Teach to ALL Learners

1. Teach to ALL Learners Contra Costa County Office of Education California Department of Corrections

2. Defining Developmental Disabilities Life-long disabilities attributable to mental and/or physical or combination of mental and physical impairments, manifested prior to age twenty-two.

3. People with severe or multiple disabilities may exhibit a wide range of characteristics, depending on the combination and severity of disabilities. There are some traits they may share. Can you guess what they would be? ?

4. If you guessed: • Limited speech or communication • Difficulty in basic physical mobility • Tendency to forget skills through disuse • Trouble generalizing skills from one situation to another • a need for support in major life activities, e.g., domestic, leisure, community use, self care. You were absolutely correct!

5. Developmental Disabilities is synonymous with the use of the term learning disability. Cognitive disability is also used synonymously in some jurisdictions.

6. Traumatic Brain Injury • Visual Impairments • Deaf and Hearing Loss • Cerebral Palsy • Mental Retardation • Down Syndrome • Emotional Disturbance • Autism or PDD (Pervasive Developmental Disorder) • Attention-Deficit/ Hyperactivity Disorder • Spina Bifida • Epilepsy • Learning Disabilities • Speech and Language Impairments

7. Developmental disabilities are usually classified as severe, profound, moderate or mild, as assessed by the individual's need for supports, which may be lifelong.

8. Indicators of Developmental Disabilities Physical Appearance Some Developmentally disabled inmates/parolees have physical handicaps in addition to their intellectual and adaptive functioning deficits. This is less common among those functioning high enough to be included in the CDCR population.

9. Speech Developmentally disabled inmates/parolees generally have limited vocabulary and use simple speech. They may speak slowly and have or have an articulation problem, e.g. stuttering or slurred speech.

10. Developmentally Disabled Inmates may avoid speaking, possibly to hide their disability or to escape from potentially embarrassing situation. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Many of these inmates/ parolees may have difficulty understanding what others say and be reluctant to ask for clarification.

11. Behavior • The most obvious maladaptive behaviors displayed by developmentally disabled inmates / parolees are in the area of: • social skills • safety skills • activities of daily living (ADLs) • some exhibit aggression toward others

12. Emotional Disturbance • An inability to learn that cannot be explained by intellectual sensory, or health factors • An inability to build or maintain satisfactory interpersonal relationships with peers and teachers • Inappropriate types of behavior or feelings under normal circumstances • A general pervasive mood of unhappiness or depression • A tendency to develop physical symptoms or fears associated with personal problems

13. Attention-Deficit / Hyperactivity Disorder (AD/HD)… What is it? It is a condition that can make it hard for a person to sit still, control behavior and pay attention. Doctors do not know just what causes AD/HD. However, researchers who study the brain are coming closer to understanding what may cause AD/HD. They believe that some people with AD/HD do not have enough of certain chemicals (called neurotransmitters) in their brain. These chemicals help brain control behaviors.

14. How common is AD/ HD? • 5 out of every 100 children in school may have AD/HD. • Boys are three time more likely than girls to have AD/HD. What about Adults???? What is much less well known is the probability that, of children who have AD/HD, many will still have it as adults. Several studies done in recent years estimate that between 30 percent and 70 percent of children with ADHD continue to exhibit symptoms in the adult years.

15. What are the signs of AD/HD? • being very active (called hyperactivity) • problems with paying attention • acting before thinking

16. There are three types of AD/HD based on the Diagnostic and Statistical Manual of Mental Disorders (DSM) • Inattentive type, where the person cannot seem to get focused or stay focused on a task or activity • Hyperactive-impulsive type, where the person is very active and often acts without thinking and • Combined type where the person is inattentive, impulsive and too active.

17. Inactivity Type of AD/HD often: • Do not pay close attention to details • Can’t stay focused on play or school work • Can’t seem to organize tasks and activities • Lose things

18. Hyperactivity-impulsive type • Being too active is probably the most visible sign of AD/HD. This person is always “on the go” (As he or she gets older, the activity may go down). • They act before thinking (called impulsivity). • They may be surprised to find themselves in a dangerous situation. They may have no idea of how to get out of the situation.

19. Hyperactivity and impulsivity tend to go together. They may: Fidget and squirm Get out of the chairs when they’re not supposed to Have trouble engaging in an activity quietly Interrupt others when they’re talking and Butt in on activities that others are doing

20. To be effective, educational programs need to incorporate a variety of components to meet the considerable needs of individuals with severe and/ or multiple disabilities.

21. Tips for Teachers Figure out what specific things are hard for the inmate/parolees. For example, one inmate/parolee with AD/HD may have trouble starting a task while another may have trouble ending one task and staring the next. Each inmate/parolee needs different help. Post rules, schedules and assignments. Clear rules and routines will help a inmate/parolee with AD/HD. Have a set time for specific tasks. Call attention to changes in the schedule. Teach study skills and learning strategies and reinforce them regularly. Help inmate/parolees channel his or her physical activity (e.g., let the inmate/parolee do some work standing up or at the board. Provide regularly scheduled breaks.

22. Tips for Teachers, cont. Make sure directions are given step by step and that the inmate/parolee is following directions. Give directions both verbally and in writing. Many inmate/parolees with AD/HD also benefit from doing the steps as separate tasks. Let the inmate/parolee do work on a computer. Regularly share with the inmate/parolee how he or she is doing in class. Have high expectations for the inmate/parolee, but be willing to try new ways of doing things. Be patient. Maximize inmate/parolee’s chances for success.

23. Learning Disabilities (LD) What are Learning Disabilities? It is a general term that describes specific kinds of learning problems. Learning disability can cause a person to have trouble learning and using certain skills. The skills most often affected are: reading, writing, listening, speaking, reasoning and doing math. LD vary from person to person. One person with LD may not have the same learning problems as another person with LD. Researchers think that LD are caused by differences in how a person’s brain work and how it processes information. People with LD are not “dumb” or ‘lazy.” In fact, they usually have average or above average intelligence. Their brain process information differently.

24. How Common are Learning Disabilities? Very common! As many as 1 out of every 5 people In the United States has a LD. Almost 3 million children (age 6 through 21) have some sort of LD. Adults? There is a growing body of reliable data that indicate that learning disabilities (LD) in adults are a wide-spread problem. Until recently, we have only had estimates of the incidence of adults with LD in specific segments of the population including various formal and informal educational and workplace training settings. Some estimates have been alarmingly high. For example, the United States Employment and Training Administration (1991) estimated that between 15-23% of Job Training Partnership Act (JTPA) title IIA recipients may have a LD. Based on the Department of Labor observations, the percent of adults with LD increases to between 50-80% among those reading below the 7 th grade level.

25. Tips for Teachers During a lecture, pause occasionally allowing inmates/ parolees to take the time to assimilate the information and catch up with note taking. Pauses can be used to erase a board or change a video. _____________________ When presenting abstract concepts, support the concepts with concrete examples or visual materials such as charts and graphs.

27. Borderline Personality Disorder BPD A commonly used mnemonic to remember some features of BPD is PRAISE: P- Paranoid ideas R- Relationship Disabilities A- Angry Outburst I- Impulsive Behavior, Identity disturbance S- Suicidal Behavior E- Emptiness

28. A diagnosis of BPD requires, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM), five or more of the following to be present for a significant period of time: Frantic efforts to avoid real or imagined abandonment. [Not including suicidal or self-mutilating behavior covered in Criterion 5] A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. Identity disturbance: markedly and persistently unstable self-image or sense of self. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, promiscuous sex, eating disorders, substance abuse, reckless driving, binge eating). [Again, not including suicidal or self-mutilating behavior covered in Criterion 5] Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days) Chronic feelings of emptiness. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights). Transient, stress-related paranoidideation or severe dissociative symptoms.

29. DSM IV-Criterion 1 focus is on the frantic efforts to avoid real or imagined abandonment. They are isolated, anxious and terrified at the thought of being alone. If a person with BPD was neglected as a child or raised in a severely dysfunctional household, they may have learned to cope by denying or suppressing their terror at being abandoned. After many years of practice, they no longer feel their original emotion.

30. Several parolees confessed that being incarcerated was actually an easier life style. “When you are locked up, you don’t have to worry about anything. You know what you are going to eat, when you are going to sleep and all that. Out here, there are so many things to worry about… and when you do try to make it out here in the world, so many people judge you and don’t give you a chance.” STAR Parolees/Inmates Interview, 2007.) The fear of abandonment is climaxed when the BPD parolee is released from jail.

31. DSM IV-Criterion 2 focus is on a pattern of interpersonal relationships characterize by alternating between extremes of idealization and devaluation. People with BPD look to others to provide things that they find difficult to supply for themselves, such as self-esteem, approval and a sense of identity.

32. “It is no wonder that many find a sense of identity in the gang culture or in imprisonment.” Most of all, they are searching for a never-ending love and compassion will fill the black hole of emptiness and despair inside them. The intense neediness of people with BPD can put a strain on any relationship. People with BPD often have highly unstable patterns of social relationships. While they can develop intense but stormy attachments, their attitudes towards family, friends, and loved ones may suddenly shift from idealization (great admiration and love) to devaluation (intense anger and dislike). Thus, they may form an immediate attachment and idealize the other person, but when a slight separation or conflict occurs, they switch unexpectedly to the other extreme and angrily accuse the other person of not caring for them at all. Even with family members, individuals with BPD are highly sensitive to rejection, reacting with anger and distress to such mild separations as a vacation, a business trip, or a sudden change in plans. These fears of abandonment seem to be related to difficulties feeling emotionally connected to important persons when they are physically absent, leaving the individual with BPD feeling lost and perhaps worthlessness.

33. DSM IV-Criterion 4 focuses on impulsivity and self –damaging behavior (spending, sex, substance abuse, reckless driving, binge eating). BPDs are aware of the long term consequence of their behavior, but find it very difficult to resist or control their impulses. If a person feels empty and anxious most of the time, pleasant activities are a welcome diversion. Mood-altering drugs provide an even more immediate relief and therefore can be a powerful distraction. Harmful activities may be a way of expressing rage or self-hate.

34. BPDs have no sense of “self.” They do not know who they are; hence, they try to fill the emptiness and create an identify for themselves through impulsive behaviors such as indiscriminate sex activity, shoplifting, compulsive drinking or substance abuse. BPD and substance abuse goes hand in hand. Recent statistics show 23% of BPDs had a diagnosis of substance abuse. Borderline substance abusers are likely to abuse more than one drug (a frequent combination is drug and alcohol abuse.)

35. People with BPD are quite intuitive and have the ability to read others very well. In the presence of others, the person with BPD is able to fit in much like a chameleon lizard by pretending to blend in to their surroundings. Self-image is based on the people around them. This allows the person with BPD to feel in control and liked by those present. The person with BPD tends to go in whatever direction the wind is blowing. There appears to be no depth of identity or individuality to their own thinking. People with BPD often have self-destructive behaviors that may threaten their life or physical well-being. It’s estimated that as many as 9% of all people with BPD commit suicide.

36. DSM IV-Criterion 5 focuses on recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. Drug and alcohol abuse falls into this category of dangerous and compulsive behavior. Another common behavioral trait many is provoking physical fights with others. Self-injury is a coping mechanism that BPDs use to release manage overwhelming emotional pain-usually feeling of shame, anger, sadness or abandonment. Self-mutilation may release the body’s own opiates, known as beta-endorphins. These chemicals lead to a general feeling of well-being. People with BPD see themselves as in control of these behaviors, which provides a false sense of security.

37. Avoidance and denial is a sense of security and protection. Projecting blame, showing apathy and remaining distance geographically and emotionally are just some of the ways people with drug addiction and criminality cope with obvious toxic problems. Many would rather die alone in prison than admit they are afraid, confused and need help.

38. DSM IV-Criterion 6 focus is on the affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days) People with BPD may experience dramatic mood swings from being very happy and in control of their world, to suddenly feeling very depressed, lonely, helpless, and hopeless. In similar fashion, people with BPD can move from a state of total independence to one demanding lots of attention.

39. It is reassuring to know that there is hope. Astonishingly enough, researchers commonly believe that BPD results from a combination that can involve individual genetic vulnerability and environmental stress, neglect or abuse as young children, and maturational events during adolescence or adulthood. Numerous studies have shown a strong correlation between childhood abuse and development of BPD. Many (but not all) individuals with BPD report having had a history of abuse, neglect, or separation as young children. Patients with BPD have been found to be significantly more likely to report having been verbally, emotionally, physically, and sexually abused by caretakers of either gender. They were also much more likely to report having caretakers (of both sexes) deny the validity of their thoughts and feelings. They were also reported to have failed to provide needed protection, and neglected their child's physical care. Parents (of both sexes) were typically reported to have withdrawn from the child emotionally, and to have treated the child inconsistently. Additionally, female borderlines who reported a previous history of neglect by a female caretaker and abuse by a male caretaker were consequently at significantly higher risk for being sexually abused by a non-caretaker (not a parent).

40. Post Traumatic Stress Disorder (PTSD) The traumas that cause PTSD are as unique as the individuals suffering from the disorder. Any fearful trauma can produce symptoms of PTSD. “I remember being in a tornado a few years back, and for the longest time, any wind, and I mean any wind, would send tremors through my body.” ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ PTSD can be either acute or chronic; the acute phase occurring directly after the trauma, while the chronic phase can come along much later. In the acute phase, PTSD is said to be treatable and curable. In its chronic phase, it is only treatable. One must learn to live with it and to cope with it.

41. People with PTSD are famous for self-medicating (drugs, alcohol), and may have an additional addiction that often lands them in trouble, or jail: an addiction to adrenaline. We love danger, even when trying to avoid it. Deep down inside, we love adrenaline.

42. It has recently been learned that prolonged stress actually changes a person’s brain chemistry. PTSD is a physical disease. There is no escaping it. Even if most of the symptoms are suppressed, a person with PTSD will make all his/her decisions through the veil of this disorder, simply because one’s brain chemistry determines one’s thought patterns.

43. PTSD: The Time Bomb Inside every person with PTSD is a time bomb. It is merely a matter of time before symptoms begin to show up. One might exhibit all manner of symptoms in nearly everything s/he does, and still live what appears to be a normal life. However, it doesn’t take much to bring out full-blown symptoms of a full-blown case of PTSD.

44. Keeping busy keeps the symptoms down. Free time (and worry) exacerbates PTSD symptoms. Additional Stress: Stress kills; we know this. Additional stress in the life of a PTSD sufferer will bring out their PTSD symptoms. Even good stress can increase one’s symptoms; good stress such as a birth, or a new love, or a promotion at work. Anything that wobbles the apple cart—little changes, big changes, good changes, bad changes—will promote PTSD symptoms. Then there are the huge stressors; the larger the stressor, the more virulent the PTSD symptoms. Reminders: anything that reminds the PTSD sufferer of the original trauma will pique symptoms. This includes odors, sounds, and sites. Additionally, the anniversary of a trauma will cause a rise in PTSD symptoms. If a woman was assaulted near an elevator, elevators will trigger her symptoms. If she remembers the date of her assault, as the anniversary approaches, symptoms increase.

45. PTSD &… Anger Flashbacks/Hallucinations Fear Dread Hyper-Vigilance Anxiety Intimacy Issues Intrusive Thoughts Depression

46. Here are some more symptoms of PTSD Drug and Alcohol Abuse Addictions do come in handy sometimes: at least you have to get out of bed for them.Martin Amis Avoidance/Immersion Of all the…alternatives, running away is best.Chinese Proverb. Guilt Guilt always hurries towards its complement, punishment; only there does its satisfaction lie.Lawrence Durrell Memory Loss/Cognitive Dysfunction The effectiveness of our memory banks is determined not by the total number of facts we take in, but the number we wish to reject.Jon Wynne-Tyson

47. Teacher’s Tips for PTSD • Teach Symptom Management, Anger Management, and attending rap groups (such as AA or NA) is a way of keeping one’s symptoms at bay. • Help inmates/ parolees know when to reach out for help, is a second strategy; one to fall back on when the others don’t work. • Practicing relaxation, meditation have an enormous healing power for the PTSD sufferer.

48. Anti Social Personality Disorder (APD or ASPD) This is a psychiatricdiagnosis in the DSM-IV-TR recognizable by the disordered individual's disregard for social rules and norms, impulsive behavior, and indifference to the rights and feelings of others.

49. Did you know???????? Diagnosis of antisocial personality disorder is significantly more common among men than among women Central to understanding individuals diagnosed with antisocial personality disorder is that they appear to experience a limited range of human emotions. This can explain their lack of empathy for the suffering of others, since they cannot experience the emotion associated with either empathy or suffering. Risk-seeking behavior and substance abuse may be attempts to escape feeling empty or emotionally void. The rage exhibited by psychopaths and the anxiety associated with certain types of antisocial personality disorder may represent the limit of emotion experienced or there may be physiological responses without analogy to emotion experienced by others.

50. Research has shown that individuals with antisocial personality disorder are indifferent to the possibility of physical pain or many punishments and show no indications that they experience fear when so threatened. This may explain their apparent disregard for the consequences of their actions and their aforementioned lack of empathy.