CLP4134 Unit 4 Notes Ch. 9 Intellectual Disability (Intellectual Development Disorder)Learning Objectives 1. [Book Only] What did Alfred Binet & Theophile Simon have to do with early IQ testing? a. Developed first intelligence tests to measure judgment & reasoning [theybelieved these were the basic processes of higher thought]i. Way to identify school children who might need special help in schoolii. Manipulate unfamiliar objects [blocks or figures to solve puzzles and match familiar parts of objects]2. What do various standardized IQ tests have in common? a. Standardized IQ Tests [book reference]i. Approx. two Standard deviations below/above the mean b. Current Labels for ID i. “…federal statutes in the Unites States (Public Law 111-256, Rosa’a Law) replaces the term mental retardation with intellectualdisability, and research journals use the term intellectual disability.” (DSM-V, via dsm.psychiatryonline.org)ii. New Severity Criteria (same four levels) 1. Level of adaptive function, not IQ2. IQ less vaild at low end (why?)3. More practically useful 3. What is “adaptive function,” and what does it have to do with the diagnosis of ID?a. Definition of intellectual disability includes sub-average intelligence & sub-average adaptive functioningb. Adaptive Function [refers to how effectively individuals cope with ordinary life demands, and how capable they are of living independently and abiding by community standards]i. IQ < 70 is not enough ii. Demands of daily life 1. Conceptual receptive & expressive language, reading/writing, money concepts, self-directions 2. Social interpersonal, responsibility, self-esteem, gullibility, obeys laws, avoids victimization 3. Practical eating/dressing oneself (keeping up with housetasks), feeding yourself (cooking)4. How stable is IQ for typically developing children? How is the stability of IQ different for children with ID? What influence to genes and environment exert on a child’s IQ?a. Stability of IQ i. Without ID –typically developing children1CLP4134 Unit 4 Notes 1. r = .00 before age 1 year (~near zero)a. Unstable, could change a lot 2. r = .77 from age 4-12 years a. Gets more stable but not permanent ii. With ID, stable from younger age iii. Experience matters 1. r = .77 accounts for only 60%2. So, environment (or G*E) may be 40%3. Applies only to mild ID (least severe) environment has largest effect on least severe cases iv. Environment 1. Before & After birth prenatal environment also has to dowith it 2. Appropriate stimulation 3. Absence of prolonged stress (remember cortisol?)5. What is the Flynn Effect? What changes in IQ test scoring reflect the pattern described by the Flynn Effect? a. Flynn Effect i. Apparent increase in average IQ ii. New norms periodically reset mean to 100 1. Shape doesn’t change but distribution shifts iii. Environmental explanations? 1. More stimulation? 2. Better nutrition? 3. No real strong evidence for these iv. Educational placements 1. Are somewhat made by IQ scores 6. What four explanations [some in text, others in lecture only] are offered for apparent race differences in IQ, and what evidence (if any) supports each explanation? a. Racial Differences in IQ? i. Test bias could be bias against some cultures 1. i.e., Asking about snow in South Africa where it doesn’t even snow ii. Referral bias iii. Actual biological differences no evidence for this iv. Environment / Socioeconomic Status after these things are controlled for the differences disappear 7. How are individuals with ID typically similar to each other? What features tend to differ? a. Clinical Presentation of ID i. Consistent differences from typically developing (TD) children1. Speech & Language impairments 2CLP4134 Unit 4 Notes 2. Social skills impaired expressive language skills often leads to impaired social skills 3. Severity related to IQ ii. Differences within ID1. Academic support required 2. Self-care skills 8. What are the diagnostic criteria for ID, and why is each one important? a. Diagnostic Criteria for ID i. “Significantly sub-average intellectual functioning”1. More than 2 standard deviations below the mean2. Not enough because every score is between (i.e., score of 70is the middle of the range 65-75)ii. Impaired adaptive function 1. 2+ areas 2. “Real” effects how well can a child tie their shoes, clean themselves, etc. 3. Don’t mistake lack of experience for impairment a. If kid has never been on and off a bus how is he supposed to know he has to pay b. Did they have the life experience to learn the thing they are being penalized for not knowing 4. Problem with cut scores a. How different is a score of 68 and 70 iii. Present by age 18 1. Problem in development 9. For each of the FOUR degrees of impairment defined in DSM-IV-TR: (a) what percentage of children (with ID) have this level of impairment? (b) What IQ range is associated with this degree of impairment? (c) What adaptive behaviorswould a typical child be capable of? a. Degrees of Impairment i. % of ID within Intellectual Disability1. Mild: 85% 2. Moderate: 10%3. Severe: 3-4%4. Profound: 1-2% ii. Typical IQ Range 1. Mild : 55-70 2. Moderate : 40-54 3. Severe: 25-394. Profound: IQ< 25iii. Level of Adaptive Behavior 1. Mild (diagnosed after preschool)a. Verbal communication b. Engage with peers 3CLP4134 Unit 4 Notes c. Academic skills ~6th grade d. Adults can work and live independently e. Require support in unfamiliar situations 2. Moderate a. Apparent in preschool b. Single words / gestures c. Wide variation in support needed d. Adults are often capable of self-care with minimal support 3. Severe a. Delayed physical milestones b. Problems with mobility c. Cardiovascular problems d. By age 13-15, abilities of typical 4-6 year old e. Often adapt well to group homes, if no severe medical problems 4. Profound a. Diagnosed in infancy b. Abnormal facial features c. Require extensive support to learn eating, grooming,dressing d. Structures environment can improve motor behavior e. Require intensive, lifelong support 10. How do DSM and AAIDD definitions of degrees of ID differ? [Lecture only]. For what purpose is each more useful? a. IQ Score vs. Impairment i. DSM-IV-TR used IQ 1. Predictive studies a. Easier to study with numbers2. Inter-rater reliability a. IQ test has higher inter-rate reliability because number cut offs ii. AAIDD & DSM-V use Impairment 1. Clinically useful a.
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