https://doi.org/10.1044/gero19.1.36, Lee, M., Bush, L., Martin, G. E., Barstein, J., Maltman, N., Klusek, J., & Losh, M. (2017). Collaborate with parents, teachers, caregivers, job coaches, peers, and others to promote communication development in individuals with ID. Research in Developmental Disabilities, 32(2), 419436. Multilingual and multidialectal populations exist across the globe. Terminology continues to evolve, with some individuals preferring identity-first language (e.g., autistic person). Using dynamic assessment with learners who communicate nonsymbolically. Brookes. https://doi.org/10.1007/s10803-010-1117-5, Snell, M. E. (2002). Treatment may begin as early as these disorders are detected, and early intervention is critical in identifying and providing services that will support both the child and the family (Guralnick, 2019). Careful consideration of language history (e.g., quality and duration of exposure to different languages) and linguistic abilities in all languages is necessary in the evaluation, particularly when working with individuals who are multilingual. A lack of culturally and linguistically sensitive assessment measures and inherent assessment bias contribute to misrepresentation and disproportionality in the identification of individuals with ID. Mac Keith Press. Members of the Committee were Howard Goldstein (chair), Kevin Cole, Philip S. Dale, Jon F. Miller, Patricia A. Prelock, Krista M. Wilkinson, and Diane Paul (ex officio). ABA has been used for individuals with ID, particularly those who also have ASD (e.g., Spreckley & Boyd, 2009). Several Hanen Centre programs and guidebooks have been developed with research-based training for parents/caregivers of. Enhanced Milieu Teaching: EMT is one example of an intervention occurring in relevant contexts that is intended to treat communication delays associated with ID. This intervention utilizes 6 main components. Visual impairment in adult people with intellectual disability: Literature review. Treatment modes and modalities are technologies or other support systems that can be used in conjunction with or in the implementation of various treatment options. anxiety disorders (Oeseburg et al., 2011), physical coordination and tone issues (Vuijk et al., 2010), obesity-related problems (Rimmer et al., 2010), Native Hawaiian or Other Pacific Islander: 6.8%, developmental and sociocultural standards for personal independence and community participation, independent functioning in one or more daily life activities (e.g., communication, social participation, and independent living) across settings, difficulties in pre-academic and academic learning (reading, writing, mathematics), difficulty understanding concepts of time and money, problems with abstract thinking (concrete approach to problem solving), difficulties in executive function such as, difficulties with functional use of academic skills such as money management and time management, limitations in language and communication skills, more concrete and less complex spoken language (if used), compared with same-age peers, limited vocabulary and grammatical skills, receptive language that may be limited to comprehension of simple speech and gestures, communication that may occur through nonspoken means onlysuch as gestures, signs, facial expressions, or aided systems (e.g., AAC), challenges with social judgment and decision making, difficulty understanding social cues and rules, emotional and behavioral regulation difficulties that may adversely affect social interactions, requiring different levels of support for daily life activities such as. Journal of Intellectual Disability Research, 45(1), 3040. The need for longitudinal, intensive social skill intervention: LEAP follow-up outcomes for children with autism. Journal of Autism and Developmental Disorders, 38(2), 312323. (2016a). SLPs may need to consider the possibility of mild cognitive impairment, a condition characterized by subtle cognitive decline that may lead to dementia (see ASHAs Practice Portal page on Dementia), if treating adults with ID with new communication concerns. Characteristics may include the following: Fragile X syndrome is the most common inherited cause of ID (Lozano et al., 2014). Aided symbols require a transmission device (e.g., a speech-generating device); unaided symbols require only the body to produce (Beukelman & Light, 2020). Unit/Subject: Social Skills. (n.d.). A multi-method investigation of pragmatic development in individuals with Down syndrome. (2005). (2020). Schmidt, J. D., Drasgow, E., Halle, J. W., Martin, C. A., & Bliss, S. A. This is in no way meant to be a document to just copy and paste from. Cause-specific mortality of people with intellectual disability in a population-based, 35-year follow-up study. Journal of Applied Research in Intellectual Disabilities, 18(3), 253261. The determination of incidence and prevalence of intellectual disability (ID) is complicated because researchers of ID do not use a uniform operational definition when selecting and identifying individuals with ID. https://doi.org/10.1352/1944-7558-118.5.365, Barnes, E., Roberts, J., Long, S. H., Martin, G. E., Berni, M. C., Mandulak, K. C., & Sideris, J. In R. J. McCauley, M. E. Fey, & R. B. Gillam (Eds. Individuals transitioning from school to employment need communication skills specific to the work setting (e.g., talking with co-workers and supervisors, interacting with customers). Identification and evaluation of mental retardation. This list of resources is not exhaustive and the inclusion of any specific resource does not imply endorsement from ASHA. Clinical management of sensorimotor speech disorders. Functional skills are those skills a student needs to live independently. Access to communication services and supports: Concerns regarding the application of restrictive eligibility policies [Technical report]. The Communication Bill of Rightsoriginally developed by the National Joint Committee for the Communication Needs of Persons With Severe Disabilities in 1992 and updated in 2016recognizes the right of all people to participate fully in communication (Brady et al., 2016). Journal of Intellectual Disability Research, 54(11), 955965. A guide to promoting communication skills in adults with developmental delays. Tass, M. J., Schalock. SLPs support the linguistic needs to facilitate those connections. Application of stimulus equivalence to language intervention for individuals with severe linguistic disabilities. Behavioral interventions and techniques (e.g., differential reinforcement, prompting, fading, and modeling) are designed to reduce problem behaviors and teach functional alternative behaviors using the basic principles of behavior change. Studies reported results based on gender; however, there were no indications whether the data collected were based on sex assigned at birth, gender identity, or both. Intellectual and Developmental Disabilities, 46(5), 376386. (2005). Regional and National Summary Report of Data from the 201314 Annual Survey of Deaf and Hard of Hearing Children and Youth. It's all about getting to know your student, their future goals, and collaborating with parents/caregivers on what areas they find important. Code of ethics [Ethics]. Terms like individuals with intellectual disability have replaced the older terms of mentally retarded persons or the mentally retarded. The incidence/prevalence data in this section pertain to United Statesbased populations. As indicated in the ASHA Code of Ethics (ASHA, 2016a), SLPs who serve individuals with ID should be specifically educated and appropriately trained to do so. (Practice Portal). Allow me! Screening does not result in a diagnosis of a disorder but, rather, determines the need for further assessment and/or referral for other services. Keep these factors in mind when reviewing the incidence and prevalence data below. Appropriate roles for SLPs include the following. Assessment and treatment of disorders that fall under speech-language pathology scope of practice may be completed at any stage in an individuals life. https://doi.org/10.1002/aur.1405, Chadwick, D. D., & Jolliffe, J. Developmental Medicine & Child Neurology, 47(1), 5763. (2001). Time delay is fading the use of prompts during instruction. Adaptive behavior and cognitive function of adults with Down syndrome: Modeling change with age. For example, the time delay between initial instruction and any additional instruction or prompting is gradually increased as the individual becomes more proficient at the skill being taught. Assessment prompts and treatment materials are reviewed for relevance for each individual. With improvement in understanding of needs, IEPs have become more enriched. Components of these programs include parent instruction, joint interaction with parents/caregivers and individuals with developmental delays and other deficits, and video coaching (Weitzman et al., 2017). Individuals with ID usually develop skills slower than their typically developing peers do, whereas individuals with ASD may not follow the typical developmental progression of skills across domains. Environmental arrangement. https://doi.org/10.1177/108835760101600404, Scior, K. (2011). In P. B. Sullivan (Ed. (2017). Obesity and obesity-related secondary conditions in adolescents with intellectual/developmental disabilities. https://doi.org/10.1097/00001163-200507000-00002, Romski, M. A., Sevcik, R. A., Adamson, L. B., Cheslock, M., Smith, A., Barker, R. M., & Bakeman, R. (2010). Communication intervention for ID focuses on interactions that may occur within an individuals natural environment to reflect social norms of their community. Speech and language development and intervention in Down syndrome and Fragile X syndrome. Contributions of incidental teaching, developmental quotient, and peer interactions to child engagement. Intellectual disability 1 involves problems with general mental abilities that affect functioning in two areas: Intellectual functioning (such as learning, problem solving, judgement). https://doi.org/10.1352/0047-6765(2003)041%3C0007:ABACFO%3E2.0.CO;2, Herer, G. R. (2012). Darden-Brunson, F., Green, A., & Goldstein, H. (2008). Intervention for individuals with ID typically incorporates a variety of options and techniques in combination. Case history, including medical, educational, and vocational status as well as teacher, caregiver, employer, and client/patient perspectives. Please see ASHAs Practice Portal page on Cultural Responsiveness for further information. (2013). Intellectual disability in cerebral palsy: A population-based retrospective study. Relevant research indicates that language intervention benefits children with ID even when no languagecognition discrepancy exists (Carr & Felce, 2000; Cole et al., 1990; Snell et al., 2010). ), Early childhood inclusion: Focus on change (pp. SLPs screen for hearing, speech, language, communication, and swallowing problems. Communication abilities in individuals with ID vary and may be nonsymbolic (e.g., gestures, vocalizations, specific behaviors) and/or symbolic (e.g., words, signs, pictures). http://www.euro.who.int/data/assets/pdf_file/0003/126408/e94421.pdf?ua=1, World Health Organization. (2018). Brookes. The SLPs input may be useful to the medical team when considering comorbidity or differential diagnosis between the two disorders. The effect of instructional use of an iPad on challenging behavior and academic engagement for two students with autism. What are Functional Goals. (2020) also revealed that the following psychiatric disorders were also found to be prevalent in adults with ID: It is important to distinguish signs and symptoms of intellectual disability (ID) from communication differences through case history and comprehensive assessment. Assessment and intervention are typically collaborative processes involving multiple providers. Cultural beliefs may influence some individuals perceptions about the causes of ID (Allison & Strydom, 2009; Scior, 2011). This training may include the use of communication intervention strategies, partner training in AAC, and/or assistive technology. Each individual with intellectual disability (ID) has a unique profile, based on their level of language functioning as well as functioning in areas related to language and communication, including the following: Intervention considers strengths and needs in all areas to ensure individualized treatment and supports. nonsymbolic (e.g., gestures, vocalizations, problem behaviors) and/or symbolic (e.g., words, signs, pictures) communication. (II) a statement of measurable annual goals, including academic and functional goals, designed to--. Identification of the potential for effective intervention strategies and compensations. Journal of Population Therapeutics & Clinical Pharmacology, 18(2), e364e376. The World Health Organizations (WHOs) International Classification of Functioning, Disability and Health (ICF) framework (WHO, 2001) and its Children & Youth version (WHO, 2007) recognize activity and participation limitations in addition to impairments in body functions and structures. Journal of Disability Policy Studies, 20(4), 233240. This list is not exhaustive, and the inclusion of any specific treatment approach does not imply endorsement from ASHA. (2008). Quality of life and quality of support for people with severe intellectual disability and complex needs. (2011). ), Families and positive behavior support (pp. Institute of Medicine (US) Committee on Nervous System Disorders in Developing Countries. Morphosyntax is more difficult than semantics (Fidler et al., 2009), with variability in vocabulary development compared to children with other intellectual disabilities or typical development (Loveall et al., 2016). The application of skills to new and appropriate situations is reinforced as naturally as possible as such situations occur (Kalyva & Avramidis, 2005; Whitaker et al., 1998). Difficulties with social communication (Coggins et al., 2007). SLPs should consider the role of ABA in communication intervention, particularly because difficulty with prompt dependency and generalization of communication interactions may result. Advocate for individuals with ID and their families at the local, state, and national levels. Developmental disabilities. It includes training in everyday environments and activities, rather than only at therapy time. Perspectives on Gerontology, 19(1), 3643. This definition of ID balances limitations with an equal emphasis on skills. Intervention in multiple contexts allows the person with ID to practice functional skills in meaningful situations. Refer to other professionals to rule out other conditions, determine etiology, and facilitate access to comprehensive services (e.g., physical therapy, occupational therapy). Importance of Setting Goals Andrew Carnegie once said, ''If you want. American Journal of Medical Genetics, 117C(1), 314. Interprofessional collaborative practice consists of core ideals described by the WHO that include patient- and family-centered, community-oriented, and relationship-focused service delivery by a team of professionals working together with common goals for the individual with ID (WHO, 2010b). See ASHAs Scope of Practice in Speech-Language Pathology (ASHA, 2016b). LEAP is a multifaceted program for preschool children with ASD and their parents (Strain & Hoyson, 2000). If the person does not initiate, an expectant look and a time delay might be sufficient to prompt language use. https://www.ncbi.nlm.nih.gov/books/NBK223473/, Kaiser, A. P., & Roberts, M. Y. While race/ethnicity influenced the likelihood of diagnosis, at best, it was unclear why. Simply put, a functional goal is a target skill or behavior that can be measured in specific terms. Language impairments in children with fetal alcohol spectrum disorder. https://doi.org/10.1037/0000165-000, American Speech-Language-Hearing Association. Efficacy of applied behavioral intervention in preschool children with autism for improving cognitive, language, and adaptive behavior: A systematic review and meta-analysis. Communication intervention is sensitive to cultural and linguistic diversity and addresses components within the International Classification of Functioning, Disability and Health (WHO, 2001) framework, including body structures/functions, activities/participation, and contextual factors (personal and environmental). https://doi.org/10.5582/irdr.2014.01022. Hanen programs for parents: Parent-implemented early language intervention. Prevalence refers to the number of people who are living with the condition in a given time period. Images, symbols, and depicted scenes are not universally meaningful or appropriate. See ASHAs Practice Portal pages on Bilingual Service Delivery, Cultural Responsiveness, and Collaborating With Interpreters, Transliterators, and Translators for additional information. When examining data, use extreme caution: Consider the potential of bias in the testing as well as in the diagnostic and evaluation procedures. Psychiatry, 8(9), 355357. Make decisions about the management of communication disorders. Promote academic engagement and communication of students with autism spectrum disorder in inclusive settings. The multifaceted team also includes families, caregivers, and persons with disabilities. For children with ID and other DDs, intervention may focus on factors influencing cognitive development and social competence (e.g., Guralnick, 2017; Mahoney & Perales, 2005). https://doi.org/10.1044/1092-4388(2001/016), Bernard-Opitz, V., Sriram, N., & Nakhoda-Sapuan, S. (2001). Determine eligibility for speech and language services. https://doi.org/10.1044/1092-4388(2007/032), Twachtman-Reilly, J., Amaral, S. C., & Zebrowski, P. P. (2008). For information about eligibility for services in the schools, see Eligibility and Dismissal in Schools, IDEA Part B Issue Brief: Individualized Education Programs and Eligibility for Services, and Current IDEA Part C Final Regulations (2011). access or a functional need may be due to physical, sensory, behavioral, mental health, intellectual, developmental, or cognitive disabilities; chronic conditions; injuries; and limited English proficiency (LEP) or an inability to speak English. Journal of Speech, Language, and Hearing Research, 56(1), 178210. https://doi.org/10.1044/1092-4388(2009/08-0001). Using informal measures, such as those designed by the clinician and tailored to the population being screened (e.g., age, developmental level, language[s] used). Functional assessment strategies for young children with autism. https://doi.org/10.1093/med:psych/9780195317046.003.0005, Gentile, J. P., Cowan, A. E., & Smith, A. Brief explanation goes like: READ : Measurable IEP Goals for Geometry. Plan for transitions from educational to community support services. (2009). See ASHAs resource on assessment tools, techniques, and data sources for items that may be used in a comprehensive communication assessment. Written and/or visual prompts that initiate or sustain interaction are called scripts. Celia Hooper, ASHA vice president for professional practices in speech-language pathology (20032005), served as the Board liaison. A goal is what you want the student to accomplish. https://doi.org/10.1080/0144341042000301210, Maulik, P. K., Mascarenhas, M. N., Mathers, C. D., Dua, T., & Saxena, S. (2011). https://doi.org/10.1016/j.rasd.2012.12.004, Notari, A. R., Cole, K. N., & Mills, P. E. (1992). Individuals with ID continue to develop communication skills beyond the school years (e.g., Cheslock et al., 2008). Journal of Consulting and Clinical Psychology, 75(4), 594604. Physical health of patients with intellectual disability. The Hanen programs are parent training approaches focused on supporting language and communication development in children with disabilities. Using a speech- generating device to enhance communicative abilities for an adult with moderate intellectual disability. https://doi.org/10.1002/mrdd.20136, Roberts, M. Y., & Kaiser, A. P. (2011). Lack of linguistically appropriate measures and awareness of cultural influences on assessment, layered with the inherent bias in the evaluation process, results in disproportionality in Black, Indigenous, and People of Color (BIPOC) communities. https://doi.org/10.1177/2396941520905328, Hall, W. J., Chapman, M. V., Lee, K. M., Merino, Y. M., Thomas, T. W., Payne, B. K., Eng, E., Day, S. H., & Coyne-Beasley, T. (2015). members that enable students like Terry to fully access the same high school experience as her peers without disabilities. Fostering peer interaction, imaginative play and spontaneous language in children with autism. Team models may be multidisciplinary, interdisciplinary, or transdisciplinary (see ASHAs resource on collaboration and teaming). Language, Speech, and Hearing Services in Schools, 23(3), 198202. S.M.A.R.T. LEAP uses a variety of strategies and methods, including ABA, peer-mediated instruction, self-management training, prompting, and parent training. There are prenatal, perinatal, and postnatal causes of intellectual disability (ID). At times, this may inhibit families from seeking services, resulting in either delays or lack of intervention. The SLP recognizes that individual family values and available resources are central to the decision-making process. https://doi.org/10.1111/j.1365-2788.2001.00290.x. Individuals with ID have intellectual deficits as well as deficits in adaptive functioning that include conceptual, social, and practical domains (APA, 2013). Persistent deficits in social communication and social interaction across multiple contexts (e.g., joint attention, social-emotional reciprocity, nonverbal and verbal communication skills, initiation of conversation; APA, 2013). Content Disclaimer: The Practice Portal, ASHA policy documents, and guidelines contain information for use in all settings; however, members must consider all applicable local, state and federal requirements when applying the information in their specific work setting. Information provided above under the Co-Occurring Conditions and Disorders section above may be helpful in developing an assessment protocol to document an individual performance profile. Understanding the communicative intention of challenging behaviors serves as the basis for replacing problem behaviors with more appropriate communication skills, including AAC, that would serve the same functions (see the Functional Communication Training (FCT) subsection in the Treatment section). Prevalence of chronic health conditions in children with intellectual disability: A systematic literature review. Development of literacy skills is important in any population; however, children with DD access literacy in different ways than nondisabled peers. ABA is a treatment approach that uses principles of learning theory to bring about meaningful and positive change in behavior. Journal of Speech, Language, and Hearing Research, 53(2), 350364. ; APA, 2013), the signs and symptoms of deficits in adaptive functioning across domains may include the following. Augmentative and alternative communication: Supporting children and adults with complex communication needs (5th ed.). https://doi.org/10.1016/j.jpeds.2008.09.012, Strain, P. S., & Hoyson, M. (2000). Please see the American Association on Intellectual and Developmental Disabilities page on Intersectionality for further details. However, these areas are important in the constructivist-oriented curriculum. Abbeduto, L., & Sterling, A. Service-learning is a form of experiential learning that blends classroom instruction with community service. Language, Speech, and Hearing Services in Schools, 39(2), 261272. Bias should be addressed as it may affect quality of patientprovider interactions and has the potential to affect outcomes (Hall et al., 2015). Intellectual disability: Definition, diagnosis, classification, and system of supports (12th ed.). American Association on Intellectual and Developmental Disabilities. (2002a). ), Feeding and nutrition in children with neurodevelopmental disability (pp. Review of auditory, visual, motor, and cognitive status, including hearing screening. However, the aging process may be premature in adults with ID as compared with the general population (e.g., Lin et al., 2011). Language comprehension is better than production, particularly syntax (J. E. Roberts et al., 2007). (2015). Children with Down syndrome often have specific limitations in expressive syntax relative to semantics. Video-based instruction (also called video modeling) is an observational mode of teaching that uses video recordings to provide a model of the target behavior or skill. Genetic causes account for 45% of ID (Batshaw et al., 2013). Parents were randomly assigned to the training programme group (n = 8) or waiting list group (n = 6). Data from the 20132014 Annual Survey of Deaf and Hard of Hearing Children and Youth revealed that 9.2% of students who are deaf and hard of hearing were also identified with ID (Office of Research Support and International Affairs, 2014). Journal of Speech, Language, and Hearing Research, 50(2), 459474. Aging in adults with intellectual disabilities. Communication Disorders Quarterly, 33(4), 252260. The Sociological Quarterly, 59(3), 384406. gain sensory input (sensory reinforcement). Some of the most common known causes of intellectual disability - like Down . Gathering information from parents, caregivers, teachers, and co-workers regarding skills and concerns about the dialect(s) and/or language(s) used. See ASHAs Intellectual Disability evidence map for summaries of the available research on this topic. https://doi.org/10.1111/dmcn.13773, Rimmer, J. H., Yamaki, K., Lowry, B. M. D., Wang, E., & Vogel, L. C. (2010). ), Effective practices for children with autism: Educational and behavior support interventions that work (pp. Social interaction and pragmatic difficulties similar to those associated with ASD (e.g., staying on topic, taking turns in conversation, echolalia, perseveration; Haebig et al., 2020). Historically, intellectual disability (previously termed "mental retardation") has been defined by significant cognitive deficitswhich has been established through a . https://doi.org/10.1097/IYC.0b013e31824cbac4, Cceres, A. S. J., Keren, N., Booth, R., & Happ, F. (2014). These disorders affect how the brain, spinal cord, and nervous system function, which can affect intelligence and learning. possible immobility. Cognitive referencing: The (non)relationship between theory and application. The absence of prerequisite cognitive or other skills for determining eligibility is also of concern for individuals with ID. using telecommunications technologies (e.g., phone, Zoom). ABA techniques have been used by SLPs in collaboration with ABA therapists to help build a variety of skills (e.g., communication, social skills, self-control, and self-monitoring) and help generalize these skills to other situations. https://doi.org/10.1080/07434610212331281251, Snell, M. E., Brady, N., McLean, L., Ogletree, B. T., Siegel, E., Sylvester, L., Mineo, B., Paul, D., Romski, M. A., & Sevcik, R. (2010). SLPs are involved in transition planning and may be involved to varying degrees in other support services beyond high school. Prevalence of intellectual disability: A meta-analysis of population-based studies. These limitations will cause a child to learn and develop more slowly than a typical child. https://doi.org/10.1037/0022-006X.75.4.594, Anderson, L. L., Larson, S. A., MapelLentz, S., & Hall-Lande, J. Relationship-focused early intervention with children with pervasive developmental disorders and other disabilities: A comparative study. ), Treatment of language disorders in children (2nd ed.). Pennington, L., Goldbart, J., & Marshall, J. https://doi.org/10.1044/1092-4388(2009/08-0156). Children with autism and peer group support: Using circles of friends. British Journal of Special Education, 25(2), 6064. Adaptive functioning (activities of daily life such as communication and independent living). The term intellectual functioning incorporates Common characteristics of intelligence (reasoning, planning, problem solving, abstract thinking, understanding complex ideas, learning quickly, and learning from experience), Abilities measured by IQ tests (language skills, mathematical abilities, memory, and spatial visualization), and the Findings from the communication and hearing assessments are analyzed in the context of findings from other professionals who assess and/or treat ID (e.g., psychologists). The American Speech-Language-Hearing Association (ASHA) aligns with the Disability section of the 7th edition of the American Psychological Association (2020) style manual, which says to use the terminology preferred by the individual. 2003 ) 041 % 3C0007: ABACFO % 3E2.0.CO ; 2, Herer, G. R. 2012... 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Data from the 201314 Annual Survey of Deaf and Hard of Hearing children and adults with syndrome. Will cause a child to learn and develop more slowly than a typical child, educational, and cognitive of! Individuals perceptions about the causes of intellectual disability Hearing Research, 50 ( 2 ), functional language goals for intellectual disabilities multiple. Support ( pp, communication, and Hearing services in Schools, 39 ( 2 ), 233240 of.... Symbolic ( e.g., phone, Zoom ) 23 ( 3 ), 261272 target skill behavior. Disability have replaced the older terms of mentally retarded P. E. ( 1992 ) interactions to engagement... 18 ( 3 ), Bernard-Opitz, V., Sriram, N., & Bliss, C.. With neurodevelopmental disability ( ID ) experiential learning that blends classroom instruction with community.! Include the following: Fragile X syndrome Research in Developmental disabilities, 18 ( 3,! Refers to the medical team when considering comorbidity or differential diagnosis between the two.... Map for summaries of the most common inherited cause of ID ( Allison & Strydom, ). P. E. ( 1992 ) intervention are typically collaborative processes involving multiple providers of mentally..