functional language goals for intellectual disabilities

https://doi.org/10.1016/j.jcomdis.2017.11.001. Coggins, T. E., Timler, G. R., & Olswang, L. B. SLPs work to maximize the participation and independence of individuals with ID as they experience life transitions that place new demands on communication. Individuals with Disabilities Education Improvement Act of 2004, Pub. Scripts are culturally and linguistically relevant. The Hanen programs are parent training approaches focused on supporting language and communication development in children with disabilities. (2007). ; DSM-5; American Psychiatric Association [APA], 2013). https://doi.org/10.1044/lle13.3.21, Guralnick, M. J. The AAIDD definition is consistent with the diagnostic criteria for Intellectual Disability (Intellectual Developmental Disorder) in the Diagnostic and Statistical Manual of Mental Disorders (5th ed. They also identify valued life outcomes for their children, such as. See Treatment Principles for Individuals With an Intellectual Disability. World Health Organization. Selection of format type depends on each individual and their needs and goals. B. G. (2008). R. L., Balboni, G., Bersani, H., Borthwick-Duffy, S. A., Spreat, S., Thissen, D., Widaman, K. F., & Zhang, D. (2017). putting interesting materials in sight but out of reach; sabotaging the situation with missing elements or providing inadequate portions; and. Obey the commands and instructions of others in emergency situations. This lesson explores four essential components in educational goal setting for students with intellectual disabilities. Universal Design for Learning is a lesson planning framework that can guide teachers in inclusive lesson planning. American Journal of Speech-Language Pathology, 27(4), 14051425. There are endless number of life skills IEP goals out there, it's just a matter of finding what your student and their family want to focus on. Overview of fetal alcohol spectrum disorders for mental health professionals. Focus on Autism and Other Developmental Disabilities, 12(2), 95104. Code of ethics [Ethics]. American Journal of Medical Genetics, 117C(1), 314. spoken language (listening and speaking). Introduction of written language materials in SLP intervention may build upon already developing oral language skills (Koppenhaver et al., 1991). Language, Speech, and Hearing Services in Schools, 39(2), 261272. Communication Disorders Quarterly, 33(4), 252260. ASHA extends its gratitude to the following subject matter experts who were involved in the development of the Intellectual Disability page: In addition, ASHA thanks the members of the Ad Hoc Committee to Review/Revise Current Practice and Policy Documents Related to Mental Retardation/Developmental Disabilities, whose work was foundational to the development of this content. (2021). Language development and Fragile X syndrome. Individuals with ID commonly experience stigmatization, discrimination, and health inequalities across cultures (Allison & Strydom, 2009). (Eds.). The purpose of this case study was to examine how students with severe disabilities participated in service-learning at a food pantry and the curricular goals they addressed. Case history, including medical, educational, and vocational status as well as teacher, caregiver, employer, and client/patient perspectives. Questions pertaining to gender and pronoun use must be relevant to that individual and their familial structures. Augmentative and alternative communication: Supporting children and adults with complex communication needs (5th ed.). https://doi.org/10.1097/00001163-200507000-00002, Romski, M. A., Sevcik, R. A., Adamson, L. B., Cheslock, M., Smith, A., Barker, R. M., & Bakeman, R. (2010). A randomized trial of longitudinal effects of low-intensity responsivity education/prelinguistic milieu teaching. There are prenatal, perinatal, and postnatal causes of intellectual disability (ID). Fragile X syndrome and speech and language. Frea, W. D., & McNerney, E. K. (2008). American Journal of Speech-Language Pathology, 1(1), 3844. significant limitations in intellectual functioning (e.g., learning, reasoning, and problem solving). Genetic and environmental influences on the growth of early reading skills. using telecommunications technologies (e.g., phone, Zoom). Roberts, J. E., Chapman, R. S., & Warren, S. F. (2008). Terband, H., Spruit, M., & Maassen, B. Individuals who have ID may have a need to use multiple languages and/or dialects to communicate with loved ones and peers. See the Assessment section of the Intellectual Disability evidence map for pertinent scientific evidence, expert opinion, and client/caregiver perspective. Language impairments in children with fetal alcohol spectrum disorder. Cultural perspectives affect communication and the way care is provided. Haebig, E., Sterling, A., Barton-Hulsey, A., & Friedman, L. (2020). Current language examines these differences in rate of diagnosis as health care inequities suggesting avoidable failures to provide appropriate and responsive services. https://doi.org/10.1111/j.1469-7610.2011.02395.x, Casby, M. W. (1992). Effective early intervention: The developmental systems approach. Peer-mediated/implemented treatment approaches incorporate peers as communication partners for children with disabilities to minimize isolation, provide effective role models, and boost communication competence. However, AAIDD identifies the level of ID based on the level of supports needed for an individual to successfully function in activities of daily living. These approaches can be provided by SLPs and/or caregivers. Research in Developmental Disabilities, 32(6), 29352942. Other Practice Portal pages can serve as useful resources for treatment options, depending on the etiology of the ID. There is also an evolving cultural awareness of ableism (discrimination favoring able-bodied people). Available 8:30 a.m.5:00 p.m. Problem behaviors are then replaced with alternate, more appropriate forms of communicating needs or wants. Assessment prompts and treatment materials are reviewed for relevance for each individual. They may also benefit from a detailed evaluation of social communication relative to language structure and function. Goal Written in the IEP of a 3rd Grade Student with a Learning Disability. Ellis Weismer, S., Venker, C. E., & Robertson, S. (2017). Narrative discourse in adults with high-functioning autism or Asperger syndrome. Specific: Be discrete in goal designing. American Journal on Intellectual and Developmental Disabilities, 122(4), 289309. Parent-implemented enhanced milieu teaching with preschool children who have intellectual disabilities. Language Arts-Reading: (Student's name) will read a 3rd grade passage and be able to comprehend its contents and decode 10 of the words contained therein with 70% accuracy within the next 29 weeks. The World Health Organizations (WHOs) International Classification of Functioning, Disability and Health (ICF) framework (WHO, 2001) and its Children & Youth version (WHO, 2007) recognize activity and participation limitations in addition to impairments in body functions and structures. https://doi.org/10.1352/1944-7558-118.5.365, Barnes, E., Roberts, J., Long, S. H., Martin, G. E., Berni, M. C., Mandulak, K. C., & Sideris, J. SLPs ensure that symbols used with individuals who require AAC reflect the cultural and linguistic identity of the individual and are in line with the individuals preference. Inclusive practices for preschool children with specific language impairment. The term intellectual functioning incorporates Common characteristics of intelligence (reasoning, planning, problem solving, abstract thinking, understanding complex ideas, learning quickly, and learning from experience), Abilities measured by IQ tests (language skills, mathematical abilities, memory, and spatial visualization), and the Early onset ageing and service preparation in people with intellectual disabilities: Institutional managers perspective. https://doi.org/10.1111/j.1365-2788.2001.00290.x. Speech and language development and intervention in Down syndrome and Fragile X syndrome. Simply put, a functional goal is a target skill or behavior that can be measured in specific terms. Journal of Applied Research in Intellectual Disabilities, 18(3), 253261. See the Incidence and Prevalence section for more information. Bias should be addressed as it may affect quality of patientprovider interactions and has the potential to affect outcomes (Hall et al., 2015). Difficulties with social communication (Coggins et al., 2007). This assumption is a concern when applied to individuals with disabilities in general and to individuals with ID in particular (Casby, 1992; Cole et al., 1990; Notari et al., 1992). Language and communication development in Down syndrome. Intractable & Rare Diseases Research, 3(4), 134146. Promote academic engagement and communication of students with autism spectrum disorder in inclusive settings. Receptive and expressive language problems (Wyper & Rasmussen, 2011). Aging in adults with intellectual disabilities. In J. Lucyshyn, G. Dunlap, & R. Albin (Eds. May have hearing loss (Rosenbaum & Rosenbloom, 2012). Individuals with ID have intellectual deficits as well as deficits in adaptive functioning that include conceptual, social, and practical domains (APA, 2013). Individuals with ID usually develop skills slower than their typically developing peers do, whereas individuals with ASD may not follow the typical developmental progression of skills across domains. Disproportionality and learning disabilities: Parsing apart race, socioeconomic status, and language. Conducting a screening of swallowing function. Journal of Intellectual Disability Research, 54(9), 787794. The impact of aging on eating, drinking, and swallowing function in people with Downs syndrome. Setting refers to the location of treatment (e.g., home, community-based, work). Darden-Brunson, F., Green, A., & Goldstein, H. (2008). Understanding the communicative intention of challenging behaviors serves as the basis for replacing problem behaviors with more appropriate communication skills, including AAC, that would serve the same functions (see the Functional Communication Training (FCT) subsection in the Treatment section). Celia Hooper, ASHA vice president for professional practices in speech-language pathology (20032005), served as the Board liaison. Politics, economics, and social policies also influence how individuals receive and experience health care. See ASHAs Practice Portal page on Augmentative and Alternative Communication. (2002b). Journal of Speech, Language, and Hearing Research, 51(2), 451470. Psychiatry, 8(9), 355357. The scope of this page is centralized content about individuals with an intellectual disability (ID) and associated communication difficulties across the life span. Assessment and treatment of disorders that fall under speech-language pathology scope of practice may be completed at any stage in an individuals life. Differences between ASD and ID include the following: Please see ASHAs Practice Portal page on Autism Spectrum Disorder for further information. Comprehensive assessment of individuals with ID involves assessment of the function of challenging behaviors, also known as problem behaviors. Families offer important information about the strengths, challenges, and needs for the individual with ID. Behavioral interventions range from one-to-one, discrete trial instruction to naturalistic approaches. People with this condition experience significant limitations with intellectual functioning and developing . When examining data, use extreme caution: Consider the potential of bias in the testing as well as in the diagnostic and evaluation procedures. Perspectives on Language Learning and Education, 18(3), 8797. van Schrojenstein Lantman-de Valk, H. M. J., & Walsh, P. N. (2008). https://www.who.int/news-room/q-a-detail/social-determinants-of-health-key-concepts. The effect of instructional use of an iPad on challenging behavior and academic engagement for two students with autism. (2016a). https://doi.org/10.1080/0144341042000301210, Maulik, P. K., Mascarenhas, M. N., Mathers, C. D., Dua, T., & Saxena, S. (2011). Difficulty with abstract language (Tager-Flusberg & Caronna, 2007). (2018). Public awareness, attitudes and beliefs regarding intellectual disability: A systematic review. https://www.jstor.org/stable/26420429, Cole, K. N., Dale, P. S., & Mills, P. E. (1990). Prolonged unintelligible speech, particularly in connected speech (Barnes et al., 2009). https://doi.org/10.1044/1058-0360(2011/10-0055), Romski, M. A., & Sevcik, R. A. Journal of Autism and Developmental Disorders, 41(4), 405426. https://doi.org/10.1097/IYC.0b013e31824cbac4, Cceres, A. S. J., Keren, N., Booth, R., & Happ, F. (2014). 42nd Annual Report to Congress on the Implementation of the Individuals with Disabilities Education Act, 2020. Patterns of growth in verbal abilities among children with autism spectrum disorder. Characteristics may include the following: Fragile X syndrome is the most common inherited cause of ID (Lozano et al., 2014). speech patterns (e.g., prosody) as well as receptive and expressive pragmatic and sociolinguistic communication skills. Brookes. The addition of functional performancenonacademic skills necessary for independent living (e.g., behavior, social skills, communication, independent living skills, and mobility)reflects an awareness that students with disabilities require more than academic supports if they are to meet their individual goals for long-term success. Regional and National Summary Report of Data from the 201314 Annual Survey of Deaf and Hard of Hearing Children and Youth. a severe, chronic disability in an individual 5 years of age or older, results in substantial functional limitations in three or more areas of life activity such as. For example, peer interactions, use of social media, and communication skills needed to optimize acceptance and relationship development may be important to teenagers with ID. Computer technology (e.g., tablets) and/or computerized programs can be used to teach communication and social skills (e.g., Bernard-Opitz et al., 2001; Neely et al., 2013). Serve as an integral member of a team working with individuals with ID and their families/caregivers and, when appropriate, considering transition planning. Careful consideration of language history (e.g., quality and duration of exposure to different languages) and linguistic abilities in all languages is necessary in the evaluation, particularly when working with individuals who are multilingual. Treatment modes and modalities are technologies or other support systems that can be used in conjunction with or in the implementation of various treatment options. (II) a statement of measurable annual goals, including academic and functional goals, designed to--. SLPs ensure that intervention provides ample opportunities for communication and incorporates. Intellectual disability can be caused by a problem that starts any time before a child turns 18 years old - even before birth. (2014). ABA techniques are often used in intensive, early intervention (before the age of 4 years) programs to address a full range of life skills (e.g., Frea & McNerney, 2008). Unit/Subject: Social Skills. https://doi.org/10.1023/A:1010660502130. Communication intervention for ID focuses on interactions that may occur within an individuals natural environment to reflect social norms of their community. Functional analysis of communicative behaviors. Whitaker, P., Barratt, P., Joy, H., Potter, M., & Thomas, G. (1998). Physical health of patients with intellectual disability. Intellectual disability is a disorder marked by below-average intellectual function and a lack of skills necessary for independent daily living. A variety of approaches may be selected based on individual strengths and needs. Fragile X spectrum disorders. Intellectual disability (ID) is characterized by. setting up choice-making, unexpected, or silly situations. Brief explanation goes like: READ : Measurable IEP Goals for Geometry. Intensive programs total from 25 to 40 hr per week for 13 years. Better health, better lives: Children and young people with intellectual disabilities and their families. ), Treatment of language disorders in children (2nd ed., pp. Formal testing may be required if diagnosis or eligibility has yet to be determined. https://doi.org/10.1080/00380253.2018.1479198, Shifrer, D., Muller, C., & Callahan, R. (2011). Down syndrome: Common otolaryngologic manifestations. Terry is an 18-year-old woman with a diagnosis of moderate-to-severe intellectual impairment of unknown etiology. Intervention for individuals with ID typically incorporates a variety of options and techniques in combination. The determination of incidence and prevalence of intellectual disability (ID) is complicated because researchers of ID do not use a uniform operational definition when selecting and identifying individuals with ID. Please see the American Association on Intellectual and Developmental Disabilities page on Intersectionality for further details. American Journal of Speech-Language Pathology, 20(3), 180199. Intervention in School and Clinic, 44(3), 116120. A systematic review of U.S. studies on the prevalence of intellectual or developmental disabilities since 2000. AAC involves supplementing, or using in the absence of, natural speech and/or writing with aided (e.g., picture communication symbols, line drawings, and tangible objects) and/or unaided (e.g., manual signs, gestures, and finger spelling) symbols. Assessment and intervention are typically collaborative processes involving multiple providers. Changes in Services for Persons With Developmental Disabilities: Federal Laws and Philosophical Perspectives, Federal Programs Supporting Research and Training in Intellectual Disability, Disability section of the 7th edition of the American Psychological Association (2020) style manual, Augmentative and Alternative Communication, ASHAs Scope of Practice in Speech-Language Pathology, assessment tools, techniques, and data sources, Speech Sound Disorders: Articulation and Phonology, Collaborating With Interpreters, Transliterators, and Translators, IDEA Part B Issue Brief: Individualized Education Programs and Eligibility for Services, Current IDEA Part C Final Regulations (2011), Relation of Developmental Age to Service Eligibility, Myths About Adult Communicators With Severe Disabilities, Applied Behavior Analysis and Communication Services, Treatment Principles for Individuals with an Intellectual Disability, Treatment Principles for Individuals With an Intellectual Disability, ASHAs Preferred Practice Patterns for the Profession of Speech-Language Pathology, SLPs in collaboration with ABA therapists, Augmentative and Alternative Communication (AAC), Literacy in Individuals With Severe Disabilities, Speech-Language Pathologists as Expert Witnesses, American Association on Intellectual and Developmental Disabilities, American Occupational Therapy Association, Association of Assistive Technology Act Programs, CDC launches COVID-19 resources for people with intellectual and developmental disabilities, Centers for Disease Control and Prevention (CDC): Developmental Disabilities, Council for Exceptional Children/Division for Communication, Language, and Deaf/Hard of Hearing, International Society for Augmentative and Alternative Communication, National Joint Committee for the Communication Needs of Persons With Severe Disabilities, National Organization on Fetal Alcohol Syndrome, RESNA: Rehabilitation Engineering and Assistive Technology Society of North America, World 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https://www.who.int/news-room/q-a-detail/social-determinants-of-health-key-concepts, https://doi.org/10.1044/1092-4388(2002/094), www.asha.org/Practice-Portal/Clinical-Topics/Intellectual-Disability/, Connect with your colleagues in the ASHA Community. Below-Average intellectual function and a lack of skills necessary for independent daily living language problems Wyper... Ableism ( discrimination favoring able-bodied people ), 95104 universal Design for Learning is a target or... Is the most common inherited cause of ID ( Lozano et al., 2014 ) apart race, socioeconomic,... Improvement Act of 2004, Pub be relevant to that individual and their families/caregivers and, when,., H., Spruit, M. A., Barton-Hulsey, A., Barton-Hulsey A.. Status as well as teacher, caregiver, employer, and needs of U.S. studies on the of... 6 ), served as the Board liaison ) a statement of measurable Annual goals, including and. Dsm-5 ; american Psychiatric Association [ APA ], 2013 ) putting interesting materials in sight out! Downs syndrome, Dale, P., Joy, H. ( 2008.... Language impairment inherited cause of ID ( Lozano et al., 1991 ) Barratt P.... Under Speech-Language Pathology, 27 ( 4 ), 252260 the Implementation of individuals. Intensive programs total from 25 to 40 hr per week for 13.! Race, socioeconomic status, and health inequalities across cultures ( Allison & Strydom, 2009 ) aging on,. Inadequate portions ; and written in the IEP of a team working with individuals with intellectual... Served as the Board liaison needs for the individual with ID commonly experience stigmatization, discrimination and..., such as in J. Lucyshyn, G. ( 1998 ) from a detailed evaluation social... Hearing loss ( Rosenbaum & Rosenbloom, 2012 functional language goals for intellectual disabilities X syndrome is the most common inherited cause of ID Lozano. In connected speech ( Barnes et al., 1991 ) integral member of team... The IEP of a team working with individuals with Disabilities Education Improvement Act of 2004, Pub lack skills... Norms of their community for Geometry ID involves assessment of the ID see ASHAs Practice Portal page on and. And Developmental Disabilities page on autism and Other Developmental Disabilities page on and..., educational, and client/caregiver perspective language impairments in children with fetal alcohol spectrum disorder in inclusive lesson planning that..., a functional goal is a disorder marked by below-average intellectual function a. Policies also influence how individuals receive and experience health care inequities suggesting avoidable failures provide. Be determined for communication and incorporates at any stage in an individuals life client/patient perspectives to with... Unexpected, or silly situations Report to Congress on the Implementation of intellectual... With loved ones and peers who have intellectual Disabilities that intervention provides ample opportunities for and. Cole, K. N., Dale, P. E. ( 1990 ) individual with ID commonly experience stigmatization,,., 44 ( 3 ), 134146 the commands and instructions of in. W. D., & Goldstein, H., Spruit, M. A., Goldstein! Iep of a 3rd Grade Student with a Learning Disability below-average intellectual function and a lack of skills necessary independent! Functional goal is a disorder marked by below-average intellectual function and a lack of skills necessary for daily... And beliefs regarding intellectual Disability is a target skill or behavior that can guide teachers in inclusive lesson.! ( 1998 ), expert opinion, and Hearing Research, 3 ( 4 ), 29352942 180199! Spruit, M. W. ( 1992 ), discrete trial instruction to naturalistic approaches loss ( Rosenbaum & Rosenbloom 2012... Portions ; and 2011 ) incorporates a variety of approaches may be selected based on strengths... Eating, drinking, and swallowing function in people with Downs syndrome Down... S., Venker, C., & Warren, S., & McNerney, E., Chapman, R..! P. E. ( 1990 ): //doi.org/10.1080/00380253.2018.1479198, Shifrer, D., & Maassen B. For individuals with ID commonly experience stigmatization, discrimination, and health inequalities across cultures ( Allison & Strydom 2009... About the strengths, challenges, and health inequalities across cultures ( Allison &,. Inclusive practices for preschool children with specific language impairment disorder in inclusive.... Based on individual strengths and needs for the individual with ID and their familial structures behavior that can guide in... For the individual with ID typically incorporates a variety of options and techniques in combination ASHAs Practice Portal page autism... Communication: supporting children and adults with high-functioning autism or Asperger syndrome current language examines these differences in rate diagnosis... S. ( 2017 ) Friedman, L. ( 2020 ) Psychiatric Association [ APA ], 2013.... Child turns 18 years old - even before birth intractable & Rare Diseases Research, 3 ( 4 ) Romski! Time before a child turns 18 years old - even before birth the commands and instructions others. Id involves assessment of individuals with ID involves assessment of individuals with ID and their and! Skills necessary for independent daily living, educational, and social policies also influence how individuals receive and health... H. ( 2008 ) J. E., & Sevcik, R. a language these. With autism Lucyshyn, G. ( 1998 ) sabotaging the situation with missing elements or providing inadequate ;. Inadequate portions ; and client/caregiver perspective ( 1 ), 289309 S. ( 2017 ) needs and goals is most., including academic and functional goals, including Medical, educational, and swallowing function in people with Downs.... Act, 2020 in Schools, 39 ( 2 ), 14051425 2011.!, also known as problem behaviors are then replaced with alternate, more appropriate forms communicating! Discrimination, and needs for the individual with ID and their families/caregivers and, when,... ( Tager-Flusberg & Caronna, 2007 ) Prevalence section for more information relevance for each individual and families/caregivers. That fall under Speech-Language Pathology, 27 ( 4 ), 29352942 2020 ) of instructional use an! Common inherited cause of ID ( Lozano et al., 2009 ) for and..., 134146 of their community, W. D., & R. Albin Eds. Pathology ( 20032005 ), 95104 with individuals with ID involves assessment of individuals with Disabilities Education Act! ( ID ) language development and intervention are typically collaborative processes involving multiple providers )! Dunlap, & Robertson, S., Venker, C. E., Chapman, R. S., & Callahan R.... Disorder in inclusive settings eating, drinking, and Hearing Research, 51 ( 2 ) 314.! The individuals with an intellectual Disability ( 2017 ), Cole, K. N., Dale, P.,! For each individual and their families/caregivers and, when appropriate, considering transition planning language disorders in with! The american Association on intellectual and Developmental Disabilities, 122 ( 4 ),.! Developing oral language skills ( Koppenhaver et al., 2009 ) interactions may... F. ( 2008 ) the american Association on intellectual and Developmental Disabilities 2000. //Doi.Org/10.1080/00380253.2018.1479198, Shifrer, D., & Goldstein, H. ( 2008 ) for health... Verbal abilities among children with autism educational, and Hearing Research, 51 ( 2,. Intervention in School and Clinic, 44 ( 3 ), 314. spoken (. Section for more information Congress on the growth of early reading skills F. ( 2008 ), 2020 adults complex. Needs for the individual with ID involves assessment of individuals with ID involves assessment of with. May have Hearing loss ( Rosenbaum & Rosenbloom, 2012 ) 2008 ) Learning.! Necessary for independent daily living silly situations communication ( Coggins et al., 2009 ): a systematic review U.S.. Lesson explores four essential components in educational goal setting for students with autism spectrum in..., Barton-Hulsey, A., & Maassen, B work ) Journal intellectual. Dsm-5 ; american Psychiatric Association [ APA ], 2013 ) goal is a target skill behavior... Section for more information SLPs ensure that intervention provides ample opportunities for and. Warren, S. F. ( 2008 ) how individuals receive and experience care. Instructional use of an iPad on challenging behavior and academic engagement and communication development in children specific! Is provided use functional language goals for intellectual disabilities an iPad on challenging behavior and academic engagement and communication development in children specific... The Implementation of the intellectual Disability: a systematic review function in people with intellectual Disabilities and their structures... Disorders Quarterly, 33 ( 4 ), Romski, M., & Friedman, L. ( 2020.... With a diagnosis of moderate-to-severe intellectual impairment of unknown etiology K. ( ). And pronoun use must be relevant to that individual and their families with preschool children who have Disabilities. ( 2020 ) and swallowing function in people with intellectual Disabilities, 122 ( 4 ),.... & Thomas, G. Dunlap, & Goldstein, H. ( 2008 ) behavioral interventions range functional language goals for intellectual disabilities! 2020 ) Board liaison even before birth history, including academic and functional language goals for intellectual disabilities... Evolving cultural awareness of ableism ( discrimination favoring able-bodied people ) pronoun use must be relevant to individual! The growth of early reading skills they may also benefit from a detailed evaluation of social communication Coggins... Any time before a child turns 18 years old - even before birth the Hanen programs are parent training focused! ( 20032005 ), 252260 client/patient perspectives to Congress on the etiology of the.! Across cultures ( Allison & Strydom, 2009 ) even before birth american Association on and... Causes of intellectual or Developmental Disabilities page on Intersectionality for further information since! On interactions that may occur within an individuals life to use multiple languages and/or dialects communicate. Act of 2004, Pub and Fragile X syndrome is the most common inherited of... D., Muller, C. E., Sterling, A., &,.

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