Praxis Special Education (5355)

Intellectual disability is characterized by significant limitations in both intellectual functioning and adaptive behavior, originating during the developmental period. Intellectual functioning, measured by standardized intelligence tests, falls approximately two or more standard deviations below the mean. Adaptive behavior limitations affect conceptual, social, and practical skills. The AAIDD definition emphasizes that limitations must be considered within the context of typical community environments and cultural backgrounds.

Severity levels include mild, moderate, severe, and profound, determined primarily by adaptive functioning rather than IQ scores alone. Individuals with mild intellectual disabilities typically achieve academic skills around the sixth-grade level, can live independently with support, and maintain employment in unskilled or semi-skilled positions. Moderate intellectual disability is associated with academic achievement around the second-grade level, semi-independent living with supervision, and supported employment. Severe and profound levels require more intensive support across all life domains.

Etiology is identified in approximately fifty percent of cases. Prenatal causes include chromosomal abnormalities such as Down syndrome, single-gene disorders such as fragile X syndrome, brain malformations, and environmental factors including maternal infections, substance exposure, and malnutrition. Perinatal causes include birth complications and premature birth. Postnatal causes include traumatic brain injury, infections, and environmental deprivation.

Educational approaches emphasize functional academics, life skills instruction, and community-based learning. Systematic instruction with task analysis, prompting hierarchies, and reinforcement strategies supports skill acquisition. Generalization and maintenance require explicit programming across settings and over time.

Specific learning disabilities involve significant difficulties in acquiring and using listening, speaking, reading, writing, reasoning, or mathematical abilities. These difficulties are presumed to result from central nervous system dysfunction and are not primarily attributable to intellectual disabilities, sensory impairments, emotional disturbance, cultural differences, or inadequate instruction.

Dyslexia, the most common learning disability, involves unexpected difficulty with accurate and fluent word recognition and poor spelling and decoding abilities. Phonological processing deficits underlie most cases of dyslexia. Individuals with dyslexia often demonstrate average or above-average intelligence but struggle with reading despite adequate instruction.

Dyscalculia involves difficulties with number sense, memorization of arithmetic facts, accurate or fluent calculation, and mathematical reasoning. Affected individuals may struggle with understanding quantities, recognizing patterns, and applying mathematical concepts to real-world situations.

Dysgraphia affects written expression through difficulties with handwriting, spelling, and organizing ideas on paper. Fine motor difficulties may contribute to illegible handwriting, while language processing difficulties affect spelling and composition.

Processing deficits commonly associated with learning disabilities include phonological processing difficulties affecting sound manipulation and sound-symbol correspondence. Visual processing deficits affect perception, discrimination, and memory for visual information. Auditory processing disorders involve difficulty processing auditory information despite normal hearing. Working memory deficits limit the ability to hold and manipulate information during cognitive tasks. Processing speed deficits slow the rate of cognitive operations.

Identification traditionally relied on IQ-achievement discrepancy models requiring significant difference between measured intelligence and academic achievement. Response to intervention models identify students who fail to respond adequately to evidence-based instruction. Pattern of strengths and weaknesses approaches identify cognitive processing deficits related to academic difficulties.

Emotional disturbance, as defined by IDEA, involves one or more of the following characteristics exhibited over a long period, to a marked degree, and adversely affecting educational performance: inability to learn unexplained by intellectual, sensory, or health factors; inability to build or maintain satisfactory interpersonal relationships; inappropriate behaviors or feelings under normal circumstances; pervasive mood of unhappiness or depression; and tendency to develop physical symptoms or fears associated with school problems. Schizophrenia is included, while social maladjustment alone does not qualify.

Externalizing behaviors include aggression, defiance, noncompliance, and disruptive conduct. Attention-deficit/hyperactivity disorder, while not automatically qualifying under emotional disturbance, frequently co-occurs with other behavioral disorders. Conduct disorder involves persistent patterns of violating others' rights and major societal norms. Oppositional defiant disorder involves persistent patterns of angry, defiant, and vindictive behavior toward authority figures.

Internalizing behaviors include anxiety, depression, social withdrawal, and somatic complaints. Anxiety disorders affecting school performance include generalized anxiety disorder, social anxiety disorder, separation anxiety disorder, and specific phobias. Depression manifests differently in children than adults, often presenting as irritability rather than sadness.

Functional behavior assessment identifies the function or purpose that problem behaviors serve for individuals. Common functions include obtaining attention, accessing tangibles, escaping or avoiding demands, and automatic reinforcement. Behavior intervention plans based on functional assessment replace problem behaviors with functionally equivalent appropriate alternatives.

Autism spectrum disorder is characterized by persistent deficits in social communication and social interaction across multiple contexts, along with restricted, repetitive patterns of behavior, interests, or activities. Symptoms must be present in early developmental periods, cause clinically significant impairment, and not be better explained by intellectual disability or global developmental delay.

Social communication deficits include difficulties with social-emotional reciprocity, ranging from abnormal social approach and conversation to reduced sharing of interests and emotions to failure to initiate or respond to social interactions. Nonverbal communication deficits range from poorly integrated verbal and nonverbal communication to abnormalities in eye contact and body language to total lack of facial expressions and nonverbal communication. Difficulties developing, maintaining, and understanding relationships range from difficulties adjusting behavior to social contexts to difficulties sharing imaginative play to absence of interest in peers.

Restricted, repetitive behaviors include stereotyped or repetitive motor movements, use of objects, or speech. Insistence on sameness, inflexible adherence to routines, and ritualized patterns of behavior are common. Highly restricted, fixated interests may be abnormal in intensity or focus. Hyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment affect many individuals.

Severity levels are specified for both social communication and restricted repetitive behaviors, ranging from Level 1 requiring support to Level 3 requiring very substantial support. Many individuals with autism also have intellectual disability, language impairment, or other co-occurring conditions.

Evidence-based practices for autism include applied behavior analysis, structured teaching approaches, social skills instruction, visual supports, and augmentative and alternative communication for individuals with limited verbal language.

Speech sound disorders involve difficulty with articulation or phonological processes affecting speech intelligibility. Articulation disorders involve difficulty producing specific sounds. Phonological disorders involve difficulty understanding and using the sound system of language.

Language disorders involve difficulties with comprehension or production of vocabulary, sentence structure, or discourse. Receptive language disorders affect understanding of spoken or written language. Expressive language disorders affect verbal or written production. Mixed receptive-expressive disorders affect both modalities.

Childhood-onset fluency disorder, commonly known as stuttering, involves disturbances in the normal fluency and time patterning of speech. Characteristics include sound and syllable repetitions, sound prolongations, broken words, audible or silent blocking, circumlocutions, and excess physical tension during speech production.

Social pragmatic communication disorder involves persistent difficulties in the social use of verbal and nonverbal communication. Affected individuals struggle with using communication for social purposes, changing communication to match context, following rules for conversation and storytelling, and understanding what is not explicitly stated.

Hearing impairments range from mild to profound and may be unilateral or bilateral, conductive, sensorineural, or mixed. Age of onset significantly affects language development, with prelingual deafness having greater impact than postlingual hearing loss. Educational approaches include oral/aural methods emphasizing spoken language, total communication combining speech and sign, and bilingual-bicultural approaches emphasizing American Sign Language as the primary language.

Visual impairments include low vision, legal blindness, and total blindness. Low vision involves significant visual impairment that cannot be fully corrected with glasses, contact lenses, or surgery but allows some functional vision. Legal blindness is defined as visual acuity of 20/200 or less in the better eye with correction or visual field of 20 degrees or less. Educational approaches include adapted materials, optical and electronic magnification, braille, and orientation and mobility instruction.

Deaf-blindness involves combined hearing and vision impairments causing severe communication and other developmental and educational needs. Individuals with deaf-blindness require specialized instruction addressing unique learning needs arising from the combination of impairments.

Orthopedic impairments include congenital anomalies, impairments caused by disease, and impairments from other causes. Cerebral palsy, the most common physical disability in childhood, results from brain injury affecting movement and posture. Spina bifida involves incomplete closure of the spinal column during fetal development. Muscular dystrophy encompasses genetic disorders causing progressive muscle weakness.

Other health impairments involve limited strength, vitality, or alertness due to chronic or acute health problems adversely affecting educational performance. Conditions include attention-deficit/hyperactivity disorder, epilepsy, diabetes, asthma, sickle cell anemia, leukemia, and heart conditions.

Traumatic brain injury involves acquired injury to the brain caused by external physical force, resulting in total or partial functional disability, psychosocial impairment, or both. Effects vary based on injury location, severity, and age at injury but may include cognitive, physical, sensory, and emotional changes.

Multiple disabilities involve concomitant impairments causing severe educational needs that cannot be accommodated in programs designed solely for single impairments. The combination of impairments creates unique learning needs requiring specialized approaches.

Developmental delay applies to children ages three through nine experiencing delays in physical, cognitive, communication, social-emotional, or adaptive development. States may adopt this category to provide services without requiring specific disability labels for young children.

Gifted and talented students demonstrate outstanding abilities in intellectual, creative, artistic, or leadership domains or in specific academic fields. Characteristics may include advanced vocabulary, rapid learning, intense curiosity, and preference for complexity.

Twice-exceptional students are gifted individuals who also have disabilities. Their giftedness may mask their disabilities, and their disabilities may mask their giftedness, making identification challenging. Both exceptional abilities and disabilities must be addressed through educational programming.