L3.2 Intellectual disability Flashcards
Intellectual disability definition
Developmental disability that can arise from various causes and involving significant impact in general intelligence and deficits in adaptive behaviour.
DSM 5 criteria for ID
A. Intellectual deficits
B. Deficits in adaptive functioning
C. Onset during the developmental period
Adaptive functioning
How effectively someone copes with ordinary life demands and is capable of living independently.
Specifiers
Convey the severity of deficit (mild, moderate, severe or profound) for each of the conceptual, social and practical domains.
Conceptual
Difficulties in learning academic skills involving reading, writing, arithmetic, time, money.
Social
Difficulties in social behaviour and verbal and nonverbal communication.
Practical
Difficulties with daily living tasks - handling meals, dressing, bathing, transportation, recreation.
ID Prevalence
- Between 1% and 3% of the population
- More common in males than females.
High rates of comorbidity with
- Anxiety/mood disorders
- ADHD
- ASD
Causes of ID: levels of analysis
Environment: biological level, cognitive level, behavioural level
(Visual representation on slide makes more sense but can’t replicate here)
Biological level
- Chromosome abnormalities
- Most common: Down Syndrome
- Other syndromes: Williams, Fragile X, Prader-Willi, Angelman
Fetal Alcohol Spectrum Disorder (FASD)
- Most extreme form of FAS
- 33% of heavy pregnant drinkers have a FAS birth
- Leading known cause of mental retardation
- Physical characteristics: CNS dysfunction, slow growth; distinct facial features
- Psychological characteristics: low IQ, hyperactivity, irritability, poor motor control.
Profound intellectual impairment
Approx. 75% of cases have an identifiable organic cause.
Mild Intellectual impairment
Only about 10% have a known organic cause
2 groups
- Organic mental retardation: clear biological basis, and is usually associated with severe impairment
- Cultural-familial mental retardation: no clear organic basis, and is usually associated with mild impairment -psychological, social, educational factors
Genetic conditions: Down Syndrome
-Abnormality in Chromosome 21 (damaged or incorrect # of chromosomes)
-Psychological characteristics:
~Delayed, but reasonable social skills
~Expressive language weaker than receptive language
~Delayed development of motor skills
Genetic condition: Williams Syndrome
Deletion on Chromosome 7
Psychological characteristics:
-hypersensitive to sound
-surprisingly good language production and receptive vocabulary
-poor global visual-spatial abilities (except face recognition)
-hypersocial and overly friendly
-can be musically talented
Genetic Disorder: Fragile X
Narrow and therefore fragile X chromosome
Psychological Characteristics:
-sensory hypersensitivity (vision, audition, touch)
-Weak verbal abilities
-Anxiety
-Withdrawn and shy or inattentive
-High comorbidity with autism
Conclusion on psychological consequences of IDs
Substantially different patterns of impairment are presented as a function of the different cause of ID.
Mild
Develop social and communication skills, possibly with moderate delays in expressive language
With appropriate support, adults usually live successfully in the community
Moderate
Benefit from vocational training and in adulthood can perform supervised unskilled or semiskilled work.
Severe
Low academic achievement
Need special assistance throughout life
Adapt well to living in group homes or with family
Profound
Require lifelong care and assistance
Most live in supervised homes or specialised facilities
Typical challenging behaviours associated with ID
- Aggression towards others (e.g. Biting)
- Self injurious behaviours (e.g. Head banging)
- Inappropriate social behaviour (e.g. Hugging strangers)
- Self-stimulatory behaviours (e.g. Rocking)
- Non-compliance
- Withdrawal
Interventions
- Behavioural interventions
- Parent training programs
- Educational Programs
- Early intervention is most effective
Behavioural interventions
- Break problem behaviours down into simple parts
- manipulate contingencies (consequences for both desirable and undesirable behaviours) to shape the child towards more adaptive behaviours
Parent training programs
- Reinforce contingency learning
- useful in helping generalise new skills across home, school, wider community
Educational programs
Special education or “mainstreaming” (integration into regular classrooms)?
