PSYC 3850 Chapter Notes - Chapter 7: Dual Diagnosis, Functional Skills Qualification, Motivation

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Educational Characteristics
Educational characteristics
are highly variable and dependent on many factors
severity of disability, type of support in the home/school/community, student age, physical environment, teaching content,
curricula, etc.
aected by the cognitive and learning characteristics discussed in the previous chapter
Academic skills
definitions of CIDs focus on deficits and challenges, and support needs
IWCIDs can and do learn academic skills
many diculties
e.g. abstract concepts, cognitive functioning issues, attention, learning development
may need a modified functional curriculum
Conceptual thinking
concepts = abstractions that are the result of assigning objects, people, ideas, or experiences to categories
concept formation is enhanced by the ability to learn attributes and characteristics of the concept
need to focus on the relevant stimuli (which is often dicult for IWCIDs)
learning abstract concepts requires using metacognitive skills
also requires memory, another area of issue
IWCIDs experience challenges to concept acquisition AND storage
IWCIDs are better at remember prototypical information (e.g. ‘most mammals live on land) than exemplars (e.g. ‘some mammals live
in the ocean’)
but are capable of learning concepts, given appropriate instruction
Comprehension skills
comprehension can be dicult, due to aforementioned issues (esp. deficits in speed and language)
but it can be improved through strategy instruction
adequate support and emphasis
daily, comprehensive reading instruction
esp. if they have ‘meaningful’ literacy instruction, instead of sight vocabulary, etc.
Functional skills = skills that, if not performed in part or fully by the student, must be completed for the student by someone else
those with more severe levels may need to focus almost solely on functional skills, rather than academics
aside from functional academics (literacy, arithmetic)
learning these are possible and important
don’t switch to focussing entirely on functional skills until they’re a little older
because with young children, it can often be dicult to know exactly what their capabilities are
Psychological Characteristics
Learned helplessness = tendency to give up easily or not to try at all when faced with new/dicult tasks
can be developed when they feel lack of control over learning and success
or from repeated failure
or believing that others are in control
or having other people do all your work for you
aects ability to adult successfully
can limit their experiences
Self-concept
important in task initiation and completion
and critical to long-term development
can be influenced through integration within the larger community
esp. when participating in integrated programs
if self-concept is diminished, they may have dicult with self-regulation
Self-regulation = ability to plan and manage time, attend to and concentrate on tasks, organize information strategically, establish a
productive environment, and utilize resources, and more
children with CIDs had more dicult in tasks
esp. identifying objectives and paying attention
frequently learned from others
leads to self-ecacy
should be stressed by teachers
Locus of control
as early as 8yo, IWCIDs tend to be more externally oriented
which changes little over time
but can still fluctuate depending on the task at hand
Self-determination
self-determined individuals
are autonomous, self-regulated, psychologically empowered, and self-realized
can make choices, solve problems, set goals, self-orbserve, self-instruct, self-advocate,
have an internal locus of control, self-ecacy, self-awareness and self-knowledge
can be improved through instructional procedures
but is dependent on opportunity, capacity to learn, scaolding and support
is often inhibited when communication is more dicult
Motivation = internal state that arouses, directs, and maintains our behaviour
intrinsic motivation
stems from curiosity and interest
these people tend to seek out and conquer challenges
rely less on external incentives, or punishments
extrinsic motivation
stems from an interest in consequences, and less in the actually task
we can have dierent motivations for dierent tasks
development in children with CIDs
engaging in choice making, challenging opportunities and activities, goal-setting, self-monitoring
develop some more intrinsic motivation when possible
Behavioural Characteristics
Dicult behaviour can result from a number of issues
internal triggers
e.g. pain, seizure, sensory experiences, fear, psychosis
external triggers
e.g. threats from others, environmental cues, lack of safety
trauma (physical, sexual, PTSD)
limited range of expression
dierentiation from mental illness diagnoses
e.g. syndromes, learned behaviours, mannerisms, disease processes
The relationship between CIDs and behavioural disorders
overall, IWCIDs exhibit more behavioural problems (esp. severe disabilities)
but the study of psychiatric processes, and its role in the development of CIDs is not resolved
some behaviours may be attributable to psychiatric disorders
exceptional behavioural needs occurs from
externally directed destructiveness
self-injury, pica, and suicidal behaviour
sexual aggression, inappropriateness
other behaviours (tantrums, wandering, substance abuse, failure to follow treatments)
Dual diagnosis
CIDs and mental illness are dierent conditions
and its dicult to attribute symptoms to one condition or another
people with CIDs can have the same psychiatric disorders that individuals without CIDs can have
Destructive or aggressive behaviour
indication: screaming, crying, property damage, attacking others
noncompliance, running away, etc.
screaming and aggression are often associated with depression in individuals with severe disabilities
can be minimized or eliminated through intervention
positive behavioural supports, and possibly medical/psychiatric interventions
Self-injurious behaviour
e.g. hitting one’s head, intentionally falling, biting, gouging, scratching oneself
occurs more frequently in those with severe levels
most treatments are successful
but eorts might need to focus on preventative techniques
Stereotypic behaviour = repetitive behaviours that tend to be physically harmless, but interfere with adjustment
includes (but is not limited to) rocking motions, weaving head motions, flapping fingers or hands
most research is conducted with individuals on the Autism Spectrum
high stereotypy scores associated with lower adaptive behaviour scores
more limited in expressing their thoughts
limited in performing necessary daily activities for survival / well-being
more dicult to keep a safe and clean home environment
more dicult to develop interpersonal relationships
harder to engage in functional and enjoyable activities (alone and with other)
amenable to treatment — reinforcement, support, and contact (esp. positive behaviour supports)
Interpersonal and sexual relationships
interpersonal relationships vary widely in scope and depth
most of their relationships are shared with a paid sta —> rich relationships, friendships, and community
quality of life is connected to quality and extent of their social network
contribution to life satisfaction: social support, interpersonal skills, leisure skills
sexual relationships are of concern
may be perceived as child-like
may be unable to control their sexual ‘urges'
may not be of the mental ability to consent to sexual activities
may not receive proper sex education
children with CIDs are at a higher risk for child and sexual abuse (up to 4x more likely)
dependent and intense interactions with caregivers (e.g. clothing, bathing)
lack the vocabulary and language skills to report abuse
special ed. tends to teach compliance (may be misinterpreted as consent)
poorer social skills, aecting the ability to discriminate between in/appropriate touching
exclusion from sex education programs
lack of privacy may encourage public, and unsafe behaviour
general reluctance to acknowledge and respect the sexual rights of those with disabilities
Adaptive Skill Characteristics
Leisure
participation in leisure activities fosters growth, development and wellness
also provides opportunities to participate with peers without disabilities
can participate in a wide variety of leisure activities
but is much more limited in duration and type for those with profound disabilities
lack of support and leisure times may lead to undesirable behaviour
most children with CIDs (80%) report having at least one friend
Work
historically, having a disability has led to less likelihood of being employed, and if employed, to lower income levels
1990 — Americans with Disabilities Act
employers with 15+ employees cannot refuse to hire/promote an individual on the basis of disability if they are otherwise
qualified
issues in preparing individuals for employment
diculties in learning concepts, storing and retrieving information, and developing comprehension skills
challenges in transfer and generalization of skills
psychological, behavioural, and other adaptive skill characteristics also interfere with work characteristics
Community
we need to look at this because historically, IWCIDs have been excluded from their communities
and around the world, many still do
esp. those with more severe levels, multiple disabilities, and/or challenging behaviours
being integrated with the community showed higher adaptive behaviour scores
performing activities associated with adulthood tends to indicate adult status
Self-care and home living
most individuals, even those with severe disabilities are capable of learning to meet most of their self-care needs
they might still need help, but much less
community living is important in developing self-care and home living skills
we want supports to be minimized to the level that individuals can be as independent as possible
we all need help from friends/family/coworkers, and IWCIDs are no dierent
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