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intellectual disability

Terms in this set (20)

considerable range of abilities and interpersonal qualities
experience limitations that involve most areas of daily living
-most obvious difficulties: learning to communicate effectively due to limited speech and language skills
-problems developing friendships because of limited ability to comprehend what other children are expressing
-many cognitive abilities affected (language and problem solving)-> therefore difficulty with some aspect of learning
-learning problems depend of extent of cognitive impairment

criteria- 3 core features:
1. deficits in intellectual functions of reasoning, problem-solving, planning, abstract thinking, judgement, academic learning, and learning from experience- typically determined by clinical assessment and IQ testing
-DSM5- no specific cut off criteria as previously seen
2. deficits in adaptive functioning, results in failure to meet developmental and sociocultural standards for personal independence and social responsibility
-communication, self-care, social/interpersonal skills, functional academic or work skills
-important criteria because excludes people who function well in own surroundings but perform poorly on IQ tests
-adaptive skills related to ability, ALSO experience and opportunity
3. intellectual and adaptive deficits must have begun during developmental period (before 18)
-acknowledges ID is a developmental disorder that is evident during childhood and adolescence
-rules out people who show mental deficiencies caused by adult-onset degenerative diseases

diagnoses specifies level of impairment
-mild, moderate, severe, profound
-no IQ cut offs to allow greater focus on adaptive functioning and levels of support that may be required

changes in DSM5
-sought to focus more on nature or qualities of person rather than IQ score due to controversy
-not likely to create shift in numbers of diagnoses because most people fall in mild range
-need balance between identifying special needs of persons with ID and labeling them as having a disability on the basis of somewhat arbitrary criteria

definition and identification also depend on social institutions
defined on basis of adaptive functioning in 3 domains
1. conceptual
2. social
3. practical

shift away from IQ focus, toward needed supports
-emphasizes the resources and strategies necessary to promote the overall adjustment and well being
-based on ability and needed support

mild ID- largest group, 85% of IDs, small delays in development during preschool years, typically not identified until academic or behavior problems emerge during early elementary years, over-representation of minority group members
-typically develop social and communication skills during preschool years
-modest delays in expressive language
-minimal or no sensorimotor impairment
-engage with peers regularly
-as adult skills are adequate for minimum self-support
-may need supervision, guidance, assistance
-with support usually live successfully in community independently or in supervised settings

moderate ID- 10% IDs, more intellectually and adaptively impaired than mild group, usually identified during preschool years when show delays in reaching early developmental milestones
-may communicate through combination of single words and gestures
-show self-care and motor skills similar to 2-3 year old upon entering school
-many people with Down syndrome function at this level
-social judgement and decision-making abilities limited- need supportive services to function daily
-acquire limited communication skills during early years, by age 12 may be using practical communication skills
-benefit from vocational training, with supervision can attend to personal care
-benefit from social and occupational skills training, unlikely to progress beyond 2nd grade academic level
-difficulty recognizing social conventions, interferes with peer relationships
-as adult typically adapt well to living in community, can perform unskilled or semiskilled work under supervision in sheltered workshops or general work force

severe ID- 4% IDs, most suffer one or more organic causes of impairment (genetic defects), identified at young age because of substantial delays in development and visible physical features or anomalies
-milestones delayed
-basic self-care skills by 9
-may also have problems with physical mobility or other health-related problems
-require special assistance throughout life
-childhood- little to no communication skills
-12- 2 or 3 word phrases
-13-15- academic and adaptability skills of 4-6 year old
-adapt well to life in community in group homes or with families

profound ID- 2% IDs, identified in infancy because of marked delays in development and biological anomalies
-childhood- considerable impairments in sensorimotor functioning
-learn only rudimentary communication skills
-require intensive training to learn self-care
-require lifelong care and assistance
-almost all show organic causes of ID, many have severe co-occurring medical conditions
-supervised homes or small specialized facilities
genetic or environmental causes known for 2/3 with moderate to profound ID, 1/4 for mild ID
-prenatal
-perinatal (birth related insults)
-postnatal

historically causes in 2 groups
1. organic group- clear biological basis, usually associated with severe and profound ID
2. cultural-familial- no clear organic basis, usually associated with mild ID

4 major categories of risk factors
1. biomedical
2. social
3. behavioral
4. educational
-interact across time and generations

1. inheritance and the environment
-influence of genetics modifiable by environmental input
-environmental influences may involve genes or structures to which the genes have contributed
*children do not inherit IQ, inherit genotype: collection of genes that pertain to intelligence
*expression of genotype in gene-environment interaction is phenotype

2. genetic and constitutional factors
a. chromosome abnormalities
-Downs syndrome- extra chromosome result of nondisjunction: failure of 21st pair of mother's chromosomes to separate during meiosis- related to maternal age
-Fragile-X syndrome- most common cause of inherited ID
-Prader-Willi syndrome
-Angelman syndrome
b. single-gene conditions
-phenylketonuria (PKU)

3. neurobiological influences
-adverse biological conditions- malnutrition, exposure to toxic substances, prenatal and perinatal stressors
-trauma, infections, other complications during pregnancy and delivery
-fetal alcohol spectrum disorder- most extreme is fetal alcohol syndrome
-viral infections, x-rays, drugs of mother during pregnancy, mechanical pressure on head during birth, lack of oxygen, poisons, tumors and cysts in the head

4. social and psychological dimensions
-least understood, most diverse
-environmental influences- deprived physical and emotional care and stimulation, other mental disorders that are accompanied by ID- autism spectrum disorder