, the cause of their intellectual disability is not known. A., Abbeduto, L., & Conners, F. A. FCT is a behavioral intervention program that combines the assessment of the communicative functions of problem behavior with ABA procedures to teach alternative responses. The use of incidental teaching may be effective in increasing engagement in children with disabilities (Casey et al., 2012). Aligned IEP Goal/s: Students will be able to identify and describe the consequences of different choices and decisions. https://doi.org/10.1352/0895-8017(2005)110[268:AIAWID]2.0.CO;2, Carr, D., & Felce, D. (2000). The level of support needed for adaptive functioning (i.e., performance of basic life skills) determines the severity level for ID. Please see NJCs resource titled Myths About Adult Communicators With Severe Disabilities. The cognitive hypothesis and its influence on speech-language services in schools. Delayed speech and language acquisition (Cone-Wesson, 2005; Terband et al., 2018). Brookes. 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. https://doi.org/10.1352/1944-7558-122.4.289, Liber, D. B., Frea, W. D., & Symon, J. An analysis of functional communication training as an empirically supported treatment for problem behavior displayed by individuals with intellectual disabilities. ABA has been used for individuals with ID, particularly those who also have ASD (e.g., Spreckley & Boyd, 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., . https://doi.org/10.1111/j.1365-2788.2010.01305.x. Development of literacy skills is important in any population; however, children with DD access literacy in different ways than nondisabled peers. FCT has a stepwise progression, as follows: Incidental teaching is a teaching technique that uses behavioral procedures to teach elaborated language; naturally occurring teaching opportunities are provided based on the individuals interests. Fidler, D. J., Most, D. E., & Philofsky, A. D. (2009). Communication skills among individuals with ID can vary due to severity; co-occurring conditions; and other behavioral, emotional, and social factors. This disability originates before the age of 18. Content for ASHA's Practice Portal is developed through a comprehensive process that includes multiple rounds of subject matter expert input and review. This is in no way meant to be a document to just copy and paste from. (2016a). Augmentative and alternative communication: Supporting children and adults with complex communication needs (5th ed.). A variety of approaches may be selected based on individual strengths and needs. Brookes. speech patterns (e.g., prosody) as well as receptive and expressive pragmatic and sociolinguistic communication skills. Mental Retardation and Developmental Disabilities Research Reviews, 12(1), 7082. The treatment effect was . Communication intervention for ID focuses on interactions that may occur within an individuals natural environment to reflect social norms of their community. The treatment modes/modalities described above (e.g., AAC) may be used to implement these treatment options. The Journal of Child Psychology and Psychiatry, 51(6), 660667. Symptoms of profound ID include: inability to understand or comply with requests or instructions. Hanen programs for parents: Parent-implemented early language intervention. Intellectual and Developmental Disabilities, 46(5), 376386. 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. Studies reported results based on gender; however, there were no indications whether the data collected were based on sex assigned at birth, gender identity, or both. Please see Treatment Principles for Individuals with an Intellectual Disability for further information. There are endless number of life skills IEP goals out there, it's just a matter of finding what your student and their family want to focus on. Limiting communication means limiting access to peer groups and daily life activities. See ASHAs resource on family-centered practice for general guidelines. Service-learning is a form of experiential learning that blends classroom instruction with community service. Terband, H., Spruit, M., & Maassen, B. Perspectives on Language Learning and Education, 13(3), 2126. Persistent otitis media; conductive and sensorineural hearing loss is common (Shott, 2006). The Sociological Quarterly, 59(3), 384406. American Journal on Intellectual and Developmental Disabilities, 122(4), 289309. (2009). Additionally, LD is not characterized by intellectual limitations. spoken language (listening and speaking). https://doi.org/10.1111/j.1365-2788.2001.00290.x. Intervention for individuals with ID typically incorporates a variety of options and techniques in combination. Other Practice Portal pages can serve as useful resources for treatment options, depending on the etiology of the ID. Code of ethics [Ethics]. 106-402, 102(8). However, these areas are important in the constructivist-oriented curriculum. See ASHAs Practice Portal page on Late Language Emergencefor further information. Intervention in School and Clinic, 44(3), 116120. (2010b). A randomized controlled trial of Hanens More Than Words in toddlers with early autism symptoms. https://doi.org/10.1352/0047-6765(2003)041%3C0007:ABACFO%3E2.0.CO;2, Herer, G. R. (2012). The goals are situation-specific, outcome-oriented, and were designed to teach functional skills elicited in natural environments. Team members determine strengths and limitations in adaptive functioning and collaboratively determine the levels of support needed across conceptual, social, and practical domains. https://doi.org/10.1002/ajmg.c.30095, Shriberg, L. D., Paul, R., Black, L. M., & van Santen, J. P. (2011). Of the children aged 621 years served under the Individuals with Disabilities Education Improvement Act of 2004 (IDEA), 6.7% of students were identified with ID (U.S. Department of Education, 2021). World Health Organization. National Academies Press. Rates of co-occurring disorders in male and female adults with ID were similar, with 19% and 20%, respectively (Mazza et al., 2020). https://doi.org/10.1177/027112149201100405, Oeseburg, B., Dijkstra, G. J., Groothoff, J. W., Reijneveld, S. A., & Jansen, D. E. M. C. (2011). Rosenbaum, P., & Rosenbloom, L. (2012). The importance of early intervention for children who are at high risk for communication disorders cannot be overstated. (2014). Defining language delay in young children by cognitive referencing: Are we saying more than we know? Contributions of incidental teaching, developmental quotient, and peer interactions to child engagement. https://doi.org/10.1044/1058-0360.0101.38, Krahn, G. L., Hammond, L., & Turner, A. ICF-CY: International Classification of Functioning, Disability and Health: Children & Youth version. https://doi.org/10.1177/1098300712470519, Schwartz, I. S., Boulware, G.-L., McBride, B. J., & Sandall, S. R. (2001). Individuals who have ID may have a need to use multiple languages and/or dialects to communicate with loved ones and peers. https://doi.org/10.1097/IYC.0b013e31824cbac4, Cceres, A. S. J., Keren, N., Booth, R., & Happ, F. (2014). Specific: Be discrete in goal designing. https://doi.org/10.1016/j.ridd.2011.07.005, Shifrer, D. (2018). (2013). The term intellectual functioning incorporates Common characteristics of intelligence (reasoning, planning, problem solving, abstract thinking, understanding complex ideas, learning quickly, and learning from experience), Abilities measured by IQ tests (language skills, mathematical abilities, memory, and spatial visualization), and the Efficacy of applied behavioral intervention in preschool children with autism for improving cognitive, language, and adaptive behavior: A systematic review and meta-analysis. https://doi.org/10.1111/j.1469-7610.2011.02395.x, Casby, M. W. (1992). LEAP is implemented in a classroom setting consisting of children with ASD and typically developing peers and is designed to support child-directed play. Aided symbols require a transmission device (e.g., a speech-generating device); unaided symbols require only the body to produce (Beukelman & Light, 2020). https://doi.org/10.1046/j.1365-2788.2001.00348.x, Warren, S. F., Fey, M. E., Finestack, L. H., Brady, N. C., Bredin-Oja, S. L., & Fleming, K. K. (2008). 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. Topics in Early Childhood Special Education, 11(4), 2238. American Journal of Medical Genetics, 117C(1), 314. Effects of prelinguistic milieu teaching and parent responsivity education on dyads involving children with intellectual disabilities. Direct speech and language therapy for children with cerebral palsy: Findings from a systematic review. Classification of developmental delays. SLPs help ensure that communication partners recognize and respond to communication attempts and build on the interests, initiations, and requests of persons with ID. B. These can include parents implementing interventions described above, such as enhanced milieu teaching (Kaiser & Roberts, 2013), prelinguistic milieu teaching (Yoder & Warren, 2002), and AAC (Romski et al., 2010). Individuals with ID may experience challenges in acquiring the skills necessary for independent living and achieving success in postsecondary education/training programs, employment settings, and social situations. Individuals with Fragile X syndrome often have pragmatic language difficulties (Abbeduto & Sterling, 2011). Brookes. Topics in Early Childhood Special Education, 20(2), 116122. Support individuals with ID in vocational and community settings. Assessment and treatment of disorders that fall under speech-language pathology scope of practice may be completed at any stage in an individuals life. Team members may include parents/caregivers, general education teachers, special educators, counselors, job coaches, group home supervisors, and psychologists. The case for change. See Treatment Principles for Individuals With an Intellectual Disability. A guide to promoting communication skills in adults with developmental delays. 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. However, it is possible for a person to have both LD and ID. Activity schedules/visual supports include objects, photographs, drawings, or written words that act as cues or prompts to help individuals. Unit/Subject: Social Skills. Societal norms within some communities may result in isolation of individuals with ID. ABA techniques have been used by SLPs in collaboration with ABA therapists to help build a variety of skills (e.g., communication, social skills, self-control, and self-monitoring) and help generalize these skills to other situations. Gallaudet University. Selection of target behaviors for individuals with ID has increased alongside understanding of the specific communication disorders associated with various diagnoses. 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. Preschool children with cerebral palsy is a treatment approach that uses Principles of learning theory to bring about meaningful positive. 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