Chapter 5 Child Psychopathology

Chapter 5: Intellectual Developmental Disorder (Intellectual Disability)

The term "Mental Retardation" was officially renamed to "Intellectual Developmental Disorder" (IDD) by the American Association on Intellectual and Developmental Disabilities (AAIDD) in 2007, reflecting a shift towards more respectful and accurate terminology.
IDD is defined as a neurodevelopmental disorder that manifests before the age of 18, significantly impairing social and academic functioning according to the American Psychiatric Association (APA, 2013).
The disorder is characterized by considerable limitations in both intellectual abilities and adaptive functioning, encompassing conceptual, social, and practical skills.
Over the past 50 years, key diagnostic elements have emerged, focusing on defendants in intellectual capabilities, limitations in adaptive functioning, and the need for symptom onset prior to the age of 18.
The evaluation also emphasizes the context of comparative functioning, assessing individuals against age-matched peers and cultural norms (AAIDD, 2010).

Prior to the mid-nineteenth century, individuals with IDD faced widespread misunderstanding, fear, and neglect from society, often viewed as burdens.
Gradually, social reform movements and advancements in scientific understanding began to improve support systems for individuals with IDD, although significant stigma remained.
During the 1960s, media exposés revealing institutional mistreatment, such as solitary confinement, prompted a societal shift towards advocating for humane treatment of those with IDD.
The eugenics movement, prevalent in the early twentieth century, mistakenly linked individuals with IDD to a range of social issues, which perpetuated harmful stereotypes and terms such as "moral imbeciles" (Gelb, 1995).

To gain a historical perspective on the evolution of understanding and treatment of intellectual developmental disorder over time.
To understand the comprehensive definition and core features of IDD.
To explore factors that influence IQ test results, including socio-economic factors and educational opportunities.
To examine the detrimental effects of redlining on access to quality education and its subsequent effect on IQ outcomes.

The first intelligence test, designed by Alfred Binet and Théophile Simon, was created in the early 20th century to identify children in need of special education services.
IQ tests typically report scores with a mean of 100 and a standard deviation of 15, with scores of 70 or below traditionally indicating below-average intellectual functioning.
The DSM-5 highlights the importance of diverse assessments, advocating for a comprehensive evaluation that incorporates not only IQ scores but also adaptive functioning and contextual factors to provide a full understanding of the individual's capabilities.

Numerous variables influence IQ test scores, including socioeconomic status, parenting styles, access to educational resources, and cultural background.
Historically, practices like redlining have limited access to quality educational institutions for marginalized communities, thereby affecting the educational attainment and cognitive development of children in those neighborhoods.
Environmental factors, particularly those encountered during early developmental stages, can significantly alter cognitive abilities, emphasizing the need for supportive pre- and early educational interventions.

Deficits in Intellectual Functions: Involves challenges in reasoning, judgment, and problem-solving, typically assessed through clinical evaluation and standardized tests.
Deficits in Adaptive Functioning: Characterized by limitations in daily life activities such as communication, social interactions, and self-care, adversely affecting independence and quality of life.
Onset During Developmental Period: Symptoms must emerge before the age of 18, highlighting the importance of early diagnosis and intervention.

Mild Level: Individuals often experience adaptive skills that are near those of their peers but typically require some support for academic learning and decision-making.
Moderate Level: This group often requires more substantial assistance, especially in academic and social settings, and identification usually occurs during preschool years.
Severe Level: Individuals need significant support for daily living, facing crucial challenges in basic self-care and routine activities.
Profound Level: These individuals require extensive assistance across all areas of life due to profound disabilities, and often also have additional severe disabilities.

Children diagnosed with IDD typically achieve developmental milestones, albeit at varying rates compared to their typically developing peers.
With appropriate educational and therapeutic interventions, adaptive skills can improve over time, fostering greater independence and engagement in society.
The environment plays a critical role; supportive educational settings that emphasize skill acquisition can positively influence developmental trajectories.
Common co-occurring issues include emotional, behavioral, and physical challenges that can further complicate overall development and require holistic approaches to intervention.

Using a two-group approach, the causes of IDD can be categorized into organic (biological origins) and cultural-familial (environmental influences).
Notable genetic factors that contribute to IDD include chromosomal abnormalities (e.g., Down syndrome) and single-gene disorders (e.g., fragile-X syndrome), which require targeted intervention strategies.
Certain preventable causes are linked to prenatal risk factors, including alcohol exposure (leading to Fetal Alcohol Spectrum Disorder), malnutrition, and inadequate healthcare access during pregnancy and infancy.
Early intervention strategies, such as prenatal education and screening programs, are crucial in mitigating risks and providing the best developmental outcomes for at-risk populations.

Early Intervention: Play an essential role in preschool years; incorporates family involvement to maximize effectiveness.
Behavioral Treatment: Focuses on teaching specific skills rather than merely offering behavioral management, promoting long-term adaptive functioning.
Family-Oriented Strategies: Crucial for families raising children with IDD, including support networks, training, and resource access to cope with the unique challenges encountered.
Cognitive-Behavioral Techniques: Beneficial for children who have developed language skills, enabling them to apply self-regulatory strategies for managing emotions and behaviors.

Intellectual Disability and Its Impact: Underline the complex challenges that ID can create, while also highlighting that effective interventions that emphasize individual strengths, supportive environments, and skill development can lead to positive outcomes.
Continued Research and Application: Emphasize the importance of ongoing research investigating environmental influences and genetic factors that can inform effective treatment strategies and support systems for individuals with IDD.

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