Persons with Profound Disabilities: Issues and Practices.

Persons with Profound Disabilities: issues and Practices Edited by Brown F, Lehr DH. Baltimore, MD 21285, Paul H Brookes Publishing Co, 1989, paperback, 344 pp, $30 As the title implies, the purpose of this book is to present issues and practices that relate specifically to individuals who have profound disabilities. The editors noted several reasons for focusing on this particular population. First, information relevant to persons who have profound handicaps often is assumed to belong under the general label of "severe" or is included in the heterogenous grouping of "severe/profound," making it difficult to identify information that is valid for those with profound disabilities. Second, the goals described for persons with severe disabilities might not reflect realistic outcomes for persons with profound disabilities. Finally, the provision of services for persons with profound disabilities involves issues that differ from those involved in the provision of services for persons with less severe disabilities. These issues, the editors believe, have not been acknowledged in the previous literature. One major theme forms the basis for this book: the quality of life of individuals who have profound disabilities. The authors support a philosophy of education and training that facilitates participation in the educational process, functional access to environments, ability to make choices, and opportunity to participate to the greatest extent possible in normalized routines. The book is divided into two sections. Section 1 deals with the issues that arise when education services are provided for persons who have profound disabilities. In chapter 1, the authors present a qualitative study of teachers' perceptions of the students they serve and about the procedures teachers use to meet their students' needs. Chapter 2 addresses the legal basis for the "zero-exclusion policy" of providing educational programs for persons with profound disabilities. Chapter 3 is an overview of research. Also included are discussions on defining meaningful outcomes for students with profound disabilities and on integrating these students into regular school programs. Chapter 6 addresses issues involved in educating students who have feeding tubes; who require catheterization; who have respiratory conditions that require suctioning, ventilators, or apnea monitors; or who have other complex health care needs. Also provided are brief descriptions of infectious diseases, including hepatitis B, herpes, acquired immune deficiency syndrome, and cytomegalovirus. Section 2 focuses on practices appropriate for use with persons who have profound disabilities. Written by an occupational therapist, chapter 7 covers dysfunction of posture and movement and appropriate program approaches to this dysfunction. Preventing secondary physical deformities, using programming directed toward improving posture, and using movement for functional purposes-particularly for cognitive and communicative function-are emphasized. Other chapters cover education curriculum suggestions for preschool children, school-aged children, and adults. Vocational training and residential programs also are discussed. This book is well referenced and well organized. Although the text had many authors, writing style and chapter format are relatively consistent throughout. I found the chapter on communication, "Influence of Indicating Preferences for Initiating, Maintaining, and Terminating Interactions," somewhat more laden with jargon than the other chapters. This did not detract, however, from the overall quality of the book. Intended primarily for special educators, the book would be particularly appropriate for school administrators or for those involved in teacher education programs. I cannot recommend this book to physical therapy clinicians who are looking for more detailed information on the care and treatment of individuals who have profound disabilities. Gretchen Meyer