Intellectual Impairment/Disability Flashcards
ID or Intellectual Developmental Disorder
Impaired intellectual function.
Impaired adaptive function.
Onset in developmental period (before 18 years).
Causes of ID
Prenatal
Perinatal
Postnatal
Toxins
Infections (Meningitis, HIV)
Trauma
Genetic: nonspecific (familial), chromosomal, X-linked, specific gene.
Effects of ID
Individual
Family
Society: Health, Education, Social services.
ID: Diagnostic criteria
Onset is during the developmental period that includes both intellectual, and adaptive functioning deficits in the conceptual, social, and practical domains.
3 criteria must be met:
A- Deficits in intellectual functions, such as reasoning, problem solving, planning, abstract
thinking, judgment, academic learning, and learning from experience, confirmed by
both clinical assessment and individualized, standardized intelligence testing.
B. Deficits in adaptive functioning that result in failure to meet developmental and sociocultural standards for personal independence and social responsibility. Without ongoing support, the adaptive deficits limit functioning in one or more activities of daily life,
such as communication, social participation, and independent living, across multiple
environments, such as home, school, work, and community.
C. Onset of intellectual and adaptive deficits during the developmental period.
Intellectual function
Adaptive function
Vinelands Adaptive behavior scale
IQ tests: Verbal and Non-verbal
Severity levels of ID
Mild
Moderate
Severe
Profound
Important syndrome
Down syndrome
Fragile X syndrome
Prader-Willi syndrome
Tuberous sclerosis
22q Deletion syndrome/VCF Synd
Foetal alcohol syndrome.
TB meningitis
Down syndrome
Variants
Range intellectual disability.
Physical phenotype
Development and behavioral phenotype.
Associated medical problems.
Incidence.
Fragile X syndrome
Mutation on the X chromosome at fragile site.
Incidence 1 in 2200.
Mild to severe ID.
Physical phenotype.
Behavioral phenotype and neurological abnormalities.
Females usually less impaired.
Prada-Willi syndrome
Physical phenotype.
Behavioral phenotype.
Co-morbidity: medical, psychiatric.
Velocardiofacial syndrome
Microdeletion at 22q11.2 site.
1 in 3000 births.
Cardiac, palatial, facial malformation, hypoparathyroidism, thymic hypoplasia, urinary system abnormalities, haematological problems.
Language and motor delays in children, autistic traits.
40% have ID.
Behavioral phenotype: poor social skills, psychotic disorder (20-30% and 1-2% of people with schizophrenia), Bipolar disorder (60%), ADHD (36%).
Tuberous Sclerosis Complex
Spontaneous mutation (70%) or autosomal dominat (30%).
1 in 5800 births.
Characteristic facial skin lesion may be present.
Multisystem involvement, 80% have epilepsy, 50% have ID, 40-50% have ASD and 30-50% have ADHD, and many have anxiety and mood related disorders.
Brain or renal tumours can cause medical crises.
Medication with mTOR inhibitors is being researched.
Foetal alcohol syndrome
Physical features: microcephaly, short palpebral fissures, a thin vermillion border, and a smooth philtrum. A harsh holosystolic murmur is heard at the lower left sternal border on cardiac auscultation.
Cognitive and learning problems.
Behavioral problems.
Social/health care costs.
Effect on the family
Loss: Grief, Guilt, Shame.
Ambivalence.
If not dealt with leads to adverse emotional environments and care giver burnout.
Counselling and professional support needs.
Effects on individual
Self-esteem
Stigma and discrimination.
Hardship, vulnerability, and risk of exploitation.
Medical/Neurological comorbidity.
Behavior dis-control.
Psychiatric comorbidity
