Complex Access Needs or Significant Cognitive Disabilities

  • The Complex Access Needs program at Region One Education Service Center provides technical assistance and professional development to school personnel and parents to help all children succeed in school. Our ultimate goal is to help those in the "front lines" help those special learners achieve their full potential. 

     Significant Disabilities Defined

    Significant disabilities are also identified as “low-incidence” disabilities by the U.S. Department of Education (USDE.) Low-incidence disabilities are defined by the USDE as

    • a visual or hearing impairment,
    • or simultaneous visual and hearing impairments; 
    • or a significant cognitive impairment; or 
    • any impairment for which a small number of personnel with highly specialized skills and knowledge are needed in order for children with that disability to receive early intervention services or a free appropriate public education.

     The Texas definition of a student with a significant cognitive disability

    is a student who:

    • exhibits significant intellectual and adaptive behavior deficits in their ability to plan, comprehend, and reason, and ALSO indicates adaptive behavior deficits that limit their ability to apply social and practical skills such as personal care, social problem-solving skills, dressing, eating, using money, and other functional skills across life domains;
    • is NOT identified based on English learner designation or solely on the basis of previous low academic achievement or the need for accommodations; and 
    • requires extensive, direct, individualized instruction, as well as a need for substantial supports that are neither temporary nor specific to a particular content area.

     Texas Defines Medically Fragile As: 

    Whether the student receiving special education and related services is ALSO: 

    • In the age range of birth to 22 years, AND
    • has a serious ongoing illness or a chronic condition that has lasted or is anticipated to last at least 12 or more months or has required at least one month of hospitalization, and
    • that requires daily ongoing medical treatments and monitoring by appropriately trained personnel which may include parents or other family members, and requires the routine use of a medical device or the use of assistive technology to compensate for the loss of usefulness of a body function needed to participate in activities of daily living; AND
    • requires the routine use of medical device or of assistive technology to compensate for the loss of usefulness of a body function needed to participate in activities of daily living (ADL), AND
    • lives with ongoing threat to his or her continual well being.

    Deaf-blindness Defined

    The term deaf-blindness means concomitant hearing and visual impairments, the combination of which causes such severe communication and educational needs that they cannot be accommodated in special education programs solely for children with deafness or children with blindness.

    In meeting the criteria for deaf-blindness, the child with deaf-blindness is one who:

    • Meets the criteria for auditory impairment and visual impairment; 
    • Meets eligibility criteria for visual impairment and has a suspected hearing loss that cannot be  demonstrated conclusively, but there is no speech at an age when speech would normally be expected, as determined by a speech-language therapist, a certified speech and language therapist, or a licensed speech-language pathologist; 
    • Has documented hearing and visual losses that, if considered individually, may not meet the requirements for auditory impairment or visual impairment, but the combination of such losses adversely affects the student's educational performance; or
    • Has a documented medical diagnosis of a progressive medical condition that will result in related auditory and visual losses that, without special education intervention, will adversely affect educational performance.


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Last Modified on January 31, 2023