Unit 2 - Intellectual Disability

Question 1

intellectual disability

Answer 1

disorder with onset during the developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains.

• Significantly sub-average intellectual functioning
• impairment in adaptive abilities in at least 2 developmental areas

Question 2

3 criteria for intellectual disability

Answer 2

1. deficits in intellectual functions
2. deficits in adaptive functioning
3. onset of intellectual and adaptive deficits during the developmental period

Question 3

intellectual functions

Answer 3

reasoning, problem-solving, planning, abstract thinking, judgment, academic learning and learning from experience, and practical understanding

Question 4

adaptive functioning

Answer 4

communication, social participation, and independent living, and across multiple environments, such as home, school work and school, work, and recreation

Question 5

developmental delay occurs when there is below average functioning in these areas

Answer 5

• Fine motor
• Gross motor
• Language
• Social-adaptive skills

Question 6

developmental delay may not be evident until

Answer 6

2-3 years or older

will not automatically be diagnosed with intellectual disability

Question 7

mental handicap

Answer 7

relates to a statistical interpretation of “normal” intellectual functioning

mild, moderate, severe, profound based on IQ scores

Question 8

possible etiology

Answer 8

 Chromosomal Abnormality		35%
 Multiple congenital anomalies 16%
 Early pregnancy problems        11%
 Perinatal insults 10%
 Postnatal brain damage 5%
 Other 13%

 A mental handicap requiring more extensive supports (severe/profound) is more typically linked to a biological cause. (most common are Fragile X, Down syndrome, and fetal alcohol syndrome)
 A mild mental handicap is most typically associated to low socieo-economic status or poor environment (ie. poor nutrition, neglect, abuse)

Question 9

prevalence

Answer 9

• 2.5% to 3% of the population
• Occurs more frequently in boys than girls – this is thought to be the consequence of sex-linked disorders such as Fragile-X
• Ratio of males to females in 2:1
• The prevalence has not increased since the 1940’s
o Due the natural balance between improved health care and the emergence of new diseases
o The morbidity rate of premature infants has declined, but there is an increased prevalence of prenatal drug exposure and congenital HIV
• Recurrent risk in families with 1 child with that has a severe or profound mental handicap is 3% to 9%

Question 10

associated impairments

Answer 10

	Cerebral palsy
	Visual impairment
	Seizure disorders
	Communication impairments
	Psychiatric disorders
	ADHD

Question 11

Bayley Scales of Infant Development

Answer 11

1-42 months Verbal, motor, and behavioral scales. Limited predictability of future development.

Question 12

Stanford-Binet Intelligence Scale

Answer 12

1.5 yr to adult

Measures verbal reasoning, abstract visual reasoning, quantitative and short-term memory skills. Few motor task

Question 13

Wechsler Preschool and Primary Scale of Intelligence

Answer 13

3-7 yr
General intelligence for young children. Arithmetic, vocabulary, comprehension, sentences, object assembly, geometric design, mazes, block design. Focus on motor and processing skills.

Question 14

Wechsler Intelligence Scale for Children - 3rd edition

Answer 14

6-17 yr
Standard measure of intelligence in children. Arithmetic, vocabulary, comprehension, digit span, picture completion, block design, coding, mazes – focus on problem solving.

Question 15

approach to treatment

Answer 15

developmental
to facilitate or promote optimal growth and development in milestones for work, education, play, self-care and leisure.

participation and function

Question 16

shaping and changing

Answer 16

Shaping involves the reinforcement of small steps or approximations. As the response becomes more accurate, reinforcement is given only for the correct response. Chaining refers to a sequence of steps

Question 17

forward chaining

Answer 17

is when the first step of a task is completed and the task is finished in a forward sequence of steps

Question 18

backward chaining

Answer 18

where the last in a sequence is taught first. This technique is used frequently with functional daily living skills and play and has the advantage of rewarding the child for the last-step of a task early on in skill development. This technique is effective when a child is afraid of failure or believes he cannot accomplish a task. The child will see immediate results.

Question 19

example of backward chaining

Answer 19

Teach last step 1st:

Backward-chaining method for teaching spoon feeding:

1. Place spoon into mouth from 1” away
2. Place spoon into mouth from midpoint between bowl and mouth
3. Place spoon into mouth from 1” above the bowl
4. Lift spoon out of the bowl
5. Fill spoon with food
6. Picks up spoon

Question 20

example of forward chaining

Answer 20

1. Remove toothbrush and toothpaste from cup
2. Unscrew toothpaste cap…………
3. Lean over sink………….
4. Rinse toothbrush in water………….
5. Turn off cold water……………
6. Replace brush and paste in cup

Question 21

prompting/cueing

Answer 21

varying amounts of cues or prompts can be given before or during an activity. Verbal, gestures or physical cues or a combination of the three are used. Physical guidance is frequently required to develop new skills in the severely developmentally delayed child. Fading is the gradual withdrawing of the physical/verbal guidance that is initially given in the development of the behavior. Prompts and cues should never be given unless the child needs the assistance. Cues may include pictures, color coding, hand-over-hand, modeling, etc.

Question 22

demonstration and modeling

Answer 22

demonstration of the desired behavior by the therapist is considered an abstract form of visual prompting. The child needs a good sensorimotor concept of how his body moves in space. The child must understand his/he own body and how it relates to the environment before he/she can successfully imitate the body movements of others.

Question 23

grading techniques

Answer 23

the adaptation of a task or portions of a task to fit the child’s capabilities. A therapist uses a task analysis and can vary parts of a task to suit the child’s skills. The therapist then gradually increases the demands of the task to guide the child to a more mature motor response.

Question 24

Goal Attainment Scale

Answer 24

a means to collect measurable data on specific goals set during OT treatment; an individualized criterion referenced measure of change using a scale of -2 to +2

-2 much less than expected outcome
-1 less than expected outcome
0 expected outcome after intervention
+1 greater than expected outcome
+2 much greater than expected outcome