Generally about mental
retardation
Mental
retardation is a condition in which there is a significantly sub-average mental
development from birth or early childhood. Most people with mental retardation
have the condition from birth. In a small number, the condition may occur
following damage to the brain in later childhood. This could, for example,
follow an episode of brain fever.
Generally,
mental retardation is a life-long condition. Those affected continue to have
diminished intellectual capacity throughout their lives. However, in most
individuals with mental retardation, those parts of the brain that are not
damaged continue to develop. Therefore, they continue to acquire skills and
abilities as they grow older, albeit slowly.
Mental
retardation is not mental illness. The major characteristic of mental
retardation is delay in mental development, whereas the major characteristic of
mental illness is disturbance in the mental functions of thinking, feeling, and
behaviour. Mental illness can occur at any age, whereas mental retardation is
present from childhood. However, some people with mental retardation may also
develop mental illness.
Degrees of
mental retardation
Not all
people with mental retardation have the same level of intelligence. The
scientific method of measuring intelligence is through standardized
psychological tests called IQ tests. IQ or intelligence quotient,
is the percentage of intelligence a person has, in comparison to a normal person
from a similar background. An IQ of 100 is considered normal intelligence. The
lesser the IQ, the more severe is the level of mental retardation. Based on IQ,
mental retardation can be classified into different degrees as follows[i]:
|
IQ |
Category |
|
85-100 |
Normal |
|
70-85 |
Normal but not retarded |
|
50-70 |
Mild mental retardation |
|
35-50 |
Moderate |
|
20-35 |
Severe |
|
Below 20 |
Profound |
Children with mental retardation
may learn to sit up, to crawl, or to walk later than other children, or they
may learn to talk later. Both adults and children with mental retardation may
also exhibit the following characteristics:
The limitations of cognitive
functioning will cause a child with mental retardation to learn and develop
more slowly than a typical child. Children may take longer to learn language,
develop social skills, and take care of their personal needs such as dressing
or eating. Learning will take them longer, require more repetition, and skills
may need to be adapted to their learning level. Nevertheless, virtually every
child is able to learn, develop and become participating members of the
community.
In early childhood mild mental
retardation (IQ 60–70) may not be obvious, and may not be identified until
children begin school. Even when poor academic performance is recognized, it
may take expert assessment to distinguish mild mental retardation from learning
disability or emotional/behavioral disorders. As individuals with mild mental
retardation reach adulthood, many learn to live independently and maintain
gainful employment.
Moderate mental retardation (IQ
50–60) is nearly always apparent within the first years of life. Children with
moderate mental retardation will require considerable supports in school, at
home, and in the community in order to participate fully. As adults they may
live with their parents, in a supportive group home, or even semi-independently
with significant supportive services to help them, for example, manage their
finances.
A person with a more severe mental
retardation will need more intensive support and supervision his or her entire
life.
In about one-third of all cases, the cause of mental retardation is not
known. The remaining two-thirds of cases are thought to be caused by one of
four factors: heredity, prenatal problems, childhood illnesses, and
environmental factors.
The goal of most treatment programs is to help mentally retarded
individuals develop their intellectual and functional skills to the maximum
possible level. Although
there is no specific medication for mental retardation, many people with
developmental disabilities have further medical complications and may take
several medications. Beyond that there are specific programs that people with
developmental disabilities can take part in wherein they learn basic life
skills. These "goals" may take a much longer amount of time for them
to accomplish, but the ultimate goal is independence. This may be anything from
independence in tooth brushing to an independent residence. People with
developmental disabilities learn throughout their lives and can obtain many new
skills even late in life with the help of their families, caregivers,
clinicians and the people who coordinate the efforts of all of these people.
What is the path to learning for mentally handicapped - practical
advice?
It is often thought that it takes a certain kind of person or an
individual with special education to work with people who are retarded. The
fact is that anyone who is patient and kind and who has a sincere interest in
working with people can be successful.
For
specific definition and description of the target population - the mentally
handicapped, see Psykologisk-P¿dagogisk Ordbog, Landsforeningen LEV’s definition
of "mental udviklingsh¿mning" and Diagnostic and Statistical Manual
of Mental Disorders (DSM-III), which establish criteria for mental handicaps.
Legally the
right to education for persons with disabilities is a basic principle of
international policy and is stated in several international conventions. The United
Nations Human Rights Declaration of 1948 determines that everyone has the right
to an education. The UN Convention on the Rights of the Child of 1989 and the
UN Standard Rules on the Equalization of Opportunities for Persons with
Disabilities deal more specifically with people with disabilities and their
equal rights to education. The UNESCO Salamanca Statement of 1994 is the
document that really launched the initiative of "Education for All"
and brought attention to the fundamental changes needed for schools to be able
to include all children and particularly those with special educational needs.
Equal opportunities are also a cornerstone of Danish education policy.
The
Salamanca Statement about inclusive schools - an international declaration of
equality, which also
"Young
people with special educational needs should be helped to make an effective
transition from school to adult working life. Schools should assist them to
become economically active and provide them with the skills needed in everyday
life, offering training in skills which respond to the social and communication
demands and expectations of adult life. This calls for appropriate training
technologies, including direct experience in real life situations outside
school. Curricula for students with special educational needs in senior classes
should include specific transitional programmes, support to enter higher
education whenever possible and subsequent vocational training preparing them
to function as independent, contributing members of their communities after
leaving school. These activities should be carried out with the active
involvement of vocational guidance counsellors, placement offices, trade
unions, local authorities, and the different services and agencies concerned."
Policy in
In
This Act
came into force on
The aim of this
education is that young handicapped and other young people with special needs obtain
personal, social and professional skills to promote a participation in adult life
as independent and active as possible, and to encourage further education and
employment. It is the responsibility of the municipality to ensure that young
handicapped and other young people with special needs are informed of education
offered under this law. After consulting with the young and the parents the
“Ungdommens uddannelsesvejledning” (educational guidance centre for young
people) recommends to the municipal council, if the young is fit for the education.
The proposal may, if necessary, be supplemented with references from other
experts in the municipality or other municipalities, including the observations
of pedagogical-psychological counselling and schools that the young has attended.
The recommendation includes a draft of an individual educational plan.
Secondary
education for young people with special needs is free for the young and
financed by the municipality. The young may receive disability pension during
training or social benefits associated with (pre-)rehabilitation
(“kontanthj¿lp”, “starthj¿lp” or “revalideringsydelse”) if the young person is
otherwise entitled to it.
The Danish government
has in a proposal to youth education reform stated that at least 95% of a youth
cohort must have an education, and thus the education policy is meant to accommodate
also the youngs with massive
learning difficulties - including the handicapped. A great effort is made
for the cross-sectoral guidance to secure that young people with varying
degrees of learning difficulties are offered education in accordance with their
individual capabilities, skills and needs. As an example is mentioned that the
vocational schools are a model of inclusion, where many young handicapped achieve
full competence and a subsequent diploma.
This
education is to the widest extent arranged with consideration to the individual
young person’s qualifications, degree of maturity and interests, and provides a
planned and coordinated course. The training begins with a clarification phase of
up to 12 weeks to identify the young’s aspirations and possibilities, also with
regard to future education and employment. During the clarification process the
youth guidance centre along with the young and the parents prepare an
individual education plan with a summary of the activities, including guidance
interviews and internships, that the young is to be
offered.
The
education consists of elements of teaching and practical activities, e.g. internships
in companies and institutions, and includes subjects, courses and activities, e.g.
teaching, that:
1) promote the young’s personal development and opportunity to
participate in community life,
2) increase the young person's ability to engage in social relations
and to have an independent leisure time, and
3) is aimed at developing skills for coping with educational or
employment situations.
Teaching
hours must amount to at least 840 hours annually. The share of practical
activities, including training, cannot exceed 280 hours annually. Practical
activities, including training, and teaching at other
educational institutions contribute to the annual training hours with 4.2 hours
per day.
The
training plan may comprise elements provided by the following institutions:
1) “efterskoler”
(continuation residential schools) in the form of specially designed courses,
including clarification processes and additional training opportunities, in
accordance with “Lov om folkeh¸jskoler, efterskoler, husholdningsskoler og
håndarbejdsskoler (frie kostskoler)”, (act on folk high schools, continuation
schools, home economic schools and textile design schools (independent
residential schools)),
2) home
economic schools, textile design schools, and folk high schools, see “lov om
folkeh¸jskoler, efterskoler, husholdningsskoler og håndarbejdsskoler (frie
kostskoler)” , (act on folk high schools, continuation schools, home economic schools
and textile design schools (independent residential schools)),
3) production schools, see “Lov om produktionsskoler”
(act on production schools),
4) institutions for vocational education, see “Lov om
erhvervsuddannelser” (act on vocational education and training),
5) “dagh¸jskoler” (day folk high schools), see “lov om st¸tte til folkeoplysende voksenundervisning, frivilligt folkeoplysende foreningsarbejde og dagh¸jskoler samt om Folkeuniversitetet (folkeoplysningsloven), (act on financial support to liberal adult education), and
6) workshops and other institutions.
Once the
education is complete, the young receives a diploma of competence describing
the skills that the young has acquired.
In the period from 2009 to 2012 80.5 million dkr. are
allocated to new projects and an extra annual 150 million dkr. are appropriated towards the act on secondary education for
youth with special needs. Thus municipalities will have additional funds to establish
special education for disabled youth.
The ongoing
evaluation of the act on secondary education for youth with special needs,
which was conducted by the Ministry of Education in August 2008, indicates that
the implementation of this education is well under way and that all parties
involved have made an effort to establish this youth education as an offer for
the target group.
One result
of this law is a specially designed three-year upper secondary education for
young people with special needs (“Den s¿rligt tilrettelagte tre-årige
ungdomsuddannelse for unge med s¿rlige behov”, STU). This education meets all
the statutory requirements. An important part of the education is internship in
companies and institutions to help meet the objectives of the education plan by
giving the young the following competences:
1) work experience and other experience that ensures
qualifications that are relevant in the labour market or for the development of
personal skills,
2) experiences of work and cooperation that are necessary to
achieve a more stable connection to the labour market and to participate in an
active adult life, and
3) insights into the structure and conditions at a workplace.
EGU
(“Erhvervsgrunduddannelsen”) is a two-year individually designed training for
young people from 16 to 21 years of age who cannot straight away attend the
ordinary offers of youth education. Here they are given the opportunity to
prepare for a vocational education or to become qualified for a job.
The act on special
education for adults came into force on
Special
needs education of adults is to be supervised by a leader with the appropriate
qualifications. Teachers must have the skills necessary to conduct this form of
special education. The Minister of Education lays down the specific rules thereof.
The goal of
the act on special education for adults is to alleviate and mitigate the
effects of the participant's disability by means of an individually designed
training. According to the order of the law the teaching is meant to further
active participation in society by improving functional skills, including
personal qualifications.
Before the
teaching begins a plan must be drawn up with a description of the objectives
and content of the teaching, which is tailored to individual needs. The method
can be especially considerate subject matter teaching, when the objective of
the overall education makes it necessary.
The target
group for special education for adults is broadly defined in the official
curriculum, and includes people with physical or mental disabilities, spanning
a very broad range of functional inhibitions.
The
Ministry of Education stresses that it is no natural necessity that people with
e.g. reading problems, low intelligence levels, poor social possibilities, or adjustment
difficulties cannot be accommodated in our education system or later on in the labour
market and in society in general.
Depending
on the extent and problems of the handicap several tools and methods are used
in Danish everyday life and especially in teaching situations.
AKT
Special Education in
In the
public schools in
1.
The behavior of the student
2.
The ways the student connects with
others
3.
The well-being of especially fragile
children in schools
In the year
2000 the Danish Ministry of Education published a book that described the
intended ideas of this part of special education.
http://pub.uvm.dk/2000/trivsel/hel.pdf
The ideas
of this book are unfolded in Danish University Colleges in order to teach
teachers and pedagogues to work in this area in an appreciative and supportive
way focusing on skills and abilities and creating new ways of action in
supportive network around the student.
This way of
working is intended to create better learning environments for all students and
especially supporting the students with special needs in the class room.
This way of
working can be a parallel to or integrated in training the subjects of the
class with the students, and the main idea is to identify new possibilities and
more space for the student who has problems in schools.
Special
education of mentally disabled students is mainly kept in special schools or
special classes where the teachers are trained to handle these problems and at
the same time they are teaching the students in much smaller groups in order to
be able to handle all kind of problems when they appear. These teachers would
be familiar with some of the same ideas of approaching the behavior and
well-being of the students.
René
Kristensen MSc, Associate professor, University College
The FC method
may be successfully applied to functional and mentally handicapped lacking an
active spoken language. The method is used for people with many types of
disabilities including autism, Down’s syndrome, Rett syndrome and cerebral
palsy. FC simply implies that a helper (facilitator) provides both physical and psychological facilitation while the FC-user writes,
types or points out letters.
The FC method
is suitable for those without verbal language, who, due to neuromotorical,
mental or physical disabilities, find it difficult to point, type and choose. The
helper facilitates the person's hand or arm movement to carry out typing,
writing, pointing etc. The method makes it possible for people with speech and
communication disabilities to communicate effectively, for example using
written language. The method helps to choose between different pictures,
letters, words and phrases. For some people the psychological assistance is
equally important for the ability to communicate. The aim is that the physical
facilitation is gradually reduced as the individual becomes able to perform the
above functions partially or totally independently.
The FC
method helps the users:
• control
their body,
•
communicate their own thoughts, desires and feelings,
• communicate
with the outside world, and
• control their own behaviour.
As
previously emphasize Facilitated Communication is a method that allows people
with various disabilities that reduce their communication ability to
communicate using various methods and tools.
Tools often
used in this method are:
Devices for the facility written communication may include be letter plate Dymo
label poles, electric typewriter, stationary or portable PC, Light Writer with
speech impairment, Pace Blade, Roll Number or other form of electronic device
with for example the letter keyboard and embedded speech impairment. The key
here is that there is an easily accessible keyboard letter.
Communications
Centre in Hillerod
Communications Centre is a special centre on the speech, hearing, and visual
field and the field of cognitive difficulties that specializes in special
education and other special educational assistance, and advice on compensating
ICT equipment for children and adults with communication disabilities. An
independent unit of the Centre, VIFO has many years of experience in
Alternative and Support Communication in the pedagogical work - including
information and communication technologies (ICTs). ICT is used advantageously
in relation to people in need of support for communication. In addition, also
as a professional tool for teaching and administrative operations. The
starting-point for VIFO's work is that communication always happens in the
relationship between people, regardless of whether the information exchange
happens through the sounds, mimic, movements, signs or speech. The prerequisite
for successful communication is that the relationship is equal. Communicating
parties must see themselves and each other as equal partners, despite the
parties may have different conditions. Communication is always an attempt to
exchange information. It is also a kind
of communication, even if the recipient does not perceive the message or
respond to it.
Today there are many technologies that can be used for people with mental and /
or physical disabilities and limited expressive language. The vast majority of
these technologies are developed for "normal society" and then being
adjusted to people with special needs. Of technologies that have been developed
specifically for the target group, for example the “talking machine”. The
computer is probably the single object, which today can compensate best for most. Special tools, such as the “talk machine”,
are also being "pushed away" by computers that are capable of the
same things and more. When we talk today about communication, it is also
predominantly computers and various types of computer programs, that has to be
considered. Most of these programs are designed to be "speeded up" by
staff or families, only a few communications technologies are directly designed
to be operated by the handicapped only. This also means that the environmental
resources and skills are essential for the implementation of technology.
ICT may in
particular be used for mental impaired people who have a good spoken language,
but have learning difficulties and limited social skills. They can also benefit
from communications technology - for example, e-mail programs which provide
them with access to technological developments, and increase their ability to
create and maintain social networks.
ISAAC[ii] - International Society for Augmentative and
Alternative Communication
ISAC is an international association of complementary and alternative
communication. The association was founded in 1983 by a group of teachers,
therapists, users, technicians, researchers and other professionals from many
countries.
Isaac works to promote communication and quality of life for people who have
communication impairments. Isaac will promote awareness of AAC and encourage a
development in the area so that all people will get the opportunity to
communicate in a dignified and independent way. Using complementary and
alternative communication methods - in
English Augmentative and Alternative Communication (AAC), might develop
impaired persons show what they can and have the opportunity to develop a
separate communication.
Special training for teachers and educators
CVU
Kopenhagen offers the previously mentioned AKT-teacher training.
CVU Nordjylland offers course - "special (Adult Teacher Training) -
Specific and comprehensive development disorders (autism spectrum). " Participants
acquire knowledge, insight, understanding and action competences in relation to
specific and pervasive development disorder ¬. Participants work with
describing, analyzing and evaluating action proposals and interventions, which
include considerations in relation to the individual with a focus on teaching.
On this course work with:
• Prevalence / incidence and diagnosis of specific and profound developmental
disabilities
• Difficulty with language, social interaction and imagination
• Treatment of children with specific and pervasive developmental disabilities
• A supportive learning environment for young people and adults with specific
and pervasive developmental disabilities
• Brain development, structure and function in relation to disability
• Description, observation and examination as a basis for action and education
• Pedagogical working methods and more.
The newest knowledge on mentally retardation in the form of books,
articles found in Oligofreniklinikken and Lev's library.
OLIGOS is an
information program on mental retardation and can be used as a teaching tool
and reference book. In establishing the treatment papers, many find it useful
that the text can be copied into word processing files.
The development has made the programs so simple that even people with no
experience with computers can use the program and the text is written in a
language that does not require specific educational prerequisites. OLIGOS can
be easily used by educators, teachers, nurses, doctors, psychologists,
politicians, administrators and families.
OLIGOS contains among many other elements:
• Mental retardation in general (definition, classification, symptoms, etc.).
• Intelligence (definitions, intelligence, commonly used intelligence tests).
• Causes of mental retardation (inter alia a description of a large number of
syndromes).
• Psychiatric symptoms and disorders.
• Mental health care of handicapped adults.
• Psychiatric disorders among handicapped children.
• Sexuality.
• Epilepsy (seizures types, coverage of all epilepsy funds).
• Psychotropic medication
(description of all the psychotropic effects and side effects).
• Legislation (laws and circulars relevant for handicapped).
• counselling.
• Nationwide list of schools, day and residential care for adults and children.
• associations.