Sunday, July 15, 2012

Mild-Moderate Mental Retardation



Jessica Beltran

Janice Wu
Brianna Myers
Mild-Moderate Cognitive Impairment (formerly known as Mental Retardation)

Brief Description
Mental retardation is a developmental disability relative to intelligence and the ability to function properly in daily life. It is diagnosed and defined before 18 years old. The IQ score for mild mental retardation is from 50 to 75. Academically, people with mild mental retardation can go up to Grade 6 level.this previous statement is confusing to me. Functionally, with supports from the community, these people with mild-moderate cognitive impairment are usually considered independent and self-sufficient. Maybe to make this more clear at what this means - utilizing some diagnostic criteria might be helpful?

Prevalence
  • About 1-3% of the population has mental retardation.
  • Approximately 85% of the mentally retarded population is in the mild category.
  • Mental retardation in males is more common than females, with a ratio of 1.5:1.
  • More than 545,000 children have mental retardation and receive special education services primarily for mental retardation.

Comprehension, Fluency, Narratives & Motivation
According to the study conducted by Katims (2001), out of the 54 school-aged students with cognitive impairment?, ranging from elementary school to high school, only 62% of these children received comprehension scores high enough to be ranked by the Analytical Reading Inventory (ARI). Of these 62%, 41%  placed at the primer reading level, which constituted as the highest percentage of students at any one reading level. The next highest percentage occurred at the reading level 1, with 23.5%. The distribution was equally divided among levels 2-5, at 8.8% each. No student received a reading comprehension score that placed them at level 6 or higher.

Research has shown that reading fluency of  students with a mild to moderate cognitive impairment is characteristically choppy and slow, with many instances of repetitions, insertions and omissions. Frequent semantic and syntactic miscues occur during these student’s oral reading, with much needed aid to correctly identify unknown words, demonstrating a high difficulty with decoding. This need for aided reading, however, improved from elementary, to middle, to high school students (Katims, 2001).

Children with mental retardation (MR) demonstrate reduced performance on measures of story structure and recalling events from previously heard narratives (Boudreau & Chapman, 2001). Studies have suggested that the source of these difficulties may involve establishing a mental representation from narratives, then accessing this knowledge from their long-term memory, and/or using linguistic structures to map and express these mental representations (Berman, as cited by Boudreau & Chapman, 2001). Furthermore, children with MR experience increased difficulty with the use of referents when compared to peers of the same mental age, which then decreases the overall narrative coherence (Boudreau & Chapman, 2001).
Interestingly, research on reading motivation of the Intellectually disabled was hard to come by. The little research that does exist, however, indicates that a child with MR faces similar challenges in maintaining a positive attitude towards reading that do most children with reading fluency impairment. A strategy that is suggested to aid in motivation maintenance is errorless learning, which involves children being prompted with the correct answer rather than being told that they are wrong (Rix, 2008).

Phonics, Phonological awareness, Phonemic awareness
Phonological and phonemic awareness are skills that are known to facilitate the acquisition of literacy for all children. A child’s awareness of the internal structure of words and the phonological components that makes up these words are important precursors to the development of reading and writing skills in the early years. Phonological and phonemic awareness provide children with the skills necessary to decode unknown words. The ability to decode or “sound-out” unknown words is very important in the  development of literacy skills.  

Children that have been identified with mental retardation are often not taught phonological and phonemic awareness skills because too much emphasis is placed on sight-word recognition (Katims, 2001). While it is important for students with mental retardation to increase their sight-word vocabulary, it is also important for them to develop the ability to decode unknown words using phonological and phonemic awareness. Many studies have shown that individuals with mental retardation possess the ability to develop phonological and phonemic awareness skills when provided with explicit instruction in phonological decoding of words. A study conducted by Katims (2001) examined the phonemic awareness skills of students with mild to moderate mental retardation using a phonemic awareness dictation task. The results of this study showed that these students demonstrated relative strengths in word decoding. Particularly, these students demonstrated progression in their ability to hear phonemes and write corresponding graphemes (Katims, 2001). Therefore, children with mild to moderate mental retardation have been found to possess phonemic awareness skills.


Vocabulary, spelling, writing
Previous studies have suggested that children identified with mental retardation can learn to write. Much research thus focuses on interventions/programs that improve these children’s vocabulary, spelling, and writing. Many of these interventions/programs aim to teaching children with mental retardation basic functional words in order to function in their community and gaining meaning from written texts. Katims (1996) proposed the immersing environment accompanied by direct skills instruction. Children with mild mental retardation were proven to make progress in such literacy-rich environment. Their writing gradually moved to the more conventional forms, for example, conventional orthography, invented spellings, and conventional printing. Their ability of word decoding and sight word vocabulary also improved, including word recognition, knowledge of the relationships between letters and sounds. Moreover, the more time they spent in the immersing environment, the more conventional forms were observed. Suggested immersing environment to improve writing includes providing modelling and displaying of five different writing forms: drawings, scribbles, letter strings, invented spellings, and conventional printing, within various context closely related children’s life. In addition, another strategy would be encouraging students to communicate with each other through writing. The purpose of this strategy was to relay functional messages in written text. Children were required to read to understand what others said and to write to convey their thoughts.

Other studies also investigate how to assess the literacy skills of children with mental retardation. According to Katims’ (2001) study on the literacy assessment of students with mental retardation, it is defined that a person with minimal literacy can write at least two words or letter combinations in words on a phonemic awareness dictation task and write at least two words which contain two or more letters and correctly spell them on a free-writing task. Results showed that 41% of the subjects achieved the criteria of minimal literacy in the dictation task and 77% of them in the free-writing task. In the dictation task, elementary students could correctly write 9.3 graphemes, 22.0 for middle school students, and 26.2 for high school students. It is also suggested that the progress increase by grade level.

References

Boudreau, D. M., & Chapman, R. S. (2000). The relationship between event representation and linguistic
skill in narratives of children and adolescents with down syndrome. Journal of Speech,
Language, and Hearing Research, 43, 1146-1159.
Katims, D. S. (1996). The emergence of literacy in elementary students with mild mental retardation.
Focus On Autism & Other Developmental Disabilities, 11(3), 147.
Katims, D. S. (2001). Literacy Assessment of Students with Mental Retardation: An Exploratory
Investigation. Education And Training In Mental Retardation And Developmental Disabilities,
36(4), 363-72.
Rix, J. (2008) Cracking the word code. Special Education, (4772), 50.

Information regarding disorder description and prevalence:

http://nichcy.org/disability/specific/intellectual
This website provides a general description of intellectual disability, including causes, signs, prevalence, educational considerations, IDEA definition, resources, etc. This website is extremely helpful for parents, caregivers and teachers of children with an intellectual disability and provides some very useful information to consider when working with this population.

http://www.readingassessment.info/resources/publications/mentalretardation.htm
This website provides information pertaining to literacy and students with mental retardation. The content on this website provides readers with information on the characteristics of these students, general instructional approaches used with them, and assessment approaches.


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