What Are the Foundations of Severe Disabilities?

• The history of individuals with severe disabilities closely mirrors that of individuals with intellectual disabilities. Until the early to mid-20th century, many individuals with severe disabilities were institutionalized. The last 50 years have seen a focus on advocating for the treatment and education of those with severe disabilities.
• There is no universally accepted definition of severe disabilities. Typically those with severe disabilities are served within the IDEA 04 categories of multiple disabilities or deaf-blindness.
• IDEA 04 defines multiple disabilities as the coexistence of impairments that results in severe educational needs that educational programs for the individual impairments cannot support.
• IDEA 04 defines deaf-blindness as the existence of both a hearing and a visual impairment that requires more educational support than programs for either individual impairment could provide.
• The prevalence of severe disabilities is estimated to be less than 1%. It is a low prevalence disability.

What Are the Causes and Characteristics of Severe Disabilities?

• The causes of severe disabilities are varied and can be caused by genetic, biological, or environmental factors. Several syndromes have been identified as often leading to severe disabilities.
• Students with severe disabilities may or may not have intellectual disabilities. Characteristics include difficulties in abstract reasoning/concepts, attention, memory, learning, and the transfer/generalization of skills.
• Students with severe disabilities may display problems in communication and in the social-personal arena.
• Behavioral characteristics of students with severe disabilities may vary considerably. Students may display stereotypical repetitive, nonpurposeful movements or self-injurious behaviors.
• Students with severe disabilities may be in poor health.
• Students who are deaf-blind may or may not have intellectual disabilities. They will often have communication problems as well as display characteristics related to their sensory needs. Deaf-blind students may also have issues with social adjustment and behavior due to deficits in communication and lack of sensory input. Specific characteristics are often influenced by the age of onset of the sensory losses.

How Are Students with Severe Disabilities Identified?

• Severe disabilities are often identified at birth.
• Individual disabilities that contribute to multiple disabilities are identified by professionals in related fields.
• Identification of severe disabilities in early childhood is often done through neonatal screening, medical evaluations, and developmental assessment batteries and scales to assess family functioning. A transdisciplinary approach is often used.
• Identification of severe disabilities in school-aged students often includes IQ testing, adaptive behavior scales, and dynamic assessments. A focus of assessment is on how well the individual functions in different environments.
• The identification of deaf-blindness is typically done by specialists in each field. The individual needs only to have significant losses, rather than being both legally deaf and blind, in both areas to be considered deaf-blind.

What and How Do I Teach Students with Severe Disabilities?

• Students with severe disabilities may participate in the general curriculum. Developmentally appropriate practice should guide the curriculum choices for young children with severe disabilities being taught in an inclusive environment.
• The general education curriculum for school-aged students with severe disabilities can be made accessible through the adaptation of learning objectives and standards and carefully selecting skills to be developed.
• Ecological inventories and functional behavior assessments are useful in determining functional curriculum objectives for students with severe disabilities.
• Alternate assessments may be more effective with students with severe disabilities than traditional assessment tools.
• Transition planning for students with severe disabilities should start early and heavily involve the student's family. Transition planning may include preparing students for postsecondary education programs, full-time competitive employment, or supported employment.
• Some instructional strategies to consider using with students with severe disabilities are teaching specific target behaviors, using naturalistic teaching strategies, implementing embedded skill instruction, and planning for partial participation.
• Students with severe disabilities will often be supported by paraprofessionals. Teachers should work closely with paraprofessionals to define and support the services they provide.
• Teachers should plan to work closely with parents of students with severe disabilities and be aware that culturally and linguistically diverse families may have different views and needs.

What Are Other Instructional Considerations for Students with Severe Disabilities?

• Students with severe disabilities should be educated in natural, inclusive environments when possible. Inclusion can support communication and social skills as well as provide benefits to general classroom peers.
• Community-based instruction allows students with severe disabilities to learn skills within the inclusive environment of the community at large.
• The classroom environment for students with deafblindness must be planned for with both sensory limitations in mind.
• Extended school year services should be considered for students with severe disabilities.

What Are Some Considerations for the General Education Teacher?

• Many general education teachers are involved in the IEP development and daily instruction of students with severe disabilities.
• Collaboration between general education teachers, special education teachers, paraprofessionals, related services personnel, families, and others is needed for the successful inclusion of students with severe disabilities.
• Research shows that the inclusion of students with severe disabilities does not negatively affect the learning of other students in general education classrooms.