Cognitive Development Flashcards
Formal Assessment of Abilities
Intellectual Disability
–>
Intelligence
Adaptive Behavior
Formal Assessment of Abilities
–>
Intelligence/Cognitive Ability
Academic Functioning
The Normal Curve
The Mean IQ score = 100
Approximately 95% of the population have scores within two standard deviations (SD) of the mean (70- 130)
2/3 of the population have IQ scores within one SD of the mean (85- 115)
Intelligence / Cognitive Assessment
“We must guard against defining intelligence solely in terms of ability to pass the tests of a given intelligence scale. It should go without saying that no existing scale is capable of adequately measuring the ability to deal with all possible kinds of material on all intelligence levels.”
- Terman (1921, as quoted in Sattler, 1992)
Current views of intelligence
Multifaceted and hierarchically organized
Intelligence quotient “IQ” is a general estimate of the sum of many different abilities
General factor (g) impacts global functioning on cognitive tasks as well as specific abilities
Genetic contributions to intelligence modified by experiences
A current view of intelligence
Cattell-Horn-Carroll Model of Intelligence
General Intelligence- Stratum III
Broad Abilities- Stratum II
Narrow Abilities- Stratum I
See chart nigga
Factors Influencing Intelligence
Genetic Factors
Familial Factors
Nonfamilial Factors
Genetic Factors
Genetic Makeup
Familial Factors
Mother ‘s IQ and Education Father’s IQ and Education Socioeconomic Status Prenatal Variables Early Developmental Variables Health Care and Nutrition
Nonfamilial Factors
Quality of School Teacher characteristics Culture Quality of Community Environmental Toxins
The Flynn Effect
Documented by James Flynn in 1984
Rise in standardized intelligence test scores since the beginning of the 20th century
Average rate of increase 3 IQ points per decade
Cause remains uncertain
What is an Intellectual Disability?
DSM-5 Criteria
Deficits in intellectual functions
(e.g. problem-solving, reasoning, abstract thinking, planning, learning, etc.)
Generally Full Scale IQ < 70
Deficits in adaptive functioning that result in a failure to meet developmental and socio-cultural standards for personal independence and social responsibility.
Onset of intellectual and adaptive deficits occurs during the developmental period (childhood and adolescence
Intellectual Disability
American Association on Intellectual and Developmental Disabilities (AAIDDD)
Significant limitations in intellectual functioning and adaptive behavior which are apparent prior to the age of 18
Definition based on 5 assumptions:
- Limitations are considered within the context of the person’s environment and culture
- Assessment should consider cultural and linguistic diversity as well as differences in communications, sensory, motor, and behavioral factors
- Limitations often coexist with strengths
- You must develop a profile of needed supports
- With appropriate personalized supports, the functioning of the person with the intellectual disability will generally improve
Intellectual Disability: Levels of Severity
Mild
Moderate
Severe
Profound
Mild
85 percent
IQ range 50 to 69
There may be no obvious differences in young children
Differences often appear in academic settings for children and teens
Independent employment in with special training and supervision and may be able to live partially independently
Moderate
10 percent
IQ range 34 to 49
Skills lag behind same-age peers throughout development
May need help acquiring basic skills for daily living (e.g. hygiene, safety, household chores) – may need supervised housing
May work in sheltered
environment with extensive support and supervision
Severe
3 to 4 percent
IQ range 20 to 34
Very basic communication skills
Need extensive supports throughout life in most domains
Profound
1 to 2 percent
IQ range < 20
Minimal functioning; limited understanding of others/world
Dependent on others for all aspects of daily care
Estimates of Mental Age and Academic Achievement
Mild
Adult Mental Age
9 to 11 years
Grade Level
3rd to 6th
Estimates of Mental Age and Academic Achievement
Moderate
Adult Mental Age
6 to 9 years
Grade Level
1st to 3rd
Estimates of Mental Age and Academic Achievement
Severe
Adult Mental Age
4 to 6
Grade Level
Pre-K to 1st
Estimates of Mental Age and Academic Achievement
Profound
Adult Mental Age
< 4 years
Grade Level
N/A
Developmental/Cognitive Ability Measures
Mullen Scales of Early Learning
(birth to 68 months)
Bayley Scales of Infant Development -III
(1 to 42 months)
Wechsler Preschool and Primary Scale of Intelligence – Fourth Edition (WPPSI-IV)
Ages 2:6 through 7:7
Wechsler Intelligence Scale for Children – Fifth Edition
(WISC-V)
Ages 6:0 through 16:11
Wechsler Adult Intelligence Scale – Fourth Edition (WAIS-IV)
Ages 16:0 through 90:11
Woodcock-Johnson IV Tests of Cognitive Ability
Ages 2 through 90+
Based on the Cattell-Horn-Carroll (CHC) theory of cognitive abilities
Used most often by school districts
Stanford-Binet Intelligence Scales, Fifth Edition (SB5)
Ages 2 through 85
Good for assessing very low of intellectual functioning range
Differential Ability Scales – Second Edition (DAS-II)
Ages 2 years, 6 months through 17 years, 11 months
Less culturally loaded measure
Cognitive Ability Tests: Nonverbal Measures
Leiter International Performance Scale – 3
Test of Nonverbal Intelligence – Third Edition (TONI-3)
Universal Nonverbal Intelligence Test (UNIT)
Adaptive Behavior Skill Areas:
Communication Self-care Home living Social/Interpersonal skills Use of community resources Self-direction Functional academic skills Work Leisure Health Safety
Academic Development Measures
Woodcock-Johnson IV Tests of Achievement (WJ-IV)
Kaufman Test of Educational Achievement – Third Edition
Wechsler Individual Achievement Test – Second Edition
Intellectual Disability
The range of IQ scores 2 standard deviations below the mean (<70)
Adaptive functioning must be a standard scores 70 or below
Intellectual Disability: Etiologies & Risk Factors
Medical
Genetic Syndromes
Abnormal Brain Development
Premature birth or birth injury
Prenatal Exposure to certain infections: TORCH
Prenatal Exposure to Alcohol
Prenatal Exposure to Toxins
Childhood diseases
Genetic Syndromes
Down Syndrome
Fragile X
Abnormal Brain Development
Gray matter heterotopias
Porencephaly
Premature birth or birth injury
Cerebral Palsy
Stroke
Prenatal Exposure to certain infections: TORCH
Toxoplasmosis Other Infections; syphilis, herpes zoster Rubella Cytomegalovirus Herpes simplex II
Prenatal Exposure to Alcohol
Fetal Alcohol Syndrome
Prenatal Exposure to Toxins
Lead
Childhood diseases resulting in
Meningitis
Encephalitis
Intellectual Disability: Intervention
Educational programming
Community-Based Resources
Texas Workforce Commission and the Texas Health and Human Services Commission
Educational programming
Based on level of functioning not etiology
Community-Based Resources
Arc of Greater Houston
Harris Center for Mental Health and Intellectual and Developmental Disabilities (IDD)
Texas Workforce Commission and the Texas Health and Human Services Commission
Disability determination services
Transition planning
Vocational training/job placement
Independent living services
Implications for Physicians
Pediatric Primary Care and Specialties
Early Childhood
Delayed language or motor milestones –> Early Childhood Intervention Referral
School Age
Struggling in school; Known risk factor –> Psychoeducational Assessment
Implications for Physicians
Adult Primary Care and Specialties
Understanding the diagnosis
Understanding the treatment plan
Adherence to the treatment plan
Implications for Physicians
General
First, speak to the person with intellectual disability then clarify with family if something is not clear
Use language simple language, or use a communication aid
Ask open questions or change the question to see if the response it the same
Avoid euphemisms
Check for understanding by asking them to explain to you in their own words
When talking about time, use events that the person might understand
Do not assume that the person will understand the connection between the illness and something they have done or something that has happened to them
Specific Learning Disabilities: DSM-V Guidelines
Difficulty learning or using academic skills in reading, written expression or mathematics, despite interventions
Affected academic skills well below age-expected levels
Significantly interfere with school or occupational performance
Confirmed by individually administered, standardized measures of academic achievement
Begin during school-age years but may not become fully manifested until later
Cannot be accounted for by an intellectual disability, sensory issue, lack of opportunity or, inadequate instruction
Diagnostic criteria met based on clinical synthesis of assessment, school reports, and history (developmental, medical, educational)
Specific Learning Disabilities
Prevalence 5 to 15 percent of school age children
More common in males (2:1 to 3 :1)
Persist into adulthood
Manifestation of SLD varies with age as a consequence of changes in environmental expectations
High hereditability
Neuroimaging, genetic testing not yet useful for diagnosis
Negative functional consequences:
Higher high school drop out rate
Underemployment
Lower income
Specific Learning Disability: Reading
Reading Deficit
Inaccurate Slow Reading
Specific Learning Disability: Written Expression
Written Expression Deficit Spelling Use of vocabulary/grammar Use of punctuation and capitalization Clarity of ideas Organization of thoughts
Specific Learning Disability: Mathematics
Math Deficit
Math Calculations
Implications for Physicians
Pediatric Primary Care and Specialties
Struggling in school Memory problems Inconsistent grades Grade retention --> Psycho-educational Assessment
Implications for Physicians
Adult Primary Care and Specialties
Difficulty completing pre-visit paperwork
Difficulty following complex after-visit summaries
Difficulty with treatment regimens requiring complicated calculations
Intellectual and Learning Disabilities: Interventions
Individuals with Disabilities Education Act (IDEA) – a federal law that requires school districts to provide a free and appropriate education to students with disabilities
Based on educational need not diagnosis
Schools use Response To Intervention (RTI) method to determine if the student has received high quality instruction prior to a label of “learning disability”
Intellectual and Learning Disabilities: Interventions
Intellectual Disability Specific Learning Disability Other Health Impairment Autism Speech and Language Impairment Traumatic Brain Injury Visual Impairment Hearing Impairment Orthopedic Impairment Emotional Disturbance
Intervention: Section 504
Section 504 is a portion of the Rehabilitation Act of 1973 that specifies that no program that receives federal money can discriminate against a person with a disability
Requires that students have an equal opportunity to participate in all school activities
Some children who do not qualify for Special Education services under IDEA may still receive accommodations under Section 504
