ASSIGNMENT

Michael S. Cornell
Disabilities, Modalities, & Activity Adaptations Assignment
Florida International University

ASSIGNMENT

Intellectual impairment is a subclass of Developmental Disorder (DD). Intellectual

impairment is classified as a significant limitation of intellectual functioning with an IQ of 70 or
below, limitation in at a minimum of two adaptive skills (communication, self-care, home living,
social and interpersonal skills, use of community resources, self direction, functional academic
skills, work, leisure, health and safety) that cover many everyday social and practical skills, and
an onset before the age of 18 (American Psychiatric Association, 2005a). Intellectual
impairments are often are dually diagnosed with other DD like Down syndrome, Autism or Spina
Bifida. The related category of diagnosis is developmental delay mostly used in the educational
system to identify cognitive performance below standard developmental level (Robertson &
Long, 2008). Developmental delay may be an early indication of intellectual impairment or a
need for extra services. A child may also be diagnosed with a learning disability, which is a term
used for child experiences problems in language and mathematical calculations not related to
intellectual impairment, or emotional or psychological problems. Having a learning disability is
not a severe as n intellectual impairment and learns to adapt to overcome its effects.
The causes of intellectual impairment vary from a genetic condition, events during
pregnancy, birth or childhood. Environmental causes include drug and alcohol abuse during
pregnancy, illness like rubella during pregnancy, and the lack of oxygen during birth. Causes of
intellectual impairment during childhood include disease like meningitis, and measles, head
injury due to abuse or neglect such as lack of nutrition and exposure to toxic environmental
elements like lead or mercury (CDC, 2004a). Examples of an intellectual impairment are Down
syndrome, fragile X syndrome, and phenylketonuria (PKU).
Down syndrome is the result from the production of and extra chromosome during the
cell development (Robertson & Long, 2008). Symptoms of Down syndrome include poor

ASSIGNMENT

muscle tone, hyperflexibility, a lower resistance to infections, visual issues, slower physical and
mental development and premature aging (NICHCY, 2004). People with Down syndrome come
predisposed to health issues like weakness of the spine, dementia, and heart problems.
Fragile X Syndrome is the most common inherited from of intellectual impairment.
Fragile X Syndrome often has a more severe effect on males because the trait is carried on the X
gene. The mutated gene doesnt allow the body to make enough protein for development which
provides different degrees on intellectual impairment, sensitivity to sensation, behavioral
problems and physical characteristics such as larger ears, jaw, and forehead, smaller stature, and
excessive flexibility in the joints. (Robertson & Long, 2008) Because of sensitivity to sensations
as loud noises and textures, people with fragile X can have behaviors similar to individuals with
autism.
Phenylketonuria (PKU) is an inherited metabolic disorder when left untreated can lead to
brain damage, which causes intellectual impairment or cerebral palsy. The genetic mutation of
PKU doesnt allow the body to break down the amino acid phenylalanine. The treatment
consists of monitoring of phenylalanine foods like meats, fish, eggs, beans, nuts, milk and dairy
products and foods containing NutraSweet.
Recreational therapist can utilize many different modalities for people with intellectual
impairments. The therapeutic use of Tai chi emphasizes body relaxations, mental concentration
and movement coordination. As a type of martial art, it uses slow, graceful and learned
movements that can be describe as swimming motions in the air. The therapeutic use of
Expressive Arts uses five disciplines (visual arts, music, dance, drama, and poetry) to allow the
client to express a self-image. The interventions promote nonverbal communication and improve
physical, social, cognitive and emotional functioning (Dattilo & McKenney, 2011). Horticulture

ASSIGNMENT

is another modalities that Recreational Therapist can implement which use gardens and plants to
enhance goal areas. Horticultural for people with intellectual impairments can increase
endurance, improve coordination and concentration, utilize planning and decision making skills
(Robertson & Long, 2008). Adventure therapy is an approach that encourages individuals to
become mentally and physically engaged in the activities. The combination of nature and
community creates an opportunity for individuals to assess their current perceptions and
behaviors, and the chance to modify those behaviors. Important modality for intellectual
impairment is use of exercise. Exercise increases activity level and reduces the tendency to be
over weight, provides an outlet for energy. Exercise can also contribute to psychological health
as well as physical health.
As I previously mentioned earlier, expressive art uses five art disciplines to make contact
with their authentic self. The goal of expressive art is to improve participants functioning, selfexpression and quality of life. There are a few terms associated with expressive art and they
include Expressive Art Activity, Expressive Art Therapies and Expressive Art as Therapeutic
Media.
Expressive Art Activity uses many techniques with the intentions to produce and final
product. The purpose of expressive art activity is to master art as a craft and can provide a sense
of accomplishment, fulfillment or personal satisfaction. The use of expressive art as therapeutic
media is primarily used to improve cognitive, physical, social and emotional functioning.
Expressive Art Therapy is defined as a process, which uses the visual arts, music, dance, poetry
to treat mental, social, emotional, and physical illness.

ASSIGNMENT

Expressive Art as Therapeutic Media is the merger method to creating art and the needs of the
person with the final product. The process is therapeutic in that its multisensory, involving
sensory, motor and cognitive (Arts Therapy Network, n.d., 2007).
The history of expressive art as therapeutic media evolved because the way to facilitate
positive changes in the physical, social and emotional functioning of a person with a disability
(Anderson, 1994). It is thought to have evolved from art therapy because initially art therapy
was used in institutional setting to assist people to pass the time. Art therapy began before World
War II, when a group of artist and psychiatrist initiated a more diagnostic use of art.
During the 1940s and 1950s, World War II initiated the use of art as a therapeutic media
in military hospitals. Painting was used to relieve boredom of military personal and facilitate
expression of fears and feelings of living with a disability. When military hospital personnel
recognized the art activities could be learned and utilized by developing useful skills after
discharge. In the 1960s and 1970s marked a period of influences of leisure service including art
for people with disabilities. The passing of Rehabilitation Act 1973 and Education for All
Handicapped Children Act 1975 by federal legislation was among the most influential factors of
this era (Anderson, 1994).
It was the establishment of these laws that primarily influenced extension off expressive
art as a therapeutic media to include people with disabilities. Inclusion to expressive art related
to leisure and educational services facilitates self-expression. Studies have show the
effectiveness using expressive art as a therapeutic media improved cognitive, emotional or
physical functioning.
One activity that could be used to fill this modality is window painting. The objective is
to encourage creativity, nonverbal communication and socialization. You take a picture or

ASSIGNMENT

pattern behind a window and the client draws or traces on the window with colorful window
wipe of markers. Another activity that could be used is skit acting out. This challenges
participants to use creativity, thinking skills and socialization. The participants act out a story
and express creativity by using props to aid in their skit. Another activity called the Hat Game.
This allows residents to create characters using their imagination and maintain mental cognitive
status. This related to the modality thought expression of drama. The rolling pin art allows
participants to express themselves through art and colors. The last activity that could be used is
Antique Collage. The cutting picture out of magazines helps improve coordination while using
their expression nature to describe who they are as individuals through pictures that represent
what they like, their interest, establish goals and dreams in an artistic manner.
The Antique Collage takes a group size of five to six individuals. The equipment
required is an antique magazine, mod podgy, glue, heavy cardboard, scissors, picture frame, and
a few extra odd and ends like buttons, lace fabric ribbon, anything you think the participants will
enjoy. The objective is concentration and focusing skills, reminiscing on bygone items used as
functional items and for decorating socialization, the acquisition of craft skills, and self esteem
and feelings of accomplishment.
First give each participant one to two antique magazines and ask them to find items that
are interesting to use in the collage. Encourage participants to talk about the items and if they
remember owning any of the items when they were younger. Have the participants cut out the
pictures and then arrange them in a pleasant design on the board. Type various categories i.e.,
toys, watches, clocks, rugs, paintings, quilts, etc. and place the words next to the groupings of
antique pictures. We then glued down our pictures using additional items such as antique lace,
buttons, pieces of fabric, etc. to give it a distressed or antique look and sealed the entire collage

ASSIGNMENT

with a layer of decoupage. After the picture was left to dry for several hours placed it in a
decorative frame with all the names of the participants typed on a decorative tag at the bottom of
the picture. It can now be display and receive a lot of positive feedback.
The primary position for this activity is sitting, but the participants have the choice to
stand if they prefer. The hands are the required body part, which does require grasping the
scissors and magazines. The senses required are touch and sight so a great deal of hand and eye
coordination is required. Movements, endurance, energy and flexibility are very little and a
moderate use of strength and speed to get the project done in a timely fashion. The social aspect
is intragroup with each participant sharing their stories, sharing and assisting each other. This
activity could be done with a few as two participants, but the more the better to allow social
interaction. Very little physical contact and noise is generated, and fairly close proximity to each
other to allow sharing.
The activity requires very few rules and describing the activity and how to participate is
easy to understand. The activity requires little strategy, but moderate about of long-term memory
and minimal short term memory. The activity has a moderate amount of abstract thinking,
verbalization of though process and some concentration with minimal concrete thinking. There
is little reading, writing, math and spelling required and depending what the participants want to
use a moderate amount of colors, shape. The activity is designed for the participants to express
joy, but depending on the individual thought and memories they can display any of the other
feelings.
The adaptation for this activity would require me to have picture already cut from
magazines so the participant could easily select the picture they would like to use and not require
the act of cutting. I could also adapt by removing the picture frame and using the cardboard box

ASSIGNMENT
as the collage. For those participants who prefer not to share ideas and thoughts and prefer to
work alone I could increase their proximity to the other participants.

ASSIGNMENT

9
References

American Psychiatric Association. (2005b). Diagnostic and statistical manual of mental

Disorders-IV-TR (5th ed.) Washington, DC: Author
Center for Disease Control and Prevention. (2004a). What cause mental retardation? Can it be
prevented?, www.cdc.gov/ncbddd.ddmr.htm
Dattilo, John, and Alexis McKenney. Facilitation techniques in therapeutic
recreation. 2nd ed. State College, PA: Venture Pub., 2011.
Dattilo, John. Inclusive leisure services: responding to the rights of people with
disabilities. 3rd ed. State College, PA: Venture Pub., 2012
Robertson, Terry, and Terry Long. Foundations of therapeutic recreation.
Champaign, IL.: Human Kinetics, 2008.

Therapeutic Recreation Activities & Tx Ideas: Arts & Crafts- Paper & Printing &
Scrapbooking. (n.d.). Therapeutic Recreation Activities & Tx Ideas: Arts & CraftsPaper & Printing & Scrapbooking. Retrieved April 11, 2014, from
http://www.recreationtherapy.com/tx/txpaper.htm