Condition: Severely Disabled/Multiple Disabilities

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Norms by Age Evaluation Suggested Goals Therapy

Definition:

Sometimes in our work, we come across a child who we might describe as severely disabled. This may be a child with multiple disabilities such as intellectual impairment, visual impairment, hearing impairment, motor impairments, etc. Or, it may be a child whose condition is so severe that it leaves him with very little in the way of communication skills. Developmental progress can be slow for these children but that doesn’t mean that we can’t help! Each of these children will have different needs so we’ll need to do some major problem-solving to figure it out. But these resources should get you started.

Keep in mind that our Facebook group and private Forum are great resources for these types of cases because we can help you brainstorm and hash things out. Many of our staff as well as our members have worked with severely disabled children before so we have a lot of ideas!

Developmental Norms:

When we work with children with a lot of disabilities going on, it can be hard to know where to start and what to work on. A great place to start is to look at developmental checklists. You can look at what skills the child currently has and which ones are missing. We often need to start with skills that are far below the child’s chronological age in order to meet them where they’re at. Try working first on the earliest-developing communication skills and move up the hierarchy from there.

Here’s a list of developmental norms for a variety of communication skills:

Developmental Checklists: 6 mos-8 yrs

Evaluation:

When you begin working with a child with multiple disabilities, a full communication evaluation should be conducted. A full medical history and background will be especially important with these children and all areas of communication should be considered in the evaluation. It is incredibly important to work closely with other professionals on the child’s team to get the full picture of all disabilities and limitations. Here are some additional resources that will help you with various aspects of evaluating this condition:

Report-Writing for Students with Significant Disabilities

This quick video will walk you through how to choose goals to target for children with significant disabilities and how to write your report regarding your findings.

Suggested Goals:

When working with children with severe disabilities, you’ll need to meet the child where he/she is at. Think about which communication skills would help the child the most in his/her environment. Here are some goals that may be helpful for children with multiple disabilities. You can click on one of the goals below to learn more. Or, scroll down to the therapy section for more in-depth resources and support for treating this condition.

Augmentative/Alternative Communication

Joint Attention

Establish and Maintain Joint Attention with Another Person

Following Directions

Follow 1-, 2-, and 3-Step Novel and Routine Directions

Functional Speech

Produce CV, VC, and CVC Words for Functional Communication

Therapy:

Here are some more resources and information that may help you when it comes to treating this condition.

Complex Communication Disorders Webinar Recording (Start Here!)

Overview of Therapy for Children with Multiple Disabilities

Kindergarten Options for Children with Severe Disabilities

Making Accommodations for Children with Other Impairments

Visual Impairment and Low Cognition – Therapy Ideas

Using Switches with Non-Ambulatory Children

Condition: Non-Speaking

This condition page includes links to all of our resources for working with children who are not speaking.

Condition: AAC User

Resources and tools for working with children who require augmentative/alternative communication (AAC).

Working with Children who are in Self-Contained or All Special-Education Classrooms

Working with Children with Intellectual Disabilities