Ch 5_Intellectual Disability

Intellectual Disability (Intellectual Developmental Disorder)

• Understanding the definition and context of intellectual disability.

• Chapter focuses on the prevalence, causes, and consequences of intellectual disability.

Reality in South Africa

• Article Overview: Discusses barriers to accessing intellectual disability services for children and families in Cape Town.

  • Authors: Siyabulela Mkabile and Leslie Swartz, both associated with South African universities.

  • Key Findings:

    • Higher prevalence in low-income countries.

    • Stigma and discrimination hinder access to healthcare services.

    • Qualitative interviews reveal reasons families do not utilize available services:

      • Financial constraints

      • Fragile care networks

      • Community stigma and safety issues

      • Lack of faith in available services

      • Feelings of powerlessness and self-stigmatization.

    • Emphasis on community-based interventions and collaborations.

• Challenges Faced by Women Raising Children with Intellectual Disabilities:

  • Authors: K.S. Malatji and C. Ndabele.

  • Research Approach: Interpretive paradigm with qualitative case studies.

  • Key Findings:

    • Emotional challenges: shock, anger, frustration.

    • Social challenges: rejection and discrimination in communities.

    • Recommendations for increased government intervention and community support structures.

Defining and Measuring Intelligence

• Historical context of intelligence testing by Alfred Binet and Theophile Simon.

  • Designed to identify children needing educational support.

  • Development of the Stanford-Binet scale for measuring judgment and reasoning.

  • Intelligence Quotient (IQ) as a metric for general functioning.

Intelligence Testing Characteristics

• Types of Skills Measured:

  • Verbal Skills: Evaluated through subtests on reasoning and abstraction (e.g., vocabulary comparisons).

  • Perceptual Skills: Assessed with pattern recognition and visual spatial reasoning tasks.

  • Mathematical Skills: Utilizes arithmetic tasks reflecting age-appropriate calculations.

IQ Distribution and Classification

• Understanding IQ Scores:

  • 95% of the population scores within 30 IQ points of the average (100).

  • Distribution reveals categories:

    • Subaverage intellectual functioning below 70 (2% of population).

    • Scores between 85-115 represent average to low average functioning.

Intellectual Disability Classification (DSM-5)

• Historical Context: Transition from mental retardation to intellectual disability in DSM-5 (2013).

• Three Essential Criteria for Diagnosis:

  • A: Intellectual deficits confirmed by standardized testing.

  • B: Adaptive functioning deficits impacting independence in daily life tasks.

  • C: Onset during developmental periods (before age 18).

Severity Levels of Intellectual Disability

• Determining Factors:

  • Intellectual functioning levels,

  • Adaptive functioning abilities,

  • Age of the child at diagnosis.

Levels of Severity:

1. Mild ID:

   • Approximately 85% of cases.

   • Identified later in early primary school due to minor developmental delays.

   • Able to live independently with some supervision.

2. Moderate ID:

   • About 10% prevalence; identified earlier.

   • Significant communication and self-care challenges.

   • Benefits from skills training; capable of performing in sheltered workshops.

3. Severe ID:

   • Approximately 3-4% of cases; often associated with biological issues.

   • Major delays in physical and cognitive milestones.

   • Requires lifelong intensive care and supervision.

4. Profound ID:

   • Up to 2% of cases; identified during infancy.

   • Significant physical and cognitive disabilities; limited communication abilities.

   • Requires 24/7 caregiver support and often places in care facilities.

Impacts of Intellectual Disability on Development

• Intellectual disability’s influence on developmental milestones, and the ongoing debates regarding developmental progression.

• Types of Causes:

  • Genetic and environmental factors account for most moderate to profound ID cases.

  • Distinction between organic and cultural-familial groups.

Risk Factors over Lifespan

Timing of Causes:

• Prenatal: Chromosomal disorders, maternal illness.

• Perinatal: Birth injuries, prematurity.

• Postnatal: Trauma, malnutrition.

Risk Factors Classification:

• Social: Poverty, domestic violence.

• Behavioral: Substance use.

• Educational: Lack of parental preparation.

Example Approaches to Behavior Treatment in ID

Clinical Case Study: Attachment-focused Interventions:

• Focus on developing secure attachment and desirable behaviors to manage challenging behaviors in children with intellectual disabilities.

Support Areas for Children with ID

• Areas including education, community living, employment, health and safety, behavior, and social interactions.

• Importance of tailored resources to aid in daily functioning and independence.