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Reading and Students with Mental Retardation

Reading proficiency is considered a top priority in education, and a skill with myriad implications for learning and achievement in other areas. Yet in the past, literacy rarely has been emphasized for students with mental retardation. With interventions that recognize the importance of literacy for all students, students with mental retardation can build reading skills that can lead to new interests, increased competencies, and greater independence. Understanding the characteristics of students with mental retardation is an important step toward the development of effective instruction and appropriate assessment.

This paper is intended to begin a discussion of the issues surrounding reading and students with mental retardation; it is not intended to be a comprehensive research review. The paper provides: (1) an overview of the characteristics of students with mental retardation, (2) a description of common approaches to reading instruction, and (3) assessment approaches and issues that surround the assessment of reading for students with mental retardation.
The paper is one of several brief papers developed to contribute to the process of conducting research and developing accessible reading assessments for students with disabilities. Creating accessible reading assessments based on accepted definitions of reading and proficiencies of reading requires knowledge of the issues specific to each disability and how they affect reading and the assessment of reading. The information in these papers was obtained through a broad review of literature and Web sites of national agencies and organizations, along with input and feedback from professionals in the disability areas. Each paper is intended as a first step to facilitate discussions that include individuals who do not know the disability, in this case mental retardation, and those who may know the disability but have not considered the interaction of the disability with reading or the assessment of reading through statewide testing.

Students with Mental Retardation

More than 600,000 students 6-21 years of age in the United States received special education services for mental retardation during the 2000-2001 school year, comprising about 11% of all students with disabilities in U.S. schools (U.S. Department of Education, 2002). The causes of mental retardation in children vary widely, including fetal alcohol syndrome, genetic disorders like Down syndrome and fragile X syndrome, environmental factors like lead poisoning, or diseases such as meningitis. The American Association on Mental Retardation (2002) defines mental retardation as a "disability characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills." For many years students with mental retardation were identified solely using intelligence testing. IQ levels among students labeled as mentally retarded can vary from 20-25 (profound mental retardation) to 50-75 (mild mental retardation); according to the DSM-IV-TR (American Psychiatric Association, 2000), 85 percent of individuals with mental retardation have mild mental retardation.

It has been estimated that 28,056 K-12 English language learners (ELLs) received special education services for mental retardation in 2001-2002. Thus, approximately 7.9% of school-age ELLs with disabilities were identified with mental retardation (Zehler, Fleischman, Hopstock, Pendzick, & Stephenson, 2003). The challenge of learning English and having a disability adds another level of complexity to learning to read and demonstrate reading achievement (Mueller & Markowitz, 2004).

Similar to other special education categories, but perhaps more unexpectedly, the criteria for students to be eligible for the mental retardation label varies from state to state (Beirne-Smith, Ittenbach, & Patton, 1998). The Twenty-Fourth Annual Report to Congress on the Implementation of the Individuals with Disabilities Education Act (IDEA) reported that poor students were 1.5 times more likely to be referred to special education; it noted significantly lower cognitive development and lower achievement among this population than among non-poor students. The report speculated on causes from lead poisoning to parent education level, but some advocates have argued that poor students, and particularly poor minority students, have been over-identified in the mild mental retardation category and misplaced in special education classrooms (Losen, 2002).

The term "mental retardation" is widely used and coded into federal law, but the term remains the subject of considerable controversy. Some advocacy groups and professional associations argue that the negative stigma of the term mental retardation could be avoided by using less loaded language. The ARC of the United States, one of the country's largest advocacy organizations for people with mental retardation, eschews the term mental retardation in its mission statement (The ARC, 2004) in favor of "cognitive, intellectual, and developmental disabilities." In 2004, Special Olympics updated its terminology from "mental retardation" to "intellectual disabilities" (see the Language Guide under "About Us," then "Information about Intellectual Disabilities" at www.specialolympics.org). In this paper we use the term "mental retardation" as a legal term defined by IDEA, while cognizant of this significant shift in terminology.

Characteristics of students with mental retardation vary widely. Students with mental retardation may have difficulty with expressive language, poor short-term memory, low level meta-cognition skills, and poor use of logic and organization. Some students who are labeled as mentally retarded also have motor difficulties that can affect their handwriting or their ability to hold reading material steadily (Rizopoulos & Wolpert, 2004). Students with mental retardation, like all students, demonstrate wide variation in strengths, weaknesses, interests, and motivation, all of which should be reflected in each student's Individualized Education Program (IEP).

Traditionally, special educators have de-emphasized literacy, particularly for students with moderate to severe mental retardation, in favor of functional, social, or motor skills (Kliewer & Biklen, 2001). Many people with mental retardation read below their projected capabilities, and both general and special education teacher education textbooks are marked by a scarcity of information on academic characteristics, assessment procedures, and instruction in literacy for students with mental retardation. Only recently have educators begun to recognize the value of reading and writing skills for all students, including those with severe mental retardation (Katims, 2000).

Since school systems have begun to include students with moderate to severe mental retardation in assessments (IDEA, 1997, 2004) and accountability (NCLB, 2001), and thus also included in more academic instruction, these students have been achieving at much higher and more complex levels than researchers, practitioners, and even advocates expected (see Moore-Lamminen & Olsen, 2005). This powerful evidence has forced educational professionals to revisit long-held assumptions about the benefits of academic instruction for all children, and is generating provocative reading research on new, rigorous approaches to reading instruction for students with mental retardation (e.g., Reading, Writing, Math, and Science for Students with Significant Cognitive Disabilities, Diane Browder, PI).

Instruction for Students with Mental Retardation

The focus in education for students with mental retardation has shifted from an emphasis on providing services related to placement, such as disability specific classrooms or special schools, to providing individualized supports to help every student access the general curriculum in an inclusive classroom setting. American Association on Mental Retardation (AAMR), a lead advocate of the "supports model," emphasized in its 2002 definition of mental retardation that the effects of mental retardation can be ameliorated with personalized supports. This shift in thinking correlates with an increased emphasis on inclusionary and mainstream education for students with mental retardation, giving these students access to a challenging and interesting general curriculum and an integrated social environment. IDEA 1997 emphasized that students with disabilities must have access to the same challenging content taught to all students; this was reiterated and strengthened in IDEA 2004. Many special education researchers and advocates argue that holding students with disabilities, including mental retardation, to the same high expectations as all students will improve learning and educational outcomes for these students (McGrew & Evans, 2004).

Approaches to teaching reading to students with mental retardation fall broadly into two categories. One broad category is the traditional or direct instruction approach, which teaches reading as distinct subsets of skills such as phonics and sight word recognition (Rizopoulos & Wolpert, 2004). The traditional approach is based on a behaviorist model, emphasizing drill and practice of a linear set of literacy skills. The second approach is a progressive, holistic approach that teaches comprehension and critical thinking along with phonological awareness, decoding, vocabulary, and reading for enjoyment (Katims, 2000). Each of these approaches has had support with some students with mental retardation and for various purposes (Browder & Xin, 1998; Cunningham, 1999; Driscoll & Kemp, 1996; Hendricks, Katims, & Carr, 1999; Joseph & McCachran, 2003; Katims, 2000; Moni & Jobling, 2000).

Assistive technology and technology increasingly have become important supports for reading-related instruction and reading for students with mental retardation. For example, Erickson and Koppenhaver (1995) found that computer and light technology can give students with severe mental retardation the supports they need to build communication skills. Continued interest in the literacy outcomes of students with mental retardation and supporting research has blossomed in the past few years, and is most likely to be a productive area for the reading futures of students with mental retardation (Beukelman & Mirenda, 2005; Erickson, Clendon, Abraham, Roy, & Van de Karr, 2005; Sturm, Erickson, & Yoder, 2003).

In their review of literacy approaches for adolescents with developmental delays, Rizopoulos and Wolpert (2004) suggested that both traditional and progressive approaches to literacy instruction can be appropriate for certain students. Recent research by Diane Browder looks closely at the assumption that students with the most severe mental retardation benefit only from functional approaches to literacy. Browder and Algozzine argue more research is needed to understand how students with severe mental retardation might benefit from explicit instruction in decoding and comprehension skills (Browder & Algozzine, draft).

Assessment of Students with Mental Retardation

Most students with mental retardation participate in the same large-scale reading assessments as all students. While not all students with mental retardation will require supports or accommodations on large-scale assessments, these students have access to the same accommodations that other students with disabilities receive. Whether a student will require extra time on tests, large print, read-aloud directions, alternative setting accommodations, or other supports to demonstrate maximum proficiency depends on the individual strengths and weaknesses of each student. The most common accommodations used for students with mental retardation include breaking tasks into smaller steps, providing read aloud directions or questions, and visual cues (such as arrows, stickers, or stop signs, highlighting of key words or verbs, or supplementing text with pictures). Other accommodations range from encouraging students to stay on task and oral directions accompanied by written directions, to noise buffers and adaptive furniture (Clapper, Morse, Lazarus, Thompson, & Thurlow, 2005).

Some students with the most significant cognitive disabilities who are unable to participate in large-scale assessments even with accommodations are eligible to take alternate assessments. All alternate assessments are aligned to grade-level academic content standards, but they can be based on either grade level achievement standards or alternate achievement standards. The students who may participate in alternate assessments on grade level achievement standards may need accommodations not available on general assessments or need different formats or contexts to demonstrate grade-level proficiency (National Center on Educational Outcomes Web site, 2005). Students with the most significant cognitive disabilities can demonstrate proficiency on an alternate achievement standard. Alternate assessments should promote access to the general curriculum and reflect professional judgment of the highest achievement standard possible for each individual student.

Summary

The intent of this brief paper is to highlight issues surrounding reading and students with mental retardation. While not a comprehensive review, it is intended to give enough of a sense of the characteristics of the students, general instructional approaches used with them, and assessment approaches and issues to generate discussion about the possible ways in which more accessible assessments can be designed for those students who are proficient readers given their diagnosis of mental retardation. This paper is part of the background for research on accessible reading assessments conducted by the Partnership for Accessible Reading Assessments, and for discussions among collaborators on the National Accessible Reading Assessment Projects (NARAP).

References

American Association for Mental Retardation. (AAMR). (2002). Definition of mental retardation and fact sheet: Frequently asked questions about mental retardation. Retrieved May 2, 2005, from the World Wide Web: http://www.aamr.org/Policies/faq_mental_retardation.shtml.

Algozzine, B., & Wood, K. D. (1994). Reading and special education in the twenty-first century: Time to unify perspectives. In K. D. Wood & B. Algozzine (Eds.), Teaching reading to high-risk learners: A unified approach (pp. 1-8). Boston: Allyn and Bacon.

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders-IV-TR (4th ed.). Washington, DC: Author.

Beirne-Smith, M., Ittenbach, R., & Patten, J. (1998). Mental retardation. New Jersey: Merrill.

Beukelman, D., & Mirenda, P. (2005). Augmentative and alternative communication: Supporting children and adults with complex communication needs (3rd ed.). Baltimore: Brookes.

Browder, D. M., & Algozzine, R. F. (DRAFT). Research on reading for students with significant cognitive disabilities.

Browder, D. M., & Xin, Y. P. (1998). The meta-analysis and review of sight word research and its implications for teaching functional reading to individuals with moderate and severe disabilities. The Journal of Special Education, 32, 130-53.

Clapper, A. T., Morse, A. B., Lazarus, S. S., Thompson, S. J., & Thurlow, M. L. (2005). 2003 state policies on assessment participation and accommodations for students with disabilities (Synthesis Report 56). Minneapolis, MN: University of Minnesota, National Center on Educational Outcomes. Retrieved August 2005, from the World Wide Web: http://education.umn.edu/NCEO/OnlinePubs/Synthesis56.html.

Cunningham, P. M. (1999). The teacher's guide to the four blocks. North Carolina: Carson- Dellosa.

Driscoll, C., & Kemp, C. (1996). Establishing the equivalence of single word reading and language in children with disabilities. Journal of Intellectual and Developmental Disability, 21, 115-139.

Erickson, K.A., Clendon, S.A., Abraham, L., Roy, V., Van de Karr, H. (2005). Toward positive literacy outcomes for students with significant developmental disabilities. Assistive Technology Outcomes and Benefits, 2(1), 45-55.

Erickson, K. A., & Koppenhaver, D. A. (1995). Developing a literacy program for children with severe disabilities. The Reading Teacher, 48, 676-84.

Hendrick, W. B., Katims, D. S., & Carr N. J. (1999). Implementing a multimethod, multilevel literacy program for students with mental retardation. Focus on Autism and Other Developmental Disabilities, 14, 231-239.

Joseph, L. M., & McCachran, M. (2003). Comparison of a word study phonics technique between students with moderate and mild mental retardation and struggling readers without disabilities. Education and Training in Developmental Disabilities, 38, 192-199.

Katims, D. S. (2000). Literacy instruction for people with mental retardation: Historical highlights and contemporary analysis. Education and Training in Mental Retardation and Developmental Disabilities, 35, 3-15.

Kliewer, C., & Biklen, D. (2001). 'School's not really a place for reading': A research synthesis of the literate lives of students with severe disabilities. The Journal of the Association for Persons with Severe Handicaps, 26,1-12.

Losen, D. (2002). "New research on special education and minority students with implications for federal education policy and enforcement." In Rights at Risk: Equality in an Age of Terrorism, Citizens' Commission on Civil Rights. Retrieved June 17, 2005, from the World Wide Web: http://www.cccr.org/Chapter18.pdf.

McGrew, K. S., & Evans, J. (2004). Expectations for students with cognitive disabilities: Is the cup half empty or half full? Can the cup flow over? (Synthesis Report 55). Minneapolis, MN: University of Minnesota, National Center on Educational Outcomes. Retrieved May 2, 2005 from the World Wide Web: http://education.umn.edu/NCEO/OnlinePubs/Synthesis55.html

Moni, K. B., & Jobling, A. (2000). Latch-On: A program to develop literacy in young adults with Down syndrome. Journal of Adolescent & Adult Literacy, 44, 40-49.

Moore-Lamminen, L., & Olsen, K. (2005). Alternate assessment: Teacher and state experiences. Alliance for Systems Change / Mid-South Regional Resource Center. Retrieved June 17, 2005, from the World Wide Web: http://www.ihdi.uky.edu/msrrc/PDF/Alt_Assm_stories_handout.pdf.

Muller, E., & Markowitz, J. (2004). Synthesis brief: English language learners with disabilities. Alexandria, VA: National Association of State Directors of Special Education Inc.

National Center on Educational Outcomes. (2005). Special topic area: Alternate assessments for students with disabilities: Frequently asked questions. Retrieved May 2, 2005, from the World Wide Web: http://education.umn.edu/nceo/TopicAreas/AlternateAssessments/
alt_assess_FAQ.htm

Rizopoulos, L. A., & Wolpert, G. (2004). An overview of the techniques used to develop the literacy skills of adolescents with developmental delays. Education, 125, 130-36.

Special Olympics. Language guide. Retrieved August 2005, from the World Wide Web: http://www.specialolympics.org/Special+Olympics+Public+Website/
English/About_Us/Language_Guide/default.htm

Sturm, J.M., Erickson, K.A., & Yoder, D.E. (2003). State of the science: Enhancing literacy participation through AAC technologies. Journal of Assistive Technology, 14, 45-54.

The ARC (2004). Q&A. Retrieved May 2, 2005, from the World Wide Web: http://www.thearc.org/faqs/mrqa.doc.

U.S. Department of Education (2002). Twenty-fourth annual report to Congress on the implementation of the Individuals with Disabilities Education Act. Washington, DC: Author.

Zehler, A. M., Fleischman, H. L., Hopstock, P. J., Pendzick, M. L., & Stephenson, T. G. (2003). Descriptive study of services to LEP students and LEP students with disabilities (No. 4 Special topic report: Findings on special education LEP students). Arlington, VA: Development Associates, Inc.

Acknowledgments

This paper was developed through a collaborative effort of numerous members of the PARA staff. The contributors are listed here alphabetically: Kristin Eisenbraun, Christopher Johnstone, Sheryl Lazarus, Kristi Liu, Danielle Matchett, Ross Moen, Mari Quenemoen, Rachel Quenemoen, Sandra Thompson, and Martha Thurlow. In addition, we had the invaluable assistance of a member of the General Advisory Committee for the National Accessible Reading Assessment Projects (NARAP), Stan Dublinske, who is Senior Advisor for Planning of the American Speech-Language-Hearing Association, and several individuals working with him who provided detailed input, including suggestions for specific (and better) wording. These individuals included Diane Paul, Kathleen Whitmire, Patricia Prelock, and Rose Sevcik.

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