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Copyright, ii
Preface, iii
Part One. Important Considerations Prior to Teaching Persons with Severe Disabilities, 1
1. Students with Severe Disabilities: Definitions, Descriptions, Characteristics, and Potential, 2
Defining Severe Disabilities, 3
Intellectual Disability Categories and Syndromes, 5
Moderate, Severe, and Profound Intellectual Disabilities, 5
Syndromes of Intellectual Disabilities and Other Conditions Associated with Severe Disabilities, 6
Dual Diagnosis (Intellectual Disabilities and Mental Illness), 10
Autism Spectrum Disorders, 11
Deaf–Blindness, 12
Characteristics of Persons with Severe Disabilities, 14
Learning Characteristics and Abilities, 14
Personal–Social Characteristics, 15
Physical Characteristics, 17
Potential for Success by Persons with Severe Disabilities, 21
Language and Communication Skills, 21
Inclusion in Regular Classrooms and Participation in the General Curriculum, 21
Advances in the Development of Adaptive Technology Devices and the Use of Technology for Accessing the General Curriculum, 22
Improvement of Challenging Behavior, 23
Success in the Community and Acceptance by Others, 23
Conclusion, 24
Questions for Reflection, 24
References, 25
2. Philosophy and Best Practices for Educating Students with Severe Disabilities, 30
A Philosophy of Services, 31
A Philosophy for Providing Services to Students with Severe Disabilities, 31
The Evolution of Philosophies and Practices for Teaching Students with Severe Disabilities, 31
Contemporary Best Practices for Students with Severe Disabilities, 33
Inclusion and Functional Instruction, 33
Participation in the General Curriculum and in Alternate Assessments, 37
Self-Determination as an Educational Outcome, 41
Self-Determination and Students with Very Significant Disabilities, 46
Other Best Practices, 46
Best Practices for Individuals with Autism Spectrum Disorders, 49
The Bases of Best Practices, 50
Social Values, 50
Legal Requirements, 50
Consensus of Professionals and Others, 53
Evidence-Based Practices, 54
The Meaning of Special Education, 56
Definition of Special Education, 56
Conclusion, 56
Questions for Reflection, 57
References, 58
3. Collaboration Among Professionals and Paraeducators, 62
The Meaning of Collaboration, 63
Collaborating with Other Professionals, 65
The Structure of Teams, 67
Collaborating Effectively as a Team, 69
Collaborating with Paraeducators, 71
Critical Issues Related to the Use of Paraeducators, 74
Recommendations Regarding the Appropriate Use of Paraeducators, 78
Matching Paraeducators and Their Duties, 80
Conclusion, 81
Questions for Reflection, 81
References, 82
4. Parents, Families, and Cultural Issues, 84
Promoting Family Involvement, 85
The Meaning of Collaboration, 85
Establishing Partnerships with the Family, 86
What Parents Want Their Children to Learn, 87
What Kind of School Parents Want, 87
The Importance of Social Development, Relationships, and Friendships, 87
Involvement by Parents, 88
Needs During the Adolescent and Adult Years, 89
Providing Culturally Competent Education and Support, 89
Needs of Minority and Poor Families, 90
Verbal and Nonverbal Communication, 90
Differences in Beliefs, Values, and Parenting Styles, 91
Needs of Families with Multiple Risks, 91
Providing Support to Parents, 92
The Role of Teachers When Collaborating with Parents, 94
Communicating with Parents, 94
Offering Help to Parents, 95
Providing Culturally Competent Instruction, 96
The School and Classrooms, 96
Interactions with Students and Families, 97
When Culture Intersects with Instructional Decisions, 98
Conclusion, 100
Questions for Reflection, 100
References, 101
Part Two. Preparing to Teach: Planning and Assessment Procedures, 105
5. Planning Instructional Programs for Students with Severe Disabilities, 106
Planning for Students with Severe Disabilities, 107
The Importance of Planning for Meaningful Life Outcomes, 107
Individual Educational Programs (IEPs), 109
Individual Family Service Plans, 117
Positive Collaborative Characteristics, 119
Negative Collaborative Characteristics, 119
Concerns about Plans and Alternative Approaches to Planning, 120
Person-Centered Plans, 121
The Value of Person-Centered Planning, 127
Conclusion, 128
Questions for Reflection, 128
References, 128
6. Conducting Assessments to Determine Instructional Needs, 131
Approaches to Assessment, 132
Collecting Information from Existing Records, 132
Interviewing Parents to Determine Educational Goals, 133
Using Adaptive Behavior Scales, 134
Using Functional Curriculum and Activity Guides, 137
Conducting Ecological Inventories and Directly Observing Students in Natural Settings, 144
Assessing Related Skills, 148
The van Dijk Approach to Assessment, 150
Determining Academic Skills for Instruction, 152
Conclusion, 156
Questions for Reflection, 156
References, 157
Part Three. General Instructional Procedures, 159
7. Teaching Students to Acquire New Skills, 160
Elements of Effective Instruction, 161
Types of Objectives to Teach, 161
Objectives with Added Value, 162
Function Over Form, 163
Extending the Objective, 163
Partial Participation, 163
Good General Teaching Practices, 164
How Behaviors and Skills Are Learned, 165
Instructional Tactics for Teaching New Skills to Students with Severe Disabilities, 166
Instructional Prompts, 167
Applying Prompts During Skill Acquisition Training, 169
Nondirect Instruction of Skills, 176
Modifying Stimulus Materials, 177
Modifying Material Difficulty, 178
Use of Natural Cues, 179
Reinforcing Correct Responses, 179
Delivery of Reinforcement, 182
Correcting Errors, 182
Increasing Compliance, 183
Writing an Instructional Program for a Student with Severe Disabilities, 184
Considerations for Teaching Students with Autism Spectrum Disorders, 184
Conclusion, 188
Questions for Reflection, 188
References, 189
8. Teaching Skills for Generalization and Maintenance, 192
The Importance of Generalization and Maintenance, 193
Strategies That Have Been Used to Achieve Skill Generalization, 193
Train and Hope, 194
Arranging Consequences During Initial Instruction to Improve Generalization, 194
Arranging Antecedents During Initial Instruction to Improve Generalization, 196
The Effect of Peers on Generalization, 197
The Effect of Self-Mediation or Self-Management on Generalization, 198
The Effect of Video Instruction on Generalization, 200
Summary of the Effectiveness of Generalization Strategies, 201
Applying Generalization Strategies, 202
Tactics of Generalization Programming, 202
Incorporating Peers into Generalization, 203
Using Self-Mediation or Self-Instruction to Promote Generalization, 204
Using Video Recordings to Promote Generalization, 205
Using the General Case Method, 205
Teaching Skill Maintenance, 208
Skill Overlearning, 208
Learning Through Distributed Practice, 209
Intermittent Reinforcement, 209
Building on Learned Skills, 209
Using a Maintenance Schedule, 210
Using the Skill at Home and Elsewhere, 210
Writing Instructional Programs to Include Generalization Instruction and to Promote Maintenance, 210
Conclusion, 211
Questions for Reflection, 211
References, 212
9. Evaluating Student Progress, 215
The Importance of Evaluating Student Progress, 216
Alternate Assessment Requirements for Students with Severe Disabilities, 216
Issues Related to Alternate Assessments, 217
Constructing Alternate Assessments for Participation by Students with Severe Disabilities with Multiple Ability Levels, 220
Portfolio Assessment Procedures, 222
Portfolio Content, 222
Evaluating Portfolio Contents, 222
The Value and Limitations of Portfolios as Alternate Assessments, 223
Continuous Direct Assessment, 225
Types of Behaviors and Units of Measure, 226
Defining the Behavior, 226
Observation of the Behavior, 226
Recording the Data, 227
Data Collection During Baseline, 234
Data Collection During Instruction, 234
Data Collection During Probe Sessions, 234
Data Collection During Generalization, 235
Graphing Direct Measurement Data, 235
Interpreting the Graphs, 237
Conclusion, 237
Questions for Reflection, 239
References, 239
10. Creating Inclusive Educational Environments, 242
Teaching in Inclusive Environments, 243
The Importance of School Inclusion, 243
Legal Rationale, 244
Philosophical Rationale, 245
Educational Rationale, 245
Benefits of Inclusion, 245
Instructional Benefits, 245
Social Interaction Benefits, 246
Impact on Nondisabled Peers, 246
The Inclusive Education Model, 248
Facilitating School Acceptance: Structures for Successful Inclusion, 249
Classroom Membership, 249
Promoting Diversity and Understanding of Differences, 250
Teacher Modeling, 251
Collaborative Teaming, 251
Peer Programs, 252
Making Inclusion Work: Essential Supports, 252
Peer Supports, 252
Peer Programs, 252
Circle of Friends, 254
Collaborative Teaming, 254
The Role of the Collaborative Team, 254
Providing Supports in General Education, 255
Developing Curriculum Modifications, 256
Universal Design, 257
Scheduling Support Personnel, 259
Meaningful Instructional Arrangements, 261
Basic Principles of Instructional Arrangement, 262
Providing Individualized Instruction on Nonacademic Goals, 263
Peer Interaction During Instruction, 264
Effective Instruction in the General Education Classroom, 267
Implementing Inclusive Instruction, 268
The Changing Role of the Special Educator, 269
Case Study 1: Sarah, 270
Case Study 2: Ray, 271
Conclusion, 272
Questions for Reflection, 272
References, 272
Part Four. Specific Instructional and Management Procedures, 279
11. Teaching Communication Skills, 280
The Instruction of Communication Skills, 281
Communication Skill Development, 282
Early Communication Development, 282
Intentionality, 283
Communicative Means and Functions, 283
Assessment Issues, 284
Communication Skill Assessment, 284
Ecological Assessment, 286
Selecting a Communication Mode, 286
Augmentative and Alternative Communication, 287
Teaming with Families, 287
Gestural Communication, 288
Aided Systems, 289
Selecting an Alternative or Augmentative Communication Mode, 291
Initiating an Augmentative System, 293
Expanding the Communication System, 294
Facilitated Communication, 294
Instructional Strategies, 295
Interaction Style, 295
Interacting with Learners Who Are Nonsymbolic, 298
Designing Instructional Strategies, 299
Naturalistic Teaching Procedures, 300
Interrupted Chains, 300
Picture Exchange Communication System, 302
Conversational Skill Training, 303
van Dijk Method, 303
Generalization Issues, 304
Social Skills Instruction, 305
Conclusion, 307
Questions for Reflection, 307
References, 308
12. Providing Behavioral Supports to Improve Challenging Behavior, 313
Addressing Challenging Behavior, 314
Defining Problem Behavior, 314
Stereotypic Behaviors, 314
Self-Injurious Behaviors, 315
Aggressive Behaviors, 315
Inappropriate Social Behaviors, 315
A Functional Approach, 315
Eliminative Approach, 315
Positive Behavior Support, 316
The Process of Individualized Positive Behavior Support, 318
Conducting a Functional Assessment, 318
Lifestyle Understanding, 318
Indirect Assessment Methods, 319
Direct Observation Assessment Methods, 320
Setting Events, 323
Hypotheses Development, 323
Experimental Analysis, 324
Behavior Support Plan Development, 324
Teaching Functionally Equivalent Communication Skills, 326
Developing Support Plans, 327
Support Plan Components, 327
Reinforcement Strategies, 330
Other Consequence Strategies, 331
Crisis Intervention Procedures, 331
Support Plan Evaluation, 332
Comprehensive Interventions, 332
Conclusion, 332
Questions for Reflection, 333
References, 335
13. Managing Sensory and Motor Systems, 338
Addressing Sensory and Motor Challenges, 339
The Sensory Systems, 339
Atypical Sensorimotor Responses, 340
The Motor System, 341
Muscle Tone, 341
Primitive Reflexes, 341
Posture and Movement, 342
Positioning and Handling, 342
Body Mechanics, 343
Posture and Movement, 344
Positioning, 344
Instructional Programming, 346
Sensory Integration, 346
Neurodevelopmental Treatment, 346
Behavioral Programming Intervention, 346
Integrated Programming, 347
Classroom Support Strategies, 349
Sensory Impairments, 349
Hearing Impairments, 350
Vision Impairments, 352
Dual Sensory Impairments, 358
Conclusion, 359
Questions for Reflection, 359
References, 360
14. Providing Support for Health and Medical Needs, 364
Supporting Students with Health Care Needs, 365
Therapeutic Management, 366
Universal Precautions, 366
Hand Washing, 366
Incontinence and Toileting, 367
Dental Care, 368
Seizure Management, 368
Skin Conditions, 370
Postural Drainage, 370
Passive Range of Motion, 370
Medication, 371
Nutrition and Feeding, 372
Nutrition, 372
Eating Skills, 373
Tube Feeding, 375
Special Concerns, 377
Tracheostomy, 377
Ileostomy and Colostomy, 380
Catheterization, 380
Infectious Disease, 381
HIV/AIDS, 381
Cytomegalovirus, 383
Conclusion, 383
Questions for Reflection, 384
References, 384
15. Teaching Personal Care Skills, 387
The Importance of Personal Care, 388
General Considerations, 388
Ethical Instructional Practices, 388
The Role of Parents, 389
When and Where to Teach Personal Care Skills, 389
The Relation Between Personal Care and Self-Determination, 389
The Need for Collaboration, 390
Tactics for Personal Care Skill Acquisition, 390
Skill Generalization, 392
Self-Management of Personal Skills, 392
Eating, Self-Feeding, and Other Mealtime Skills, 393
Finger-Feeding, 394
Drinking from a Cup, 394
Learning to Eat with a Spoon, 396
Learning to Use Other Utensils, 396
Decreasing Inappropriate Mealtime Behaviors, 397
Teaching Other Appropriate Mealtime Behaviors, 398
Other Suggestions for Improving Eating, 398
Learning to Use the Toilet, 399
Determining Readiness for Toileting, 399
Teaching Independent Toilet Use, 400
Teaching Skills Associated with Toileting, 402
Using the Toilet Independently, 403
Teaching to Use the Toilet in Different Settings, 403
Other Suggestions for Improving Toileting, 403
Learning to Dress, 404
Selecting Skills to Teach, 404
Assessing Dressing Ability, 405
Instructional Strategies for Teaching Dressing, 405
Dressing and Students with More Severe Disabilities, 407
Teaching Skills Related to Dressing, 408
Other Suggestions for Improving Dressing, 408
Learning Personal Hygiene and Grooming Skills, 409
Personal Dental Care, 409
Menstrual Care, 413
Other Suggestions for Improving Hygiene and Personal Grooming, 413
Conclusion, 414
Questions for Reflection, 414
References, 414
16. Teaching Leisure and Recreational Skills, 418
The Importance of Recreation Skills, 419
Recreation Skill Instruction, 419
Recreation as a Related Service, 420
Selecting Recreation Activities, 420
Assessing Student Preference, 422
Leisure Activity Goal Areas, 425
Choice-Making Issues, 426
Social Interaction, 427
Instructional Methods, 428
Partial Participation, 430
Adapting Activities, 430
Community Recreation Opportunities, 431
Strategies for Families, 432
Developing Friendships, 432
Friendship Skills, 434
Friendships with Disabled Peers, 435
Conclusion, 435
Questions for Reflection, 436
References, 436
17. Teaching Academic Skills, 439
Issues Related to Academic Instruction and Accessing the General Curriculum, 440
Students’ Learning Potential in the General Curriculum, 440
Appropriate Academic Instruction and Student Level, 441
Functionality and the General Curriculum, 442
Evidence-Based Practices for Learning Within the General Curriculum, 443
Where Students Receive Academic Instruction in the General Curriculum, 443
Facilitating Access and Participation in the General Curriculum, 444
Aligning with the General Curriculum, 444
Applying Universal Design for Learning (UDL) Principles, 444
Self-Determination and Access to the General Curriculum, 445
Facilitating Access with Peers, 445
Embedding Instruction During Regular Classroom Instruction, 445
The Role of Technology in Accessing the General Curriculum, 446
Teaching Literacy Skills, 446
Selecting Sight Words for Instruction, 447
Instructional Methods for Teaching Sight Words, 447
Teaching Phonics Skills, 451
Improving Oral Reading Fluency, 455
Teaching Comprehension Skills and Applying Reading Skills in Real Settings, 457
Teaching Writing, 459
Teaching Spelling, 461
Expanding Literacy Instruction and Participation for Students with Severe Disabilities, 462
Using Commercial Materials to Teach Reading and Literacy Skills, 467
Teaching Math Skills, 468
Acquiring Basic Concepts and Skills, 468
Applying Skills to Time Management, 473
Expanding Math Instruction and Participation for Students with Severe Disabilities, 476
Teaching Science Skills, 476
Examples of Teaching Science Content Linked to the General Curriculum, 476
Considerations About Science Instruction for Students with Severe Disabilities, 478
Conclusion, 479
Questions for Reflection, 479
References, 480
18. Teaching Community and Domestic Skills, 485
Why Teach Community and Domestic Skills?, 486
Including Nondisabled Peers in Community Learning, 486
General Procedures Related to Teaching Community and Domestic Skills, 487
Who Should Participate in Community and Domestic Skills Instruction?, 487
Partial Participation, 487
Where to Teach Community and Domestic Skills, 487
Determining Target Sites and Skills, 489
Determining Operational Skills to Be Taught, 489
Determining Associated Skills to Be Taught, 489
Developing Instructional Plans, 489
Planning for Skill Generalization, 490
Implementing Instruction in Community Settings, 490
Using Simulated Community Settings in Schools, 491
Using Technology to Create Simulations, 492
Providing Concurrent Instruction in School, 493
Evaluating Community Skills, 493
Securing Adequate Funds for Community Instruction, 494
Teaching Community and Domestic Skills in the Most Meaningful Way, 494
Community Settings and Activities, 494
Grocery Stores, 495
Restaurants, 496
Vending Machines, 497
Pedestrian Skills and Public Transportation, 498
Safety Issues in Community Activities, 499
Domestic Skills and Activities, 500
Preparing Meals and Snacks, 501
Performing Household Chores, 502
Using a Telephone, 503
Issues Related to Community-Based Instruction, 506
School Administrative Policies, 506
Relation of Other Instruction to Community Instruction, 506
Conclusion, 507
Questions for Reflection, 508
References, 508
Part Five. Special Considerations, 511
19. Using Technology to Enhance Teaching and Learning, 512
Assistive Technology Devices and Services, 513
Assistive Technology Devices for Students with Severe Disabilities, 513
Use of Assistive Technology by Persons with Intellectual Disabilities, 516
Computer Programs and Applications Designed for Persons with Intellectual Disabilities, 518
Considerations for Identifying Appropriate Assistive Technology Devices and Services, 519
Involve the IEP Team in the Decision-Making Process, 519
Determine the Specific Needs of the Student for the Device and the Goals of Using the Device, 520
Consider Student Characteristics, Including Abilities Related to the Use of a Specific AT Device and Preference for a Device, 520
Determine Where the Device Is to Be Used, 520
Determine How Long the Device Is to Be Used, 520
Especially for AAC Devices, Determine with Whom the Device Will Be Used, 520
Determine How Well the Device Must Operate, 521
Determine the Reliability of the Device, 521
Consider Practical Constraints in Acquiring the Device and Determine Whether They Can Be Adequately Addressed, 521
Consider the Real Cost of the Device, 521
Consider the Response to the Device Within the Student’s Family and Cultural Contexts, 521
Use of AT Devices in Family and Cultural Contexts, 522
Funding of AT Devices and Services, 525
Effectiveness of AT Devices and Services, 526
Limitations of AT Devices and Services and Needed Directions, 532
Funding, 532
Teamwork, Family, and Cultural Understanding, 532
Adequate Assessment and Related Services, 533
Personnel Training and Support, 533
Continuity and Context, 533
Conclusion, 533
Questions for Reflection, 534
References, 534
20. Meeting the Needs of Young Children, 536
Special Education Programs and the Law, 537
Historical Development, 537
Goals of Early Childhood Special Education Programs, 538
Teaching Young Children, 538
Transactional Approach, 538
Instructional Activities, 539
Instructional Content, 539
Family Support, 539
Family-Centered Approach, 539
Individualized Family Service Plan, 540
Initial Contact, 541
The Intervention Context, 543
Natural Learning Opportunities, 544
Interagency Collaboration and Teaming, 545
Assessment in Early Intervention, 545
Guiding Principles for Assessment, 545
Assessment for Program Planning, 546
Progress Monitoring, 546
Instructional Programs for Young Children, 546
Developmentally Appropriate Practice, 547
Activity-Based Instruction, 547
Naturalistic Teaching Procedures, 548
The Importance of Systematic Instruction, 551
Environmental Arrangements, 551
Infant Intervention, 555
Inclusion and Young Children, 555
Transition Issues, 556
Preparation for Transition, 557
Transition from the Neonatal Intensive Care Unit, 557
Transition from the Early Intervention Program to Preschool, 557
Transition to Kindergarten, 558
Conclusion, 558
Questions for Reflection, 559
References, 559
21. Transition Planning and Adult Issues, 563
The Importance of Transition Planning, 564
Self-Determination, 564
Promoting Student Self-Competence, 564
Natural Supports, 565
Postschool Outcomes, 566
Supported Employment, 566
Supported Living, 567
Community Participation, 568
Recreation and Leisure, 568
Postsecondary Education and Training, 568
Social Relationships, 569
Transition Services, 569
Families as Partners in the Transition Process, 570
Person-Centered Planning, 571
Developing the Transition IEP, 571
Postschool Outcomes, 574
Teaching the Secondary Student, 575
Vocational Instruction, 575
Community Work Experience, 576
Instructional Strategies, 577
Customized Employment, 578
Conclusion, 581
Questions for Reflection, 581
References, 581
Name Index, 585
Subject Index, 597

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