Simply reporting data on health care disparities may leave the false impression that biological markers create those disparities. Setting refers to the location of treatment (e.g., home, community-based, work). (2007). https://doi.org/10.1111/jar.12233. (2016). Some prenatal causes such as environmental influences (e.g., exposure to lead-based paint) may be preventable. (2003). S.M.A.R.T. Pediatric Clinics of North America, 54(3), 469481. 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). A randomised clinical trial was conducted. SLPs are involved in transition planning and may be involved to varying degrees in other support services beyond high school. nonsymbolic (e.g., gestures, vocalizations, problem behaviors) and/or symbolic (e.g., words, signs, pictures) communication. Classification of developmental delays. The ASHA Leader, 8(19), 67. Comprehensive assessment includes a hearing screening and referral for a complete audiological assessment if hearing concerns are indicated. American Journal on Mental Retardation, 110(4), 268284. Improving communication between children with autism and their peers through the circle of friends: A small-scale intervention study. This list is not exhaustive, and the inclusion of any specific treatment approach does not imply endorsement from ASHA. Receptive and expressive language problems (Wyper & Rasmussen, 2011). Please see ASHAs resource on interprofessional collaborative practice for further information. This paper presents goals to develop specific communication skills needed to function independently in the community. B. Serve as an integral member of a team working with individuals with ID and their families/caregivers and, when appropriate, considering transition planning. For example, evaluators determine if failure to recognize a photo of a party reflects word retrieval challenges or is due to an unfamiliar representation of a party to an individual. https://doi.org/10.1002/mrdd.20098, Kurtz, P. F., Boelter, E. W., Jarmolowicz, D. P., Chin, M. D., & Hagopian, L. P. (2011). Target-level language. (2001). ), Feeding and nutrition in children with neurodevelopmental disability (pp. Respond appropriately to oral commands. Pennington, L., Goldbart, J., & Marshall, J. https://www.jstor.org/stable/26420429, Cole, K. N., Dale, P. S., & Mills, P. E. (1990). Team models may be multidisciplinary, interdisciplinary, or transdisciplinary (see ASHAs resource on collaboration and teaming). Language, Speech, and Hearing Services in Schools, 39(2), 261272. (1998). SLPs may need to consider the possibility of mild cognitive impairment, a condition characterized by subtle cognitive decline that may lead to dementia (see ASHAs Practice Portal page on Dementia), if treating adults with ID with new communication concerns. Participate as a member of the school or adult service planning team to determine appropriate educational and/or community services. How often do you take data? These changes reflect the movement away from a medical model and institutionalization and toward inclusive practices, self-advocacy, and self-determination. https://doi.org/10.1111/j.1365-2788.2008.01115.x, Cheslock, M. A., Barton-Hulsey, A., Romski, M. A., & Sevcik, R. A. An FCT approach may be considered with students with ID to replace challenging behaviors with appropriate communication alternatives (Brady & Halle, 1997; Martin et al., 2005; Schmidt et al., 2014). Scope of practice in speech-language pathology [Scope of practice]. Individuals with ID have intellectual deficits as well as deficits in adaptive functioning that include conceptual, social, and practical domains (APA, 2013). 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). Deficits are more severe for boys than for girls (Haebig et al., 2020). [PDF], World Health Organization. Communication Disorders Quarterly, 33(4), 252260. Intellectual disability in cerebral palsy: A population-based retrospective study. Unit/Subject: Social Skills. Intractable & Rare Diseases Research, 3(4), 134146. Enhancing social problem solving in children with autism and normal children through computer-assisted instruction. anxiety disorders (Oeseburg et al., 2011), physical coordination and tone issues (Vuijk et al., 2010), obesity-related problems (Rimmer et al., 2010), Native Hawaiian or Other Pacific Islander: 6.8%, developmental and sociocultural standards for personal independence and community participation, independent functioning in one or more daily life activities (e.g., communication, social participation, and independent living) across settings, difficulties in pre-academic and academic learning (reading, writing, mathematics), difficulty understanding concepts of time and money, problems with abstract thinking (concrete approach to problem solving), difficulties in executive function such as, difficulties with functional use of academic skills such as money management and time management, limitations in language and communication skills, more concrete and less complex spoken language (if used), compared with same-age peers, limited vocabulary and grammatical skills, receptive language that may be limited to comprehension of simple speech and gestures, communication that may occur through nonspoken means onlysuch as gestures, signs, facial expressions, or aided systems (e.g., AAC), challenges with social judgment and decision making, difficulty understanding social cues and rules, emotional and behavioral regulation difficulties that may adversely affect social interactions, requiring different levels of support for daily life activities such as. https://doi.org/10.1044/leader.FTR2.08192003.6, Roberts, J. E., Price, J., & Malkin, C. (2007). Components of these programs include parent instruction, joint interaction with parents/caregivers and individuals with developmental delays and other deficits, and video coaching (Weitzman et al., 2017). (2016b). Psychiatry, 8(9), 355357. An analysis of functional communication training as an empirically supported treatment for problem behavior displayed by individuals with intellectual disabilities. Other goals may be appropriate for individuals with extremely limited functional communication (e.g., broader communication goals such as turn-taking and social participation). See also Relation of Age to Service Eligibility and Relation of Developmental Age to Service Eligibility for the NJC position on eligibility. See ASHAs Practice Portal page on Late Language Emergencefor further information. Relevant research indicates that language intervention benefits children with ID even when no languagecognition discrepancy exists (Carr & Felce, 2000; Cole et al., 1990; Snell et al., 2010). (2013). Intellectual disabilities and hearing loss. FCT is a behavioral intervention program that combines the assessment of the communicative functions of problem behavior with ABA procedures to teach alternative responses. Specific: Be discrete in goal designing. Inclusive practices for preschool children with specific language impairment. https://doi.org/10.1002/ajmg.c.10015, Beadle-Brown, J., Leigh, J., Whelton, B., Richardson, L., Beecham, J., Baumker, T., & Bradshaw, J. Importance of Setting Goals Andrew Carnegie once said, ''If you want. Oxford University Press. professionals and individuals to measure and to profile the effect of sensory processing on functional performance." Most appropriate for individuals aged 11-65+. See ASHAs Intellectual Disability evidence map for summaries of the available research on this topic. May have hearing loss (Rosenbaum & Rosenbloom, 2012). 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). LEAP is implemented in a classroom setting consisting of children with ASD and typically developing peers and is designed to support child-directed play. Using informal measures, such as those designed by the clinician and tailored to the population being screened (e.g., age, developmental level, language[s] used). Please see Co-Occurring Conditions and Disorders section above for further information regarding ID in specific populations. Fragile X spectrum disorders. Seminars in Pediatric Neurology, 5(1), 214. Service-learning is a form of experiential learning that blends classroom instruction with community service. May have hearing loss (Cone-Wesson, 2005). Wiley. onset in the developmental period (before the age of 22 years; American Association on Intellectual and Developmental Disabilities [AAIDD], n.d.); significant limitations in adaptive behavior (i.e., conceptual, social, and practical skills to function in daily life); and. https://doi.org/10.1352/1934-9556-49.2.59, Office of Research Support and International Affairs. Intervention in multiple contexts allows the person with ID to practice functional skills in meaningful situations. A medical practitioner or team may have difficulty making a diagnosis of ID or ASD due to similarities and comorbidity between the two conditions. Research in Developmental Disabilities, 32(1), 188193. https://doi.org/10.1044/1092-4388(2007/032), Twachtman-Reilly, J., Amaral, S. C., & Zebrowski, P. P. (2008). Multiple communication partners besides the SLP may also be involved in service delivery across settings. Fostering peer interaction, imaginative play and spontaneous language in children with autism. Diagnostic Adaptive Behavior Scale users manual. The recommended citation for this Practice Portal page is: American Speech-Language-Hearing Association. Conditions that commonly co-occur with ID include, but are not limited to, the following. https://doi.org/10.1111/1467-8527.t01-1-00058, White, G. W., Simpson, J. L., Gonda, C., Ravesloot, C., & Coble, Z. Child Language Teaching and Therapy, 15(2), 4152. Definitions of ID have changed from being strictly IQ based to including strengths in adaptive behavior (Schalock et al., 2021; Tass, 2017). SLPs need to (a) be aware of culturally associated beliefs about the cause of ID, (b) provide person-centered care, (c) build working relationships with caregivers, and (d) address communication barriers (Allison & Strydom, 2009). https://doi.org/10.1007/s10803-007-0357-5, Cone-Wesson, B. https://doi.org/10.1352/1934-9556-57.5.421, Barker, R. M., Sevcik, R. A., Morris, R. D., & Romski, M. A. https://doi.org/10.1111/j.1469-8749.2005.tb01041.x, Petersen, M. C., Kube, D. A., & Palmer, F. B. Journal of Disability Policy Studies, 20(4), 233240. Circle of friends is a treatment approach that uses the classroom peer group to improve the social acceptance of a classmate with special needs by setting up a special group or circle of friends. The focus is on building behaviors that are valued in everyday settings. Global prevalence based on international studies estimated the prevalence of ID in adults ranged from 0.05% to 0.08% (McKenzie et al., 2016). 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). Responsiveness to the child's communicative attempts. Children with Down syndrome often have specific limitations in expressive syntax relative to semantics. very basic nonverbal communication. Individuals with ID of all ages are eligible for SLP services because enhancement of communication skills is needed to function effectively, regardless of age or cognitive level relative to communication abilities. (2009). Education and Training in Autism and Developmental Disabilities, 53(1), 8499. For information about eligibility for services in the schools, see Eligibility and Dismissal in Schools, IDEA Part B Issue Brief: Individualized Education Programs and Eligibility for Services, and Current IDEA Part C Final Regulations (2011). https://doi.org/10.1044/2018_AJSLP-17-0013, Thorne, J. C., Coggins, T. E., Olson, H. C., & Astley, S. J. 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. SLPs should consider the role of ABA in communication intervention, particularly because difficulty with prompt dependency and generalization of communication interactions may result. Following the individuals lead, attempts to communicate are reinforced as these attempts get closer to the desired communication behavior (McGee et al., 1999). Hanen programs for parents: Parent-implemented early language intervention. Direct speech and language therapy for children with cerebral palsy: Findings from a systematic review. https://doi.org/10.1037/0022-006X.75.4.594, Anderson, L. L., Larson, S. A., MapelLentz, S., & Hall-Lande, J. A., Eklund, S. J., James, D. R., & Foose, A. K. (2003). Twenty years of communication intervention research with individuals who have severe intellectual and developmental disabilities. putting interesting materials in sight but out of reach; sabotaging the situation with missing elements or providing inadequate portions; and. Assess the need for AAC services and supports. Intervention in School and Clinic, 44(3), 116120. Assessments address components within the International Classification of Functioning, Disability and Health (WHO, 2001) framework, including body structures/functions, activities/participation, and contextual factors. Delayed speech and language acquisition (Cone-Wesson, 2005; Terband et al., 2018). However, information gathered during SLP evaluation and treatment may be useful to medical professionals who may diagnose ID. Difficulty with narrative discourse (Colle et al., 2008). Video-based instruction (also called video modeling) is an observational mode of teaching that uses video recordings to provide a model of the target behavior or skill. (2017). https://doi.org/10.1177/109830079900100202, Eggers, K., & Van Eerdenbrugh, S. (2018). In J. Lucyshyn, G. Dunlap, & R. Albin (Eds. The impact of aging on eating, drinking, and swallowing function in people with Downs syndrome. 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). (2013). 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. See ASHAs Practice Portal page on Augmentative and Alternative Communication. https://doi.org/10.1177%2F15257401020230030301, Neely, L., Rispoli, M., Camargo, S., Davis, H., & Boles, M. (2013). Roberts, J. E., Hennon, E. A., & Anderson, K. (2003). For these individuals, a comprehensive assessment is likely to be the first step. Overview of fetal alcohol spectrum disorders for mental health professionals. https://doi.org/10.1044/gero19.1.36, Lee, M., Bush, L., Martin, G. E., Barstein, J., Maltman, N., Klusek, J., & Losh, M. (2017). https://doi.org/10.1097/00004703-200504000-00002, Martin, C. A., Drasgow, E., Halle, J. W., & Brucker, J. M. (2005). Cultural beliefs may influence some individuals perceptions about the causes of ID (Allison & Strydom, 2009; Scior, 2011). In J. K. Luiselli, D. C. Russo, W. P. Christian, & S. M. Wilczynski (Eds. Functional analysis of communicative behaviors. The speech-language assessment incorporates an evaluation of skills needed to support the individuals changing communication needs. 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). 1400 et seq. Language impairments in children with fetal alcohol spectrum disorder. https://www.ncbi.nlm.nih.gov/books/NBK223473/, Kaiser, A. P., & Roberts, M. Y. https://doi.org/10.1044/1058-0360.0101.38, Krahn, G. L., Hammond, L., & Turner, A. (2015). Students will be able to use problem-solving strategies to analyze social situations and make appropriate decisions. However, the aging process may be premature in adults with ID as compared with the general population (e.g., Lin et al., 2011). These individuals may have physical, programmatic, or communication Stuttering is more prevalent (Eggers & Van Eerdenbrugh, 2018). https://doi.org/10.15585/mmwr.ss6904a1, Mahoney, G., & Perales, F. (2005). 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). Journal of Speech, Language, and Hearing Research, 50(2), 459474. Background paper for World Health Organization Conference, Bucharest, Romania. Individuals with ID require substantial family support and advocacy. Examples of such considerations follow: Persons with ID and their families are integral to assessment, goal selection, and treatment. Clarke, M. E., & Gibbard, W. B. Common challenging behaviors include aggressive, disruptive, self-injurious, and stereotypic behaviors. The definitions of ID and related terminology have evolved over time to reflect the legal and social gains made by individuals with such a disability and their families. The National Joint Committee for the Communication Needs of Persons With Severe Disabilities (NJC) emphasizes that there are no prerequisites for communication (NJC, 2002a, 2002b). See ASHAs resource on family-centered practice for general guidelines. Team members determine strengths and limitations in adaptive functioning and collaboratively determine the levels of support needed across conceptual, social, and practical domains. Narrative discourse in adults with high-functioning autism or Asperger syndrome. 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). https://doi.org/10.1352/0895-8017(2005)110[268:AIAWID]2.0.CO;2, Carr, D., & Felce, D. (2000). (2002b). Prevalence of cooccurring psychiatric disorders in adults and adolescents with intellectual disability: A systematic review and metaanalysis. The Journal of Pediatrics, 154(3), 338344. Mazza et al. This includes math, reading, writing and functional goal ideas. Intellectual and Developmental Disabilities, 46(5), 376386. Focus on Autism and Other Developmental Disabilities, 12(2), 95104. Wyper, K. R., & Rasmussen, C. R. (2011). . setting up choice-making, unexpected, or silly situations. https://doi.org/10.1016/j.jpeds.2008.09.012, Strain, P. S., & Hoyson, M. (2000). Restricted and repetitive use of language (e.g., echolalia, perseveration; APA, 2013). 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., . Early intensive applied behavior analysis intervention for autism. According to the Diagnostic and Statistical Manual of Mental Disorders (5th ed. Rosenbaum, P., & Rosenbloom, L. (2012). Environmental arrangement. Cause-specific mortality of people with intellectual disability in a population-based, 35-year follow-up study. The hypothesis of apraxia of speech in children with autism spectrum disorder. The clinician can prompt with a question (e.g., What do you want?) or model a request (e.g., Say I need paint). Mental Retardation and Developmental Disabilities Research Reviews, 13(1), 2635. 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. Other characteristics include the following: Fetal alcohol syndrome is a congenital syndrome resulting from alcohol exposure in utero. 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. See Changes in Services for Persons With Developmental Disabilities: Federal Laws and Philosophical Perspectives and Federal Programs Supporting Research and Training in Intellectual Disability. R. L., Balboni, G., Bersani, H., Borthwick-Duffy, S. A., Spreat, S., Thissen, D., Widaman, K. F., & Zhang, D. (2017). The life expectancy of most persons with developmental disabilities now approaches that of the general population. https://doi.org/10.1044/1092-4388(2001/016), Bernard-Opitz, V., Sriram, N., & Nakhoda-Sapuan, S. (2001). Down Syndrome Research and Practice, 12, 3744. Feeding and nutrition in neurodevelopmental disability: An overview. The AAIDD definition is consistent with the diagnostic criteria for Intellectual Disability (Intellectual Developmental Disorder) in the Diagnostic and Statistical Manual of Mental Disorders (5th ed. https://doi.org/10.1016/j.ridd.2010.09.018, Loveall, S. J., Channell, M. M., Phillips, B. Please see ASHAs Practice Portal page on Cultural Responsiveness for further information. Delayed speech and language skills, particularly syntax, with relative strengths in vocabulary and language comprehension (J. E. Roberts et al., 2008). Journal of Positive Behavior Interventions, 1(2), 7787. Providing effective interventions for individuals with severe intellectual disabilities (ID) continues to challenge educators, speech-language pathologists, and other allied health professionals. Coggins, T. E., Timler, G. R., & Olswang, L. B. Schmidt, J. D., Drasgow, E., Halle, J. W., Martin, C. A., & Bliss, S. A. Ruiter, I. D. (2000). Determine eligibility for speech and language services. Developmental disabilities. Administering formal screening assessments that have normative data and/or cutoff scores and that have demonstrated evidence of adequate sensitivity and specificity. 108-446, 20 U.S.C. Persistent otitis media; conductive and sensorineural hearing loss is common (Shott, 2006). Terms like individuals with intellectual disability have replaced the older terms of mentally retarded persons or the mentally retarded. In R. J. McCauley, M. E. Fey, & R. B. Gillam (Eds. Journal of Positive Behavior Interventions, 16(1), 4455. Each individual with intellectual disability (ID) has a unique profile, based on their level of language functioning as well as functioning in areas related to language and communication, including the following: Intervention considers strengths and needs in all areas to ensure individualized treatment and supports. American Journal of Speech-Language Pathology, 27(4), 14051425. Perspectives on Language Learning and Education, 18(3), 8797. Speech intelligibility problems, which may result from disturbances in voice, articulation, resonance, fluency, or prosody (Kent & Vorperian, 2013). (2007). ), Families and positive behavior support (pp. (aa) meet the child's needs that result . Intensive programs total from 25 to 40 hr per week for 13 years. 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. Guralnick, M. J. Expansion of those skills and ensuring that appropriate communication skills are used effectively in different contexts and that the challenging behavior is extinguished. It is important for individuals with ID to have the opportunity for literacy intervention, including a focus on phonological processing/word decoding and reading comprehension (Barker et al., 2013). https://doi.org/10.2105/AJPH.2015.302903a, Hart, J. E., & Whalon, K. J. United Statesbased studies reported the prevalence of ID to be 7.9 per 1,000 adults (L. L. Anderson et al., 2019). Retrieved month, day, year, from www.asha.org/Practice-Portal/Clinical-Topics/Intellectual-Disability/. Phonological accuracy and intelligibility in connected speech of boys with Fragile X syndrome or Down syndrome. Journal of Intellectual Disability Research, 54(11), 955965. Intellectual and Developmental Disabilities, 57(5), 421438. 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). Therefore, SLPs may help make a differential diagnosis between late language emergence and ID or another DD. Rates of co-occurring disorders in male and female adults with ID were similar, with 19% and 20%, respectively (Mazza et al., 2020). See ASHAs Practice Portal page on Transitioning Youth for further details. (2021). Journal of Speech, Language, and Hearing Research, 56(1), 178210. When they are included, they may spend their time on non-academic learning experiences. It's all about getting to know your student, their future goals, and collaborating with parents/caregivers on what areas they find important. More severe disabilities are more likely to result in early identification of ID (Daily et al., 2000). Individuals with Fragile X syndrome often have pragmatic language difficulties (Abbeduto & Sterling, 2011). (2010a, November). 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Considering transition planning and may be involved in service delivery across settings however, gathered...: fetal alcohol spectrum Disorders for Mental health professionals inclusive practices, self-advocacy, stereotypic... Toward inclusive practices for preschool children with cerebral palsy: Findings from a medical model and institutionalization toward! Preschool children with autism and normal children through computer-assisted instruction they are included, they may spend their time non-academic... S., & Anderson, L. ( 2012 ) in multiple contexts allows the person with ID to be first... Function independently in the community Strain, P. S., & Nakhoda-Sapuan, S..! Use of language ( e.g., What do you want play and spontaneous language in children with cerebral:... Participate as a member of a team working with individuals with ID and their peers the!, B Research and Practice, 12, 3744, and self-determination & Whalon, K. R. &... Contexts allows the person with ID include, but are not limited to, the following: fetal alcohol Disorders! Wilczynski ( Eds ASHA Leader, 8 ( 19 ), families and Positive behavior Interventions, (.
