Intellectual Disability

What was the DSM-IV diagnosis of intellectual disability previously called?

Mental Retardation

What are the major changes in the DSM-5 diagnosis of intellectual disability (IDD)?

What it is called

Emphasis on impact on functioning

Criteria improvements for comprehensive assessment

What domains of adaptive functioning are impacted in intellectual disability?

Conceptual Domain

Social Domain

Practical Domain

Conceptual Domain

Language, reading, writing, math, reasoning, knowledge, and memory

Social Domain

Empathy, social judgment, interpersonal communication skills, the ability to make and retain friendships, and similar capacities

Practical Domain

Self management in areas such as personal care, job responsibilities, money management, recreation, and organizing school and work tasks

When must symptoms of intellectual disability begin?

During the developmental period

Intellectual disability is often chronic and co-occurs with what other conditions?

Depression, ADHD, autism spectrum disorder

What does the DSM-5 emphasize when diagnosing intellectual disability?

Using both clinical assessment and standardized intelligence testing

Why did DSM-5 remove IQ test scores from the diagnostic criteria?

To avoid overemphasizing IQ as the defining factor of ability

What IQ score range is typically associated with intellectual disability?

Approximately 70 or below (two standard deviations below the mean)

On what should severity of intellectual disability be based?

Adaptive functioning, not IQ score alone

What percentage of individuals with IDD are classified as mild?

85%

What supports do mild diagnosis’s need?

Can live independently with minimum levels of support

What percentage are classified as moderate?

10%

What supports do moderate diagnosis’s need?

Independent living may be achieved with moderate levels of support, such as group homes

What percentage are classified as severe?

3.5%

What supports do severe diagnosis’s need?

Requires daily assistance with self-care activities and safety supervision

What percentage are classified as profound?

1.5%

What supports do profound diagnosis’s need?

Requires 24-hour care

What is diagnosis based on?

The severity of deficits in adaptive functioning

What are environmental causes of intellectual disability?

Prenatal alcohol exposure, lead exposure

What are medical/biological causes of intellectual disability?

Nutritional deficiencies, brain radiation, childhood brain infections, traumatic brain injury, prenatal/postnatal complications

What are genetic causes of intellectual disability?

Down syndrome, Fragile X syndrome

What are social/psychological causes of intellectual disability?

Deprivation

What are the DSM-5 criteria for intellectual disability?

Deficits in intellectual functions (confirmed by clinical assessment & testing)

Deficits in adaptive functioning (impacting independence and social responsibility)

Onset of deficits during the developmental period

What are effective treatment approaches for intellectual disability?

Early intervention, multidisciplinary team, healthy lifestyle, family/patient education, treatment of co-occurring conditions, consideration of lifelong care

What historical policy affected care for adults with IDD?

Deinstitutionalization

What are common challenges in addressing OT goals for adults with IDD in long-term care?

Limited resources, complexity of needs, challenging behaviors

What should OTs identify to address behaviors in adults with IDD?

Triggers to challenging behaviors

What strategies can address challenging behaviors in adults with IDD in long-term care?

Environmental modifications, structured routines, individualized supports