Definition of Severe and/or Multiple
Fact Sheet Number 10 (FS10), January
National Information Center for Children and Youth with Disabilities
People with severe disabilities
are those who traditionally have been labelled as having severe to profound
mental retardation. These people require ongoing, extensive support in more
than one major life activity in order to participate in integrated community
settings and enjoy the quality of life available to people with fewer or no
disabilities. They frequently have additional disabilities, including movement
difficulties, sensory losses, and behavior problems.
In the 1998-99 school year,
the states reported to the U.S. Department of Education that they were providing
services to 107,591 students with multiple disabilities (Twenty-Second Annual
Report to Congress, 2000).
Children and youth with
severe or multiple disabilities may exhibit a wide range of characteristics,
depending on the combination and severity of disabilities and the person's age.
Some of these characteristics may include:
- Limited speech or communication;
- Difficulty in basic physical
- Tendency to forget skills
- Trouble generalizing
skills from one situation to another; and/or
- A need for support in
major life activities (e.g., domestic, leisure, community use, vocational).
A variety of medical problems
may accompany severe disabilities. Examples include seizures, sensory loss,
hydrocephalus, and scoliosis. These conditions should be considered when establishing
school services. A multi-disciplinary team consisting of the student's parents,
educational specialists and medical specialists in the areas in which the individual
demonstrates problems should work together to plan and coordinate necessary
Early intervention programs,
preschool and educational programs with the appropriate support services are
important to children with severe disabilities. Educators, physical therapists,
occupational therapists, and speech-language pathologists are all members of
the team that may provide services, along with others, as needed for each individual.
Assistive technology, such as computers and augmentative/alternative communication
devices and techniques, may provide valuable instructional assistance in the
educational programs for students with severe/multiple disabilities.
In order to effectively
address the considerable needs of individuals with severe and/or multiple disabilities,
educational programs need to incorporate a variety of components, including
language development, social skill development, functional skill development
(i.e., self-help skills), and vocational skill development. Related services
are of great importance, and the appropriate therapists (such as speech and
language, occupational, physical, behavioral and recreational therapists) need
to work closely with classroom teachers and parents. Best practices indicate
that related services are best offered during the natural routine of the school
and community, rather than by removing the student from class for isolated therapy.
Classroom arrangements must
take into consideration students' needs for medications, special diets, or special
equipment. Adaptive aids and equipment enable students to increase their range
of functioning. The use of computers, augmentative/alternative communication
systems, communication boards, head sticks, and adaptive switches are some of
the technological advances which enable students with severe disabilities to
participate more fully in integrated settings.
nondisabled peers is another important component of the educational setting.
Research is showing that attending the same school and participating in the
same activities as their nondisabled peers is crucial to the development of
social skills and friendships for children and youth with severe disabilities.
Traditionally, children with severe disabilities have been educated in center-based,
segregated schools. However, recently many schools are effectively and successfully
educating children with severe disabilities in their neighborhood school within
the regular classroom, making sure that appropriate support services and curriculum
modifications are available. The benefits to inclusion are being seen to benefit
not only those with disabilities but also their nondisabled peers and the professionals
who work with them.
Schools are addressing the
needs of students in several ways, generally involving a team approach. Modifications
to the regular curriculum require collaboration on the part of the special educator,
the regular educator, and other specialists involved in the student's program.
Community-based instruction is also an important characteristic of educational
programming, particularly as students grow older and where increasing time is
spent in the community. School to work transition planning and working toward
job placement in integrated, competitive settings are important to a student's
success and the long-range quality of his or her life.
In light of the current
Vocational Rehabilitation Act and the practice of supported employment, schools
are now using school-to-work transition planning and working toward job placement
in integrated, competitive settings rather than sheltered employment and day
Downing, J.E. (1996). Including
students with severe and multiple disabilities in typical classrooms: Practical
strategies for teachers. Baltimore, MD: Paul H. Brookes. (Telephone: 1-800-638-3775.)
Klein, M.D., Chen, D., &
Haney, M. (in press). PLAI (Promoting learning through active interaction):
A guide to early communication with young children who have multiple disabilities.
Baltimore, Paul H. Brookes. (Telephone: 1-800-638-3775.)
Orelove, F., & Sobsey,
D. (1996). Educating children with multiple disabilities: A transdisciplinary
approach (3rd ed.). Baltimore, MD: Paul H. Brookes. (Telephone: 1-800-638-3775.)
Rainforth, B., York, J.,
& Macdonald, C. (1997). Collaborative teams for students with severe disabilities:
Integrating therapy and educational services (2nd ed.). Baltimore, MD: Paul
H. Brookes. (Telephone: 1-800-638-3775.)
Update January 2001
This fact sheet is made
possible through Cooperative Agreement #H326N980002 between the Academy for
Educational Development and the Office of Special Education Programs. The contents
of this publication do not necessarily reflect the views or policies of the
Department of Education, nor does mention of trade names, commercial products
or organizations imply endorsement by the U. S. Government.
This information is in the
public domain unless otherwise indicated. Readers are encouraged to copy and
share it, but please credit the National Information Center for Children and
Youth with Disabilities (NICHCY).
National Information Center
for Children and Youth with Disabilities
P.O. Box 1492
Washington, DC 20013
Web site: http://www.nichcy.org/