Scope of practice in speech-language pathology [Scope of practice]. It can be used with a large variety of individuals. However, the aging process may be premature in adults with ID as compared with the general population (e.g., Lin et al., 2011). . SLPs ensure that intervention provides ample opportunities for communication and incorporates. Publication manual of the American Psychological Association (7th ed.). Global prevalence based on international studies estimated the prevalence of ID in adults ranged from 0.05% to 0.08% (McKenzie et al., 2016). ID is a subset of developmental disability (DD). These and other features include the following: Communication delays or limitations in social functioning may signal ASD, ID, or other conditions. Speech and language development and intervention in Down syndrome and Fragile X syndrome. Cerebral palsy is a motor disorder that may affect speech, language, and swallowing. It indicates a failure to achieve age-appropriate developmental milestones (Battaglia & Carey, 2003; Petersen et al., 1998). Tager-Flusberg, H., & Caronna, E. (2007). Journal of Communication Disorders, 71, 7284. Interview with family members about communication during daily routines. Findings from the communication and hearing assessments are analyzed in the context of findings from other professionals who assess and/or treat ID (e.g., psychologists). https://doi.org/10.1111/j.1468-3148.2005.00232.x, Kent, R. D., & Vorperian, H. K. (2013). See ASHAs Intellectual Disability evidence map for summaries of the available research on this topic. It is important for individuals with ID to have the opportunity for literacy intervention, including a focus on phonological processing/word decoding and reading comprehension (Barker et al., 2013). Language development and Fragile X syndrome. (1998). These levels of support are described as intermittent, limited, extensive, or pervasive. Dietz, P. M. (2020). complex tasks (e.g., shopping, transportation, care organization, meals, money management), genetic syndromes (e.g., Down syndrome and Fragile X syndrome), maternal disease (e.g., placental disease), environmental influences (e.g., alcohol, other drugs, toxins, teratogens), labor and deliveryrelated events (leading to neonatal encephalopathy), seizure disorders (e.g., infantile spasms), toxic metabolic syndromes and intoxications (e.g., lead, mercury). Fidler, D. J., Most, D. E., & Philofsky, A. D. (2009). Respond appropriately to oral commands. This goal bank includes a variety of examples/ ideas of goals and objectives for students with moderate to severe disabilities. These teams establish and coordinate services that are family centered, culturally appropriate, comprehensive, and compassionate and that produce meaningful life outcomes. Students with language learning disabilities are at a disadvantage in school due to having reduced/limited background knowledge and language proficiency as compared to typically developing peers. Adults with ID experience the same age-related health problems and functional decline observed in the general elderly population (Lazenby-Paterson & Crawford, 2014). https://doi.org/10.1002/mrdd.20098, Kurtz, P. F., Boelter, E. W., Jarmolowicz, D. P., Chin, M. D., & Hagopian, L. P. (2011). The implications of emergent literacy research for children with developmental disabilities. http://www.euro.who.int/data/assets/pdf_file/0003/126408/e94421.pdf?ua=1, World Health Organization. Definition: Intellectual disability is a disability characterized by significant limitations both in intellectual functioning and in adaptive behavior, which covers many everyday social and practical skills. Screen individuals who may have hearing, speech, language, communication, and/or swallowing difficulties and determine the need for further assessment and/or referral for other services. Other goals may be appropriate for individuals with extremely limited functional communication (e.g., broader communication goals such as turn-taking and social participation). Characteristics may include the following: Other conditions that may also co-occur with ID include the following: Individuals with ID may have more health problems than others in the general population, often because of inadequate health care, limited access to quality services (Krahn et al., 2006; van Schrojenstein Lantman-de Valk & Walsh, 2008), and communication limitations (Gentile et al., 2015). Journal of Speech, Language, and Hearing Research, 56(1), 295309. Journal of Applied Research in Intellectual Disabilities, 33(2), 126138. (2019). Team members may include parents/caregivers, general education teachers, special educators, counselors, job coaches, group home supervisors, and psychologists. Studies reported results based on gender; however, there were no indications whether the data collected were based on sex assigned at birth, gender identity, or both. Behavioral interventions range from one-to-one, discrete trial instruction to naturalistic approaches. These methods are based on behavioral/operant principles of learning; they involve examining the antecedents that elicit a certain behavior, along with the consequences that follow that behavior, and then making adjustments in this chain to increase desired behaviors and/or decrease inappropriate ones. putting interesting materials in sight but out of reach; sabotaging the situation with missing elements or providing inadequate portions; and. (2005). 1997- American Speech-Language-Hearing Association. Treatment typically encompasses a variety of techniques and approaches (Goldstein, 2006). The cognitive hypothesis and its influence on speech-language services in schools. American Journal of Speech-Language Pathology, 1(1), 3844. Overall pooled prevalence of approximately 37% of adults with ID had a co-occurring psychiatric disorder. Applied Psycholinguistics, 11(3), 291302. A demonstration of behavioral support for young children with autism. While the number sense, number recognition IEP goals or reading or vocabulary IEP goals strengthen basic skills, the cognitive abilities IEP goals touch the other aspects of building overall intelligence in children. Managing health problems in people with intellectual disabilities. anxiety disorders (Oeseburg et al., 2011), physical coordination and tone issues (Vuijk et al., 2010), obesity-related problems (Rimmer et al., 2010), Native Hawaiian or Other Pacific Islander: 6.8%, developmental and sociocultural standards for personal independence and community participation, independent functioning in one or more daily life activities (e.g., communication, social participation, and independent living) across settings, difficulties in pre-academic and academic learning (reading, writing, mathematics), difficulty understanding concepts of time and money, problems with abstract thinking (concrete approach to problem solving), difficulties in executive function such as, difficulties with functional use of academic skills such as money management and time management, limitations in language and communication skills, more concrete and less complex spoken language (if used), compared with same-age peers, limited vocabulary and grammatical skills, receptive language that may be limited to comprehension of simple speech and gestures, communication that may occur through nonspoken means onlysuch as gestures, signs, facial expressions, or aided systems (e.g., AAC), challenges with social judgment and decision making, difficulty understanding social cues and rules, emotional and behavioral regulation difficulties that may adversely affect social interactions, requiring different levels of support for daily life activities such as. Communication services and supports for individuals with severe disabilities: Guidance for assessment and intervention. World Health Organization. Educate communication partners on effective strategies for supporting the use of AAC, where appropriate. 42nd Annual Report to Congress on the Implementation of the Individuals with Disabilities Education Act, 2020. Hanen programs for parents: Parent-implemented early language intervention. Assessment and intervention are typically collaborative processes involving multiple providers. Case history, including medical, educational, and vocational status as well as teacher, caregiver, employer, and client/patient perspectives. Support individuals with ID in vocational and community settings. https://doi.org/10.2105/AJPH.2015.302903a, Hart, J. E., & Whalon, K. J. See ASHAs Practice Portal page on Augmentative and Alternative Communication. Focused stimulation approach to language intervention. the diagnosis of a communication disorder or delay secondary to ID; a description of the characteristics and severity of the communication disorder or delay; a determination of the effect of communicative situation/contexts on performance; the identification of a possible hearing loss; recommendations for intervention and support; the recommendation of a communication system (e.g., speech-generating device); a referral to other professionals as needed, such as, recommendations for support for parents, caregivers, teachers, and employers; and. https://doi.org/10.1016/j.ridd.2011.07.005, Shifrer, D. (2018). Social determinants of health: Key concepts. Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: A systematic review. Speech disfluencies in children with Down syndrome. Brookes. Frea, W. D., & McNerney, E. K. (2008). (2019). Down Syndrome Research and Practice, 12, 3744. You do not have JavaScript Enabled on this browser. A systematic review of U.S. studies on the prevalence of intellectual or developmental disabilities since 2000. very basic nonverbal communication. At times, this may inhibit families from seeking services, resulting in either delays or lack of intervention. Oxford University Press. Institute of Medicine (US) Committee on Nervous System Disorders in Developing Countries. Screening does not result in a diagnosis of a disorder but, rather, determines the need for further assessment and/or referral for other services. https://doi.org/10.1002/ajmg.c.10015, Beadle-Brown, J., Leigh, J., Whelton, B., Richardson, L., Beecham, J., Baumker, T., & Bradshaw, J. The ASHA Leader, 8(19), 67. Pennington, L., Goldbart, J., & Marshall, J. American Journal on Intellectual and Developmental Disabilities, 121(2), 121138. Parent-mediated/implemented treatment approaches involve partnerships between SLPs, parents/caregivers, and other professionals and communication partners in supporting the natural communication behaviors of individuals with intellectual and other developmental disabilities (Guralnick, 2017; M. Y. Roberts & Kaiser, 2011). Observing speech production, language comprehension and production, social communication, and literacy skills in natural environments. Specific: Be discrete in goal designing. https://doi.org/10.1352/2008.46:376-386. Journal of Speech, Language, and Hearing Research, 52(4), 10481061. Small groups of children play together under the guidance of an adult facilitator. Educate other professionals on the needs of persons with ID and the role of SLPs in diagnosing and managing communication disorders of those with ID. https://doi.org/10.1093/med:psych/9780195317046.003.0005, Gentile, J. P., Cowan, A. E., & Smith, A. Intervention for individuals with ID typically incorporates a variety of options and techniques in combination. Girolametto, L., Weitzman, E., & Clements-Baartman, J. Service delivery decisions are made based on the individuals communication needs relative to their family, community, school, or work setting. https://doi.org/10.1352/1934-9556-49.2.59, Office of Research Support and International Affairs. Difficulty with narrative discourse (Colle et al., 2008). Using informal measures, such as those designed by the clinician and tailored to the population being screened (e.g., age, developmental level, language[s] used). Based on data from the 2011 meta-analysis of international studies, the female-to-male ratio of adults with ID varied between 0.7 and 0.9 (i.e., seven to nine females with ID for every 10 males with the condition; Maulik et al., 2013). Intervention in multiple contexts allows the person with ID to practice functional skills in meaningful situations. Peer-mediated/implemented treatment approaches incorporate peers as communication partners for children with disabilities to minimize isolation, provide effective role models, and boost communication competence. https://doi.org/10.1044/1092-4388(2012/11-0231), Kalyva, E., & Avramidis, E. (2005). https://doi.org/10.1352/0047-6765(2003)041%3C0007:ABACFO%3E2.0.CO;2, Herer, G. R. (2012). https://doi.org/10.1080/0144341042000301210, Maulik, P. K., Mascarenhas, M. N., Mathers, C. D., Dua, T., & Saxena, S. (2011). https://doi.org/10.1044/gero19.1.36, Lee, M., Bush, L., Martin, G. E., Barstein, J., Maltman, N., Klusek, J., & Losh, M. (2017). Dysphagia, 23(1), 8897. Intellectual disabilities and hearing loss. Narrative discourse in adults with high-functioning autism or Asperger syndrome. Appropriate roles for SLPs include the following. This is in no way meant to be a document to just copy and paste from. inability to care for their . SLPs determine which options are appropriate by taking into consideration the individuals age, language profile, communication needs, factors related to language functioning, the presence of coexisting conditions, communicative opportunities and partner supports, linguistic needs, cultural background and values, and available research evidence. Mental Retardation and Developmental Disabilities Research Reviews, 13(1), 2635. (2001). Circle of friends is a treatment approach that uses the classroom peer group to improve the social acceptance of a classmate with special needs by setting up a special group or circle of friends. The focus is on building behaviors that are valued in everyday settings. Prelinguistic milieu teaching applies natural environmental cues and prompts to promote development of gestures, gaze alternation, vocalizations, play, and other prelinguistic skills (Warren et al., 2008). Please enable it in order to use the full functionality of our website. As individuals with ID reaches adolescence and adulthood, their communication and functional needs change. See Treatment Principles for Individuals With an Intellectual Disability. Information provided above under the Co-Occurring Conditions and Disorders section above may be helpful in developing an assessment protocol to document an individual performance profile. (2007). https://www.gallaudet.edu/office-of-international-affairs/demographics/, Patja, K., Mls, P., & Iivanainen, M. (2001). Language Arts-Reading: (Student's name) will read a 3rd grade passage and be able to comprehend its contents and decode 10 of the words contained therein with 70% accuracy within the next 29 weeks. Participants included 3 high school students with severe disabilities enrolled in a private faith-based school . Social interaction and pragmatic difficulties similar to those associated with ASD (e.g., staying on topic, taking turns in conversation, echolalia, perseveration; Haebig et al., 2020). Phonological accuracy and intelligibility in connected speech of boys with Fragile X syndrome or Down syndrome. Communication intervention is sensitive to cultural and linguistic diversity and addresses components within the International Classification of Functioning, Disability and Health (WHO, 2001) framework, including body structures/functions, activities/participation, and contextual factors (personal and environmental). SLPs may be part of a team making a differential diagnosis between ID and autism spectrum disorder or other conditions. Cultural differences in the attitudes, beliefs, and perceptions of individuals with ID are well documented within the United States and in other countries (Allison & Strydom, 2009; Scior, 2011; WHO, 2010a). It includes training in everyday environments and activities, rather than only at therapy time. express wants or needs (tangible reinforcement), indicate frustration or a desire to avoid a nonpreferred activity or event (escape-avoidance), or. When examining data, use extreme caution: Consider the potential of bias in the testing as well as in the diagnostic and evaluation procedures. World Health Organization. 106-402, 102(8). Prevalence of autism spectrum disorder among children aged 8 yearsAutism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2016. Journal of Applied Research in Intellectual Disabilities, 18(3), 253261. Guralnick, M. J. A descriptive investigation of dysphagia in adults with intellectual disabilities. Brookes. Identifying and treating behaviors early in development may promote appropriate communication using alternative modes and prevent negative long-term consequences. American Journal on Intellectual and Developmental Disabilities, 115(5), 364380. It is a leading cause of developmental disabilities in the United States (Clarke & Gibbard, 2003). Some of the most common known causes of intellectual disability - like Down . Motor performance of children with mild intellectual disability and borderline intellectual functioning. SLPs ensure that symbols used with individuals who require AAC reflect the cultural and linguistic identity of the individual and are in line with the individuals preference. Identification of the potential for effective intervention strategies and compensations. (2007). Symptoms of profound ID include: inability to understand or comply with requests or instructions. See ASHAs Practice Portal pages on Hearing Loss in Children and Hearing Loss in Adultsfor more information. (2002b). Following the individuals lead, attempts to communicate are reinforced as these attempts get closer to the desired communication behavior (McGee et al., 1999). 108-446, 20 U.S.C. Current Developmental Disorders Reports, 3(2), 104115. intellectual disabilities have challenges in areas of problem solving and evaluation. Journal of Autism and Developmental Disorders, 41(4), 405426. Rates and predictors of co-occurring autism spectrum disorder in boys with fragile X syndrome. https://doi.org/10.1017/S0142716400008900, Colle, L., Baron-Cohen, S., Wheelwright, S., & van der Lely, H. K. J. Conduct a culturally and linguistically relevant and age-appropriate assessment of speech, language, communication, and swallowing, using formal and informal tools. Journal of Intellectual Disability Research, 45(1), 3040. United Statesbased studies reported the prevalence of ID to be 7.9 per 1,000 adults (L. L. Anderson et al., 2019). The SLP helps maximize independent functioning in aging adults with ID. 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