What Is Intellectual Disability - Case Study Example

Challenges Encountered by People with Intellectual Disabilities Introduction Intellectual disability is a condition in which an individual has general mental impairments that affect how the person functions in different domains of life. There are three domains that are affected by intellectual disabilities; the three domains determine how the people with the intellectual disability cope with life. According to Dykens, Hodapp and Evans (2006) the first domain is the social domain in which the person with the condition is faced with challenge of empathy, unfriendly social judgement, problems in communication skills, inability to make and retain friends. The second domain is the conceptual domain in which in which the affected areas include language skills, reading, writing reasoning and knowledge. The third domain is the practical domain; this involves the self-management in daily tasks such as learning, job responsibilities and management of time. The intellectual disabilities are not age specific. The developmental symptoms start being noticed at early stages of life. The diagnoses of the symptoms depend with the severity of the condition (Dykens, Hodapp & Evans, 2006). There are different types of mental disabilities that affect people at different stages of life; this paper focuses on Down Syndrome, its challenges among the adolescents and ways to overcome the challenges. Down syndrome Down syndrome is categorised as an intellectual disability that is caused by having an additional copy of chromosome 21 in all the body cells or the majority of the cell lines (Morris & Alberman, 2009). Down syndrome has been relatively attributed to learning disability. In the United Kingdom an average of 815 babies with the Down syndrome are born each year. Health researches have shown the probability of getting a baby with Down syndrome increases in cases of older mothers compared to the younger mothers (Morris & Alberman, 2009). The researches have also shown that the cases of Down syndrome that are genetically inherited are very few, Morris & Alberman noted that the people with down syndrome have the genetic condition from the time of conception which later affects the development in various life stages. The people with the Down syndrome have varied needs that sometimes are unique to an individual. The discovery of the needs early in life helps in planning for interventions that help the victims as they progress in life. According to Rondal and Buckley (2003) the effects of Down syndrome and the disabilities that relate to it can be significantly reduced if the right programmes for intervention are implemented. The children and adolescents with the Down syndrome have slow progression in the different areas of development. The common challenges include: Learning challenges Social challenges Behavioural challenges Communication Self help Learning challenges Adolescent stage is the life transition stage in which important aspects of development takes place such as making lifetime friends and learning as most people are schooling and generally want to socially fit in society. Every aspect of life at the adolescent stage is very crucial; a failure in an aspect can lead to an individual feeling not fitting well in society which could affect him/her psychologically (Morris & Alberman, 2009). This presents great challenges to the adolescents with the condition and if proper interventions are not carried the adolescents are likely to be stressed and sometimes end up being depressed. Learning is a pivotal aspect of the life of the adolescents as they spend most of the time with fellow students and any challenges affecting the learning will impact negatively on their lives. The following are some of the challenges faced by adolescents with Down syndrome in their learning process. Hearing challenges Hearing is very important in the learning process. According to Chapman and Key (2011), 70% of children with the syndrome normally suffer from conductive hearing loss while 15% of the adolescents with Down syndrome have sensorineurial hearing loss. Therefore, the adolescents will have learning problems due to the difficult in listening and in many occasions, they will have problems of discrimination between sounds that may be similar. For instance, the use of phonics becomes a great problem to them which puts them at a learning disadvantage with their fellow classmates without the disability. In addition to learning, the hearing loss affects them while in games which is an important part of socialisation (Fidler & Nedal, 2007). As a result they end up isolating themselves from the rest of students. Motor skills challenges The gross motor skills normally result due to low muscle tone and the inability of the body to have messaging system that is optimally working. Most of the people with the Down syndrome normally have motor skills challenge. The challenges result to inability to actively engage in physical activities such as games and sometimes lead to delayed self help skills which leave the adolescents to depend on other people for help. The poor messaging system leads to short concentration span (Wing & Tylon, 2007). This means that the students with the down syndrome will have difficult in paying attention to what the teacher is saying, in many occasions they get carried away by other things which draws their attention out of the class, i.e. they get distracted by side happenings as the lesson or an important session is going on. The result for such is that if the teacher is not keen on them they are academically left behind by their fellow classmates. Listening memory As noted by Chapman and Key (2011) 70% of the people with Down syndrome have hearing problems, either conductive or sensorineurial. The persons with Down syndrome also have the challenges relating to skill retention and consolidation. This may be exhibited in difficulties when it comes to memorisation of sequences and the ability to learn new terms (Fidler, Philosofky & Hepburn, 2007). They also have difficulties in transferring the information that has been acquired in learning to long term memory. This affects their test scores especially when assessed at end term or end year. Communication Challenges Communication plays a crucial role in enhancing learning, general development, behavior, and social interactions of the adolescents. The adolescents are still in their early years of education and language is very important; language forms the basis of social interactions and plays key role in boosting the confidence of the students. According to Chapman and Key (2011), students with intellectual disorders have deficits in communication, which affect their overall speech. The deficit in communication among the students with Down syndrome vary in the severity, some will have monotone speech that is limited to a given topic while other experience total absence of the verbal communication. People with the Down syndrome have difficulties in speech and language development. As a result this people tend to have a slowed learning pace. Specifically, they have problems when they have to listen, deal with sentences that are long during class dictations, articulate speech, weak comprehension that is due to slow thinking and reasoning (Morris & Alberman, 2009). Socialization Adolescents with Down syndrome are characterized with the inability to start and carry on a meaningful social relationship with their peers. The adolescents with the disorder find it difficult to identify and interpret emotions; this means that they have no social skills that are required in the general life and classroom (Dykens, Hodapp & Evans, 2006). For instance, if the students are in general classroom with the students without disabilities, they will have strained social interactions during group discussions. The same applies when the children are in sports and social socializing games. Dykens, Hodapp & Evans (2006) said that it was advisable for the teacher to keenly monitor the student and identify the special activity of interest for the student with Down syndrome. The teacher or the person in charge should bear in mind that the needs vary from one student to the other. The difficulties in socialisation arise due to speech and communication problems. Challenging Behavior It has been found that people with Down syndrome normally engage in challenging behaviors than the other children. The adolescents with the syndrome should be carefully monitored as they are likely to be stressed and in case of depression they can attempt actions that can cause physical injury to them. In addition, the adolescents with the syndrome commonly have attention deficit disorder which can affect their concentration span, prevent them from getting the right academic instructions and consequently impact negatively on their social life in school. The adolescents should thus be closely monitored in classroom and in other social activities to identify the negative behaviours and take corrective measures early in advance. Health Challenges In addition to these challenges that affect the adolescents with Down syndrome, there also health related challenges that affect them in their lifetime and also influences the severity of the challenges discussed above, examples of health problem are sleep disordered breathing and reduced cardiovascular response. Studies have also found that Autistic Spectrum Disorder (ASD) and attention deficit hyperactivity disorder challenges will be found in 10-20% of the both children and adolescents with the Down syndrome (Ashworth, Hill, Kermiloff & Dimitriou, 2014). This explains the behavioural and social related challenges that are common with the Down syndrome adolescents. These challenges require assessment and support that is specific to individual needs. The adolescents are mainly in school and thus intervention measures will be required that holistically address the challenges. Morris and Alberman (2009) underscored the importance of holistic interventions that should be aimed at changing the following aspects of life that are crucial for the learning and general development of the adolescents. Learning Communication Socialisation Behaviour Health Overcoming Learning challenges The main goal of education is to ensure that students become autonomous and independent as much as possible. However, this is not always the case for students with Down syndrome. Most of them have challenges that make them lag behind their peers without the disability. Therefore, in planning for the education for the students, the stakeholders (parents, teachers, school administration) should consider the challenges and come up with programmes that are learner friendly for the affected students (Grodon and Levasseur, 2005). For instance, due to short concentration spans, breaks should be incorporated in the planning of lessons. There are teaching strategies that have been found to be effective for most people with intellectual disorders. One of the strategies is the discrete trial teaching. Discrete Trial Teaching (DTT). DDT is a teacher-directed approach in which the teacher analyses a student’s skills based on curriculum requirements. These skills are then broken down into small steps and taught using prompts. As the student masters the steps, the prompts are gradually eliminated. The core strategy in this method is giving the student opportunities to repeat the various steps and to practice these steps in different settings. Grodon and Levasseur (2005) carried out an experiment to investigate the effect of DTT in learning among students with Down syndrome. The study composed of a control and experiment group in which each group had five students with Down syndrome. In the experiment group, the DTT method was applied while in control group, the DTT was not applied. The students were assessed using both oral and written test. The scores in the experiment group were relatively higher compared to those of control group. This model is thus very effective for addressing the challenges of attention. The strategy reinforces acquired skills using rewards. Overcoming Communication Challenges In teaching the students, a teacher should keenly observe the student as sometimes they end up caught in a private world and their attention is out of the class, such happening may be due to the inability to communicate or due to the attention deficit. A teacher should pay attention to the difficulties expressed by the student in using and understanding of non verbal communication such as the use of gestures, facial expression and body postures. To address the communication challenges, there are two interventions that can be used to improve communication depending on the unique need of the student. The strategies include the Pivotal Response Training (PRT) and Picture Exchange Communication System (PECS). These strategies assists the teacher to motivate the student to communicate and they are based on stimuli response or putting the student in an environment that encourages the communication. Most of the students with Down syndrome have strong visual learning skills such as use of gestures, symbols that can assist them in both reading and writing (Rondal & Buckley, 2005). The Picture Exchange Communication System entails teaching of the student how to communicate through the use of a symbol card. The symbol used should depict the c communicative intention of the student (Rondal & Buckley, 2005). An example is when a child wants to take a snack; the child may show the teacher the picture or symbol of the snack. The teacher encourages the child to use this means and discourages a behavior that could entail the child struggling to reach for a snack without communicating. The teacher keeps on encouraging this picture method and complex pictures are used over time. For example, the child will graduate from using simple pictures to start using cards that can form a sentence. This method fosters picture-based communication and the teacher gets to a situation where he/she can communicate with the child with Autism Spectrum Disorder. In adolescents the model should be modified to fit the need at hand for the student. This intervention has been found to be effective by Rondal and Buckley, (2005) who conducted a research to evaluate the effectiveness of PECS among 10 students across different schools that had verbal communication challenges carried out a research. Teachers were trained on how to use pictures and symbols to communicate with the children. There was a marked improvement on the communication behavior of the children, in addition to the pictorial communication; the researchers found that the approach also increased speech communication among the participants. The Pivotal Response (PRT) is another intervention that can be applied to address the communication challenge. Unlike the PECS intervention that targets communication through symbols and pictures, this intervention aims at improving the verbal communication. In this intervention, the teacher should model the requests made by the student with the intellectual disorder by saying the name (Rondal & Buckley, 2005). For example, if students are learning about examples such as “crackers” for morning break snacks, the teacher will say the name of the snack in order to prompt the student to understand and internalize the name and repeat the said word. If the student is unable to articulate the name, then a verbal estimation of the name can used. The method concentrates on the repeating the words he/she is prompted to utter and it is through the trial of the words that the one can receive the natural award through the word reinforcement. It is worth noting that the hearing problems affect the ability of the students with the disability in grasping the word being said, therefore the instructor needs to take note of that. Overcoming Social challenges There are different ways that can be used to overcome the social challenges among the students with Down syndrome. The ways include priming, script fading and actively encouraging peers to interact with the students with Down syndrome. Through the priming, the instructor is supposed to give the adolescents with disorder a chance to actively participate in schools social activities. For example, they can be given an opportunity to rehearse in the games of their interest, this happens before the student is given the opportunity to participate in the real social context. In a situation where students will be involved in playing basketball, the student with Down syndrome will be given an opportunity before the main occasion to practice how to dribble the ball and the general rules of the game. This enhances the confidence of the student and prepares the student psychologically for the social interaction in the course of a learning activity. In implementing this measure, a teacher needs to be very patient as it is time consuming but very effective. This intervention has been supported by a research carried out by Embse, Brown and Fortan (2011) who were involved in a research to determine the effectiveness of priming. Four students aged 10 -12 years diagnosed with downs syndrome were included in the study and their parents. Parents of two students were given a task to train their children on before the actual task could take place. The other two acted as control. This action was repeated for four different tasks alternatively. The findings of the research showed that whenever the children were involved in priming there was positive performance on actual activity. A teacher can also improve social interaction through direct involvement of the peers. This entails training the classmates’ ways to model and prompt targeted social behavior. Dykens, Hodapp and Evans (2006) carried out a research to determine social interactions of children with Down syndrome. The research included three students with Down syndrome and was to interact with students without the disorder. The three children with the Down syndrome had poor social interactions. At the end of the direct involvement study, analysis was carried out. The children with Down syndrome had significant development of social interaction in the group activities and communication. Overcoming the behaviour challenge In order to address the challenging behaviour, the teacher should apply behavioural interventions that make it favourable for the student with an intellectual disorder to learn. This can include the modification of the classroom or the environment at home in order to deter the occurrence of the behaviours considered negative, and engaging in teaching the child behaviours that are considered more positive (Buckley, Bird & Sacks, 2006). Researches have established that behaviours that are proactive and positive are essential if good education is to take place. Teachers should thus be aware of environments that will support the proactive and positive behaviors. A common intervention that the teachers can employ includes positive behaviour support (PBS) that has been found to be effective for teenagers and children aged between 5 and 12 years with intellectual disabilities and consequent challenging behaviours. The intervention is normally aimed at improving life quality for the students with the disorder and enhance confidence in them behaviour (Buckley, Bird & Sacks, 2006). It also entails adjustment of the environment in order to discourage re-occurrence of the inappropriate behaviour. In this approach a model that is tiered is used in which three tiers are used i.e. primary, secondary and tertiary. The tiered model involves prevention measures, assessment of the functional behaviours and application of comprehensive behavioural interventions that are aimed at reducing the challenging behaviours. Each tier has a special emphasis on fostering positive behaviour through family and friend involvement To improve the behaviour of the student a teacher should also engage the student in taking control of his or her actions. This strategy is referred to as self management. In this teaching strategy, the child with Down syndrome is encouraged to take leadership and ownership of the desired learning activity that is aimed at fostering confidence. Kamps et al (2004) carried out a study that encouraged five students with Autism to use self-appraisal mechanism. The selected students with Down syndrome were trained on the choosing right behavior and discarding the perceived wrong behavior during sporting activities. If the child engaged in an appropriate behavior, he/she rewards him/herself. Different reward systems were used; one was ticking a one-week chart that was given to the student. The chart had a list of positive and negative behaviors. At the end of the week, the charts were collected and analyzed (Kamps et al, 2004). The findings indicated that children ticked more positive behaviors as the days progressed. For students who face the challenge of behavior and have communication impairment, communication techniques can be taught to the child to replace the challenging behavior, through the Functional Communication Training. This will entail coming up with the communication intention of the expected right behavior, then teach the right behavior that will help in replacing the challenging behavior. The replaced desired behavior is rewarded. However, the reward is withheld if the challenging behavior is repeated. Overcoming Health Challenges Individuals who are typically developing and happen to have Down syndrome have been noted to have problems relating with attention difficulties. Adolescents with intellectual disabilities have been found to suffer from attention problems and lack of quality sleep. Ashworth, Hill, Kermiloff and Dimitriou conducted a study to investigate how good sleep influenced the attention of students with Down syndrome. To assess the sleep, actigraphy was used while the sleep disordered breathing was assessed by oximetry. The attention of the students was tested using a novel visual Continuous Performance Task (CPT). The results showed that adolescents with Down syndrome had attention deficit disorder. Better sleep quality and appropriate sleep duration was found to correlate to better test scores for the continuous Performance Task (CPT). This study shows that the attention deficit disorder in adolescents with Downs Syndrome can be reduced by ensuring that they have good sleep. Conclusion Downs syndrome is an intellectual disorder whose severity and challenges vary from one person to the other. The disorder is not age restricted, therefore it will be found in children, adolescents and adults. The adolescents with the Down syndrome face challenges that mainly relate to their education, as at adolescent they are still schooling. Notably adolescents with the Down syndrome have challenges in communication (speech and language), learning, behavioural and health challenges. The challenges can be overcome by establishing the unique needs of the affected adolescents. The identified needs helps in design and implementation of intervention to reduce the challenges based on the unique needs of the adolescents/students with the Down syndrome. References Ashworth, A, Hill, C., Karmiloff, S.A. and Dimitriou, D. (2014). The importance of sleep: Attention problems in school aged children with Down syndrome and Williams syndrome. Journal of Behaviour and sleeping medicine. 1(1), pp. 144-162. Buckley SJ, Bird G. and Sacks B. (2006). Evidence that we can change the profile from a study of inclusive education. Down syndrome Research and Practice. 9(3), pp.51-53. Chapman, R. and Kay, E. (2011). Language development in childhood, Teaching number skills and concepts with Numicon materials. 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