Determine whether the classification as child with intellectual disability appears appropriate
Jennie is 8 years old, the eldest of four children. She lives at home with her mother and siblings in Section 8 housing in a small midwestem city. Her father has been an infrequent part of their lives due to repeated convictions for drug offenses.
Jennie was born prematurely after a difficult pregnancy. Her mother has had the support of a “Mentor Mom” since before Jennie was born. The Mentor Mom program was established in their area to assist young, inexperienced mothers who otherwise would have few supports in caring for their babies. The Mentor Mom’s role is similar to that of grandmothers, mothers, and aunts in times when extended families were able to help new parents learn to parent their own children. The Mentor Mom has helped Jennie’s mother with child-rearing information and problem-solving support over the years. Jennie frequently spends time with the Mentor Mom at her home in the country. Jennie’s mother has been participating in adult basic education programs and counseling for several years, and she wants to make life for her children better than hers has been. Frequently she depends on the Mentor Mom when the demands of living with four young children overwhelm her.
In kindergarten Jennie was tested by her school system for possible identification as a child in need of special education services. This evaluation was prompted by her low skill performance levels and her history of prematurity, neurological problems, and environmental disadvantage. At 8 months of age, she developed a seizure disorder for which she is currently on medication. The following information from Jennie’s school file was compiled almost 3 years ago as part of Jennie’s original referral to special education.
Jennie, Age: 5 years, 11 months: Referral and Background Information
Jennie was referred for evaluation because of behavioral and academic concerns. From age 3-4, Jennie attended a preschool program for children with developmental delays. Upon her completion of the preschool program, a multidisciplinary team determined that she was not eligible for special education and should enter the 4-K kindergarten in her home school district. She is presently enrolled in the 5-K kindergarten program.
The referral noted that she engages in frequent self-stimulating behaviors such as rocking and making
noises and that she interacts minimally with the other children. Her language skills are significantly delayed in both receptive and expressive areas. She does not speak much in class or attend well to group instruction. She is seated near the teacher in the classroom to reduce distractibility.
Jennie was cooperative and appeared 10 try to do her best throughout the evaluation. Her speech was difficult to understand at times because of faulty articulation. It was difficult to understand Jennie when she said the proper names of her family members. Jennie could give her name, address, and age but did not know her birthday or telephone number. Some mild tremors were noted in her arm when she was engaged in writing and drawing tasks. She was able to hop on both feet and to hop on her left foot quite well, but not on her right. She could not walk heel-to-toe and had trouble balancing on her left foot with her eyes closed.
Test Results:
Stanford-Binet Intelligence Scale
IQ: 68
M.A. 4-6
Test of Visual-Motor lntegration (VMI)
Standard Score – 74
Age Equivalent: 4-3
Draw-a-Person Test
Estimated Mental Age: 4-5
Vineland Adaptive Behavior Scale (Classroom Edition)
| Standard | Adaptive | |
| Domain | Score | Level |
| Communication domain | 70 | Moderately Low |
| Daily Living Skills domain | 80 | Moderately Low |
| Socialization domain | 67 | Low |
| Motor skills domain | 60 | Low |
| Adaptive behavior composite | 67 | Low |
Discussion of Test Results
Jennie was found to be functioning within the significantly-below-average range of intelligence on the StanfordBinet Test. She was able to match pictures of animals and shapes, to discriminate pictorial likenesses and differences, and to identify pictures in terms of their functions. She could not answer comprehension questions at the 4-year level. She simply repeated the questions rather than responding with an answer. At the 5-year level she was able to identify pictures in terms of similarities and differences and to copy a square. Jennie’s drawing of a person, copying of the VMI shapes, and mental age on the Stanford-Binet were all at the level of age 4.0-4.5. This indicates a general 2-year delay in the areas of functioning assessed by these tests.
In terms of skills, Jennie was able to rote count orally to 12 but could not correctly count objects beyond 5. She could recognize only the numerals 1 and 2. She could match the correct quantity of crayons only to the numerals I and 2. She could not identify any letters of the alphabet by name, but she was able to sing the alphabet song with only one error. She could not print her name but did print a series of letters that looked like J, N. and E when asked to write her name. Jennie was able to identify 10 basic colors correctly. Behaviorally, Jennie’s teacher noted that there are problems with constant fidgeting, humming, making odd noises, being inattentive, being easily distracted, and crying often and easily. To a lesser degree there are problems with being restless, overactive, excitable, impulsive, overly sensitive, disturbing other children, and having quick and drastic mood changes. She further described Jennie as tending to isolate herself from other children, appearing to be easily led, and interfering with other children’s activities. Her attitude toward authority was described as submissive and on the shy side. The teacher indicated that Jennie bas very poor socialization skills, that she doesn’t assert herself, and that when she does try to interact with others, it tends to be inappropriate.
Summary and Recommendations
Jennie has a long history of developmental delays, evidently related to prematurity. She also has a seizure disorder for which she takes medication. Jennie was found to be functioning within the range of intelligence associated with mild intellectual disability, with developmental levels generally around the 4.5-year level in terms of her cognitive ability and physical skill development. She appears to be a child with global delays who very likely does not understand much of what transpires in her kindergarten classroom. Her inattentive and distracting behaviors are possibly a reaction to her inability to compete and perform at a level that is comparable to that of the other children in the class. Her teacher comments that Jennie’s socialization skills are similar to those of younger children. It appears that Jennie would benefit from a smaller, structured classroom situation in which she can receive individualized work at her instructional level. She could benefit from a program with a heavy emphasis on the development of socialization and communication skills. She appears to meet the criteria for an individualized education program (IEP) as a child with mild intellectual disability.
Recently Jennie was seen at the neonatal neurological clinic that has been following her since birth because of her history of prematurity and her subsequent seizure disorder. The report noted that Jennie continues to receive speech and language therapy twice weekly at school, once in a group setting, the other individually. Jennie’s mother reported that the speech teacher is working on improving Jennie’s grammar and articulation. The clinic report noted that she engaged easily in conversation. She was able to follow all simple one and two-step directions. She exhibited some difficulty with using correct verbs in sentences. Phonological errors were present but were still within expectations for her age. Although grammar errors were evident in her conversational speech, her ability to convey meaning appears to be appropriate for her overall developmental levels. The clinic recommended that Jennie continue to receive speech and language therapy at school as it appeared to be addressing al I appropriate speech/language developmental goals.
When Jennie turned 8, an observational report was prepared by an independent educational evaluator to assist Jennie’s mother and the Mentor Mom in preparing for her triennial review. Both Jennie’s mom and the Mentor Mom had voiced their concern that Jennie seemed to be making little progress despite all the years she has been in school. They were looking for information to support their request for a full triennial evaluation, including a repeat of the ability and achievement testing done 3 years earlier.
Observational Report
Age: 8 years
At the request of Jennie’s mother, an observation was conducted in Jennie’s special education classroom to determine whether her current placement in a primary class for youngsters with mild intellectual disability appeared appropriate for her. It was apparent from watching Jennie’s performance in her classroom that she had great difficulty with tasks like naming and writing letters and numbers, especially when these tasks were presented without context.
In contrast, in preparation for a parent program the following week, she recited a long poem from memory and without prompts. She appeared to function as well or better than most of her classmates.
Jennie’s class behavior was attentive and conforming. It appeared that the majority of class time was spent on counting, reading color words, and naming and writing letters. The teacher mentioned that use of whole language had been suggested but that she didn’t think that method was appropriate for students at this functional level. The teacher based her program on acquisition of basic skills such as counting and naming and writing letters. Until the students had mastered those skills, the teacher felt it was inappropriate to move on.
In a subsequent diagnostic teaching session outside of school, Jennie was presented with a whole-word approach to decoding words, using picture cues and repeated self-drill. She quickly learned six words she had selected from a book. She seemed to benefit from the meaningfulness of the words and the picture cues. She was taught to drill herself on these selected words using single-concept picture cards that she and the evaluator had created; she also learned to congratulate (reinforce) herself when she was correct. The process appears to have promise for getting her started on reading.
A second activity was the making of pies for a picnic. As the pie was being made, Jennie and the observer wrote down the steps of the recipe. After each step, the full recipe to that point was read and reread. With the repetition and meaningful activity, Jennie was able to read the entire recipe at the end of the project.
Next, Jennie picked up a book that had been read to her previously. She said she would read it to the observer. She then commenced to “pretend read” the book as many young children do. The difference was that she carefully hid the pages from the observer so that it would not be apparent that she was not actually reading the page. It appeared that Jennie had already decided that she was supposed to be able to read, knew she could not, and was trying to hide that fact. This behavioral pattern was particularly troubling since it suggested that she would be increasingly resistant to real attempts to teach her to read.
Behaviorally, Jennie has developed a talent for getting what she wants and avoiding what she doesn’t want to do. She bargains with those around her: “Let me do/have this, then I’ll do that.” The problem is that she frequently resists the less desired activity after having received her reward, refusing to comply. It is essential that any behavior program established for Jennie place the reward after the compliance action has occurred.
From all of these observations, it appears that Jennie is a child with a variety of strengths and weaknesses. She is clearly delayed in developing skills typically expected of an 8-year old. It appears that she is a child who would benefit from more holistic, experiential forms of teaching. These actions are recommended:
· Her reading instruction should focus on whole words and real language. Appropriate methods might include language experience activities, repeated rereading of trade books with the teacher or parent (perhaps using Reading Recovery or the Fernald multisensory method for learning whole words). For now, focusing on individual letters and sounds should probably be avoided.
· Story reading to and with Jennie may help reduce her anxiety about not reading.
· Consistent use of manipulatives in math instruction, using a curriculum such as Math Their Way, is essential if numbers are to begin to have meaning for Jennie.
· Her delays in oral language are obvious. Good models and structured language training should be continued.
· Behavior interventions should pair low-interest activities with high-interest activities (rewards): rewards should be contingent on her completing the required behavior before the reward is received.
Learners with Mild Disabilities: A Characteristics Approach, Enhanced Pearson 5th Edition By Eileen B. Raymond Published by Pearson, p. 104-107.