Multiple Disabilities

Definition
Severe Multiple Disabilities- IDEA defines this as concomitant impairments causes such severe educational needs that they cannot be accommodated in special education programs solely for one of the impairments.
Deaf Blindness- IDEA defines this as concomitant hearing and visual impairments, the combination of which causes such severe communication and other development and educational needs that they cannot be accommodated in special education programs solely for children with deafness or children with blindness
Traumatic Brain Injury-IDEA defines this as an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child's educational performance.

Teaching Implications
Instruction must be carefully planned, systematically executed, continuously monitored
-The students current level of performance must be assessed
-The skill to be taught must be defined clearly
-The skill may need to be broken down into smaller component steps
-The teacher must provide a clear prompt to cue the child
-The students must receive feedback and reinforcement
-Strategies that promote generalization and maintenance must be used
-The student's performance must be directly and frequently assessed

Technology

When possible use a voice output device to give students a voice and respond just like other students
-Present low tech pictures representing answer choices to student on eye gaze board or Velcro board
-Use a Step by Step to answer
-Record a single answer or a series of answers on a Step by Step and gives to the student to activate.
-Use a Go Talk 20, Tech Speak or Tech Talk with an overlay prepared with Boardmaker symbols representing answer choices
-Dynamic Display devices with core or content specific vocabulary that they can navigate to independently
Choose
-Using low to high tech
-Direct the student’s attention to each choice, “Look at the first
-Use a display of items or pictures—can be presented choice right here. Now look at the 2ND choice, etc” Make sure the student has looked at all options.
-Build choice making into as many activities as possible across the day
Color
-Allow a student with significant physical disability to participate in a coloring activity by directing a peer or adult to color using a voice output device
-Provide adapted access to markers, crayons, paints, etc
-Use a Step-by-Step to record a series of directions—”First color the flower blue. Then color the stem green. Then make the sun yellow.”
-Use a Tech Talk or other display to allow the student to make a choice of colors from a color based overlay.
-Use switch adapted digital camera to take a picture of what is being represented in a drawing
-Provide directions by independently navigating to appropriate vocabulary on dynamic display device
-Use computer software (Intellitools Classroom Suite provides switch accessible paint tools) to produce artwork
Count
-Use a number line as a low tech tool for counting, where the student uses his finger to indicate each number counted
-The student uses a Step-by-Step to participate in counting activities
-Program a Step-by-Step with numbers 1-10, step counting (2’s, 5’s, 10’s, etc).
-Look for a variety of counting opportunities throughout the day—number of students in a group, number of books read, number of dollars/coins needed to pay, etc
Write
-Adapted writing tools (fat pencils, grips, etc)
-Use of AlphaSmart Keyboard
-Student will engage in writing activities using Intellitools Classroom Suite or Clicker 5 on the computer.
-Use Intellikeys with an overlay or switch(es) to scan through a selection of words and phrases.
-Can be scaffolded to be made simpler or more complex depending on the needs of the student

References
Edyburn,D., Higgins, K.,& Boone R 2005 The Handbook of Special Education Technology Research and Practice Whitefish Bay, WI: Knowledge by Design Publishing
This handbook is essential reading for special education teachers, administrators, teacher educators, graduate students, technology specialists, researchers, and policy makers.

Pagabo, B & Pagano, E 2004 The Transparency Edge. McGraw- Hil
When the subject is you, you practice a key aspect of transparency and show others that you value them.

Buckinham M & Clifton., D 2001 Now Discover Your Strengths, The Free Press
Shows you how to discover your strengths when dealing with multiples disabilities

Olson, D. A. & Deruyter, F 2001 Clinician's Guide to Assistive Technology 1st ed . Mosby Publishing.
This useful resource is designed to offer healthcare professionals specific information about the diverse area of assistive technology. It covers the variety of technology available and explains the adaptations of the technology, as well as how different devices work together.

Heward, William L. Exceptional Children An Introducatin to Specail Education 9th edition 2009 Upper Saddle River New Jersey.