Positive Aspects of Categorization: The Thirteen Categories of Disabilities

Autism

Children with autism require a structured, individualized curriculum that emphasizes functional skills, language and communication, and behavior management. Speech therapy is often necessary, and occupational therapy (OT) and physical therapy (PT) may be needed if fine or gross motor weaknesses are noted. The child with autism likely will have a case manager who has experience in working with children with autism, because it takes some coordination of the various specialties to provide adequate services to these children.

Deaf-Blindness

Children who are deaf and blind require assistance with orientation and mobility. This special training helps children to learn how to move around safely, efficiently, and independently. An example of training in orientation would be helping a child understand how to navigate around the house or classroom. Mobility, on the other hand, involves actually moving. Once a child has become oriented to a home or classroom, getting from one place to another becomes the goal. This can be accomplished by crawling, walking, or using a wheelchair.

Deafness

Children who are deaf may need a sign language interpreter. Many children who are deaf use sign language to receive information and to communicate. What goes on in the classroom is conveyed by an interpreter to the child, and what is expressed by the child is conveyed to the teacher and other children. Other accommodations may include lecture notes, visual and written instructions, written exams, visual behavioral cues, or amplification equipment.

Emotional Disturbance

Children with an emotional disturbance may have a variety of diagnoses. Those with anxiety, depression, schizophrenia, or bipolar disorder fall within this category. While many children with emotional disturbance do well in the general education classroom, some of them have severe behavioral difficulties that require a more restrictive setting. They may have frequent outbursts, throw chairs or desks, or be physically or verbally aggressive. In cases of severe behavior problems, it is best that children be in a setting that is very structured and includes fewer peers. Some children with emotional disturbance may require individual or group counseling.

Hearing Impairment

Children with a hearing impairment who don't meet the definition of deafness still need assistance—for example, auditory training, instruction in oral and total communication (the use of all available means of communication), or hearing aid training. While these children may have fewer communication problems than a child who is deaf, they may still have difficulties because of the hearing loss. Accommodations may include lecture notes, visual and written instructions, written exams, and visual behavioral cues.

Intellectual Disability (Formerly Mental Retardation)

Recently, the American Association on Mental Retardation (AAMR) changed its name to the American Association on Intellectual and Developmental Disabilities (AAIDD, 2007). The change reflects the intent to replace the term mental retardation (MR) with intellectual disability (ID), which is the more common term used throughout Europe and Canada. However, the term mental retardation can still be found in major sources of classification, including IDEA 2004 and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR; American Psychiatric Association, 2000). We will use the term intellectual disability (ID) throughout this book to refer to both designations. Children with an intellectual disability will have significant weaknesses in both intellectual functioning and adaptive behavior. According to the DSM-IV-TR, children with an intellectual disability fall in one of four categories: mild, moderate, severe, or profound. It may be necessary to implement significant modifications to the general curriculum, depending on the severity of the disorder. Adaptive skills, which are skills needed to live, work, and play in the community, include self-care (dressing, toileting, bathing), communicating with others, social skills, and academic skills. Children with an intellectual disability may qualify for participation in a work program or vocational training.

Multiple Disabilities

Children with multiple disabilities have special needs depending on the nature of the different disabilities that exist. These children often have extreme educational needs that require the coordination of special education services involving various school personnel and health professionals.

Orthopedic Impairment

Children with an orthopedic impairment may have a range of needs. An orthopedic impairment may be caused by a congenital anomaly (something unusual at birth), disease, or other causes. A missing limb or clubfoot would be an example of a congenital anomaly. Bone tuberculosis is an example of an orthopedic anomaly caused by disease, while cerebral palsy or an amputation would fall in the "other" category. The services and expertise of a physical therapist are critical in assessing a child's continuing needs and tracking progress, which should occur on a regular basis.

Other Health Impairment

Children in the "Other Health Impairment" category are affected by a chronic or acute health problem. Many disorders fall in this category, including ADHD, asthma, epilepsy, leukemia, sickle cell anemia, and diabetes. It is difficult to suggest typical interventions because the range of disorders is so broad, but accommodations might include permission to complete tests and assignments in a small-group setting, extra time to complete tests or assignments, or permission to make up work when school is missed for medical appointments.

Specific Learning Disability

Children with a learning disability have a significant weakness in one or more of seven areas: reading, reading comprehension, math calculation, math reasoning (solving problems), writing, listening comprehension (understanding what is heard), or speaking. These children need extra help, support, and encouragement. They often have difficulty learning at the same pace as others. Children with a learning disability may need additional time to complete assignments, a quiet place to work, abbreviated assignments, or tutoring. The accommodations needed will depend on the age of the child and the severity of the disability. Unlike students who have intellectual impairments that cause global difficulties in learning, children in this category have at least average intelligence but encounter academic problems in "specific" areas.

Speech or Language Impairment

Children with a speech or language impairment are likely to be diagnosed with some type of communication disorder. They may have problems with stuttering or articulation, or they may have a noticeable language or voice impairment. In the schools, speech-language pathologists (SLPs), also called speech therapists or speech teachers, work with children who have a variety of speech and language disorders. The disorders may be congenital or acquired and may include feeding and swallowing disorders in infants and children, language-based learning disabilities, selective mutism, or right-hemisphere brain damage. SLPs may help children to attain normal speech patterns, eliminate a lisp, speak more intelligibly, or learn to retrieve words more easily.

Traumatic Brain Injury

Children with a traumatic brain injury (TBI) have an acquired brain injury that affects specific parts of the brain. The external physical force that caused an open or closed head injury may have resulted in total or partial functional disability. Depending on the part of the brain that was injured, there may be impairments in functions such as cognition, language, speech, memory, attention, reasoning, abstract thinking, judgment, motor abilities, or psychosocial behavior. The specific personnel needed and accommodations implemented to assist a student with TBI will depend largely on the severity of the head injury and which functions are impaired.

Visual Impairment (Including Blindness)

Children with a visual impairment or blindness may have partial sight or be completely blind. While some children are born with an impairment or blindness, others have acquired it through an accident or disease. Children with visual impairment may need books and textbooks on tape, Braille books, training in computer and typing skills, or assistance in getting around school. Teacher assistants and peer helpers may work with visually impaired children, especially those who are younger or who have recently become disabled.

For More Information

An appropriate diagnosis allows parents and teachers to access a wealth of information, including recent research and suggestions for effective interventions. A list of organizations that you can contact for more information is available in Appendix H. If you have access to the Internet, visiting an organization's Web site opens a world of information to you, free of charge. You will find tips, resource guides, treatment suggestions, and other helpful resources to assist you in better understanding a child's diagnosis and particular needs. For example, the Web site of the Council for Exceptional Children (CEC: http://www.cec.sped.org) includes an Information Center on Disabilities and Gifted Education, where you will find fact sheets, information on research-based interventions, links to discussion groups, links to relevant laws, and more.