I.

Autism is a complex developmental disability that typically appears during the first three years of life. is the result of neurological disorder that affects the functioning of the brain, autism and its associated behaviors have been estimated to be four times as prevalent in boys than girls and knows no racial, ethnic or social boundaries. it affects about one out of every 500 Filipino children. in the past, autism was thought to be a mental illness caused by bad parenting. Autism spectrum disorders are a variety (or spectrum) of related disorders that affect childs social development and ability to communicate and that include unusual behavioural manifestations such as repetitive motor movements.

The early identification of these children is made possible through a few tasks provided to paediatricians, who are often the first professionals to come into contact with the family. Children with autism have difficulty with pretend play (such as pretending to drink from a teacup), or imitating adult behaviour (rapping on the table), or pointing to objects on request (point to the dog). The failure to respond well in these instances is often the cue to enter into a more comprehensive examination of child and family.

Special Characteristics of Children with Autism: THEORY OF MIND One of the indicators of a fundamental developmental disability in autistic children has been lack of a theory of mind, the ability of human beings to understand the thinking and feelings of other people. It is necessary for understanding, predicting, and shaping the behaviour of others. HYPERSENSITIVITY TO SENSORY STIMULI One of the characteristics shared by many persons with autism is a hypersensitivity to noises in the environment. It almost seems as if they have lost the ability to modulate sounds, as these sounds come through terrifying impact. MOTOR SKILLS Children on the autism spectrum also have difficulty with a range of motor skills-such as gross motor skills (such as running and jumping), fine motor skills, and motor planning (moving ones body in space).

Although children with ASD may meet motor milestones on time, the quality of the childs movements can appear stiff or clumsy.

II.

IDD

IDEA: -significantly sub-average general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period that adversely affects a childs educational performance.

AAMR: -a particular state of functioning that begins in childhood and is characterized by limitation in both intelligence and adaptive skills.

A disability characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills. The disability originates before 18.

CAUSES: A. Genetic factors 1. Down Syndrome - most common and easily recognizable genetic disorders - occurs once in every 600-900 live births and result from genotype that features three copies of chromosome 21. - genotype is responsible or moderate retardation. 2. PKU Phenylketonuria (PKU) - a single gene defect that can produce severe retardation. - unusual genetic disorder in that it can be modified by environmental treatment- a special diet. - importance on this strict diet can be judged by the ff facts: - the earlier treatment begun, the les intelligence will be lost. - Children with PKU who abandoned the diet at school age suffer social and intellectual setbacks. 3. Fragile X Fragile X Syndrome - the leading cause of inherited developmental disability, results from a long mutation on the long arm of the X chromosome, and it affects about twice as many males as females- prevalence is about one in four thousand. - a wide range of individual planning and treatment based on a childs own profile and patterns of development.

B. Toxic agents 1. Fetal Alcohol Syndrome - produces moderate retardation and behavioral problems such as hyperactivity and inattention. Effects of Lead - ingesting heavy metals can result in severe consequences including IDD. -Many children have developed lead poisoning from eating the flaking lead-based paint often found in older buildings. C. Infection -three weeks after fertilization, the central nervous system is highly susceptible to disease. If the mother contacts rubella (German measles) during this time, her child will likely be born with IDD. D. Envi. Factors - Ignored or neglected infants who are not provided with the mental and physical stimulation required for normal development may suffer irreversible learning impairment.

-Children who live in poverty and suffer from malnutrition, unhealthy living conditions, abuse, and improper or inadequate medical care are at a higher risk. Characteristics of Children with IDD

Ability to Process Information -* The most obvious characteristic of a children who have mild or moderate IDD is their limited cognitive ability which means the ability to process information. These children may lag in language-related subjects by two to five grades. * Children who have IDD have problems in: - Central processing: classification of a stimulus through the use of memory, reasoning and evaluation.

- Classification: the organization of information; Less able to group things; They have difficulty in comparing and contrast - Memory problems: stem from poor initial perception of what info has been stored in a given situation. - Executive function: the decision-making function that controls attention. (a key factor in poor performances of children.)

Ability to acquire and use language * Language develops in the same fashion, only more slowly in children with IDD. * Children with down syndrome have retardation in language even lower than that of their general mental deficit. * Williams syndrome those with this kind of syndrome have advanced language beyond their general mental abilities. Ability to acquire emotional and social skills * Emotional and behavioral problems lower the level of social acceptance experienced by children with IDD. * A range of studies reveal many problems in peer relationships for children with IDD. With the current stress on inclusion, it becomes particularly important to find ways to improve the social relationships of the children with IDD as the formation of such relationships is one of the key purposes of inclusion. III. Hearing impairment Definitions Hearing Impairment A generic term indicating a hearing disability which may range in severity from mild to profound; It includes the subsets of deaf and hard of hearing. In education, a child who needs special services because of a hearing loss.

Deaf One whose hearing disability precludes successful processing of linguistic formation through information, through audition, with or without a hearing aid. Hard of Hearing One who, generally with the use of hearing aid, has residual hearing sufficient to enable processing of linguistic information through audition. Will need some necessary special adaptations to learn. Deafness means a hearing impairment that is so severe that the child is impaired in processing linguistic information through hearing, with or without amplification, that adversely affect a childs educational performance. Hearing impairment means an impairment in hearing, whether permanent or fluctuating, that adversely affects a childs education performance. Types of hearing loss Conductive hearing loss Problem with conducting sound vibes to the inner ear due to abnormalities and complications of the outer or middle ear. Sensorineural Hearing Loss Defects in the inner ear (cochlea) or auditory nerve Mixed Hearing Loss Problems in the outer, middle and inner ear (combination of sensorineural hearing loss); sounds are distorted Central Hearing Loss Damage in hearing receptions and pathways of the brain Congenital Present at birth Adventitious Acquired later in life Prelinguistic Acquired after the child had developed speech or language Unilateral Hearing loss in one year; generally learns speech and language without difficulties; difficulties in localizing sounds and listening in noisy places Bilateral Hearing loss in both ears Causes of congenital hearing loss Genetic Factors Maternal Rubella Congenital Cytomegalovirus Prematurity

Causes of Acquired Hearing LossOtitis Media

 Meningitis Mnires Disease Noise-Induction Hearing Loss Characteristics of Hearing Loss First, students who receive special education because of hearing loss comprise an extremely heterogenous group. It is a mistake to assume that a commonly observed behavioral characteristic or average level of academic achievement is representative of all children with hearing loss. Second, the effects of hearing loss on a childs communication and language skills, academic achievement, and social and emotional functioning are influenced by many factors, including the type and degree of hearing loss, the age at onset, the attitudes of the childs parents and siblings, opportunities to acquire a first language (whether through speech or sign), and the presence or absence of other disabilities. Third, generalizations about how deaf people are supposed to act and feel must be viewed with extreme caution Identification of Hearing Problems Symptoms that might indicate hearing impairment in the classroom: Tilting the head at an angle in order to receive a better sound Listless or inattentive behavior Failure to respond when questioned Defective articulation, particularly when sounding of words is important Peculiar voice quality, often high-pitched and flattish in nature Tendency to avoid association with other people Tendency to run words together Poor oral reading ability Discrepancy between academic performance and IQ scores Louder speech than would be indicated by the situation Tendency to watch the face of speaker with considerably greater attention Identification processes: Early detection Audiometric testing - pure-tone audiometry Educational assessment Communication and language assessments expressive and receptive vocabulary skills, non-linguistic language competence

 Intelligence and achievement testing An individuals hearing impairment is usually described by the terms slight, mild, moderate, severe and profound, depending on the average hearing level in decibels (dB), throughout the frequencies most important for understanding speech
Degree Faintest sound heard Slight loss 20 to 40 dB Effects on the understanding of language and speech May have difficulty hearing faint or distinct speech School difficulties are not usually present and can be remediated with careful seating near the teacher

Mild loss 40 to 60 dB Moderate loss 60 to 75 dB

Understands conversational speech at a distance of 3 to 5 feet (face to face) May miss as much as 50 percent of classroom conversations especially in noisy environments The child may have limited vocabulary and oral speech problems Can understand loud conversations only Is likely to have impaired speech and have difficulty in language used in comprehension Probably will have limited vocabulary Most often required special class placement or a resource teacher

Degree

Faintest sound heard

Effects on the understanding of language and speech

May hear loud voices 1 foot from ear May be able to identify environmental sounds May be able to discriminate vowels but not all consonants Speech and language likely to be impaired or deteriorate Speech and language unlikely to develop spontaneously if loss is present before 1 year of age Special education placement or special classroom placement are most likely May hear some loud sounds but senses vibrations more than tonal pattern Relies on vision rather hearing as primary avenue for communication Speech and language are likely to be impaired or deteriorate Speech and language unlikely to develop spontaneously if loss is prelingual

Severe loss

75 to 90 dB

Profound loss

91 db and up

Normal hearing will hear sounds between 0 and 20 dB with no difficulty and have no difficulty hearing in any conversational setting.

Effects of Hearing Impairment Language Development: At a great disadvantage in acquiring language skills The grammar and structure of English often do not follow logical rules Vocabularies are smaller and sentence structure simpler and more rigid Tend to write short, incomplete and improperly arranged sentences May omit endings of words such as - -s, -ed, -ing Difficulty in differentiating questions from sentences

On cognitive and Academic Performances: Most of them posses normal intelligence - they are not deficient or deviant in cognitive abilities. If they do not do as well as expected in acquiring reading, writing and literary skills, it is probably because the manner which they are being taught is inappropriate for them Excluding the effects of the amount, type or quality of instruction, other variables affect the academic achievement of hearing impaired students: Severity of the hearing loss Age at the onset Intelligence Familys socio-economic status Hearing status of parents

On social and psychological factors Behavior depends largely on other peoples attitudes and the childs ability to communicate in some mutually acceptable way Hearing impaired persons frequently express feelings of depression, withdrawal and isolation particularly those who experience adventitious loss Deaf children of deaf parents are thought to have higher levels of social maturity, adjustment to deafness, and behavioral self-control than do deaf children of hearing parents largely because of early use of manual communication between parents and child

Educational needs and programs

Degree Slight loss Mild loss

Probable Educational Needs and Programs May benefit from hearing aid as loss approaches to 40 dB Attention to vocabulary development Needs favorable seating and lighting May need speech reading instruction and speech correction Should be referred to special education evaluation for educational follow-up May benefit from individual hearing aid and training in its use Favorable seating and possible special education supports especially for primary age children Attention to vocabulary and reading May need speech reading instruction Speech conversation and correction

IV. Unimpaired Vision has four components: - The object to be viewed -The light that reflects from object to the eye - The normally functioning eye to receive the reflections - The occipital lobes of the brain to interpret the signals transmitted from the eye LEGALLY BLIND- indicates that a person has less than 20/200 vision in the better eye or a very limited field of vision 20/20 VISION-it is not synonymous to perfect vision. What it does indicate is that at a distance of 20 feet, the eye can see what a normally seeing eye should be able to see at that distance LOW VISION- individual who can generally read print although they may depend on optical aids FUNCTIONALLY BLIND- individuals who typically use braille for efficient reading and writing. They use their limited vision to supplement the combination of tactual and auditory learning methods TOTALLY BLIND- indicates complete lack of vision and dependence on Braille or other non visual media INDICATORS OF VISUAL IMPAIRMENT IN CHILDREN BEHAVIOR: Rubs eyes excessively

 Shuts or covers one eye, tilts head or thrusts head forward Has difficulty in reading or in other work requiring close use of the eyes Blink more than usual or is irritable when doing close work Stumbles over small objects Holds books close to eyes Unable to see distant things clearly Squints eyelids together or frowns APPEARANCE Crossed eyes Red rimmed, swollen eyelids Inflamed watery eyes Recurring sties COMPLAINTS Eye itch, burn or feel scratchy Cannot see well Dizziness Headaches following close eye work Nausea Blurred or double vision CAUSES OF VISUAL IMPAIRMENTS: Myopia- referred to as nearsightedness. This condition occurs when the rays of light from distant objects are not focused on the retina. The individual with this condition is able to see objects more clearly close up. Hyperopia- referred to as farsightedness. This condition occurs when the eye is too short and the rays of light from near objects are not focused on the retina. Individuals with this condition is able to see objects more clearly at a distance. Astigmatism- referred to as blurred vision. It is caused by uneven curvature of the cornea or lens. This curvature prevents light rays from focusing correctly on the retina. This condition can usually be corrected by corrective or contact lenses. Cataracts- a cloudiness in the lens of the eye, which blocks the light necessary for seeing clearly. Vision may be blurred, distorted, or incomplete.

 Glaucoma- a condition caused by the failure of the aqueous fluid to circulate properly. This results in an elevation of pressure in the eye, which may gradually destroy the optic nerve. Retinitis pigmentosa- an inherited disease that causes a gradual degeneration of the retina. This condition is not treatable. Diabetic Retinopathy- found in children and adults with diabetes. These individuals frequently have impaired vision due to hemorrhages and the growth of new blood vessels in the area of the retina. This results in a condition known as diabetic retinopathy. May be helped with laser surgery Ushers Syndrome- Results from a combination of congenital deafness and retinitis pigmentosa Macular degeneration- a fairly common disorder in which the central area of the retina gradually detriorates. The individual usually retains peripheral vision but loses the ability to see clearly in the center of the visual field Retrolental fibroplasia- a condition that results from the use of too much oxygen in the incubation of premature babies Aniridia (occular albinism)- lack of color in the iris of the eyes; leads to extreme sensitivity to light and reduced visual activity Strabismus- result of improper muscle functioning that causes either or both eyes to be directed inward; two separate images may be sent to the visual cortex of the brain Nystagmus- characterized by the rapid, involuntary movements of the eyes, usuallly laterally; movements like these make it difficult to focus upon objects and cause dizziness and nausea Visual cortex damage- can lead to visual insufficiency at many different levels; figure/ground discrimination problems Retinal Detachment- retina becomes separated from the outer layers of the eye tissue; causes interruption in the transmission of visual signals for the brain to interpret Retinal degeneration- can be the result of an infection or it may be inherited; underlying cause of deterioration is known Coloboma- retina is malformed; results in both visual field and visual acuity problems Optic nerve atrophy- cause the optic nerve to function less efficiently and results in reduced visual efficiency of many types Color vision problems- diminished ability to differentiate colors; have little or no effect to visual acuity Optic tumors- An optic nerve melanocytoma is a tumor made up of melanocytes and melanin. These tumors are typically a benign; they can grow, but rarely transform into a malignancy. Even so, local growth can affect adjacent tissues. CLASSIFICATION OF VISUAL IMPAIRMENTS: Moderate- the impairment can be almost entirely corrected with the help of visual aids; children can either learn in a regualr classroom or a resource room Severe- Necessary use of visual aids

 Profound- the child can no longer use vision as educational tool; touch and hearing are predominant channels of learning Blindness- loss of vision OPTHAMOLOGIST- a medical doctor who specializes in examining, diagnosing, and treating eyes and eye diseases. WHAT DO DOCTORS DO? Visual Acuity Test- a person reads an eye chart to measure how well he or she sees at various distances Visual field test- to measure side, or peripheral vision Tonometry test- determines the fluid pressure inside the eye to evaluate for glaucoma ASSISTIVE TECHNOLOGY Optical character readers (OCRs)- also known as scanners, these devices scan printed material and create a text file in a computer Screen readers- using synthesized speech, screen readers read the text that is displayed on a computer monitor as the user moves the cursor or inputs from the keyboard. Braille embossers- connected to a computer and used with a Braille translation software, a braille embosseds print a braille version of the text. Screen Enlargement and navigation systems- increases the size of the characters on screen; screen navigators help the user keep his or her place on the screen Closed circuit televisions (CCTVs)- magnify any object placed on the viewing platform for viewing on a monitor Note taking devices- have audio input; some create Braille on an electronic display V. LEARNING DISABILITY LEARNING DISABILITY

- children who are neurologically impaired, perceptually disordered, dyslexic, slow learner, remedial reader, and hyperactive. - defining learning disability is has thus been an evolving process over the past forty years. Causes: ACQUIRED TRAUMA

- used to describe injury or damage to the central nervous system or CNS that originates outside the person and results in learning disorders - depending on when the damage occurs, the trauma is identified as prenatal, perinatal, or postnatal - according to Mercer, these have been linked to learning problems in children Prenatal Causes:

- smoking -illicit drugs, alcohol Perinatal Causes: - prolonged and difficult delivery - anoxia - prematurity or low birth weight - trauma caused by medical instruments such as forceps Postnatal Causes: - strokes - concussions - meningitis/encephalitis - high fever - head injury resulting from GENETIC OR HEREDITARY FACTORS

- FAMILIALITY STUDIES- examine the tendency of certain condition to occur in a single family, suggest that reading difficulties and certain types of speech and language impairments are family related BIOCHEMICAL ABNORMALITIES

- FEINGOLD championed the view that allergic reactions to certain artificial colorings, flavorings and additives contained in many food products contribute to childrens learning problems and hyperactive behavior. ENVIRONMENTAL POSSIBILITIES

- low socioeconomic status, malnutrition, lack of access to health care, and other variables that may contribute to neurological dysfunction - equality of instructions that students receive - result of poor teaching - students labeled learning disabled have been seriously mis-taught. Learning disabilities are MADE not BORN.- Engelmann CHARACTERISTICS OF PERSONS WITH LEARNING DISABILITIES: Academic Performance Includes reading, mathematics, written language, spoken language, memory Metacognition- ability to evaluate and monitor ones own performance

Attribution- what individuals believe about what contributes to their success or failure on a task is known as attribution Social and Emotional problem Low self-esteem, and self-concept, most likely due to frustration with their learning difficulties Low in social competency and school adjustment Social-emotional difficulties of persons with learning disabilities may be the result of social imperceptiveness Attention problems and Hyperactivity Difficulty staying in task and completing assignments Difficulty in following instructions Difficulty in focusing their attention for a sustained period of time Easily distracted ATTENTION DEFICIT (HYPERACTIVITY) DISORDER- ADD/ADHD

- Attention Deficit Disorder (ADD) is a syndrome which is usually characterized by serious and persistent difficulties resulting in poor attention span, weak impulse control, hyperactivity VI. EMOTIONAL BEHAVIORAL DISORDERS emotional disturbance means a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a childs educational performance: - 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 or school problems In 1997, the term was replaced by serious emotional disturbance)

Characteristics Learning characteristics Social characteristics Externalizing and Internalizing behaviors Language or communication characteristics

Causes: Biological risk factors Environment factors - family factors - school factors Psychosocial risk factors - child maltreatment - depression, conduct disorder, post-traumatic stress disorder, delinquency, and ADHD - includes neglect, physical abuse, sexual abuse, and emotional abuse VII. Physical disabilities According to the Individuals with Disabilities Education Act (IDEA), a person with an orthopedic impairment, brain injury, or other health impairment who, by reason of that impairment, needs special education and related services is considered to have a physical disability. The condition must interfere with or substantially limit the childs ability to take part in routine school activities. A physical disability or health condition need not limit activity; instead, it may involve other restrictions, such as a special diet (i.e. celiac-disease) or the students need to use medical equipment. A physical disability is one that affects a person's mobility or dexterity. It also includes people who have lost limbs or who, because of the shape of their body, require slight adaptations to be made to enable them to participate fully in society. These individuals usually must rely on assistive devices which take advantage of their specific abilities and on their ability to use these assistive devices with standard products. Commonly used assistive devices include mobility aids (e.g., crutches, wheelchairs), manipulation aids (e.g., prosthetics, orthotics, reachers) communication aids (e.g., single switch-based artificial voice), and computer/device interface aids (e.g., eye gaze-operated keyboard).

Classification and Characteristics: Orthopedic Impairment involves the skeletal system; bones, joints, limbs and associated muscles Neurological Impairment involves the nervous system affecting the ability to move, use, feel or control certain parts of the body Whatever the cause, both impairments are frequently described in terms of the affected parts of the body Plegia derived from the Greek word to strike; often used in combination to indicate the location of limb involvement Quadriplegia all four limbs are affected are affected; movement of the trunk and face may also be impaired

Paraplegia motor impairment of the legs only Hemoplegia one side of the body Diplegia major involvement of legs, with less sever involvement of the arms Monoplegia only one limb is affected Triplegia three limbs are affected Double Hemiplegia major involvement of the arms, with less severe involvement of the legs

Types of Physical Disabilities Physical disabilities and health conditions are classified as either congenital or acquired. Students with congenital conditions either are born with physical difficulties or develop them soon after birth. Acquired disabilities are those developed through injury or disease while the child is developing normally. The age at which a condition develops often determines its impact on the child. Levels of Impairment Mild Handicap Independence in meeting physical needs Potential to improve the quality of motor and/or perceptual skills with therapy intervention Potential for regression in quality of motor and perceptual skills without intervention Moderate Handicap Some independence in meeting physical needs Functional head control Deformities, present or potential, that limit independent function or produce pain Perceptual and/or sensory-integrative deficits that interfere with achievement of academic and age-appropriate motor skills Severe Handicap Total dependence in meeting physical needs Poor head control Deformities, present or potential, that limit function or produce pain Perceptual and/or sensory: integrative deficits that prevent achievement of academic and age-appropriate motor skills CEREBRAL PALSY Cerebral means brain and palsy means disorder of movement Characteristics

 Most prevalent A long term condition resulting from a lesion to the brain or an abnormality of brain growth that causes a variety of disorders of movement and posture Can be treated but not be cured Does not progressively get worse as a child gets older Not fatal, not contagious, and not inherited in great majority classes Have disturbances of voluntary motor function: paralysis, extreme weakness, involuntary convulsion, lack of coordination May also have impaired vision or hearing as well as intellectual impairment Types of Cerebral Palsy Categories are according to muscle tone and quality of motor involvement Mixed Cerebral Palsy more than one type and impairments are severe a) Hypertonia Commonly classed spasticity Characterized by tens, contracted muscles Movement jerky, exaggerated, poorly coordinated Unable to grasp objects with fingers Walk scissors gait (standing on the toes with knees bent and pointed inward) Deformities of the spine, hip dislocation and structures of the hand, elbow, foot and knee are common

b) Hypotonia Weak, floppy muscles particularly in the neck and trunk Low levels of motor activity Slow to make balancing responses Must use external support to achieve and maintain upright position

c) Athetosis Large, irregular twisting movements that cannot be controlled May not be able to control muscles of the lips, tongue, throat and may drool

Seem to stumble or lunch awkwardly when walking Can experience extreme difficulty in expressive language, mobility and activities of daily living

d) Ataxia Have poor sense of balance and hand use May fall easily when not supported Movement jumpy and unsteady

e) Rigidity & Tremor Rigidity display extreme stiffness in the affected limbs; may be fixed an immobile for long periods Tremor marked by rhythmic, uncontrollable movements; tremors may increase when children attempt to control their actions

Spina Bifida A congenital defect in the vertebrae that encloses the spinal cord A portion of the spinal cord and the nerves that normally control muscles and feeling in the lower part of the body fail to develop normally Neural Tube Defect sometimes used to describe spina bifida

Muscular Dystrophy

Refers to a group of long term diseases that progressively weaken and waste away body muscles. Loses ability to walk by the age of 10 to 14 Osteogenesis Imperfecta A rare inherited condition marked by extremely brittle bones Children with this are fragile and must be protected As they mature, bones may become less brittle

Spinal Cord Injury Usually stem from accidents and generally described by letters and numbers indicating the site of the damage There is paralysis and loss of sensation below the level of injury

Traumatic Brain Injury Common causes: accidents, falls, gunshot wounds, assaults, child abuse Temporary and lasting symptoms cognitive and language deficits, memory loss, seizures and perceptual problems Coma an abnormal sleep tumor

Limb Deficiency

Absence or partial loss of an arm or leg congenital or acquired

Arthritis An inflammation of the joints which can lead to joint abnormalities that can eventually affect mobility Marfan Syndrome A genetic disorder in which muscles are poorly developed and the spine is curved heart and blood vessels are usually affected Polio Virus invades the brain and causes severe paralysis of the total body system Club Foot Various ankle or foot deformities twisting inward, sharply angles at the heel (calcanel valgus), part of the foot turned inward (metatarsus varus) Cleft Lip & Cleft Palate Openings of the lip or of the roof of the mouth that fall to close before birth; can be repaired through surgery Stroke (cerebral vascular accident; CVA) The three main causes of stroke are: thrombosis (blood clot in a blood vessel blocks blood flow past that point), hemorrhage (resulting in bleeding into the brain tissue; associated with high blood pressure or rupture of an aneurysm), and embolism (a large clot breaks off and blocks an artery). The response of brain tissue to injury is similar whether the injury results from direct trauma (as above) or from stroke. In either case, function in the area of the brain affected either stops altogether or is impaired. identification Activities of daily living evaluate the childs daily living potential; eating, drinking, dressing, toileting, personal hygiene, self-help skills; expanding skills cooking, housekeeping and self-transportation abilities

 Mobility assessment mobility skills and needs; appropriate therapy or education Physical abilities assessment physical actions performed; limitations that affect the child in the future; rehabilitation needs Psychosocial abilities assessment self-image; ability to initiate and maintain social relationships; adapting emotionally to a disability Communication assessment ability to understand language; speech; formulating thoughts Academic potential assessment intelligence testing; reading comprehension; skill testing; grade-level achievement tests Setting assessment modifications in the environment; accessibility and accommodations; space for equipment Assistive technology assessment