Intellectual Disabilities

Question 1

What is the definition of Intellectual Disability (ID) according to WHO, 1992?

Answer 1

Intellectual Disability (ID) is a condition of arrested or incomplete development of the mind, characterised by impairment of skills that contribute to the overall level of intelligence (WHO, 1992).

Question 2

What skills are impaired in Intellectual Disability (ID)?

Answer 2

Cognitive, language, motor, and social abilities.

Question 3

According to AAIDD, what characterises Intellectual Disability?

Answer 3

Significant limitations in both intellectual functioning and adaptive behaviour.

Question 4

At what age does Intellectual Disability originate?

Answer 4

Before age 18.

Question 5

What is the IQ range for Very Superior Intelligence?

Answer 5

IQ > 130.

Question 6

What is the IQ range for Average Intelligence?

Answer 6

IQ range 90-109.

Question 7

What IQ range is considered Mentally Retarded?

Answer 7

IQ < 70.

Question 8

What is important to consider when measuring adaptive functioning in individuals with ID?

Answer 8

Use culture-fair assessment tools and evaluate adaptive behaviour by comparing functional abilities to peers of similar age and education.

Question 9

Name three synonyms for Intellectual Disability.

Answer 9

Mental retardation, learning disability, mental impairment.

Question 10

What limitations characterise Intellectual Disability according to DSM IV?

Answer 10

Limitations in >2 of communication, self-care, home living, social skills, self-direction, community living, health and safety, academic abilities, leisure, and work.

Question 11

What is the prevalence of Intellectual Disability in the general population?

Answer 11

1-3%.

Question 12

What percentage of Intellectual Disability cases are Mild?

Answer 12

80%.

Question 13

What is the IQ range for Moderate Intellectual Disability?

Answer 13

IQ range 35-49.

Question 14

What are the key features of Severe and Profound Intellectual Disability?

Answer 14

Severe: IQ 20-34 (3-4%); Profound: IQ < 20 (1-2%).

Question 15

What physical co-morbidities are common in individuals with severe Intellectual Disability?

Answer 15

Visual impairment, hearing impairment, speech and language disorders, cerebral palsy, seizures.

Question 16

What psychological co-morbidities are increased in individuals with Intellectual Disability?

Answer 16

ADHD, affective disorders, psychotic disorders, eating disorders.

Question 17

Who are the key members of a multidisciplinary team for assessing ID?

Answer 17

Developmental or neurology specialists, psychologists, psychiatrists, speech and language therapists, occupational therapists, audiologists, optometrists.

Question 18

What are essential components of a typical assessment for Intellectual Disability?

Answer 18

Age and culture-appropriate IQ testing, formal assessment of adaptive skills, investigation of family and developmental history, assessment of psychological and behavioural functioning, physical examination, speech assessment, auditory assessment, and relevant investigations.

Question 19

What are some common ways mental health problems present in children with ID?

Answer 19

Overactivity, attention deficits, self-injurious behaviour, cyclical mood and behaviour change, ritualistic and obsessional behaviours.

Question 20

Name contributors to psychological difficulties in children with ID.

Answer 20

Severity of ID, social factors like abuse and stigma, schooling, poverty, cause of ID.

Question 21

What are the goals of management for Intellectual Disability?

Answer 21

Minimise symptoms and disability, reduce risk, teach life skills, improve quality of life, and support families.

Question 22

What reactions do families often have when caring for someone with severe Intellectual Disability?

Answer 22

Caregivers are often overwhelmed, may reject the individual, and in severe cases, may abandon or institutionalise them.

Question 23

List common challenging behaviours associated with Intellectual Disability.

Answer 23

Aggression, self-injury, destroying objects, non-compliance, socially inappropriate behaviour.

Question 24

What strategies can be used to manage challenging behaviour in individuals with ID?

Answer 24

Adapt environment, establish routines, encourage group activities, adapt communication, use modelling, and redirection.

Question 25

What is the role of medication in managing Intellectual Disability?

Answer 25

Medication is often overused and should not be the first line; it targets symptoms and carries a higher risk of side effects.

Question 26

What are the needs of individuals with Intellectual Disability in adulthood and old age?

Answer 26

Needs include work, family, independent living, community participation, and addressing the increased risk of Alzheimer’s and other health problems.

Question 27

Define Autism Spectrum Disorder (ASD).

Answer 27

A complex neurodevelopmental disorder that impacts a child’s ability to communicate and interact socially, usually diagnosed in early childhood, with varying abilities and needs.

Question 28

What are the DSM criteria for diagnosing Autism Spectrum Disorder?

Answer 28

Deficits in social communication and interaction, restricted, repetitive patterns of behaviour, interests, and activities.

Question 29

What is the estimated prevalence of ASD according to WHO?

Answer 29

1 out of 100 children worldwide.

Question 30

What are the key etiological factors in Autism Spectrum Disorder?

Answer 30

Genetic factors (20-80 fold risk in 1st degree relatives, associated genetic syndromes) and environmental factors (prenatal, perinatal, postnatal, psychosocial, immunologic).

Question 31

Describe the typical clinical features of Autism Spectrum Disorder.

Answer 31

Deficits in social communication and interaction, restricted, repetitive patterns of behaviour, unusual responses to environmental stimuli, self-injurious behaviours, sleep problems.

Question 32

Name some co-morbidities associated with Autism Spectrum Disorder.

Answer 32

Personality disorders, general medical conditions, developmental disorders, metabolic disorders.

Question 33

What are some differential diagnoses for Autism Spectrum Disorder?

Answer 33

Social communication disorder, language disorders, selective mutism, sensory deficits, Landau-Kleffner syndrome, psychosocial deprivation, reactive attachment disorder, social anxiety disorder.

Question 34

What investigations might be carried out to assess Autism Spectrum Disorder?

Answer 34

Audiology testing, electroencephalogram, brain MRI, lead test, wood lamp examination, metabolic screening, genetic testing.

Question 35

List some instruments used in the assessment of Autism Spectrum Disorder.

Answer 35

Autism diagnostic observation schedule (ADOS-2), childhood autism rating scale (CARS-2), modified checklist for autism in toddlers (M-CHAT), Autism Diagnostic Interview – Reviewed (ADI-R).

Question 36

What are the goals of managing Autism Spectrum Disorder?

Answer 36

Start early, individualised, intensive, family therapy, multidisciplinary approach, treat co-occurring conditions.

Question 37

What are some behavioural management strategies used in Autism Spectrum Disorder?

Answer 37

Applied behavioural analysis (ABA), discrete trial training (DTT), pivotal response training (PRT), developmental therapies like speech and language therapy, occupational therapy.

Question 38

What therapeutic approaches are used in the management of ASD?

Answer 38

Cognitive-behavioural therapy (CBT), social skills groups, educational interventions like TEACCH, socio-relational approaches like floor time.