Developmental Disabilities

1. Developmental Disabilities The Details Development of Young Children with Disabilities#872.514 (61)Carol Ann Heath

2. What is a Developmental Disability?

3. Developmental Disabilities • Developmental disabilities are a diverse group of severe chronic conditions that are due to mental and/or physical impairments. • People with developmental disabilities have problems with major life activities such as language, mobility, learning, self-help, and independent living. • Developmental disabilities begin anytime during development up to 22 years of age and usually last throughout a person’s lifetime.

4. U.S. Code Definition of Developmental Disability • The definition of "developmental disability" is described in the U.S. Code at 42 USC 15002 as follows: • 42 USC Sec. 15002 — Definitions • (8) Developmental disability • (A) In general • The term "developmental disability" means a severe, chronic disability of an individual that: • (i) is attributable to a mental or physical impairment or combination of mental and physical impairments; • (ii) is manifested before the individual attains age 22; • (iii) is likely to continue indefinitely; • (iv) results in substantial functional limitations in three or more of the following area of major life activity: • (I) self care • (II) receptive and expressive language • (III) learning • (IV) mobility • (V) self-direction • (VI) capacity for independent living • (VII) economic self-sufficiency; and • (v) reflects the individual's need for a combination and sequence of special, interdisciplinary, or generic services, individualized supports, or other forms of assistance that are of lifelong or extended duration and are individually planned and coordinated.

5. (B) Infants and young children • An individual from birth to age nine, inclusive, who has a substantial developmental delay or specific congenital or acquired condition, may be considered to have a developmental disability without meeting 3 or more of the criteria described in clauses (i) through (v) of subparagraph (A) if the individual, without services and supports, has a high probability of meeting those criteria later in life.

6. Global Developmental Delay • Temporary diagnosis in young children at risk for developmental disabilities • Refers to a failure to achieve age-appropriate developmental milestones • Domains: • Language • Motor • Social-adaptive

7. What is difference between a developmental disability and a birth defect? • Some diseases can cause both birth defects and developmental disabilities • Examples?

8. Occurrence of Disabilities • Issues in Measurement • Sources of Data

9. Prevalence • 17% of children in United States • 2 to 3% have severe disabilities • Costs for most severe exceed $50 billion annually (2003 estimate)

10. Four Disabilities 1996-2000 • During 1996, the prevalence of mental retardation was 15.5 per 1,000 children aged 8 years; it decreased to 12.0 per 1,000 in 2000. • The overall prevalence of cerebral palsy was 3.6 per 1,000 in 1996 and 3.1 per 1,000 in 2000. • The prevalence of mental retardation and cerebral palsy was highest among males and black children. • The prevalence of hearing loss was 1.4 per 1,000 in 1996 and 1.2 per 1,000 in 2000; • The prevalence of vision impairment during 1996 was 1.4 per 1,000 and 1.2 per 1,000 in 2000. • Minimal differences by study year were observed in the prevalence of all four disabilities when examined by sex, race, and severity. • Corresponding author: Tanya Karapurkar Bhasin, MPH, Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, CDC, 1600 Clifton Rd., NE, MS E-86, Atlanta, GA 30333. Telephone: 404-498-3875; Fax: 404-498-3550; E-mail: tfk2@cdc.gov.

11. Approximately 1 in 150 children—representing various communities in the United States—have an autism spectrum disorder, according to a Centers for Disease Control and Prevention working group. Known as the Autism and Developmental Disabilities Monitoring (ADDM) Network, it includes researchers from the Johns Hopkins Bloomberg School of Public Health and 12 additional institutions.

12. What are the different types of developmental disabilities? • Nervous system disabilitiesThese are birth defects that affect the functioning of the brain, spinal cord, and nervous system, which can impact intelligence and learning. These conditions can also cause problems such as behavioral disorders, speech or language difficulties, convulsions, and movement disorders.  Some of the common nervous system disabilities include: • Mental retardation - The term mental retardation describes a certain range of scores on an IQ (intelligence quotient) test. Mental retardation can result from a number of different conditions, including (but not limited to): • Down syndrome - a set of mental and physical characteristics related to having an extra copy of Chromosome 21. • Fragile X syndrome- the most common inherited form of mental retardation caused by a defect in a specific part of the Fragile X Mental Retardation-1 gene that causes the body to produce low amounts or none of a certain protein.  Without the protein, the brain doesn’t develop normally. • Autism Spectrum Disorder - a range of problems that can affect a person's communication skills, social skills, and intelligence. Because autism is diagnosed on a spectrum, people with this condition can have mild symptoms or severe symptoms; but they all have a type of autism.

13. Sensory-related disabilities • Sensory-related problems are often a key part of complex birth defect patterns. • Children with congenital rubella are likely to be deaf, and to develop cataracts of the eyes. • Children with Williams syndrome have trouble seeing spatial relationships between objects around them. • Those with Fragile X syndrome are often very sensitive to loud noises; they may overreact or have outbursts in reaction to such sounds.

14. Metabolic Disorders • This group of functional birth defects affects a person's metabolism, which is the way the body builds up, breaks down, and otherwise processes the materials it needs to function. • Two commonly known metabolic disorders include: • Phenylketonuria (PKU) - a condition in which a problem with a specific enzyme, a protein that speeds up certain chemical reactions, causes mental retardation. • Hypothyroidism - a hormonal condition that, if left untreated in an infant, can cause mental retardation.

15. Degenerative Disorders • Some infants born with degenerative disorders appear normal at birth, but then lose abilities or functions due to the in condition. In these cases, the defect is usually not detected until an older age, when the child or person starts to show signs of loss of function. Some degenerative disorders are the result of metabolic disorders. • Degenerative disorders can cause physical, mental, and sensory problems, depending on the specific defect.

16. Population Distribution • 41.3 million • Number of people who have some level of disability. They represent 15 percent of the civilian non-institutionalized population 5 and older. • By age — • 6 percent of children 5 to 15 have disabilities. • 12 percent of people 16 to 64 have disabilities. • 41 percent of adults 65 and older have disabilities. • 16% Percentage of females with a disability, compared with 14 percent of males. Source: 2006 American Community Survey

17. Using or Needing Assistance • 10.7 million - Number of disabled people 6 and older who need personal assistance with one or more activities of daily living (such as taking a bath or shower) or instrumental activities of daily living (such as using the telephone). This group amounts to 4 percent of people in this age category. • 2.7 million - Number of people 15 and older who use a wheelchair. Another 9.1 million use an ambulatory aid such as a cane, crutches or walker.

18. Specific Disabilities • 1.8 million - Number of people 15 and older who report being unable to see. • 1 million - Number of people 15 and older who report being unable to hear. • 2.6 million - Number of people 15 and older who have some difficulty having their speech understood by others. Of this number, 610,000 were unable to have their speech understood at all. • 14.3 million - Number of people with limitations in cognitive functioning, or who have a mental or emotional illness that interferes with daily activities, including those with Alzheimer’s disease and mental retardation. This group comprises 6 percent of the population 15 and older.

19. On the Job • 11.8 million - Number of 16- to 64-year-olds who reported a medical condition that makes it difficult to find a job or remain employed. They comprise 6 percent of the population this age. • 56% - Percentage of people 21 to 64 having some type of disability who were employed in the past year. The rate ranged from 82 percent of those with a non-severe disability to 43 percent with a severe disability. For those without a disability, the employment rate is 88 percent for the same period. • 44% - Percentage of people with a non-severe disability who work full time, year-round. This compares with 53 percent without a disability and 13 percent with a severe disability.

20. Health Status • 33% Percentage of people 25 to 64 who have a non-severe disability and report their health as being “very good” or “excellent.” This compares with 13 percent of those with a severe disability and 73 percent of those without a disability.

21. Income and Poverty • $22,000 - Median earnings for people with a non-severe disability. This compares with $25,000 for those with no disability and $12,800 for those with a severe disability. • 18% - Percentage of people with a non-severe disability with household incomes of $80,000 or more. By comparison, 26 percent of people without a disability had household incomes of $80,000 or more, with the same being true of 9 percent of those with a severe one. • 11% - The poverty rate for people 25 to 64 with a non-severe disability. This compares with 26 percent for those with a severe disability and 8 percent of those without a disability.

22. Living Arrangements • 60% - Percentage of people 25 to 64 with a non-severe disability who live in married-couple families. The corresponding rates are 68 percent for those without disabilities and 50 percent for people with severe disabilities. • 23% - Percentage of people with a non-severe disability who live alone or with nonrelatives. This compares with 28 percent of those with a severe disability and 19 percent without a disability.

23. Education • 33% - The percentage of people 25 to 64 who had a non-severe disability and were college graduates. This compares with 43 percent with no disability and 22 percent with a severe disability. • 2.2 million - The number of undergraduates with a disability, as of the 2003-04 school year. These students represented 11 percent of all undergrads. Source: Statistical Abstract of the United States: 2008, Table 279 <http://www.census.gov/compendia/statab/>.

24. Plugged in to the Net … • 36% and 29% Percentages of people 15 to 64 with a severe disability who use a computer and the Internet at home, respectively. The respective figures for those without a disability are 61 percent and 51 percent.

25. Serving The Nation • 2.7 million - Number of veterans who received compensation totaling $26.6 billion for service-connected disabilities in 2006. Source: Statistical Abstract of the United States: 2008, Table 508 and Table 509 at <http://www.census.gov/compendia/statab/>.

26. Accommodations • 96.5% - Percent of transit buses that were ADA lift- or ramp-equipped, as of 2005. This represents an increase from 61.7 percent since 1995. Source: Statistical Abstract of the United States: 2008, Table 1083 at <http://www.census.gov/compendia/statab/>. Unless otherwise indicated, all the data are from the Americans with Disabilities: 2002 report at <http://www.census.gov/Press­Release/www/releases/archives/aging_population/00809.html>.

27. Specific Disabilities • Autism • Intellectual Disabilities • Cerebral Palsy • ADHD • Communication Disorders • Hearing Loss • Vision Impairments

28. What are the treatments for developmental disabilities?

29. Sources • Batshaw, M. L., Pellegrino, L., & Roizen, N. J. (2007). Children with Disabilities, 6th Edition