intellectual Disability Program
The percentage of intellectual disability ranges from 1-3%, and itappears in a form of below-average mental functional performance and concurrentdeficiency in adaptive performance that occurs before the age of 18. Theprevalence of intellectual disability is five times higher among males thanfemales. The prevalence increases in community with low economic and sociallevels. Intellectual disabilities are not considered as a medical orintellectual disability inherent in the individual; however, it is a disorderdetermined by statistical concepts and societal influence. Down syndrome,fragile X syndrome, which are both genetic disorders, fetal alcohol syndromeand drinking alcohol before giving birth are the most common reasons for mentaland developmental disabilities, as almost 500 genetic disability are associatedwith mental and developmental disabilities. However, the reason of intellectualdisabilities is still unknown in accordance with almost third of the affectedcases. Individuals with intellectual disabilities are more likely to sufferfrom health-related disorders and mental disorders three or four times thanothers.
85% of individuals with intellectual disabilities are categorizedin "mild " category in accordance with their functional performance.This means that their IQ falls under 2-3 points below average standarddeviation with a marked deficiency in adaptive functional performance. A lot ofindividuals with mild intellectual and developmental disabilities exhibitskills of communication and self-care with social skills that are similar tothose of their peers in early childhood. As a result, disabilities may not beobserved and identified till the beginning of adolescence or later when thesocial and academic requirements increase (Sattler, 2002). Adults with mildintellectual and developmental disabilities are able to achieve social andacademic success; however, they may need more guidance when they face socialand economic stresses.
10% of individuals with intellectual disabilities are categorizedin "moderate " category in accordance with their functionalperformance. This means that their IQ falls under 3-4 points below averagestandard deviation. Individuals with moderate intellectual and developmentaldisabilities need intensive support especially in school and in transitionalphase to work. These individuals exhibit delay in early development, especiallyin communication skills and mental skills, and then they exhibit delay inacademic skill acquisition.
The IQ of individuals, who fall under the category of "severe " or "profound " in accordance with their functionalperformance, falls under 5 or more points below average standard deviation.These individuals need intensive support and guidance in different environments.Usually these individuals are diagnosed in early childhood due to significantdeficiency in their development, including the inability to demonstratecommunication skills and early movement skills. Also, visual and auditorydeficiency, or one of them, spread among these individuals. Genetic diseasesand prenatal events, such as exposure to fetal alcohol or brain abnormalities,lead to severe cases of intellectual disabilities. Adaptive Behavior Scale is acritical step in the diagnostic process and intervention planning forindividuals with intellectual disabilities, regardless the severity of thesedisabilities.
Individuals with intellectual disability exhibit varying degrees ofcompetence in adaptive functional performance. The developmental nature isimportant for forming the concept of adaptive functional performance.Expectations related to adaptive skills increase and become more complicated asthe individual progresses and the environmental requirements around him/herincrease. Delay of self-care and social, academic, and professional skillsmaybe noticed for the first time in early childhood while self-care and social,academic, and professional skills delay becomes more evident in late childhoodand adolescence. Adaptive skills can be intervened because of theirdevelopmental nature. Assessment of adaptive functional performance takes intoconsideration the present performance of the individual in different contextsand it is considered as a key element in the comprehensive and ongoing processof problem solving. It ensures the interventions and support that result fromthis process; helping people with intellectual disabilities achieve thegreatest amount of independence, have happier relationships and to participatein a better way in their schools and communities.
Intellectual disability Diagnosis
The first criterion of intellectual disability (intellectualdevelopmental disorder) diagnosis is that the individual faces deficits ingeneral mental abilities that are associated with "reasoning, problemsolving, planning, abstract thinking, judgment, academic learning, and learningfrom experience, which have been confirmed by clinical assessment andstandardized individual intelligence test. Intellectual disability should beobjectively measured by intelligence scales such as (SB-5) Stanford-BinetIntelligence Scales, Fifth Edition. Also, the test shouldbe supervised by trained clinical professionals. In other words, IQ less than70 without observed deficiencies is not enough for diagnosis, so as individualwith normal IQ. However, challenges in the abovementioned fields are notenough.
The second criterion is that deficits in mental abilities shouldhave evident impact on performance in one or more aspects of daily life, suchas "communication, social participation, academic or occupationalfunctioning, and personal independence at home or in community settings ".
The final required criterion is that the onset should take placeduring the developmental period, and this differs from the criterion of mentalretardation (MR) which requires that the symptoms should be present inindividual in childhood or adolescence. The term of "developmental period " allows for flexibility in observing the symptoms in youth, as someindividuals fail under the category of "very mild " with an IQ of65-70, and may exhibit obvious deficiencies in adapting and creating anindependent life. For young people whose mental needs may be neglected inchildhood and adolescence, this gives them opportunities to be carefullydiagnosed retroactively to provide potential support services to persons withintellectual disabilities.
The severity of intellectual disability is categorized as mild,moderate, severe, and profound. The criteria of each determinate ofintellectual disability are based on qualitative information and individualperformance. This differs from the determinants of mental retardation in DSM-4which were based on actual or estimated IQ. In addition, DSM-5 has developed aseparate diagnosis for "unspecified intellectual disability " when anindividual above five years old cannot be assessed because of physiological orpathological disorders that affect assessment. "Unspecified intellectualdisability " has replaced "unspecified diagnosis in DSM4.
IQ is a numerical value that represents the general mental abilityof the individual. It has been calculated from the factorial index and it doesnot represent any relevant weaknesses or strengths. Regarding those with normalgrowth, this value is enough to generalize the mental status of the individual,which may include strengths and weaknesses, but, generally, the abilities ofthe individual will not significantly differ on the index. Therefore, IQ willgenerally express how the individual performs. Regarding those who suffer fromintellectual disability, IQ is less beneficial especially when there aresignificant differences between represented abilities inside the score ofindex.
Diagnostic Criteria of Intellectual Disability According toDSM-5
- Intellectual disability (intellectual developmental disorder) is a disorder with onset during the developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains. The following three criteria must be met:
- 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.
- 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.
- Onset of intellectual and adaptive deficits during the developmental period.
Note: The diagnostic term intellectual disability is the equivalentterm for the ICD-11 diagnosis of intellectual developmental disorders. Althoughthe term intellectual disability is used throughout this manual, both terms areused in the title to clarify relationships with other classification systems.Moreover, a federal statute in the United States (Public Law111 -256, Rosa’sLaw) replaces the term mental retardation with intellectual disability, andresearch journals use the term intellectual disability. Thus, intellectualdisability is the term in common use by medical, educational, and otherprofessions and by the lay public and advocacy groups.
Intervention Program for Individuals with Intellectual Disability
· To enable personswith Mental Retardation to improve their functional abilities and therebyenhance their quality of life.
· To enhance andimprove function in all areas of child development.
· To prevent secondarydisabilities thro’ therapies like physiotherapy, speech therapy and playtherapy.
· To promote theacceptance of disabled child.
· To give specialeducation for young children with disability through Early Interventionprogram.