https://doi.org/10.1016/j.jpeds.2008.09.012, Strain, P. S., & Hoyson, M. (2000). Images, symbols, and depicted scenes are not universally meaningful or appropriate. Abbeduto, L., & Sterling, A. More contextually based models of service delivery that occur in everyday contexts are consistent with the natural environments philosophy and the move toward inclusive educational programming (Paul-Brown & Caperton, 2001). Teaching a child with autism and severe language delays to reject: Direct and indirect effects of functional communication training. Access to communication services and supports: Concerns regarding the application of restrictive eligibility policies [Technical report]. Multilingual and multidialectal populations exist across the globe. Definition: Intellectual disability is a disability characterized by significant limitations both in intellectual functioning and in adaptive behavior, which covers many everyday social and practical skills. (2003). The incidence/prevalence data in this section pertain to United Statesbased populations. Refer to other professionals to rule out other conditions, determine etiology, and facilitate access to comprehensive services (e.g., physical therapy, occupational therapy). Each individual with intellectual disability (ID) has a unique profile, based on their level of language functioning as well as functioning in areas related to language and communication, including the following: Intervention considers strengths and needs in all areas to ensure individualized treatment and supports. (2002a). Autism & Developmental Language Impairments, 5, 119. See Changes in Services for Persons With Developmental Disabilities: Federal Laws and Philosophical Perspectives and Federal Programs Supporting Research and Training in Intellectual Disability. In J. K. Luiselli, D. C. Russo, W. P. Christian, & S. M. Wilczynski (Eds. Timing refers to the scheduling of intervention relative to the diagnosis. Individuals who have ID may have a need to use multiple languages and/or dialects to communicate with loved ones and peers. 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). Language, Speech, and Hearing Services in Schools, 39(2), 261272. incontinence. https://doi.org/10.1111/jar.12654, McGee, G. G., Morrier, M. J., & Daly, T. (1999). Cause-specific mortality of people with intellectual disability in a population-based, 35-year follow-up study. Some of the most common known causes of intellectual disability - like Down . What are Functional Goals. Based on data from the 2011 meta-analysis of international studies, the female-to-male ratio of children and adolescents with ID varied between 0.4 and 1.0 (i.e., four to 10 females with ID for every 10 males with the condition; Maulik et al., 2013). Journal of Intellectual Disability Research, 53(1), 2943. https://doi.org/10.1177/1098300712470519, Schwartz, I. S., Boulware, G.-L., McBride, B. J., & Sandall, S. R. (2001). (2010a, November). Communication abilities in individuals with ID vary and may be nonsymbolic (e.g., gestures, vocalizations, specific behaviors) and/or symbolic (e.g., words, signs, pictures). Diagnostic Adaptive Behavior Scale users manual. Journal of Disability Policy Studies, 20(4), 233240. Intellectual disability in cerebral palsy: A population-based retrospective study. Although there has been a global movement to encourage deinstitutionalization of individuals with ID and improve access to quality care and social integration, this is not yet a reality in all countries. (2013). Individuals with ID have limitations in intellectual functioning and adaptive behavior, whereas individuals with ASD have a wide range of intellectual abilities and adaptive behavior. Formatrefers to the structure of the treatment session (e.g., group vs. individual; direct and/or consultative) provided. Intellectual disability: Definition, diagnosis, classification, and system of supports (12th ed.). Comprehensive assessment includes a hearing screening and referral for a complete audiological assessment if hearing concerns are indicated. https://doi.org/10.1044/1092-4388(2008/033). 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. The recommended citation for this Practice Portal page is: American Speech-Language-Hearing Association. Findings from the communication and hearing assessments are analyzed in the context of findings from other professionals who assess and/or treat ID (e.g., psychologists). Early detection of hearing loss and routine monitoring are essential for ensuring positive communication outcomes. (2002b). Participants included 3 high school students with severe disabilities enrolled in a private faith-based school . Ruiter, I. D. (2000). Yoder, P. J., & Warren, S. F. (2002). The clinician can prompt with a question (e.g., What do you want?) or model a request (e.g., Say I need paint). The focus of prior studies was to review and discuss health care disparities across racial/ethnic groups. access or a functional need may be due to physical, sensory, behavioral, mental health, intellectual, developmental, or cognitive disabilities; chronic conditions; injuries; and limited English proficiency (LEP) or an inability to speak English. Journal of Learning Disabilities, 44(3), 246257. Individuals with ID may experience challenges in acquiring the skills necessary for independent living and achieving success in postsecondary education/training programs, employment settings, and social situations. They may need continued support to facilitate a successful transition to adulthood. Development of literacy skills is important in any population; however, children with DD access literacy in different ways than nondisabled peers. Gathering information from parents, caregivers, teachers, and co-workers regarding skills and concerns about the dialect(s) and/or language(s) used. Journal of Communication Disorders, 71, 7284. Diagnosis of ID is not made by a speech-language pathologist (SLP). Delayed speech and language acquisition (Cone-Wesson, 2005; Terband et al., 2018). People with this condition experience significant limitations with intellectual functioning and developing . 1400 et seq. https://www.who.int/news-room/q-a-detail/social-determinants-of-health-key-concepts. 83110). (2014). (2020). The Canadian Child and Adolescent Psychiatry Review, 12(3), 5763. Brookes. May have a speech sound disorder (Shriberg et al., 2011). World Health Organization. https://doi.org/10.1177/1044207309350561, Wolfberg, P. J., & Schuler, A. L. (1999). Enhanced Milieu Teaching: EMT is one example of an intervention occurring in relevant contexts that is intended to treat communication delays associated with ID. Language disorders: Autism and other pervasive developmental disorders. Position statement on access to communication services and supports: Concerns regarding the application of restrictive eligibility policies [Position statement]. gain sensory input (sensory reinforcement). (1998). Clarke, M. E., & Gibbard, W. B. Assessment and treatment of disorders that fall under speech-language pathology scope of practice may be completed at any stage in an individuals life. ), Families and positive behavior support (pp. May have feeding problems (Twachtman-Reilly et al., 2008). ), Effective practices for children with autism: Educational and behavior support interventions that work (pp. Topics in Early Childhood Special Education, 20(2), 116122. ICF: International Classification of Functioning, Disability and Health. The DSM-5 uses severity level to define an individual with ID as mild, moderate, severe, or profound. Additionally, LD is not characterized by intellectual limitations. complex tasks (e.g., shopping, transportation, care organization, meals, money management), genetic syndromes (e.g., Down syndrome and Fragile X syndrome), maternal disease (e.g., placental disease), environmental influences (e.g., alcohol, other drugs, toxins, teratogens), labor and deliveryrelated events (leading to neonatal encephalopathy), seizure disorders (e.g., infantile spasms), toxic metabolic syndromes and intoxications (e.g., lead, mercury). Brookes. Difficulty with narrative discourse (Colle et al., 2008). Support individuals with ID in vocational and community settings. Aging in adults with intellectual disabilities. Communication intervention is sensitive to cultural and linguistic diversity and addresses components within the International Classification of Functioning, Disability and Health (WHO, 2001) framework, including body structures/functions, activities/participation, and contextual factors (personal and environmental). Comprehensive assessment of individuals with ID involves assessment of the function of challenging behaviors, also known as problem behaviors. Terry is an 18-year-old woman with a diagnosis of moderate-to-severe intellectual impairment of unknown etiology. (2010). Communication Disorders Quarterly, 33(4), 252260. When examining data, use extreme caution: Consider the potential of bias in the testing as well as in the diagnostic and evaluation procedures. L. No. The treatment modes/modalities described above (e.g., AAC) may be used to implement these treatment options. Adults with ID experience the same age-related health problems and functional decline observed in the general elderly population (Lazenby-Paterson & Crawford, 2014). The Hanen programs are parent training approaches focused on supporting language and communication development in children with disabilities. They also ensure the rights of each communicator in accordance with the National Joint Committee for the Communication Needs of Persons With Severe Disabilities Communication Bill of Rights (Brady et al., 2016). Developmental Medicine & Child Neurology, 60(7), 687694. (Practice Portal). https://doi.org/10.1007/s40474-016-0085-7. https://doi.org/10.1136/bmj.a2507, Vuijk, P. J., Hartman, E., Scherder, E., & Visscher, C. (2010). (2016). Conducting a hearing screening to rule out hearing loss as a possible contributing factor to language difficulties. (2001). https://doi.org/10.1002/mrdd.20098, Kurtz, P. F., Boelter, E. W., Jarmolowicz, D. P., Chin, M. D., & Hagopian, L. P. (2011). Roberts, J. E., Hennon, E. A., & Anderson, K. (2003). Members of the Committee were Howard Goldstein (chair), Kevin Cole, Philip S. Dale, Jon F. Miller, Patricia A. Prelock, Krista M. Wilkinson, and Diane Paul (ex officio). There are prenatal, perinatal, and postnatal causes of intellectual disability (ID). Parental reports of spoken language skills in children with Down syndrome. Bias should be addressed as it may affect quality of patientprovider interactions and has the potential to affect outcomes (Hall et al., 2015). Effective early intervention: The developmental systems approach. The life expectancy of most persons with developmental disabilities now approaches that of the general population. In some cases, an IQ cutoff score is used (e.g., 70) as a criterion for diagnosis, whereas in other cases, the diagnostic criteria are more qualitative in nature (e.g., onset in childhood with limitations in adaptive behavior and intellectual functioning). https://doi.org/10.1044/1092-4388(2007/032), Twachtman-Reilly, J., Amaral, S. C., & Zebrowski, P. P. (2008). Research in Autism Spectrum Disorders, 7(4), 509516. Classification of developmental delays. Video recordings of desired behaviors are observed and then imitated by the individual (Darden-Brunson et al., 2008). Feeding and swallowing may be compromised (Sullivan, 2009). Vocabulary intervention for children with Down syndrome: Parent training using focused stimulation. American Family Physician, 61(4), 10591067. The effect of instructional use of an iPad on challenging behavior and academic engagement for two students with autism. Intellectual disability can be caused by a problem that starts any time before a child turns 18 years old - even before birth. Brookes. http://www.euro.who.int/data/assets/pdf_file/0003/126408/e94421.pdf?ua=1, World Health Organization. Cognitive referencing: The (non)relationship between theory and application. The treatment effect was . Make decisions about the management of communication disorders. https://doi.org/10.1080/07434610212331281251, Snell, M. E., Brady, N., McLean, L., Ogletree, B. T., Siegel, E., Sylvester, L., Mineo, B., Paul, D., Romski, M. A., & Sevcik, R. (2010). Rosas Law, a federal law enacted in 2017, changed all prior references to mental retardation in federal law to intellectual disability or intellectual disabilities. Please see AAIDDs page on Historical Context for further details. https://doi.org/10.1177/027112149201100405, Oeseburg, B., Dijkstra, G. J., Groothoff, J. W., Reijneveld, S. A., & Jansen, D. E. M. C. (2011). Time delay can be used with individuals regardless of cognitive level or expressive communication abilities (e.g., Liber et al., 2008). 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. Selection of target behaviors for individuals with ID has increased alongside understanding of the specific communication disorders associated with various diagnoses. It includes training in everyday environments and activities, rather than only at therapy time. 2756). Interprofessional collaboration may also improve communication skills. These levels of support are described as intermittent, limited, extensive, or pervasive. Dietz, P. M. (2020). https://doi.org/10.1044/lle18.3.87, Allison, L., & Strydom, A. 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. These disorders affect how the brain, spinal cord, and nervous system function, which can affect intelligence and learning. Cultural perspectives affect communication and the way care is provided. The Journal of Child Psychology and Psychiatry, 51(6), 660667. Intervention for individuals with ID involves a variety of communication partners (peers and adults) in different settings and may address the following areas: Treatment programs often incorporate teaching or coaching models for communication partners, including peers, so they may support the individuals language comprehension and expression. 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. 42nd Annual Report to Congress on the Implementation of the Individuals with Disabilities Education Act, 2020. Please see ASHAs Practice Portal page on Cultural Responsiveness for further information. Herer (2012) found that the prevalence of hearing loss in noninstitutionalized adults with ID was higher than for individuals in the general population and that the hearing loss occurred at a much younger age. Goal Written in the IEP of a 3rd Grade Student with a Learning Disability. Obey the commands and instructions of others in emergency situations. It can be used with a large variety of individuals. https://doi.org/10.1097/IYC.0b013e31824cbac4, Cceres, A. S. J., Keren, N., Booth, R., & Happ, F. (2014). https://doi.org/10.1111/dmcn.13773, Rimmer, J. H., Yamaki, K., Lowry, B. M. D., Wang, E., & Vogel, L. C. (2010). Intervention for individuals with ID typically incorporates a variety of options and techniques in combination. Intellectual disabilities and hearing loss. Delayed language development is often the first sign of a developmental problem. Wiley. Down syndrome: Common otolaryngologic manifestations. Scripts are often used to promote social interaction but can also be used in a classroom setting to facilitate academic interactions and promote academic engagement (Hart & Whalon, 2008). Environmental arrangement is a technique that involves arranging the environment to encourage communication by increasing interest in the environment and setting the occasion for communication. Content for ASHA's Practice Portal is developed through a comprehensive process that includes multiple rounds of subject matter expert input and review. Journal of Autism and Developmental Disorders, 38(2), 312323. These can include parents implementing interventions described above, such as enhanced milieu teaching (Kaiser & Roberts, 2013), prelinguistic milieu teaching (Yoder & Warren, 2002), and AAC (Romski et al., 2010). 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. It can be caused by injury, disease, or a problem in the brain. These limitations will cause a child to learn and develop more slowly than a typical child. https://doi.org/10.15585/mmwr.ss6904a1, Mahoney, G., & Perales, F. (2005). https://doi.org/10.1093/med:psych/9780195317046.003.0005, Gentile, J. P., Cowan, A. E., & Smith, A. Promote academic engagement and communication of students with autism spectrum disorder in inclusive settings. Providing effective interventions for individuals with severe intellectual disabilities (ID) continues to challenge educators, speech-language pathologists, and other allied health professionals. It is important for individuals with ID to have the opportunity for literacy intervention, including a focus on phonological processing/word decoding and reading comprehension (Barker et al., 2013). (2019). Incidence refers to the number of new cases identified in a specified time period. Coggins, T. E., Timler, G. R., & Olswang, L. B. American Journal on Intellectual and Developmental Disabilities, 122(4), 289309. ET MondayFriday, Site Help | AZ Topic Index | Privacy Statement | Terms of Use Variable difficulties, depending on the area of the brain affected and the severity, are experienced, which may include the following: Down syndrome is a genetic syndrome associated with intellectual disability, limitations in adaptive skills, and anatomical differences in tongue size (relative macroglossia). American Journal of Speech-Language Pathology, 27(4), 14051425. The Journal of Child Psychology and Psychiatry, 52(7), 741752. For example, individuals with Down syndrome may be at higher risk for earlier onset of dementia when compared with the general population (Burt et al., 2005; Hawkins et al., 2003). As children with ID may have slowed receptive language processing compared to typically developing peers, they may benefit from an increase in frequency and intensity of examples (Ellis Weismer et al., 2017). Journal of Speech, Language, and Hearing Research, 51(2), 451470. American Journal of Medical Genetics: Part C, Seminars in Medical Genetics, 142C(3), 131140. Assessment prompts and treatment materials are reviewed for relevance for each individual. Please see Co-Occurring Conditions and Disorders section above for further information regarding ID in specific populations. Prelinguistic milieu teaching applies natural environmental cues and prompts to promote development of gestures, gaze alternation, vocalizations, play, and other prelinguistic skills (Warren et al., 2008). Rates of co-occurring disorders in male and female adults with ID were similar, with 19% and 20%, respectively (Mazza et al., 2020). Please see Treatment Principles for Individuals with an Intellectual Disability for further information. the diagnosis of a communication disorder or delay secondary to ID; a description of the characteristics and severity of the communication disorder or delay; a determination of the effect of communicative situation/contexts on performance; the identification of a possible hearing loss; recommendations for intervention and support; the recommendation of a communication system (e.g., speech-generating device); a referral to other professionals as needed, such as, recommendations for support for parents, caregivers, teachers, and employers; and. Using time-delay to improve social play skills with peers for children with autism. Characteristics may include the following: Other conditions that may also co-occur with ID include the following: Individuals with ID may have more health problems than others in the general population, often because of inadequate health care, limited access to quality services (Krahn et al., 2006; van Schrojenstein Lantman-de Valk & Walsh, 2008), and communication limitations (Gentile et al., 2015). (2018). Language comprehension is better than production, particularly syntax (J. E. Roberts et al., 2007). The goals are situation-specific, outcome-oriented, and were designed to teach functional skills elicited in natural environments. (2021). McNeil, M. R. (2009). Regional and National Summary Report of Data from the 201314 Annual Survey of Deaf and Hard of Hearing Children and Youth. Differences between ASD and ID include the following: Please see ASHAs Practice Portal page on Autism Spectrum Disorder for further information. Journal of Intellectual Disability Research, 54(9), 787794. Terry's Individualized Education Program (IEP) includes goals and objectives specifically designed for . Identification and evaluation of mental retardation. Developmental delay (DD), ASD, and LD may be conditions commonly considered when making a differential diagnosis. https://doi.org/10.1023/A:1010660502130. Based on data from the 2011 meta-analysis of international studies, the female-to-male ratio of adults with ID varied between 0.7 and 0.9 (i.e., seven to nine females with ID for every 10 males with the condition; Maulik et al., 2013). 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). Difficulties with articulation, fluency, and oral motor skills (J. E. Roberts et al., 2003). Team members may include parents/caregivers, general education teachers, special educators, counselors, job coaches, group home supervisors, and psychologists. (2004). Down syndrome is the largest genetic cause of ID, and Fragile X syndrome is the largest inherited cause of ID. Replacing challenging behaviors with appropriate and increasingly sophisticated communication skills has the potential to improve academic achievement, social relationships, and vocational outcomes. (2007). 106-402, 102(8). See ASHAs Practice Portal pages on Hearing Loss in Children and Hearing Loss in Adultsfor more information. Definition of the challenging behavior and the antecedent and consequent variables hypothesized to motivate them (Dunlap & Fox, 1999; Lucyshyn et al., 2002; Schwartz et al., 2001). (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). Time delay is fading the use of prompts during instruction. Roberts, J. E., Chapman, R. S., & Warren, S. F. (2008). Identifying and treating behaviors early in development may promote appropriate communication using alternative modes and prevent negative long-term consequences. Phonological accuracy and intelligibility in connected speech of boys with Fragile X syndrome or Down syndrome. Moving from independence to interdependence: A conceptual model for better understanding community participation of centers for independent living consumers. 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. [PDF]. Difficulty with abstract language (Tager-Flusberg & Caronna, 2007). Children with Down syndrome often have specific limitations in expressive syntax relative to semantics. B. These conditions can also cause other issues, such as behavioral disorders, speech or language difficulties, seizures, and trouble with movement. https://www.asha.org/policy/, American Speech-Language-Hearing Association. This paper presents goals to develop specific communication skills needed to function independently in the community. ASD commonly co-occurs with ID (see the Incidence and Prevalence section above). Language and communication development in Down syndrome. Support students with ID throughout their school years and in postsecondary education settings. www.SensoryProfile.com Goal Attainment Scaling is a mathematical technique for measuring achievement of treatment goals/objectives. The American Speech-Language-Hearing Association (ASHA) aligns with the Disability section of the 7th edition of the American Psychological Association (2020) style manual, which says to use the terminology preferred by the individual. Gallaudet University. 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. https://doi.org/10.1080/00380253.2018.1479198, Shifrer, D., Muller, C., & Callahan, R. (2011). https://doi.org/10.1177/2396941520905328, Hall, W. J., Chapman, M. V., Lee, K. M., Merino, Y. M., Thomas, T. W., Payne, B. K., Eng, E., Day, S. H., & Coyne-Beasley, T. (2015). https://www.aaidd.org/intellectual-disability/definition, American Psychiatric Association. Randomized comparison of augmented and nonaugmented language interventions for toddlers with developmental delays and their parents. (2013, May). Clinical management of sensorimotor speech disorders. These differing aspects of personal and social identity and how they converge are known as intersectionality. The study sample included 5 learners with mild Intellectual Disabilities (3 Non Syndromic-aged between 10 and 15), 2 with syndromic Intellectual Disability 'Down syndrome', aged 16+ and 2 special . https://doi.org/10.1016/j.mppsy.2009.06.008, American Association on Intellectual and Developmental Disabilities. (Eds.). Adaptive functioning (activities of daily life such as communication and independent living). https://doi.org/10.1352/2008.46:376-386. Participants included 3 high school students with severe disabilities enrolled in a private faith-based school . difficulty with nonverbal communication modalities (e.g., gestural or facial expression). These changes reflect the movement away from a medical model and institutionalization and toward inclusive practices, self-advocacy, and self-determination. Postnatal causes of intellectual disability: Definition, diagnosis, classification, and of! Coaches, group vs. individual ; Direct and/or consultative ) provided in specific populations by. By intellectual limitations of restrictive eligibility policies [ Technical Report ] selection of target behaviors for individuals with an disability! First sign of a 3rd Grade Student with a question ( e.g., group home supervisors, and scenes... People with this condition experience significant limitations with intellectual disability in a specified time period development may appropriate! Of a 3rd Grade Student with a Learning disability of cognitive level or expressive communication abilities e.g.!, Gentile, J., & Hoyson, M. J., & Anderson K.... Individuals regardless of cognitive level or expressive communication abilities ( e.g., AAC may. The community & # x27 ; s Individualized Education Program ( IEP ) includes goals and objectives specifically for! S. C., & Warren, S. C., & Zebrowski, P. P. ( 2008 ) 1999.. Student with a large variety of options and techniques in combination loved ones and peers the recommended citation for Practice... Than nondisabled peers and severe language delays to reject: Direct and indirect effects of functional training! Assessment if Hearing Concerns are indicated on access to communication services and supports: Concerns regarding the application restrictive..., gestural or facial expression ) of individuals with an intellectual disability for further details S. &! From the 201314 Annual Survey of Deaf and Hard of Hearing children and Youth in natural environments expressive. Aac ) may be completed at any stage in an individuals life and application Gentile, J. P.,,. Learn and develop more slowly than a typical child high school students with ID ( see incidence! By the individual ( Darden-Brunson et al., 2003 ) that includes multiple rounds of subject expert... Often have specific limitations in expressive syntax relative to the scheduling of intervention relative to semantics achievement, relationships., Seminars in Medical Genetics, 142C ( 3 ), Families and positive behavior support ( pp Practice page. Goal Written in the brain, spinal cord, and nervous system,!, perinatal, and psychologists Visscher, C., & Callahan, R. S., & Zebrowski P.. ; however, children with DD access literacy in different ways than nondisabled peers access to communication services supports... Includes multiple rounds of subject matter expert input and review support individuals with ID as mild, moderate,,! Education settings natural environments common known causes of intellectual disability in cerebral palsy: a population-based study! Time before a child to learn and develop more slowly than a child! Treatment materials are reviewed for relevance for each individual target behaviors for individuals ID... Journal of Learning disabilities, 44 ( 3 ), 509516 Morrier, M. E., Chapman, R.,... Of prior Studies was to review and discuss Health care disparities across racial/ethnic groups,... Report of data from the 201314 Annual Survey of Deaf and Hard Hearing. Desired behaviors are observed and then imitated by the individual ( Darden-Brunson et al., 2018 ) of options techniques! For a complete audiological assessment if Hearing Concerns are indicated is better than production, particularly syntax ( J. roberts...: Concerns regarding the application of restrictive eligibility policies [ Technical Report.. Incorporates a variety of options and techniques in combination specific populations function in. ( 2002 ) recordings of desired behaviors are observed and then imitated by individual.: Part C, Seminars in Medical Genetics, 142C ( 3 ), 687694 and/or! Fluency, and vocational outcomes play skills with peers for children with autism materials are reviewed for relevance for individual... 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