DEFINING SEVERE DISABILITIES

Most educators today maintain that developmental levels have little relevance to this
population and instead emphasize that a student with severe disabilitiesregardless of age
is one who needs instruction in basic skills, such as getting from place to place independently,
communicating with others, controlling bowel and bladder functions, and self-feeding.
Most children without disabilities acquire these basic skills in the first 5 years of life, but
the student with severe disabilities needs special instruction to do so.
The basic-skills definition makes it clear that special education for students with severe
disabilities must not focus on traditional academic instruction.
The Association for Persons with Severe Disabilities (TASH) definition:
individuals of all ages who require extensive ongoing support in more than one major life
activity in order to participate in integrated community settings and to enjoy a quality of
life that is available to citizens with fewer or no disabilities. Support may be required for
life activities such as mobility, communication, self-care, and learning, as necessary for
independent living, employment and self-sufficiency.

W. L. Heward, Exceptional Children, 6e,

2000 by Prentice-Hall, Inc. All rights reserved.

T 13.1

CHARACTERISTICS OF STUDENTS WITH

SEVERE DISABILITIES
Slow acquisition rates for learning new skills
Poor generalization and maintenance of newly learned skills
Limited communication skills
Impaired physical and motor development
Deficits in self-help skills
Infrequent constructive behavior and interaction
Frequent inappropriate behavior
Despite the intense challenges their disabilities impose upon them, many students with
severe disabilities exhibit warmth, persistence, determination, a sense of humor,
sociability, and various other desirable traits.

W. L. Heward, Exceptional Children, 6e,

2000 by Prentice-Hall, Inc. All rights reserved.

T 13.2

DEAF-BLINDNESS
IDEA defines students with deaf-blindness as a combination of both auditory and visual disabilities
that causes
such severe communication and other developmental and learning needs that
the persons cannot properly be educated in special education programs solely
for children and youth with hearing impairments, visual impairments, or severe
disabilities, without supplementary assistance to address their education needs
due to these dual, concurrent disabilities. (IDEA, 1990, sec. 1422)
the intellectual level of students with dual sensory impairments ranges from giftedness
(as in the case of Helen Keller, who lost her sight and hearing at about 16 months of age) to
profound mental retardation
over 90% of students labeled deaf-blind have some functional hearing and/or vision and can
make use of information presented in those modalities
when used in instruction, however, auditory and visual stimuli must be enhanced and the
students' attention directed toward them
tactile teaching techniques involving the sense of touch are used to supplement the information
obtained through visual and auditory modes.
dual communication boards can help students who are deaf-blind discriminate the receptive or
expressive functions of responses from a communication partner
W. L. Heward, Exceptional Children, 6e,

2000 by Prentice-Hall, Inc. All rights reserved.

T 13.3

AUTISM
autism a disability marked by severe impairment of communication, social, and emotional functioning,
usually accompanied by severe intellectual impairment
The essential features of the condition typically appear prior to 30 months of age, and consist of
disturbances of (1) developmental rates and/or sequences; (2) responses to sensory stimuli; (3) speech,
language, and cognitive capacities; and (4) capacities to relate to people, events, and objects (Autism
Society of America).
autism occurs in approximately 5 to 15 of every 10,000 children
boys are affected four to five times more often than girls
although the precise cause of autism is unknown, it almost certainly is of biological or organic origin
six frequently observed characteristics (Lovaas & Newsom, 1976):
apparent sensory deficit
severe affect isolation
self-stimulation
tantrums and self-injurious behavior
echolalic and psychotic speech
behavior deficiencies
Although the prognosis is generally considered to be extremely poor, with problems existing into
adulthood for 90% of cases, recent research evaluating the effects of intensive early intervention based
on principles of applied behavior analysis is encouraging.
W. L. Heward, Exceptional Children, 6e,

2000 by Prentice-Hall, Inc. All rights reserved.

T 13.4

CURRICULUM CONSIDERATIONS FOR

STUDENTS WITH SEVERE DISABILITIES
Functionality Functional skills are immediately useful to a student, frequently required in school
and nonschool environments, result in less dependence on others, and allow the student to
participate in less restrictive environments.
Chronological Age-appropriateness Students with severe disabilities should participate in
activities that are appropriate for same-age peers without disabilities.
Making Choices Special educators should recognize the importance of choice-making, as a way of
making activities meaningful and as an indicator of quality of life for students with severe
disabilities.
Communication Skills Instruction and supports in the area of communication for persons with
severe disabilities must increasingly focus on the development of functional communication (i.e.,
communication that "works).
Recreational and Leisure Skills Children with severe disabilities may not learn appropriate and
satisfying recreational skills unless they are specifically taught.
Prioritizing and Selecting Instructional Targets It is seldom, if ever, possible to design and
implement a teaching program to deal with all of the learning needs and challenging behaviors
presented by an individual with severe disabilities. One of the greatest responsibilities a special
educator undertakes in his role as a member of an IEP team is the selection of instructional
objectives.
W. L. Heward, Exceptional Children, 6e,

2000 by Prentice-Hall, Inc. All rights reserved.

T 13.5

INSTRUCTIONAL METHODS FOR

STUDENTS WITH SEVERE DISABILTIES
Students with severe disabilities seldom acquire complex skills through imitation and
observation alone.
Their learning and behavior problems are so extreme and so significant that
instruction must be carefully planned and executed.
The teacher must know what skill to teach, why it is important to teach it, how to
teach it, and how to recognize that the student has learned the skill.
Careful attention should be given to the following components of an instructional
program:
The student's current level of performance must be precisely assessed.
The skill to be taught must be defined clearly.
The skills may need to be broken down into smaller component steps.
The teacher must provide a clear prompt or cue to the child.
The student must receive feedback and reinforcement from the teacher.
Strategies that promote generalization and maintenance must be used.
The student's performance must be carefully measured and evaluated.
W. L. Heward, Exceptional Children, 6e,

2000 by Prentice-Hall, Inc. All rights reserved.

T 13.6

POSITIVE BEHAVIORAL SUPPORT

AND FUNCTIONAL ASSESSMENT
Special education programs are responding to challenging, excessive, or unacceptable behaviors by attempting to:
(1) understand the meaning that a behavior has for a student, (2) offer the student a positive alternative behavior,
(3) use nonintrusive intervention techniques, and (4) use research-validated strategies that are intended for use in
integrated community settings.
Called positive behavioral support, this approach begins with a functional assessment of the problem behavior.
Although functional assessment refers to a variety of behavior assessment methodologies for determining the
environmental variables that are setting the occasion for and maintaining challenging behaviors, it usually
consists of these three steps (Horner & Carr, 1997):
1. Structured interviews are conducted with teachers, family members, and others who know the child well to
find out the circumstances that typically surround the occurrence and nonoccurrence of the problem behavior and
the reactions the behavior usually evokes from others.
2. Systematic observations of the child are conducted to learn (a) the environmental context and events that
covary with the problem behavior (e.g., transitions from one classroom or activity to another, task difficulty); (b)
the intensity, duration, and form of the problem behavior; and (c) the events that follow the problems behavior and
may function to maintain it (e.g., teacher attention, withdrawal of task demands).
3. Functional analysis (i.e., experimental manipulation) of the variables identified in steps 1 and 2 is carried out
to verify their "function" in either triggering or maintaining the problem behavior.

W. L. Heward, Exceptional Children, 6e,

2000 by Prentice-Hall, Inc. All rights reserved.

T 13.8