| Multiple Disabilities -- a disability category in IDEA |
| Multiple Disabilities Characteristics and Background Information: Children with multiple disabilities will have a combination of various disabilities that may include: speech, physical mobility, learning, mental retardation, visual, hearing, brain injury and possibly others. Along with multiple disabilities, they can also exhibit sensory losses and behavior and or social problems. Children with multiple disabilities - also referred to as multiple exceptionalities will vary in severity and characteristics. These students may exhibit weakness in auditory processing and have speech limitations. Physical mobility will often be an area of need. These students may have difficulty attaining and remembering skills and or transferring these skills from one situation to another. Support is usually needed beyond the confines of the classroom. There are often medical implications with some of the more severe multiple disabilities which could include students with cerebral palsy and severe autism and brain injuries. There are many educational implications for these students. |
| MULTIPLE DISABILITIES A cross-classification of disabilities that involves significant physical, sensory, intellectual, and/or social-interpersonal performance differences. The need for extensive services and supports is evident in all environmental settings. IDEA DEFINITION OF MULTIPLE DISABILITIES: Concomitant impairments (such as mental retardation-blindness or mental retardation-orthopedic impairment), the combination of which causes such severe educational needs that they cannot be accommodated in special education programs solely for one of the impairments. Multiple disabilities does not include deaf-blindness. |
| Cerebral Palsy “Cerebral” means brain. “Palsy” means a disorder of movement. CP refers to a group of non-progressive neuromuscular problems of varying severity. CP is damage to the brain, primarily to the part of the brain that controls motor functions. However other parts of the brain may also be affected. In such cases the person affected has more than one disability. The extent of the damage varies from person to person. Mild disability might mean fine motor skills, like using scissors or writing, are difficult. Severe disability can mean poor movement of all four limbs, the trunk and neck. The child may even have difficulty in swallowing. |
| Facts ~Cerebral Palsy means damage to the brain. ~Early diagnosis has the benefit of early intervention strategies. ~Medications and surgery cannot cure this condition. ~A youngster with cerebral palsy generally has more than one disability. ~Cerebral palsy is not hereditary ~Cerebral palsy is not contagious ~Cerebral palsy is not progressive |
| There are three major types of cerebral palsy, and some individuals may have symptoms of more than one type. Spastic cerebral palsy. About 70 to 80 percent of affected individuals have spastic cerebral palsy, in which muscles are stiff, making movement difficult. When both legs are affected (spastic diplegia), a child may have difficulty walking because tight muscles in the hips and legs cause legs to turn inward and cross at the knees (called scissoring). In other cases, only one side of the body is affected (spastic hemiplegia), often with the arm more severely affected than the leg. Most severe is spastic quadriplegia, in which all four limbs and the trunk are affected, often along with the muscles controlling the mouth and tongue. Children with spastic quadriplegia often have mental retardation and other problems. Athetoid or dyskinetic cerebral palsy. About 10 to 20 percent of affected individuals have the athetoid form, which affects the entire body. It is characterized by fluctuations in muscle tone (varying from too tight to too loose) and sometimes is associated with uncontrolled movements (which can be slow and writhing or rapid and jerky). Children often have trouble learning to control their bodies well enough to sit and walk. Because muscles of the face and tongue can be affected, there also can be difficulties with sucking, swallowing and speech. Ataxic cerebral palsy. About 5 to 10 percent of affected individuals have the ataxic form, which affects balance and coordination. They may walk with an unsteady gait with feet far apart, and they have difficulty with motions that require precise coordination, such as writing. |
| In about 70 percent of cases, cerebral palsy results from events occurring before birth that can disrupt normal development of the brain. Contrary to common belief, lack of oxygen reaching the fetus during labor and delivery contributes to only a small minority of cases of cerebral palsy. Some of the known causes of cerebral palsy include: Infections during pregnancy. Certain infections in the mother, including rubella (German measles), cytomegalovirus (a usually mild viral infection) and toxoplasmosis (a usually mild parasitic infection) can cause brain damage and result in cerebral palsy. Recent studies suggest that maternal infections involving the placental membranes (chorioamnionitis) may contribute to cerebral palsy in full-term as well as preterm babies (those born before 37 completed weeks of pregnancy). A 2003 study at the University of California at San Francisco found that full-term babies were four times more likely to develop cerebral palsy if they were exposed to chorioamnionitis in the womb. Reproductive/urinary tract infections also may increase the risk of preterm delivery, another risk factor for cerebral palsy. Insufficient oxygen reaching the fetus. For example, when the placenta is not functioning properly or it tears away from the wall of the uterus before delivery, the fetus may not receive sufficient oxygen. Prematurity. Premature babies who weigh less than 3 1/3 pounds are up to 30 times more likely to develop cerebral palsy than full-term babies. Many of these tiny babies suffer from bleeding in the brain, which can damage delicate brain tissue, or develop periventricular leukomalacia, destruction of nerves around the fluid-filled cavities (ventricles) in the brain. Asphyxia during labor and delivery. Until recently, it was widely believed that asphyxia (lack of oxygen) during a difficult delivery was the cause of most cases of cerebral palsy. The ACOG/AAP report shows that fewer than 10 percent of the type of brain injuries that can result in cerebral palsy are caused by asphyxia. Blood Diseases. Rh disease, an incompatibility between the blood of the mother and her fetus, can cause severe jaundice and brain damage, resulting in cerebral palsy. Rh disease usually can be prevented by giving an Rh-negative woman an injection of a blood product called Rh immune globulin around the 28th week of pregnancy and again after the birth of an Rh-positive baby. Blood clotting disorders (thrombophilias) in either mother or baby also may increase the risk. Severe jaundice. Jaundice, yellowing of the skin and the whites of the eyes caused by the build-up of a pigment called bilirubin in the blood, occasionally becomes severe. Without treatment, severe jaundice can pose a risk of permanent brain damage resulting in athetoid cerebral palsy. Other birth defects. Babies with brain malformations, numerous genetic diseases and other physical birth defects are at increased risk of cerebral palsy. Acquired cerebral palsy. About 10 percent of children with cerebral palsy acquire it after birth due to brain injuries that occur during the first two years of life. The most common causes of such injuries are brain infections (such as meningitis) and head injuries. SEE MORE IN BOX BELOW BOOK SUGGESTIONS |
| Let's Talk About It: Extraordinary Friends by Fred Rogers |
| Special People, Special Ways by Arlene Maguire |
| Be Quiet, Marina! by Kristin DeBear and Laura Dwight |
| Someone Special Just Like You by Tricia Brown |
| Taking Cerebral Palsy to School by Mary Elizabeth Anderson |
| Rolling Along: The Story of Taylor and his Wheelchair by Jamie Riggio Heelan |
| Howie Helps Himself by Joan Fassler |
| Friends at School by Rochelle Bunnett, Matt Brown |
| Small Steps by Louis Sachar |
| Danny and the Merry-Go-Round by Nan Holcomb |
| Stuck In Neutral by Terry Trueman |
| Susan Laughs by Jeanne Willis, Tony Ross |
| From Where I Sit: Making My Way With Cerebral Palsy by Shelley Nixon |
| Stretching Ourselves: Kids With Cerebral Palsy by Alden R. Carter, Carol S. Carter |
| Step by Step: Real Life Experiences With Cerebral Palsy by Colleen Rose |
| Fair and Square by Nan Holcomb |
| Andy Opens Wide by Nan Holcomb |
| A Smile From Andy by Nan Holcomb |
| Andy Finds a Turtle by Nan Holcomb |
| Patrick and Emma Lou by Nan Holcomb |
| OTHER FACTORS that may influence the occurrence of cerebral palsy: PRENATAL: ~parents over age 35 ~very young parents ~genetic disorders ~malnutrition; vitamin deficiencies; amino acid intolerance ~radiation ~alcohol, drugs, poisons, toxins from smoking ~Human Immunodeficiency Virus ~syphilis, chicken pox, uterine infection ~placental abnormalities; vascular blockages ~neurological tissue destruction ~inflammation and infection of the uterine lining ~insufficient blood flow to the placenta ~infections such as listeria, meningitis, streptococcus group B (bacterial), septicemia (bacteria in bloodstream) PERINATAL and POSTNATAL: ~hypoglycemia, hypothyroidism ~respiratory distress syndrome ~meningitis, encephalitis ~multiple births -- twins, triplets, etc. ~stroke -- hemorrhagic or embolic stroke ~trauma -- abuse, accidents |
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