EDS 248 Human Development and LearningStephen E. Brock, Ph.D., NCSP 1Intellectual Disability(aka: Mental Retardation)Intellectual disability is a disability characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills. This disability originates before the age of 18. 2007, 2008 AAIDDDiscussion of the AAIDD Definition An extended discussion is found in the following article written by the AAIDD Terminology and Classification Committee.Schalock, R. L. et al. (2007, April). The renaming of mental retardation: Understanding the change to the term intellectual disability. Intellectual and Developmental Disabilities, 45, 116-124.AAIDD Definition of ID AAIDD, 2007 Assumptions essential to the application of the AAIDD definition. Limitations in present intellectual and adaptive behavior functioning within the context of the individual's age, peers, and culture Account for the individual's cultural and linguistic differences as well as communication, sensory, motor, and behavioral factors Recognize that limitations often coexist with strengths within an individual Describe limitations so that an individualized plan of needed supports can be developed Provide appropriate, personalized supports to improve the functioning of a person with intellectual disabilityEDS 248 Human Development and LearningStephen E. Brock, Ph.D., NCSP 2Helpful ResourceBrothwick-Duffy, S., Buntix, W., Luckasson, R., Schalock, R. L., Snell, M., Tasse, M., & Wehmeyer, M. L. (2007). User's guide: Mental retardation: Definition, classification, and systems of supports(10thed.). Washington, DC: American Association on Intellectual and Developmental Disabilitieshttp://bookstore.aaidd.org/BookDetail.aspx?bid=61The Power of the Developmental History Referring concerns for Jackie (age 9, second grade) Good interpersonal skills Below grade level achievement Retained in Kindergarten Reading at early first grade level Doesn’t understand basic math concepts Extreme difficulty writingThe Power of the Developmental History Pregnancy Full term (with prenatal care) Birth weight 7 pounds Cord wrapped around neck at birth Developmental history Spoke first word at 18 months Combined words at 3 years Walked at 21 months Family history Parents are professionals (lawyer and doctor) A very enriched home environmentWhat initial hypothesis would you develop?What additional questions should be asked?EDS 248 Human Development and LearningStephen E. Brock, Ph.D., NCSP 3Causes of ID www.thearc.org Genetic conditions E.G., Down, Fragile X, PKU Problems during pregnancy E.G., Maternal substance abuse, malnutrition, toxoplasmosis, cytomegalovirus, rubella, syphilis, HIV Problems at birth Prematurity and low birth weight more often than any other factor correlate with the problems associated with brain injury.Causes of ID www.thearc.org Problems after birth E.G., Whooping cough, chicken pox, measles, meningitis, encephalitis; traumatic brain injury (TBI); lead, mercury and other environmental toxic exposures. Poverty and cultural deprivation Due to malnutrition, disease causing conditions, inadequate medical care, environmental hazards, environmental under-stimulationCauses of MR Biomedical Online Multiple Congenital Anomaly / Mental Retardation MCA/MR) Syndromes© http://www.nlm.nih.gov/mesh/jablonski/syndrome_title.html By Stanley Jablonski A database of structured descriptions of congenital abnormalitiesassociated with mental retardation. This online resource has been developed to facilitate the identification and differentiation of syndromic entities.EDS 248 Human Development and LearningStephen E. Brock, Ph.D., NCSP 4Causes of ID Three major known causes Down syndrome Fetal alcohol syndrome Fragile X syndromeLevels of ID Mild Moderate Severe ProfoundThe following two slides were adapted from:Kenny T. J., Clemmens, R.L., (1997). Mental retardation. In R. A. Hoekelman (Ed.), Primary pediatric care (p. 410). St. Louis, M0: Mosby.Levels of MRMay achieve self-support by performing unskilled or semiskilled work under sheltered conditions; need supervision and guidance when under mild stress.Can learn some social and occupational skills; progression beyond 2nd-grade level in schoolwork is unlikely; may learn to travel alone in familiar placesCan talk or learn to communicate; social awareness is poor; muscle coordination is fair; profit from training in self-help.Moderate36-51Usually achieves enough social/ vocational skills for self support, may need guidance and assistance during times of sig. stress.Can learn up to about the 6th grade level by late teens; can be guided toward social conformity; can be educatedCan develop social and communication skills; muscle coordination is slightly impaired; often not dx until a later ageMild52-68Adult Age AbilitySchool Age AbilityPreschool AbilityLevel/IQ RangeEDS 248 Human Development and LearningStephen E. Brock, Ph.D., NCSP 5Levels of MRAdult AgeAbilitySchool Age AbilityPreschoolAbilityLevel/IQ RangeSome muscle coordination and speech; may achieve very limited self-care; need nursing careSome muscle coordination; unlikely to walk or talkExtremely retarded; little muscle coordination; man need nursing care.ProfoundBelow 20May contribute partially to self-care under complete supervision; can develop some useful self-protection skills in controlled environmentCan talk or learn to communicate; can learn simple health habits; benefit from habit training.Can say a few words; able to learn some self-help skills; have few or no expressive skills; muscle coordination is poor.Severe20-35Identifying ID Cognitive delay IQ test results below 70 (- 2 SDs) The ability to reason, plan, solve problems, think abstractly, comprehend complex ideas, learn quickly, and learn from experience. Adaptive behavior delay Adaptive behavior scores below 70 (-2 SDs) The ability to take care of one’s self, get along with others, and communicate needs.Identifying IDIQ 55 70 85 100 115 130 145 IQEDS 248 Human Development and LearningStephen E. Brock, Ph.D., NCSP 6Identifying ID The vast majority (87%) of children with mental retardation will be only mildly affected and their delays may not become readily apparent until they enter