Significant Cognitive Disabilities Research Articles

NCLB Alternate Assessment Policies and Postschool Employment Outcomes for Individuals With Significant Cognitive Disabilities.

The participation of students with significant cognitive disabilities in accountability assessments aligned with general education standards is a heavily debated topic in the field of special education. Attempts to understand the impact of these assessments have generally been limited to correlational methods. We employed a difference-in-differences approach using select waves of the National Longitudinal Transition Study-2 dataset to estimate the impact of alternate assessment policies from the No Child Left Behind Act of 2001 on the employment outcomes of individuals with significant cognitive disabilities. Our hypothesis was that these policies would produce a detrimental effect. Analyses suggested that alternate assessment policies resulted in descriptively positive employment outcomes, yet estimates were highly imprecise, which yields a complicated picture requiring more research.

What Do ‘Humans’ Need? Sufficiency and Pluralism

ABSTRACT Sufficientarians face a problem of arbitrariness: why place a sufficiency threshold at any particular point? One response is to seek universal goods to justify a threshold. However, this faces difficulties (despite sincere efforts) by either being too low, or failing to accommodate individuals with significant cognitive disabilities. Some sufficientarians have appealed to individuals’ subjective evaluations of their lives. I build on this idea, considering another individualized threshold: ‘tolerability’. I respond to some traditional challenges to individualistic approaches to justice: ‘expensive’ tastes, and adaptive preferences. Finally, I end by offering some suggestions about how this relates to policymaking.

Changes in the early communicative behaviors of young children with significant cognitive and motor developmental delays in a two-year span

IntroductionThis study examines longitudinal changes in communicative behavior of young children with significant cognitive and motor developmental delays (SDD) and determines their individual communicative trajectories. A second focus of this study is the relation of changes in communicative behavior with motor skills. MethodsData consists of codes resulting from a self-developed coding scheme used on observations of 23 children in three different settings and responses on a questionnaire. First, group trends were determined to find out whether communication-related variables tend to significantly change over the course of two years. Furthermore, these findings were contrasted with the individual trajectories of the children. Next, the association of initial communicative skills and (the acquisition of) specific motor skills with the change in their communicative functioning was studied. Wilcoxon Signed Ranks and correlational analyses were used to answer the research questions. ResultsOut of sixteen different variables related to communicative behavior, ten changed significantly over the course of two years. Children with more focus on prompt on the first datapoint showed a significantly larger increase of signs of functionality. Still, all children showed highly individual trajectories. Children with better motor skills on the first datapoint showed a significantly larger increase in communication rate. ConclusionsResults show that if a myriad of detailed variables are taken into account children with significant cognitive and motor developmental disabilities do change regarding their communicative functioning, but that they tend to all show unique developmental trajectories. Children with stronger skills in some aspects of communication and motor functioning, can be considered advantaged regarding their communicative development.

Institutionalization of Adapted Books in Enhancing the Reading Ability of Students with Cognitive Disabilities

The call toward inclusive school systems prompted educators to strengthen support and continuously accommodate students’ own unique learning strengths and needs. Thus, this study sought to examine the teacher-made adapted books to enhance students’ reading ability with significant cognitive disabilities. It utilized a quasi-experimental design to determine the relationship between the variables under study. After two months of implementing the adapted books in the control group, students’ reading ability was determined and compared to the conventional group. Results of the study revealed that the control group using the conventional book performed significantly below grade- level complexity while the control group using the teacher-made adapted books nearly met grade-level proximity. This further revealed that the use of adapted books tailored to students’ specific needs and interests proved to be beneficial, especially for students with special needs. The experiences shared by these teachers have also provided insights on how to enhance the adapted books ensuring appropriate differentiation. Based on the favorable results, the institutionalization of these adapted books to aid students with special needs reading ability is recommended. Administrative support may also be afforded to the teachers creating these adapted books as these entail considerable time and effort.

A retrospective study on acquired demyelinating diseases in children

Background: Acquired demyelinating diseases (ADS) соnstitute а heterogeneous grоuр of central nervous system disorders of autoimmune origin that causes significant physical and cognitive disabilities. Early recognition and prompt management causes significant improvement in acute episodes of demyelinating disorders. Methods: 33 children diagnosed with demyelinating disorders at Lokmanya Tilal municipal medical college and hospital in Mumbai were enrolled. The study was conducted between January 2013 and November 2022.  Demographic data, clinical profile, CSF study, serum antibody, radiological findings were collected and results were analyzed. Statistical Data was analysed using statistical software GraphPad in Stat.V3.0. Data were presented in tables and figures whenever needed.  P value <0.05 considered as significant. Results: Of 33 patients, 21 (63%) were cases of acute disseminated encephalomyelitis (ADEM), 6 (18.1%) of transverse myelitis (TM), 1 case of ADEM + TM (3%), 3 (9%) of neuromyelitis optica, 1 (3%) of Optic neuritis and 1 (3%) of multiple sclerosis. ADEM patients presented with encephalopathy and multifocal neurological deficits, 40% were MOG positive. Two patients were of multiphasic ADEM. Patients of transverse myelitis had paraparesis or quadriparesis and sensory + bladder involvement. Patients with NMO presented with bilateral visual impairment with limb weakness and bladder involvement. Steroids were the primary treatment, 3 patients (9%) required intravenous immunoglobulin (IVIG) and 1 (3%) patient received plasma exchange therapy. Conclusions: ADEM is the most common ADS. Early diagnosis and management with steroids therapy improves outcome in most of the patients. Non response to steroids warrants second line treatment options like IV Immunoglobulin (IVIG) or Therapeutic plasma exchange.

Self-Contained Special Educators’ Perceptions toward Including Students with Significant Cognitive Disabilities in General Education Classes

ABSTRACT Teachers’ perceptions play a critical role in defining and giving meaning to new initiatives and policies in schools. However, very little is known about the perceptions of self-contained special educators responsible for students with significant cognitive disabilities (SCD) pertaining to the inclusion of students with SCD in general education classes and how those perceptions impact educational programming. In this qualitative study, the authors conducted semi-structured interviews with 21 special educators responsible for students with SCD who taught in self-contained classes within traditional public schools. The interview was designed to explore special educators’ perceptions pertaining to including students with SCD in general education classes and possible personal and environmental factors that may influence their perceptions. The findings suggest that self-contained special educators responsible for students with SCD are tentatively supportive of including their students in general education classes. However, several factors (e.g., lack of support, student abilities and skills, general educator attitudes) and reservations appeared to impact special educators’ decision-making pertaining to including their students with SCD in general education classes.

Citizenship, Ability, and Contribution

AbstractPeople with significant cognitive disabilities and others who advocate on their behalf routinely state their claims in terms of enabling people to claim their full citizenship. Informed by the results of a study by one of the authors, we draw attention to some of these claims, and discuss what a just society ought to do so that members with significant cognitive disabilities see themselves – and are seen by others – as full, and therefore equal, citizens. Several political philosophers have sought to develop disability-inclusive accounts of justice, using three strategies: (1) defend a permissive understanding of who is owed justice by rejecting contribution to social cooperation as a necessary condition; (2) defend a permissive understanding of what counts as contribution; and (3) argue that some demands of justice are owed to all, while others are owed only to cooperators. We defend a version of the second strategy, arguing that the relevant notion of contribution requires that it be something the agent chooses to do because they know it to be valued by someone else, and we argue that the third strategy also has a role to play.

Improving Social and Play Outcomes for Students With Significant Disabilities During Recess.

For students with autism, recess is often a missed opportunity to develop social competence and relationships. Although interventions have been developed to promote interactions and social skills for students with average or above-average intellectual functioning, there has been less focus on students with autism who have below-average intellectual functioning or who meet the criteria for intellectual disability. In this single-case design study, we tested the efficacy of a combined peer-mediated and social skills instruction intervention on the interactions, play, and social skills of three students with autism who met their state's criteria for alternate assessment for students with significant cognitive disabilities. Social skills instruction featured video models that portrayed same-aged peers demonstrating individualized social skills on the playground. For all three students, there were substantial increases in interactions, play and social skills, and students and their peers provided positive feedback about the intervention.

Reconceptualizing Education Grounded in the Multimodal Discourses of Girls of Color Labeled with Significant Cognitive Disabilities

The experiences of girls of color labeled with significant cognitive disabilities in middle school and high school have historically been excluded from educational research. This study sought to better understand how girls of color labeled with significant cognitive disabilities navigated multimodal discourses and classroom practices as well as how they were impacted by them. Using Disability Critical Race Theory and critical discourse theory, six students were focal participants and eight educators were secondary participants. Multiple case studies were used with primary (i.e., observations, audio/video recordings) and secondary (i.e., interviews, focus groups) data sources. Findings revealed how focal participants showed their discursive resourcefulness, despite absent communication supports and prioritization of oral/aural communication. Students also repositioned themselves in response to marginalization through talk and actions. Implications for research and practice are discussed. This study underscores the necessity of centering the experiences of girls of color labeled with significant cognitive disabilities in educational research to improve their school experiences.

Reimagining Language Proficiency Assessment for English Learners with Significant Cognitive Disabilities

Language proficiency assessment (LPA) serves as a gatekeeper to accessing language services for English learners (ELs) with and without disabilities. Moreover, research suggests that EL services are often deemphasized compared with special education services for students with significant cognitive disabilities (SCDs). We highlight the intersectional nature of educational inequities faced by ELs with SCDs by briefly examining the implications of current legal requirements and offering a critique of LPAs, particularly those designed for students with SCDs. The difficulty of identifying the relative contributions of both limited English proficiency and disability to perceived deficits in English language proficiency is especially salient for students with SCDs, as their communication challenges may be misunderstood as primarily stemming from their underlying disability. This issue raises concerns about how English language proficiency should be understood for ELs with SCDs. A failure to understand this in turn may lead to inaccurate results in diagnostic testing, in addition to inequitable access to appropriate EL services. Finally, a case is made for alternative processes that could increase access to appropriate educational programs and foster increased educational equity.

Examining the Intersection of Race, Ethnicity, Culture, Language, and Severe Disability: In Search of Equitable Schooling

In this special section of Research and Practice for Persons with Severe Disabilities ( RPSD), the intersection of race, ethnicity, culture, and language influences schooling (i.e., what is taught, how, and where) for students of color with significant cognitive disabilities is explored. Contemporary issues facing people of color with severe disabilities are introduced with attention paid to a call for a “way forward.”

Professional Development Needs Reported by General Education Teachers at Inclusive Private Christian Schools

As Christian schools offer inclusive education programs for students with significant cognitive disabilities, it is crucial that teachers have access to quality professional development (PD). The purpose of this study was to survey teachers at three inclusive Christian schools about their attitudes and beliefs toward inclusive education, as well as their reported PD needs through the framework of High Leverage Practices (HLPs). Findings suggest that teachers report the most PD needs in the HLP areas of teaching, behavior, scaffolding, resources, comprehension, and progress monitoring. Implications for practitioners and suggestions for future research are included.

Fair and Equitable Grading for ALL Students in Inclusive Settings

Grading is a common practice in general education settings. Few teachers, however, are clear about how they should grade students with significant cognitive disabilities when those students are included in the general education classroom. Unfortunately, existing research provides minimal information to aid teachers and education leaders as they consider fair and equitable grading practices for these students. In this article, we examine the four criteria for high-quality inclusive grading outlined by The William & Mary Training & Technical Assistance Center for grading within the inclusive classroom: (a) grades are accurate, (b) grades are meaningful, (c) grades are consistent, and (d) grades are supportive of learning and discuss how these criteria could be applied to provide a more fair and equitable grading system for students with significant cognitive disabilities.

Does the second ischemic stroke herald a higher proportional risk for cognitive and physical impairment than the first-ever one?

BackgroundPost-stroke cognitive and physical disabilities are common sequelae; however, it seems that the second ischemic stroke carries a higher proportional risk more than expected. In this study, we aimed to study second stroke sequelae over first-ever one with regard to cognition and physical competence. This study was conducted on two groups; the first composed of 40 patients with acute first lifetime ischemic stroke, and the second group composed of 40 acute second lifetime ischemic stroke. The study was done at menoufiya university hospitals from August 2017 to August 2018. Modified Rankin Scale (MRS), National Institute of Health Stroke Scale (NIHSS), and MINI-Cog Score, were performed at onset, 2 weeks and 3 months later. In addition, routine lab and neuro-imaging were also done.ResultsSize of infarction is larger in 2nd group (p < 0.001), MRS, and NIHSS are significantly higher in 2nd group. Also, there are significant differences between baseline, 2 weeks, and 3 months follow-up in MRS and NIHSS. Mini-Cog scale showed significant difference between the two groups in favor of better cognition in the 1st group. Atrial fibrillation (AF), p = 0.012 was a significant risk factor in the 1st group while smoking, p = 0.017 was the significant risk factor in the 2nd group. Large size stroke was found as independent risk factor in the 2nd group (p < 0.001).ConclusionsThere are significant cognitive and physical disabilities in the second recurrent ischemic stroke as compared to the first-ever one, and the second stroke tend to be more dangerous and carry more disability.

Identifying Best Practices for Long-Term Success in Supported Employment

Supported employment (SE) and customized employment are key services designed to assist individuals with significant cognitive and psychosocial disabilities successfully obtain and maintain employment. The Wisconsin Division of Vocational Rehabilitation (DVR) sought to better understand whether individuals receiving SE through the public VR program returned for further employment assistance following successful case closure. Patterns in service delivery between non-return and return consumers were identified and can be used to inform best practices in serving these populations. Several types of services (e.g., On-the-Job Training) were determined as significantly associated with one’s return to VR, indicating that consumers with significant disabilities may return for further services following successful case closure. DVR counselors should be aware that consumers achieving successful supported employment outcomes may need additional or continuous disability-specific or job-related training and support.

Skills, Behaviors, Expectations, and Experiences Associated with Improved Postsecondary Outcomes for Students with Significant Cognitive Disabilities

An in-depth literature review was conducted to identify the skills, behaviors, expectations, and experiences (SBEEs) associated with employment, further education, and independent living for students with significant cognitive disabilities following high school. Analysis of 53 quantitative and qualitative studies identified 103 specific SBEEs associated with post high school outcomes. We then clustered the SBEEs into 10 constructs. We present the constructs and representative SBEEs, discuss implications for their use, and identify next steps needed to develop a new research-based transition assessment for students with significant cognitive disabilities associated with positive post-school transition outcomes.

Approaches to Identification and Instruction for Students with Significant Cognitive Disabilities Who Are English Learners

Research is needed to better understand the academic instruction needs of students with significant cognitive disabilities who are English learners and the classroom practices of their teachers. In this qualitative study, we interviewed 10 teachers to learn how they identify and meet the unique needs of this student subpopulation. Our findings suggest that teachers generally do not view disability- and language-related needs as separate and that approaches to instruction tend to follow those perceptions. Some expressed a desire for more support from language professionals in the classroom, whereas others thought their special education classrooms adequately meet student language development needs. Finally, although the teachers we interviewed went to great lengths to engage families in supporting instruction, some reported dissatisfaction with and barriers to those relationships. We discuss our findings in light of the current literature, the study’s limitations, and implications for future research and practice.

English Learners with Significant Cognitive Disabilities: Reflecting on Diverse Needs and a Call to Advance Effective Practice

ABSTRACT Historically, students who are English learners and students with disabilities have experienced inequitable schooling opportunities. These inequities are heightened when considering those individuals who are not only English learners but also have a significant cognitive disability. This particular dually classified group, while not large in number, is likely one of the most understudied and underserved school populations. Recently, researchers have begun trying to better identify these students for alternate assessment purposes. Despite more recent attention, educational research is still evolving and substantial gaps within the literature still exist. The purpose of this article is to provide a brief overview of contemporary educational issues while simultaneously providing recommendations for future researchers to enhance effective practices for this population. We attempt to define this group, which currently has no federal definition; describe their complex language needs; advocate for the use of appropriate blended educational frameworks; advocate for the need of inclusion in research studies; and, finally, argue for increased interdisciplinary research efforts.

Robust Receptive Vocabulary Instruction for Students With Significant Cognitive Disabilities Who Use AAC

Robust vocabulary instruction is an important part of comprehensive English language arts (ELA) instruction. Vocabulary instruction supports students in learning the meaning of words to build a receptive vocabulary that they can rely on to comprehend the words they read and hear. Many students with significant cognitive disabilities (SCD) and complex communication needs (CCN) struggle to read or understand grade-level words, concepts, and texts. Explicit vocabulary instruction can play an important role in addressing this area of need. Addressing the vocabulary needs of students with SCD and CCN in a comprehensive way calls for a greater investment of instructional time to build their receptive vocabulary and conceptual understandings of new vocabulary. It calls for leveraging the high frequency expressive vocabulary students are likely to have available on their augmentative and alternative communication (AAC) systems to make meaningful connections and demonstrate their understanding of new vocabulary. The aim is successful comprehension across ELA and other academic domains through a robust and expanding receptive vocabulary that extends beyond the words commonly programmed onto AAC systems. Finally, vocabulary instruction should be one part of a comprehensive approach to ELA instruction, with substantial time and effort also devoted to reading and writing instruction so that one day students with SCD and CCN can use spelling and writing to bridge the gap between the words they know and the words they have access to use expressively.

Opportunities and Challenges of Applying Cognitive Process Dimensions to Map-Based Learning and Alternate Assessment

In education, taxonomies that define cognitive processes describe what a learner does with the content. Cognitive process dimensions (CPDs) are used for a number of purposes, such as in the development of standards, assessments, and subsequent alignment studies. Educators consider CPDs when developing instructional activities and materials. CPDs may provide one way to track students’ progress toward acquiring increasingly complex knowledge. There are a number of terms used to characterize CPDs, such as depth-of-knowledge, cognitive demand, cognitive complexity, complexity framework, and cognitive taxonomy or hierarchy. The Dynamic Learning Maps (DLM™) Alternate Assessment System is built on a map-based model, grounded in the literature, where academic domains are organized by cognitive complexity as appropriate for the diversity of students with significant cognitive disabilities (SCD). Of these students, approximately 9% either demonstrate no intentional communication system or have not yet attained symbolic communication abilities. This group of students without symbolic communication engages with and responds to stimuli in diverse ways based on context and familiarity. Most commonly used cognitive taxonomies begin with initial levels, such asrecall, that assume students are using symbolic communication when they process academic content. Taxonomies that have tried to extend downward to address the abilities of students without symbolic communication often include only a single dimension (i.e.,attend). The DLM alternate assessments are based on learning map models that depict cognitive processes exhibited at the foundational levels of pre-academic learning, non-symbolic communication, and growth toward higher levels of complexity. DLM examined existing cognitive taxonomies and expanded the range to include additional cognitive processes that demonstrate changes from the least complex cognitive processes through early symbolic processes. This paper describes the theoretical foundations and processes used to develop the DLM Cognitive Processing Dimension (CPD) Taxonomy to characterize cognitive processes appropriate for map-based alternate assessments. We further explain how the expanded DLM CPD Taxonomy is used in the development of the maps, extended standards (i.e., Essential Elements), alternate assessments, alignment studies, and professional development materials. Opportunities and challenges associated with the use of the DLM CPD Taxonomy in these applications are highlighted.