Ch8 Intellectual Disabilities Flashcards
Intellectual Disabilities
Used to describe a variety of conditions with genetic a variety of conditions with genetic and nongenetic etiologies
-Characterized by deficits in intellectual functions that can vary in severity.
Down Syndrome
Common condition associated with intellectual disability
Intellectiual Disability deficits in intellectual functions include:
- Reasoning, problem-solving, planning, abstract thinking, judgment, academic learning, and learning from experience.
- These deficits lead to impairments in adaptive functioning that can impact personal, social, academic, and/or occupational functioning.
Diagnostic Criteria for Intellectual Disability (nuerodevelopmental disorder)
An individual must have onset of the condition during the developmental period and have both intellectual and adaptive functioning deficits in conceptual, social, and practical domains to the extent that ongoing support is needed to adequately perform activities in one or more life settings at home, work, school, or community
Intellectual functioning is determined by…
A qualified professional who administers an IQ test assessing the capacity for learning, reasoning, and problem-solving.
- Average: 100 (majority of individuals between 85 and 115)
- Limited intellectual functioning: 70 or below.
- Other reliable psychometrically sound assessment tools are administered to determine limitations in adaptive functioning (ex. Vineland Adaptive Behavior Scales)
Adaptive functioning is divided into three skill domains
- Conceptual skills include academic skills of memory, reading, writing, math, reasoning, language, problem-solving, judgment in novel situations, and acquisition of practical knowledge.
- Social skills include interpersonal skills, social responsibility, self-esteem, gullibility, social problem-solving, and the ability to follow rules, obey laws, and avoid being victimized.
- Practical skills include activities of daily living (ADLs), work and leisure skills, health care, travel/transportation, schedules/routines, safety, use of money, and use of the telephone.
Mild (Levels of Severity in Intellectual Disability and Adaptive Functioning)
- Slowed development, modest difficulty in school
-Higher level executive functioning such as planning, strategizing, and priority setting.
-May sustain employment in jobs that do not emphasize conceptual skills.
(Individuals at this level can often live independently with minimal support in health-care, legal, and financial decisions)
Moderate (Levels of Severity in Intellectual Disability and Adaptive Functioning)
-Can be independent in self-care with intensive training.
-Individuals maintain friendships but often have difficulty interpreting social cues.
-Performance in academic skills is significantly below peers; generally, an elementary school academic level.
-Communication is less complex when compared with peers, and communication and social supports may be needed in vocational and community environments.
(Extensive teaching and cuing supports are needed to develop independent living skills, understand social cues, and learn vocational skills; Environmental and visual cuing systems can help with communication, memory, and sequencing tasks)
Severe (Levels of Severity in Intellectual Disability and Adaptive Functioning)
-Limited attainment of conceptual skills, and cannot read or manipulate numbers
-Communication is focused on the present.
-Understands simple speech and gestures.
-Speaks with limited vocabulary and grammar
(Requires supervision at all times; Significant support for all ADLs, recreation, and work; Caregiver support for problem-solving in all life areas throughout the life span)
Profound (Levels of Severity in Intellectual Disability and Adaptive Functioning)
-Dependent in ADLs.
-Nonverbal and non-symbolic communication and social interactions.
-May follow simple 1- to 2-step actions with objects.
-Often co-occurring physical and sensory conditions creating challenges for participation in social and functional activities.
(Caregiving support for all ADLs; Those able to follow simple commands might assist with simple ADLs)
Neural Dysgenesis
Physical changes or abnormalities of the brain (associated with Intellectual disabilities)
Major Neurocognitive Disorder
Diagnosis when intellectual disability occurs after age 18
Anti-anxiety medications and SSRIs
Can alleviate symptoms related to obsessive compulsive behaviors and feelings of panic, fear, and worry. Another class of medications called benzodiazepines are also used to treat anxiety disorders. Commonly seen benzodiazepines include clonazepam (Klonopin), lorazepam (Ativan), and alprazolam (Xanax) (
Antidepressants
Affect mood and emotional responses through interacting with neurotransmitters such as serotonin, norepinephrine, and dopamine.
Most commonly used Antidepressants
- Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac) and paroxetine (Paxil).
- Other commonly used antidepressants are serotonin norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta) and venlafaxine (Effexor).
- SSRIs and SNRIs are commonly used because they have fewer side effects than other antidepressants: tricyclics such as amitriptyline (Elavil) or monoamine oxidase inhibitors (MAOIs) such as phenelzine (Nardil)
Mood stabilizers
- Used to regulate mood swings and are commonly used in the treatment of mania and bipolar disorder.
- Lithium is the most commonly known mood stabilizer.
- Anticonvulsant medications have been found to be an effective mood stabilizer (ex. carbamazepine (Tegretol) and valproic acid (Depakote)
Antipsychotic medications
Used for individuals with an intellectual disability who experience delusions and/or hallucinations. (either typical or atypical)
- Typical antipsychotic medications or neuroleptics include chlorpromazine (Thorazine), haloperidol (Haldol), and fluphenazine (Prolixin). Typical neuroleptic medications have many side effects including tardive dyskinesia. Atypical antipsychotics include risperidone (Risperdal), aripiprazole (Abilify), and clozapine (Clozaril).
- Atypical antipsychotics have fewer side effects than typical neuroleptics
- Medication use, especially psychotropic medications, for persons with an intellectual disability are used with caution because of the potential side effects that can exacerbate a behavior or the challenges and reliability with medication self-management
Is the prevalence rate of intellectual disability greater among males or females?
Among males is greater than that among females
Fragile X syndrome is higher in males than females, and Rett syndrome is almost exclusive to females
Multidimensional Human Functioning Approach
Considers the transaction of a person’s cognitive and intellectual abilities, the activities or tasks, the level of participation, the available supports, and the context of the performance in assessing human functioning.
-This means a person has the potential to adapt attention or other cognitive abilities depending on the activity and context, whether severely or mildly impaired
Sensory Function
Refers to the neurotransmission of impulses from sensory receptors to the brain for the ability to see or the ability to hear
Sensory Processing
Refers to the interpretation of sensory information into meaningful and usable constructs for action
-It is important to distinguish between these different sensory abilities for appropriate identification of factors that facilitate and constrain occupational performance.
