AEPA Special Education: Severely and Profoundly Disabled Exam

AEPA Special Education: Severely and Profoundly Disabled Practice Questions

1. Lee’s scoliosis is so severe that the OT in his residential facility had to build him a flatbed reclining wheelchair too wide to fit through the behavior specialists’ office door for IQ testing. Which is the best alternative location for testing?
A: The hallway outside Lee’s classroom
B: Lee’s living area upstairs in the facility
C: The inner hallway outside the office
D: Inside Lee’s classroom off in a corner

2. You have a population of multiply disabled students with profound mental retardation. In IQ testing, the scores you will report are most likely to be __________________________.

A: specific numbers below 55
B: below 20 but not specified
C: specific numbers below 40
D: below 30 but not specified

3. Children with Fetal Alcohol Syndrome (FAS) have symptoms that are ________________________.

A: physical
B: cognitive
C: behavioral
D: all of these

4. Fetal Alcohol Effects (FAE) compares to Fetal Alcohol Syndrome (FAS) in what way?

A: FAE has the same symptoms but not as severe.
B: FAE has the same symptoms but more severe.
C: FAE has several symptoms different from those for FAS.
D: These are synonymous, with identical symptoms.

5. Which of the following is true about the problems associated with Fetal Alcohol Syndrome as children grow older?

A: These problems tend to decrease as children grow older.
B: These problems tend to increase as children grow older.
C: These problems tend to stay the same as children grow.
D: These problems tend to vary greatly among individuals.

6. Which of the following is more likely to be diagnosed in a child rather than going unidentified?

A: Fetal Alcohol Syndrome (FAS)
B: Fetal Alcohol Effects (FAE)
C: Alcohol-Related Neurodevelopmental Disorder (ARND)
D: No one of these is more or less likely to be diagnosed.

7. Children with Alcohol-Related Neurodevelopmental Disorder (ARND) have ______________.

A: physical symptoms but not behavioral symptoms
B: developmental symptoms but not emotional ones
C: behavioral and emotional but not physical symptoms
D: physical/developmental but not emotional symptoms

8. Mary has spastic quadriplegia. The physician at her residential facility diagnoses her as having no functional grasp. The activity therapist disagrees. With much encouragement from the therapist whom she loves and several other favorite staff and by making a tremendous effort, Mary can reach and grasp an object for a few seconds, once per trial, on occasion. Who is correct?

A: The therapist is correct.
B: The physician is correct.
C: Neither of them is right.
D: It is impossible to know.

9. Eleni is a young adult who has profound symptoms of cerebral palsy with spastic quadriplegia and mental retardation. She has had training in a state residential facility for most of her life. She can point but not grasp. She can nod and shake her head. She can phonate and is able to holler with a loud voice when she wants to. She cannot form any specific speech sounds. Which kind of training would be most appropriate?

A: Gradual shaping of her phonations into phonemes, then syllables, then words, etc.
B: Voice therapy for building breath support and awareness and variation of loudness
C: Teaching her to operate a computer with a voice synthesizer to express her needs
D: A combination of yes-or-no questions and pointing to pictures for communication

10. Gerald has diagnoses of blindness, profound mental retardation, and self-injurious behavior. He is non-ambulatory. He has the manual ability to propel his wheelchair but prefers to let direct care staff push it as usual. He wears hand restraints most of the time to prevent self-injury, but with therapy, he can now go short time periods without them if supervised. Gerald loves music. What would be the best behavioral strategy incorporating this information?

A: Give him music with earphones and turn off the music any time he hits/attempts to hit himself.
B: Withhold music until he propels his chair for a specified distance, gradually increasing how far.
C: Rig the music to play only when he propels his chair; reward stationary non-injury with music.
D: Give Gerald a motorized wheelchair with buttons he can press while still wearing his restraints.

Answer key

1. C. The best alternative would be (c) the inner hallway outside the behavior specialists’ office. Being an inner hallway, it is likely to be quieter. During class hours, most professionals’ offices in this hall are empty as their occupants are doing training or monitoring in classrooms, making rounds, etc. In contrast, the hallway outside the classroom (a) is likely to be noisy during class times, with more traffic and less privacy. Lee’s living area upstairs (b) is farther away, requiring more transport time, and the behavior specialists would also have to bring all their testing materials, whereas these are much more accessible in their office when they are right outside of it. Inside the classroom, even off in a corner (d), is not a good location as the class activities can distract Lee from testing, and testing can disrupt the classroom activities and distract the students and teacher as well as violating the student’s privacy and confidentiality.
2. B. Scores for this population are most likely (b) below 20 but not specified. This is because it is impossible with existing test instruments to specify exactly any scores lower than 20. This level signifies profound mental retardation. Specific score numbers below 55 (a) would signify moderate mental retardation, going down to 40. Specific numbers below 40 (c) signify severe mental retardation, down to 25. Scores below 30 (d) are still in the range of severe mental retardation
3. D. Alcohol Syndrome includes symptoms that are (d) all of these. Physical (a) symptoms can include failure to thrive, a small head and eyes, flat cheekbones and philtrum, seizure disorders, dysfunctional organs, and poor fine motor coordination. Cognitive (b) symptoms include developmental delays, poor comprehension of language and concepts, inadequate memory and problem-solving skills, and a lack of curiosity and imagination. Behavioral (c) symptoms include attention deficit, impulsivity, hyperactivity, stubbornness, anxiety, and social withdrawal.
4. A. Fetal Alcohol Effects has the same symptoms as Fetal Alcohol Syndrome, but they are less severe (a) in FAE. Therefore the symptoms in FAE are not more severe (b). FAE does not have different symptoms from those of FAS (c). FAE and FAS are not synonyms with identical symptoms (d). The difference between the two is in the degree of the symptoms manifested.
5. B. Children’s problems related to FAS tend to increase as they grow older (b). They can develop into mental disorders, criminal behavior, and incapacity for living autonomously. Problems associated with FAS are not likely to decrease (a) or the child’s status to improve with age. Because they are likely to eventuate in more severe consequences with increasing age, problems from FAS do not tend to stay the same as children grow (c). Since the overall pattern of these problems is one of exacerbation with age, they do not tend to vary greatly among individuals (d) with respect to the way they change over time.
6. A. Alcohol Syndrome (a) is more likely to be diagnosed because its symptoms are more pronounced than the other conditions listed. Fetal Alcohol Effects (b) often goes undiagnosed in children because its symptoms are less severe than those of FAS. Alcohol-Related Neurodevelopmental Disorder (ARND) is a more recently discovered condition which has some but not all of the symptoms of FAS or FAE. It is also more likely to go unidentified than FAS is because the symptoms are fewer. Since (a) is correct, answer (d), no one of these, is incorrect.
7. C. Children with ARND have (c) behavioral and emotional symptoms, but not deficits in physical growth or delays in development. Their behavioral and emotional symptoms are the same kinds of symptoms seen in children with Fetal Alcohol Syndrome or Fetal Alcohol Effects. Thus they do not have physical symptoms without behavioral symptoms (a). They do not have developmental symptoms without emotional ones (b). They do not have physical/developmental symptoms without emotional symptoms (d).
8. B. Children with ARND have (c) behavioral and emotional symptoms, but not deficits in physical growth or delays in development. Their behavioral and emotional symptoms are the same kinds of symptoms seen in children with Fetal Alcohol Syndrome or Fetal Alcohol Effects. Thus they do not have physical symptoms without behavioral symptoms (a). They do not have developmental symptoms without emotional ones (b). They do not have physical/developmental symptoms without emotional symptoms (d).
9. D. The most appropriate method would be (d): combining yes-or-no questions, to which Eleni can respond by nodding or shaking her head and vocalizing, and pictures to which she can point to identify various objects, people, places, dates, times, emotions, etc. Trying to shape her phonations into speech sounds (a) would be unproductive because of her cerebral palsy and spasticity, which impair the brain’s control of speech mechanisms, depriving her of the strength and coordination she would need for articulating specific phonemes. Voice therapy (b) is not indicated as she can produce a loud voice. Building breath support helps weak voices, but Eleni has a strong voice. She also demonstrates awareness and variation of her vocal loudness by only being loud when she chooses. A computer with voice synthesizer (c) is likely to be cost-prohibitive in a state facility. Even if it could be procured, Eleni’s diagnosis of mental retardation might interfere with her ability to use it. Even if her cognitive ability is sufficient, her lack of fine motor skills would prohibit keyboard use; adaptations such as a touch screen with enlarged fields could get around this, but overall the computer would present more challenges than the simpler, inexpensive and practical method of yes/no questions and pointing, for which she already has the skills.
10. C. In this case, the most practicable strategy that addresses the most elements is (c) rigging the music to play when he wheels his own chair and also rewarding non-injurious behavior when he is not wheeling. Rewarding self-propelling is Differential Reinforcement of Incompatible Behavior (DRI)—keeping his hands on the wheels is incompatible with using them to hit himself. When he stops wheeling and the music stops, this creates negative punishment, i.e. the removal of a desirable stimulus. When he is not propelling, music can also reward his not self-injuring. Giving him earphones (a) is not a good idea as Gerald is blind, and he needs to hear staff’s verbal prompts and environmental sounds. Also, this option withdraws music for self-injury but does not address reinforcement for self-propelling. Making the music contingent on self-propelling for a given distance (b) is good for shaping the propelling behavior, but does not address the self-injury. A motorized wheelchair (d) would likely not be feasible for an individual with both profound mental retardation and blindness.

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