Intellectual Disability

Question 1

Intellectual Disability

Answer 1

Characterized by limitations in intellectual functioning or adaptive behavior as expressed in conceptual, social, and practical adaptive skills that develop before the age of 18

Question 2

Intellectual Functioning

Answer 2

Involves the mental capacity for learning, reasoning, and problem-solving

Question 3

Adaptive behavior

Answer 3

Conceptual, social, and practical skills

Question 4

Inntellectual Disabilites can be in what areas?

Answer 4

• Reading
• Math
• Writing
• Motor Skill Deficits
• Language Deficits
• Auditory and Visual Processing Issues

Question 5

Mild vs. Severe Intellectual Disabilities

Answer 5

Mild: Challenges in a few of these areas
Severe: Challenges in all of the areas described

Question 6

Down-Syndrome

Answer 6

Tyoe of genetic intellectual disability

Question 7

Who is “at risk” for developmental delay (often referred to as global developmental delay)?

Answer 7

Infants at higher risk include

• Premature infants
• Those infants with perinatal complications, other known health conditions, or maternal factors
• Infants with low socioeconomic family factors

Question 8

What is the basis for early identification of developmental delay?

Answer 8

• Significant delays in acquisition of age-appropriate developmental milestones in language, motor and social-adaptive skill development
• Developmental delay is defined as a young child’s inability to meet age-appropriate expectations based on a typical developmental progression.
• Ex. Delayed responsiveness to auditory and visual in first. months of life, poor suck for feeding, hyper or hypotonicity leading to delays in head control, sitting, or standing and delays in language acquisition

Question 9

How is global developmental delay identified in the young child?

Answer 9

• Monitoring of developmental progression (Early Intervention referral, pediatrician record of developmental milestones)
• Multidisciplinary team screening and evaluation (recognition of caregiver concerns) Example: Developmental Screening Assessment, such as the Ages & Stages Questionairre

Question 10

What are additional Best Practice Approaches for children identified with developmental delay?

Answer 10

• Parent/ caregiver education and support
• Provide neonatal hearing and vision screening and evaluation follow up
• Maintain consistent well-child health (pediatrician) follow up
• Multidisciplinary team approach; to include early childhood educators and psychology

Question 11

Intellectual disability (ID) replaced the term…

Answer 11

“Mental Retardation” after the passing of U.S Federal law, known as Rosa’s Law

Question 12

An ID diagnosis must include the following:

Answer 12

• An intellectual impairment supported by IQ testing
• Adaptive Behavior deficits
• Onset during the developmental period; typically under age 5

Question 13

Adaptive skill impairment

Answer 13

The child’s inability to adapt or function in daily living skills when compared with same age peers of the same culture.
-Such impairments may limit the child’s participation in daily occupations such as communication, social participation, school participation, and self care with home and community.

Question 14

How is Adaptive Skill Impairment identified?

Answer 14

• The AAIDD definition of intellectual disability requires deficits in at least one of the three domains of adaptive behavior.
• Adaptive skill performance is measured using standardized and psychometrically sound assessments

Question 15

Conceptual Domains (adaptive skill impairments)

Answer 15

• Expressive Language
• Literacy
• Numeracy

Question 16

Social Skill Domain (adaptive skill impairments)

Answer 16

• Interpersonal skills
• Social problem solving
• Rule-following

Question 17

Practical Domain (adaptive skill impairments)

Answer 17

• ADL Skills
• IADLs
• Occupational Skills

Question 18

How is intellectual and adaptive skill performance of young children measured?

Answer 18

Two standard deviations on either side of the mean makes up approx. 95% of the population and defines the range of typical intellectual functioning.

Question 19

Average IQ score is…

Answer 19

100. • Given a 15 point standard deviation on most IQ tests, an individual scoring greater than 2 standard deviations below the mean, or below an IQ of 70-75 may be considered to have an intellectual disability.
     • Based on IQ levels: mild, moderate, severe, profound

Question 20

An intellectual disability diagnosis must include a…

Answer 20

Psychometric measure of both intellectual functioning and adaptive skill performance and must occur during the developmental period. (0-5 yrs)

Question 21

Mild intellectual disability

Answer 21

(IQs of 50-70)

• Linked with socioeconomic and familiar factors i.e., poverty and poor nutrition.
• Common biological factors include perinatal complications, prenatal alcohol and drug exposure.

Question 22

Severe Intellectual Disability

Answer 22

(IQs of less than 50)

• Linked with more biological or genetic factors
  (ex. Trisomy 21 or Down’s Syndrome, fragile X syndrome, and fetal alcohol syndrome)
• Identifiable in greater than 75% of children diagnosed.

Question 23

Most commonly used psychological assessments for children

Answer 23

• Bayley Scales of Infant Development (BSID-III)
• Wechsler Preschool and Primary Scale of Intelligence (4th Ed)
• Wechsler Intelligence Scale for Children (5th Ed)

Question 24

Most commonly used assessment of adaptive behavior

Answer 24

• Vineland 3
• Scales of Independent Behavior
• Adaptive Behavior Assessment System

Question 25

Intellectual disability in the presence of other impairments is known as comorbid conditions may include:

Answer 25

• Cerebral palsy
• Seizure disorders
• Communication disorders
• Hearing and/or visual disorders
• Genetic syndromes (Down’s syndrome, fragile X)
  
  • Inborn errors of metabolism – often the gene or chromosomal anomaly can’t be identified.
• Many of these metabolic errors lead to ID.
• Psychological/ behavioral disorders (ADHD, autism spectrum disorder, mood disorders, conduct disorders)

Question 26

Most common genetic causes of ID

Answer 26

• Down-Syndrome

- Fragile X Syndrome

Question 27

Educational Support Services

Answer 27

• A primary focus of intervention as child will receive educational support relevant to meet their strengths and needs.
• Occupational therapy may be recommended as a school-based related service.
• Focus on promoting educational participation in the least restrictive educational environment

Question 28

Behavioral Therapy

Answer 28

Serves to support behavioral management, school-related adjustment issues, and family support

Question 29

Pharmacology

Answer 29

Not a primary treatment to address intellectual dysfunction but may be used to help with comorbid issues, to include: cerebral palsy, seizure disorders, ADHD, self-injurious behaviors or aggressive behaviors, mood disorders, and OCD.

Question 30

Mild Intellectual Disability (Impact on Client Factors and Occupational Performance)

Answer 30

Some functional literacy and life skills necessary for economic, vocational and social independence in the community.

Question 31

Moderate Intellectual Disability (Impact on Client Factors and Occupational Performance)

Answer 31

Supportive vocational employment, often requires more supervised living skills at home or in a community setting

Question 32

Severe-Profound Intellectual Disability (Impact on Client Factors and Occupational Performance)

Answer 32

Often require greater modifications and supports in supervised living arrangements.