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Can you help me understand this Writing question?There are 3 different discussion. Please respond to each discussion.Discussion #1. Oguni, H. (2013). Epilepsy and intellectual and developmental disabilities. Journal of Policy and Practice in Intellectual Disabilities, 10, 89-92.Key definitions- comorbidity, developmental disability, epilepsy, intellectual disability, seizures. Epilepsy is defined as a disorder of the brain characterized by repeated seizures and by the neurobiologic, cognitive, psychological, and social consequences of this condition. Seizure is the tolerance level of the brain for electrical activity. If level of intolerance is exceeded, a seizure occurs. (Batshaw, et al. 2013).
Key findings / “takeaways”-The most recent and epidemiological survey of children with epilepsy demonstrates that approximately one-fourth of patients with childhood epilepsy had ID (Oguni, H. 2013). Studies have shown that the severity of ID is an important factor in determining the incidence of epilepsy. An intellectual disability is often accompanied by other impairments called comorbid conditions. These comorbid conditions include cerebral palsy, seizure disorders, communication disorders, sensory impairments (hearing and/or visual deficits), and psychological/behavioral disorders (e.g., mood disorders, autism spectrum disorders, attention-deficit/hyperactivity disorder, self-injury, aggression, and conduct disorders (Batshaw, et al. 2013). In considering intervention strategies, identifying these comorbid conditions and working toward their treatment is essential to obtain the best outcome.
What are potential implications for practice/educational programming? Education is the most important discipline involved in the intervention for children with ID. The article states that ” The prognosis of childhood epilepsy is generally favorable because approximately 64% of patients enter remission in adulthood (Guerrini, 2006). However, children with epilepsy as a group are at higher risk of poor academic functioning and negative psychosocial outcomes (Baca, Vickrey, Caplan, Vassar, &Berg, 2011; Sillanpaa, 2004; Sillanpaa, Jalava, Kaleva, & Shinnar,1998). As stated in the text, epilepsy is prevalent in 5-10% of people with ID and autism. It also stated that one study revealed that the IQ level between people with epilepsy and those without was not that significant. Another study showed that the IQ level was lower or higher in people with or without epilepsy. The conclusions for the disparity of the results were attributed to the different methodologies used in the study design (Oguni, H. 2013).
What do the findings mean for students with an ID? Children with epilepsy are at increased risk of developing ID when they have underlyingorganic disorders or pharmaco-resistant seizures from the preschool-age-period (Berg et al., 2012).
Discussion #2.
Key definitions
Cri Du Chat syndrome: a rare genetic disorder that involves usually the partial deletion of a the short arm of chromosome 5. The symptoms are usually a cat-like cry, low birth weight, early feeding difficulties, abnormalities of the head and face, congenital scoliosis (sideway curvature of the spine), gastrointestinal and cardiovascular issues. Individuals usually have moderate to severe range of intellectual disabilities, have better receptive than expressive language skills, self-injurious behaviors, repetitive movements, obsessive attachments to objects, clumsiness, and sensory issues in being hypersensitive to stimuli.
Sleeping disorders are is a term that can be called parasomnias which is a term that covers unusual behaviors that occur when one falls asleep, experiences during sleep or has difficulty staying asleep, or waking up. There were four types of sleeping problems observed: settling (falling asleep, mild was 1 or 2 times a week with taking under 30 minutes, severe was 3 or more times a week with taking over an hour to fall asleep); night waking (waking up in the middle of the night), mild was once or twice a week, severe was three or more nights a week and being awake for more than a few minutes and disturbed parents or caregivers; early waking was if the individual woke up before 5 am in the morning, mild was 1 or 2 times a week, severe was more than 3 times a week.
Key findings / “takeaways”
The article pointed out that there was low information on sleep disorders in individuals with Cri du Chat (CDC) syndrome and that previous articles hadn’t compared those with CDC versus those than have non-specified intellectual disabilities or Down’s Syndrome. So this article wanted to find out if there was really evidence and data to back up parents and caregivers observations of sleeping disorders in individuals who had CDC syndrome and whether it was more prevalent in those that had CDC syndrome or those that had different types of intellectual disabilities.
They used a sleep disorder questionnaire to find out that 30% of individuals with CDC syndrome do have mild to severe sleeping disorders compared to other groups. This study found that individuals usually had problems with frequent night waking. This study didn’t find that settling to sleep was a major issue while a previous study showed that 25% of those with CDC did. but that study may not have tried to compare those with CDC versus those with Down’s Syndrome or Non-Specified ID.
The article did mention there was variations of sleeping issues with those that have CDC depending on the individual’s set of symptoms. If one had more pronounced scoliosis, the individual might have more disordered breathing during sleep, or individuals were more anxious about going to sleep if they were underweight instead of normal weight.
What do the findings mean for students with an ID?
The findings show that students that have ID may have sleeping disorders that impact their quality of sleep, but not just theirs. It can impact their parents or caregivers who may have to help the individual go to sleep, help them go back to sleep if awakened through the night and may have to be up if they wake up early. It did mention that expressive language difficulties can make it hard for individuals with ID to talk about what they’re anxious or scared about going to sleep so their caregivers may not be fully able to help reassure them.
What are potential implications for practice / educational programming?
The article didn’t focus on practice or educational programming suggestions. However, as a teacher, I have found that sleep does impact how a student is able to function in the school setting. They may be more sensitive to stimuli, especially aversive or abrasive, may be more emotional or easily triggered, have difficulties processing their emotions, and may not able to complete their school work or activities as well if they had had a good night’s sleep. If the teacher is aware of how a student is impacted by sleeping issues, it would inform how to pace the day and what demands to place on them in order to help them be successful through the school day and avoid any potential emotional or behavioral outbursts.
Discussion #3. (Paul)Neece, C. L., Baker, B. L., Crnic, K., & Blacher, J. (2013). Examining the validity of ADHD as a diagnosis for adolescents with intellectual disabilities: Clinical presentation. Journal of Abnormal Child Psychology, 41,597-612.Key definitions:
Attention Deficit /Hyperactivity disorder: A chronic condition including attention difficulty, hyperactivity, and impulsiveness.
Intellectual Disability: Below average intelligence and set of life skills present before age 18. Intellectual function can be measured with a test. The main symptom is difficulty thinking and understanding. Life skills that can be impacted include certain conceptual, social, and practical skills.
Developmental Disorders: disability means a severe, chronic disability of an individual who has a mental or physical impairment by the age of 22 which is likely to continue indefinitely and results in substantial functional limitations in three or more areas of major life activity.
Disruptive Behavior Problems: disorders involve acting out and showing unwanted behavior towards others they are sometimes called externalizing disorders.
Mental disorders: are conditions that affect your thinking, feeling, mood, and behavior. They may be occasional or long-lasting (chronic).
Comorbid diagnosis: comorbidity is the presence of one or more additional conditions often co-occurring with a primary condition.
Psychopathology: the study of abnormal cognitions, behavior and experiences which differs according to social norms and rests upon a number of constructs that are deemed to be the social norm at any particular era. It can be broadly separated into descriptive and explanatory.
Key findings / “takeaways”
Research shows that Individuals with intellectual and developmental disabilities are 3 times mores likely to have mental disorders. Using current diagnostic criteria, disruptive behavior disorders, specifically Attention-Deficit/Hyperactivity Disorder (ADHD), appear to be the most prevalent co-occurring disorders. (Baker et al. 2010; Dekker et al. 2002; deRuiter et al. 2008; Emerson and Hatton 2007; Neece et al. 2011)
Of course this trend may truly be underestimated and actually be much more prevalent because the ID is so similar to the behaviors that are typical among individuals with ID and those TP individuals with ADHD.
Studies have found that two and a half to over four times as many children with ID had serious behavior/emotional problems as those with typical cognitive development (Dekker, et al. 2002; deRuiter et al. 2008; Emerson et al. 2010). Studies that examine specific diagnoses in youth with ID generally find that disruptive behavior disorders are the most common comorbid diagnoses (Dekker and Koot 2003; Emerson and Hatton 2007).
A meta-analysis by Frazier et al. (2004) of TD samples found that children with ADHD generally had an IQ nine points lower than children without ADHD. However, while ADHD can lower IQ test performance, it is not presumed to be the cause of intellectual disabilities
The reverse is less clear because many ADHD symptoms (e.g., inattentiveness, overactive/impulsive behavior) are characteristic of individuals with low cognitive functioning, and, therefore, some have argued that a diagnosis of ADHD in children and adolescents with ID is simply a misclassification of symptoms of the intellectual deficit rather than a distinct and separate co-occurring disorder (Gjaerum and Bjornerem 2003; Reiss and Valenti-Hein 1994; Tonge et al. 1996).
The base rate of inattention and hyperactive-impulsive symptoms among children and adolescents with ID has not been established and, therefore, the extent to which the symptoms of ADHD are characteristic of ID is not clear. Thus, we do not know whether ADHD symptoms among adolescents with ID are solely an expression of impairments in intellectual functioning or whether ADHD
A groundbreaking paper by Robins and Guze (1970) described a method for achieving diagnostic validity in psychiatric illnesses consisting of five phases: clinical descriptions, laboratory findings, exclusion of other disorders, follow-up study, and family study.
In their sample of 474,618 year old children with ID, the inattentive subtype was most prevalent, followed by the combined type, and finally the hyperactive-impulsive subtype. Similar findings were reported at ages 5 through 8 years in a separate sample of children with mild to moderate ID (Baker et al. 2010; Neece et al. 2011).
Studies of youth with intellectual disabilities have been inconsistent as to whether sex differences in the prevalence of ADHD are found (Einfeld et al. 2010; Hastings et al. 2005). This study confirmed that ADHD diagnosis was about the same among the sexes.
ADHD symptoms usually stayed consistent among individuals with ID than the TD peer group where these symptoms could be improved.
What do the findings mean for students with an ID?
Further research has to be done on ADHD as a separate disorder in youth with ID.
Because of the comorbidity in individuals with ID much more must be researched due to the negative outcomes for the individual with ID, his or her family, and society at large. Indeed, individuals with ID and a comorbid mental disorder are at increased likelihood for academic problems, failure in community living arrangements, frequent moves, social isolation and rejection, and reduced employment prospects (Bromley and Blacher 1991; Seltzer and Krauss 2001)
Parents of persons with dual diagnosis report elevated levels of stress (Baker et al. 2010; Neece et al. 2012) and an increased need for services (Douma et al. 2006).
It is difficult to manage the person with dual diagnosis is challenged, there is increased likelihood of placement out of the home (Blacher 1994; Bromley and Blacher 1991)
Those with ID who live at home, many of them have unmet mental health needs that have a high social cost (Blacher et al. 1999).
Lastly, General psychiatric and health care services often lack the staff experience and knowledge for assessing and treating psychopathology in individuals with ID, suggesting that the assessment and treatment let alone prevention of psychopathology in these individuals are likely inadequate (Sturmey et al. 2007).
What are potential implications for practice / educational programming?Under IDEA it is generally considered best practice to only to classify children with one eligibility criterion, which is ID for children with comorbid ID and ADHD. In public schools if a child has ID no further diagnostic consideration is needed.
The research also suggests that there is a need for further research to develop more accurate diagnostic criteria and tools.
Schools should be more diligent about offering differential services to children with ID and ADHD.
We must make sure that secondary diagnoses, like ADHD, are also not being adequately assessed, discussed, and/or treated with educational accommodations.
Some studies suggest that empirically supported treatments for typically developing children with ADHD, specifically stimulant medication, behavior modification, or a combination of these, may be effective also in treating children with ID (Handen et al. 1999; Handen et al. 1996; Heyvaert et al. 2010).
Lastly, further research is needed to ensure we have more research based, proven interventions that effectively address particular problematic behaviors in individuals with ID who have diagnosis of ADHD and other behaviors.
Have a great day! I look forward to reading and discussing all the articles.
Requirements: one to two paragraphs for each discussion board

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