Intellectual Disability

developmental testing

assess cognitive, language, and motor skills to identify possible developmental concerns

Global Developmental Delays (GDD)

in children under 5 years old, unable to undergo IQ testing, delays in at least 2 developmental areas

DSM-5 Criteria for ID

1. deficits in intellectual functioning (reasoning, problem solving, etc.)

2. deficits in adaptive functioning that hampers conforming to developmental and sociocultural standards

3. develop in childhood

Wechsler Model 5 domains

verbal composition, visual spatial, fluid reasoning, working memory, processing speed

etiology (causes) of ID

• fetal alcohol spectrum disorder

• pregnancy complications

• genetic syndromes

• perinatal asphyxia

• toxic exposure and diseases

fetal alcohol spectrum disorder

drinking during pregnancy → effects neurodevelopment

symptoms- ID, learning disabilities, speech and memory delays, physical problems

Assessing for ID

IQ test

adaptive behavior measures

developmental history

maybe genetic and language testing

IQ tests for ID

benchmark: about 0-70

• bottom 2% of normal curve

adaptive behavior measures

conceptual skills- reading + writing, language, direction

social skills- rules, gullibility, interpersonal skills

practical skills- daily life skills, occupational

severity of IDs

higher severity= earlier identification

• mild: early elementary years

• moderate: preschool years

• severe and profound: infancy

mild ID

85% of cases

up to about 6th grade academic skills

IQ: 50-69

can live independently with minimal support

moderate ID

10% of cases

up to 2nd grade level

IQ: 34-49

possible independent living with moderate support (group homes)

severe ID

3.5% of cases

IQ: 20-35

requires daily assistance with self care and safety supervision

visible features and developmental delays

profound ID

1.5% of cases

IQ <20

requires 24 hour care, basic communication skills

prevalence of ID

1-3% of the population

increased mild cases in low SES and racial minority children

equal severe and profound in different racial and economic groups

associated problems with ID

emotional and behavioral problems (aggression, anxiety and mood disorders, etc.

• 3-7x more common

Pica- eating inedible things

self-injurious behavior

high likelihood of health conditions (obesity, epilepsy, etc.)

sometimes lower life expectancy

challenges accessing healthcare

early childhood treatments of ID

prenatal education and screening

early intervention:

• speech therapies, behavioral approaches, early childhood education

behavioral treatments for ID

initially seen as a way to “normalize”, controlling for negative behaviors

social skills and adaptive behavioral skills (by modeling)

CBTs

self-instructional training- coming up with verbal cues to keep self on track)

metacognitive training

supports for ID treatments

speech therapy

OT/PT

communicative supports

educational accommodations (Individual Education Plans)

family therapy

to help caregivers cope

• higher rates of maternal stress and depression

• provide about 40+ hours of care/week

systematic problems

Expensive services

decreasing services as children grow up

stigma

communication barriers

system navigation (may have the means, but do they know how to navigate getting treatment)