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Severe
             and
                   Multiple Disabilities 

Definitions of Severe and Multiple Disabilities

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  • There is no one-size-fits-all definition that makes up severe and multiple disabilities, it is grouped in multiple categories under the IDEA.

  • For the group of severe intellectual disabilities: A disability characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills.

  • For the group which comprises both deaf and blind: Deaf-blindness means concomitant hearing and visual impairments, the combination of which causes such severe communication and other developmental and educational needs that they cannot be accommodated in special education programs solely for children with deafness or children with blindness.

  • The third group for multiple disabilities is: Multiple disabilities means concomitant impairments  (such as intellectual impairment-blindness, intellectual impairment-orthopedic impairment, etc.), the combination of which causes such severe educational needs that they cannot be accommodated in special education programs solely for one of the impairments. The term does not include deaf-blindness.

  • The TASH definition (which a lot of professionals find more adequate) is: Individuals with disabilities of all ages, races, creeds or faiths, national origins, genders and sexual orientation who require ongoing support in one or more major life activities in order to participate in an integrated community and enjoy a quality of life similar to that available to all citizens. Support may be required for life activities such as mobility, communication, self-care, and learning as necessary for community living, employment, and self-sufficiency

Causes of Severe and Multiple Disabilities

  • The known cases are put into three categories:

    • Prenatal (before birth): Chromosomal abnormalities, Viral infections (ex. rubella), Drug/alcohol intake, especially during early months of pregnancy, malnutrition or physical trauma to the mother

    • Perinatal (during birth): Lack of oxygen supply to the baby’s brain (ex. prolonged labor), Physical injury to the brain during birth, or contracted infections during birth (ex. syphilis)

    • Postnatal (after birth): Infections (ex. meningitis), Traumatic brain injury (ex. fall, car accident), Lead poisoning, Reaction to medication, Environmental conditions (ex. exposure to toxins)

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Characteristics of Severe and Multiple Disabilities

  • Cognitive Characteristics: Students will typically score within severe or profound range of cognitive delay due to verbal skills and unfamiliar environment.

    • Difficulty understanding abstract concepts

    • May need more time to learn new things

    • Difficulty generalizing information or skills learned to different settings, tasks, materials, and people

  • Academic Characteristics: There is less emphasis placed on academics, however they still will learn important skills.

    • How intricate students with severe and multiple disabilities will learn about certain topics just may be an easier level with less depth

  • Oral Language: Verbal communication can be difficult because of intellectual and physical challenges

  • Social and Emotional Characteristics:

    • May display social and emotional skills that lag far behind those of other students their age, the limitations within verbal communication can play part in these challenges

    • May have difficulty in developing social skills, but will very much benefit from social relationships

  • Behavioral Characteristics: Share common behavioral characteristics as students without disabilities

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Identification of Severe and Multiple Disabilities

  • Usually, identification happens at birth, during infancy, or after a specific trauma, when the need for special education services is obvious

  • Alternatives to formal and norm-referenced assessments are typically recommended

  • Norm-referenced assessments: standardized tests that delineate specific skills that most students should demonstrate at certain ages or stages of development

  • Authentic Assessment: Ongoing assessment process that occurs within the student’s natural environment and includes observation of a student’s performance as well as the necessary support for the student.

    • The different types of authentic assessments:

      • Person centered approach focuses the student’s assessment and education plan on their unique characteristics and interests

      • Functional-ecological assessment provides a means of organizing information from written observation notes and video or digital recordings

      • Portfolio assessment refers to student artifacts which can be aligned with grade-level topic standards to demonstrate student progress

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Education/Recommended Educational Strategies
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  • Early Childhood: early intervention is strongly recommended. Most preschool students with severe and multiple disabilities stay at home or attend a private preschool

  • Elementary and Secondary Education:  most students with severe and multiple disabilities receive schooling in a segregated program. There, the students learn mostly life skills, however, that is slowly changing.

    • Universal design for learning (UDL), cooperative learning and other peer-mediated instructional approaches, active and hands-on learning, and instructional differentiation are opening doors for students typically  excluded from the general education classroom. 

  • High School: as students transition to high school, the students are more likely to be in separate specific classrooms  or schools

  • Meaningful curriculum: appropriate curriculum issued to each student according to personal goals and  limitations in reaching those goals.

  • Positive behavior support

  • Collaboration between all staff and family is essential to providing the best support to the student

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