Multiple Disabilities

FACT SHEET

Concomitant impairments (such as mental retardation-blindness, mental retardation-orthopedic impairments, etc.), the combination of which causes such severe educational needs that they cannot be accommodated in a special program solely for one of the impairments.  The term does not include deaf-blindness (IDEA, 1997).

CHARACTERISTICS

Individuals may have one or more of the following:

·         Movement difficulties

·         Sensory losses

·         Behavior problems

·         Limited speech or communication

·         Difficulty in basic physical mobility

·         Tendency to forget skills through disuse

·         Trouble generalizing skills from one situation to another

·         A need for support in major life activities (domestic, leisure, community integration, and vocational)

·         Presence of primitive reflexes

·         Possibly nonambulatory


CAUSE

 

There is no identifiable cause in 40% of cases of multiple disabilities. Most individuals with multiple disabilities with known causes are due to prenatal biomedical factors. Other possible causes may be linked to genetic metabolic disorders, dysfunction in production of enzymes leading to a buildup in toxic substances in the brain, or brain malformations.

PROGNOSIS

The prognosis of multiple disabilities is dependent on specific disabilities associated with each individual.

IMPLICATIONS FOR PHYSICAL EDUCATION

An individual with multiple disabilities may be challenged with:

·         Motor delays

·         Abnormal muscle tone

·         Muscle atrophy, contractures

·         Problem balancing

·         Behavioral problems

ASSESSMENT SUGGESTIONS

Traditional or standardized assessments are often not practical. Authentic assessments have to be developed to suit the needs of the student – Keep in mind these assessments should be functional to skills the student will need in life. For many individuals, posture and range of motion are more appropriate criteria to assess compared to strength and skills. 


CONTRAINDICATED ACTIVITIES

·         Activities that involving fast moving objects – student may have difficulty tracking and moving out of the way

·         Holding a child with head and neck out of mid-line

·         “W” sitting position

·         Dynamic stretching

EFFECTIVE TEACHING STRATEGIES

·         Maintain a small teacher to student ratio

·         Learn from caregivers what the child likes and dislikes

·         Use positive reinforcement

·         Establish rapport

·         Talk to child as if they were any other child

·         Mirror their movements to see if they notice – assessing

·         Obtain behavior management information – use consistently

·         Use all forms of communication – sign, language, visual and tactile

·         Slow instructions – avoid excess words

·         Learn what primitive reflexes are still present

·         Focus instruction on lifetime physical activity

·         Teach in the pool

Ø       monitor temperature of pool (most cases the warmer the water the better)

Ø       learn of any allergies of chlorine

·         Find out as much information about the child as possible – allergies and feeding procedures

·         Use sensory integration instruction when appropriate

·         Preschool age children should be included

RESOURCES

Teachers:

·         Websites:

Ø       www.slc.sevier.org/sevmltol.htm

Ø       www.nichey.org.disabinf.asp

·         Books:

Ø       Adapted Physical Activity, Recreation and Sport – Sherrill

Parent:      

·         Websites:

Ø       www.parentsoup.com/offline/special/articles/

Ø       www.childrensdisabilities.info/ parenting/bklivingskin.html

Ø       www.teach-at-home.com/FastFacts/ disabilities/FactSheet.asp?A=10

Sport:

·         Websites:

Ø       http://www.lowvision.org/sports_and_recreation.htm

Ø       http://recreation-and-leisure-for-students-with-severe-disabilities.thecycles.com/

Ø       www.skillsndrills.com

REFERENCES

Sherril, C.  (1998).  Adapted physical activity, recreation and sport: crossdisciplinary and lifespan (5th ed.).  Boston: McGraw Hill.

Curtis, S.R.  (1982).  The joy of movement in early childhood.  New York: Teachers College.

National Dissemination Center for Children With Disabilities 2003.  Severe/Multiple disabilities.  Retrieved March 2, 2004, from http://www.nichcy.org/pubs/factshe/fs10.pdf.