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Intellectual Disability

Terms in this set (30)

- Primary cause can only be identified in 25-35%
o If you can't identify the cause, it becomes difficult to identify effective interventions
- For individuals with no identifiable aetiology there are differences between people with a mild/moderate vs. severe profound disabilities
o Sex
Profound/severe found equally in males and females
Mild/moderate is more common in males- though gender ratios vary
o Brain pathology
Usually identifiable brain defect in those with severe/profound
Seldom found in mild/moderate
o SES
Those with severe/profound are found across SES groups
Those with mild/moderate are over-represented in lower SES groups
- -> this has given rise to cultural familial intellectual disability hypothesis (primarily in the mild to moderate intellectually disabled group)
o Disability may be largely due to environmental factors:
Inadequate language models/stimulation
Poor diet
Inadequate medical care
Lower expectations (by teachers and family)
- Environment and brain pathology interaction
o E.g. damage to CNS - one child in raised in resource environment and the other in a resource less environment
Child who has les resources will have marked impairment in intellectual functioning compared to another child with same brain pathologies
- Chromosomal anormalies
o 4% of pregnancies have chromosomal abnormalities
Majority end in spontaneous abortion or miscarriage
Only 0.5% are born and many die soon after birth
o of the babies that survive majority have down syndrome
47 chromosomes instead of 46
Found in approx. 1 out of 800 to 1200 live births
Incidences dramatically increase about the age of 35
Heart problems are common (40%)
Detected in utero
IQs mild to moderate range but varies markedly
Mortality after age of 40 is high
- Genetic anomalies
o Dominant gene disorder e.g.
Tuberous sclerosis
• Relatively rare
• Approx. 60& have intellectually impairment
• Seizures are common
o Recessive gene disorder e.g.
Phenylketonuria deficiency of liver enzyme phenylalanine hydroxylase
Preventable
- Infectious disease
o Maternal infection in utero
o After birth
Encephalitis
Meningitis
- Accidents
o Leading cause of severe disability and death in children
- Prematurity
o Greater likelihood of intellectual disability
o = delivered 2 or more weeks before term
o Poorer quality relationship between mother and preterm infant
- Noxious chemical substances
o Foetal alcohol syndrome
Physical symptoms
Intellectual disability
- Childbirth trauma
o 2 course of brain damage during delivery
Head injury
Hypoxia (deprivation of oxygen)
- Environmental hazards
o Lead, smog, mercury
- Primary prevention
o Eugenics movement
Segregation (people with intellectual disability segregated from general population so they couldn't breed)
Sterilisation (so they can't breed)
o Heath care measures
Vaccinations e.g. rubella
Detection and treatment of infectious disease
Promotion of health enhancing behaviours e.g. in pregnant women and young children
Diagnostic testing
o Genetic counselling
Couples who believe that they are at risk for having a child with intellectual disability can undergo genetic testing
- Secondary prevention methods
- Preventing advancement of disability- attempt to identify children who are at high risk at developing intellectual disability and intervene at that early level to prevent further deterioration
o E.g. head start campaign
o Community based pre-school education focusing on the development of early cognitive and social skills
Head start children improved on socio cognitive ability and motor impulsivity compared to controls
- Tertiary prevention
o Intervention when intellectual disability has been identified
o Early intervention
Systematic home and treatment centre based instruction in language skills,, fine and gross motor skills, self-care and social development
Mainstreaming
• Integrate children into normal schooling system
Teaching strategies
• Applied behaviour analysis - operant conditioning: reinforce adaptive functioning and punish non adaptive behaviours
• E.g. backward chaining of putting pants on
• Play therapy
• Computer assisted instruction
- Psychological interventions show greatest efficacious in developing intellectual capacity and adaptive function - despite most of the evidence for aetiology is biological
- Challenges in treating autistic children
o They do not adjust normally to changes in routines - challenge in teaching and training
o Their behavioural problems and self-stimulatory movement may interfere with effective teaching
o Difficult to find reinforcers - don't report to social reinforcers
o Over selectivity of attention- difficult to shift attention
o Inability to generalise learning
- Applied Behaviour Analysis
o Behavioural intervention that uses shaping and positive reinforcement
o Targets:
Training in cognitive skills, language and social behaviour
Acquiring specific learning skills
Reducing rigid and stereotypes behaviour
• Reinforcing inconsistent behaviour
• Punish inappropriate behaviours
Eliminating maladaptive behaviour
Alleviating family distress
o Intensive
o Studies testing applied behaviour analysis
3 groups:
Intensive behavioural treatment (40hrs/week)
Less intensive behavioural treatment (10hrs)
Control
47% of intensive behavioural group achieved normal intellectual and educational functioning vs. 2% in other 2 groups
Improvements and differences between the groups were maintained at 8 year follow up
- Drug treatments
o Anti-psychotic drugs help in controlling agitated behaviours, hyperactivity & aggressiveness in some
o Drugs do not directly improve social or language skills
o Powerful side effects
o Fenfluramine (a stimulant) shows promise