Intellectual Disability (ID) Or Intellectual Developmental Disorder (IDD)

Question 1

Diagnostic and Statistics Manual-4 (DSM-4)

Answer 1

• terminology change from DSM-4 to DSM-5
• “mental retardation” changed to intellectual disability

Question 2

Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

Answer 2

• impairments of general mental abilities in 3 areas and how well an individual copes with everyday tasks
• conceptual domain (learning things) = language, reading, writing, math, reasoning, knowledge, and memory (IQ two standard deviations below the mean = 2.5% of the population)
• social domain = empathy, social judgment, interpersonal communication skills, the ability to make and retain friendships and similar capacities
• practical domain = self-management in personal care, job responsibilities, money management, recreation, and organizing school and work tasks

Question 3

Age

Answer 3

• onset before 18 years old
• begins in childhood
• diagnosis not generally given in children under 5 because it’s hard to tell
• children under 5 with delays in developmental milestones and intellectual function are generally given diagnosis of global developmental delay (GDD)
• accurate assessment of intellectual function is often not possible during early childhood

Question 4

Classification systems for intellectual disabilities

Answer 4

• DSM-5
• American Association on Intellectual and Developmental Disabilities (AAIDD)

Question 5

DSM-5 Classification

Answer 5

• based on severity of function
• mild = difficulty learning academic skills, immature social communication, independence in ADLs, training/support for IADLs
• moderate = slow development, elementary level education, spoken language for communication of wants/needs, social and communication support
• severe = understand simple speech, expressive language single word require supervision for ADLs, teaching and support assist with skill acquisition
• profound = functional use of objects, dependency for ADLs

Question 6

AAIDD Classification

Answer 6

• based upon intensity of support needs to support engagement in occupations
• considers person’s strengths and abilities
• intermittent = support as needed
• limited = over a limited time span
• extensive = provided on a daily basis for certain occupations
• pervasive = supported needed in all life areas across all environments on a daily basis

Question 7

Etiology

Answer 7

Biomedical influences:
- genetic causes = Fragile X, Down Syndrome
- birth defects = issues with CNS (hydrocephaly, spinal bifida)
Environmental influences:
- prenatal factors = interuterine exposure, low birth weight
- perinatal = hypoxia
- postnatal = trauma (near drowning, child abuse, head injuries) and infection

Question 8

Co-occurring conditions

Answer 8

• cerebral palsy
• epilepsy
• autism
• ADHD
• depression/anxiety

Question 9

Impact of occupational performance on conceptual skills (delayed adaptive skills)

Answer 9

• receptive and expressive language
• reading/writing
• money concepts
• time concepts
• number concepts
• critical thinking/problem solving
• memory

Question 10

Impact of occupational performance on social skills (delayed adaptive skills)

Answer 10

• interpersonal
• empathy
• gullibility
• ability to make and keep friends
• following rules/laws
• social problem solving

Question 11

Impact of occupational performance on practical skills

Answer 11

• ADLs
• IADLs
• school
• work
• leisure