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INTELLECTUAL DISABILITY: DIAGNOSIS AND INTERVENTION

TERM PAPER

SEMESTER 1

(2023-2024)

Master of Arts in Psychology

By
NAME: - Savleen Kaur
UID: - 23MHP10008
COURSE: - Masters in Psychology
NAME OF SUPERVISOR: - Dr. Shahnawaz Mushtaq
DATE OF SUBMISSION: - November 15,2023

University Institute of Liberal Arts and Humanities

Chandigarh University

Mohali - 140413, Punjab – India

November - 2023
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Abstract

Between 1% and 3% of persons in the general population are estimated to have some degree of
intellectual disability. A diagnosis of intellectual disability is based on clinical history, level of
intellectual ability and level of adaptive function. Both the intellectual and adaptive functioning
are measured using individually administered standardized tests. More than 75% of persons who
have intellectual disability have mild intellectual disability and an underlying specific etiology is
less likely to be identified; whereas, in a small percentage of persons with severe intellectual
disability, an underlying specific biologic cause is highly likely to be identified. Genetic
abnormalities, inborn errors of metabolism and brain malformations are major categories of
causes identified in severe to profound intellectual disability. The initial clinical presentation and
recognition depends on the severity and underlying cause of intellectual disability. The etiology,
severity, cognitive abilities, and adaptive function vary among persons with intellectual disability
and need consideration in developing a treatment plan. The physician plays an essential role in
the evaluation, treatment of associated medical conditions and preventive care, and in facilitating
and coordinating consultative services and community-based care.

Keywords: Disability, intellectual disability, adaptive functioning, intelligence quotient (IQ)

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Table of Content

1. Introduction

2. Objective

3. Review of Literature

4. Gap in Literature

5. Results

6. Conclusion

7. References
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Introduction

Intellectual disability is a prevalent condition, impacting individuals across the globe. The World
Health Organization estimates that approximately 1 to 3% of world's population has some form
of intellectual disability. This prevalence can vary based on the region, with certain areas
reporting slightly higher or lower rates full (WHO,2002).

Intellectual disability refers to significant limitations in intellectual functioning and adaptive

behavior. It's a lifelong condition that benefits before the age of 18 and impacts an individual's
cognitive abilities, affecting their reasoning, problem solving and learning capabilities. There is a
wide spectrum within intellectual disability, ranging from mild to profound, impacting
individuals differently. Various causes contribute to intellectual disability, including genetic
conditions, parental exposure to toxins or infections, complications during birth, 4 environmental
factors whose job early detection and intervention play a crucial role in managing intellectual
disability comma providing support comma educational resources comma and therapies tailored
to an individual's need (Schalock, R. L., 2010).

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is a widely
used manual in the field of psychiatry and psychology for diagnosing mental and developmental
disorders. The criteria for diagnosing intellectual disability (previously known as mental
retardation) are outlined in the DSM-5. Below are the criteria for diagnosing intellectual
disability:
Criterion A: Deficits in Intellectual Functioning
• The individual has significantly subaverage intellectual functioning, typically indicated
by an IQ (intelligence quotient) score below 70.
• The intellectual deficits must be confirmed by clinical assessment and standardized
testing. However, it's important to note that an IQ score alone is not sufficient to diagnose
intellectual disability.
Criterion B: Deficits in Adaptive Functioning
• The individual has deficits in adaptive functioning, which refers to their ability to meet
the social and practical demands of everyday life. Adaptive functioning involves skills in
three domains: Conceptual (e.g., academic, communication), Social (e.g., interpersonal
relationships, social judgment), and Practical (e.g., self-care, safety).
Criterion C: Onset During the Developmental Period
• The intellectual and adaptive deficits must have their onset during the developmental
period, which is typically defined as before 18 years of age. It's important to assess the
individual's functioning during their developmental years to establish this criterion.
Criterion D: Clinical Severity
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• The DSM-5 introduces three levels of severity for intellectual disability: Mild, Moderate,
Severe, and Profound. The level of severity is determined based on the level of
intellectual and adaptive functioning impairments, with specific criteria for each level.
Mild Intellectual Disability:
• IQ score approximately 50 to 75
• Deficits in adaptive functioning
• May learn academic skills up to approximately the sixth-grade level
• Often not identified until later in childhood or adolescence
Moderate Intellectual Disability:
• IQ score approximately 35 to 49
• Significant deficits in adaptive functioning
• Can learn basic self-care and communication skills
• Typically identified during early childhood
Severe Intellectual Disability:
• IQ score approximately 21 to 34
• Profound deficits in adaptive functioning
• Require significant support for daily living and communication
• Typically identified in early childhood
Profound Intellectual Disability:
• IQ score below 20 and below
• Profound deficits in adaptive functioning
• Require extensive support and supervision for all aspects of daily life
• Identified in infancy or early childhood
•
The prevalence of intellectual disability is a complex issue influenced by various factors,
including diagnostic criteria, access to healthcare, socioeconomic conditions, and environmental
factors (American Psychiatric Association, 2013). In the United States, the estimated prevalence
of intellectual disability ranges from 1% to 3% of the general population (CDC, 2020). These
estimates have likely increased over the years due to improved diagnostic practices, early
interventions, and more inclusive educational opportunities. This reflects a shift towards a
broader understanding of intellectual disability, emphasizing the importance of adaptive
functioning and individualized support needs.

Globally, the prevalence of intellectual disability varies, influenced by socioeconomic

disparities, healthcare access, and the availability of educational and support services (Emerson
& Hatton, 2007). In many low- and middle-income countries, the prevalence of intellectual
disability may be higher due to limited access to healthcare and social services, as well as higher
rates of prenatal and perinatal risk factors, such as malnutrition and exposure to toxins (Durkin et
al., 2011).
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It's important to consider that the prevalence of intellectual disability can also be impacted by
various genetic and environmental factors, such as exposure to toxins during pregnancy, prenatal
infections, genetic syndromes, and other risk factors (Schendel et al., 2012). Additionally,
cultural and social factors may influence the recognition and diagnosis of intellectual disability
in different communities (Crawford et al., 2019).
Efforts to improve early detection, access to healthcare, inclusive education, and support services are
crucial in addressing the prevalence of intellectual disability. Public health initiatives, research, and
awareness campaigns play a vital role in reducing the impact of intellectual disability on individuals and
their families, fostering greater inclusion and promoting a more inclusive society (Rosenberg et al.,
2020).

Treatment for intellectual disability involves a comprehensive and individualized approach

aimed at addressing the specific needs of the person with intellectual disability and improving
their overall quality of life (American Psychiatric Association, 2013). Early intervention services
are critical for children with intellectual disabilities, often including speech therapy, occupational
therapy, physical therapy, and special education programs (Durkin et al., 2011). These services
can help children acquire essential skills and minimize developmental delays.
Special education programs tailored to individual needs provide a structured and supportive
environment for children and adolescents with intellectual disabilities, focusing on academic and
adaptive skills (Emerson & Hatton, 2007). Behavioral interventions, including Applied Behavior
Analysis (ABA), are commonly used to teach individuals adaptive skills, address challenging
behaviors, and promote skill development (Schendel et al., 2012).
Speech and language therapy is often used to help individuals with intellectual disabilities
develop their language and communication skills, improving their ability to express themselves
and understand others (CDC, 2020). Occupational and physical therapy can assist individuals in
improving motor skills, coordination, and independence in daily living activities (Schendel et al.,
2012).
In some cases, individuals with intellectual disabilities may have co-occurring conditions such as
ADHD, epilepsy, or mood disorders. Medications can be prescribed to manage these conditions
and improve overall functioning, with medication management closely monitored by a healthcare
provider (American Psychiatric Association, 2013).
Social skills training is essential to help individuals with intellectual disability improve their
social interactions and relationships (Crawford et al., 2019). Supportive services, including
vocational training and job coaching, can assist individuals in gaining employment and
becoming more self-sufficient (Rosenberg et al., 2020).
Support for families and caregivers is crucial, with education, training, and access to community
resources helping caregivers better understand and meet the needs of their loved ones with
intellectual disability (American Psychiatric Association, 2013). Encouraging inclusion and
community integration is fundamental, creating opportunities for individuals with intellectual
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disability to participate in community activities and interact with their peers in inclusive settings
(Emerson & Hatton, 2007).
Advocacy and legal support may be necessary to ensure that families and individuals with
intellectual disability receive appropriate educational, healthcare, and support services (CDC,
2020). Treatment plans should be individualized and adapted to the specific strengths and
challenges of each person, with the involvement of a team of professionals, including
psychologists, educators, therapists, and healthcare providers, to create and implement a
comprehensive plan (American Psychiatric Association, 2013).

Objective

The aim of this paper is to understand the diagnosis and intervention of intellectual disability and
its prevalence.

Review of Literature

Bittles, Petterson, Sullivan, Hussain, Glasson, Montgomery published a paper in year 2002 with
title: The Influence of Intellectual Disability on Life Expectancy, which investigated, the database
to calculate survival probabilities on a total of 8724 individuals, 7562 out of which were still
alive by 2000. Survival plots showed a strong negative association between severity of
intellectual disability and survival, with median life expectancies of 74.0, 67.6, and 58.6 years
for people with mild, moderate, and severe levels of handicap. Significant negative associations
also were observed with male gender. The findings indicate a major and expanding increase in
the service requirements of this aging, intellectually disabled population during the past two
generations.

In the study of Catherine, Gwynnyth and Jan published in 2008 titled as: Review of parent
training interventions for parents with intellectual disability, reviewed recent research to provide
an updated perspective on the effectiveness of parent training interventions for parents with
intellectual disability. Seven studies are reviewed which resulted in the support of the use of
individually administered home-based behavioral intervention for parents with intellectual
disability. There is reasonable evidence of the effectiveness of parent training for parents with
intellectual disabilities. This presents a significant gap in the literature in contrast to other areas
of parenting intervention research where the influence of family and the broader community
context has been shown to influence the effectiveness of parent training interventions.
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A study by Lee, cascella, Marwaha published in 2019, titled as: “Intellectual Disability”
reviewed the intervention, diagnosis and prevalence of intellectual disability. According to this
study, Management of intellectual disability must begin promptly with the goals to prevent
further worsening, minimize the symptoms of disability, and improving the quality of everyday
life. Educational support, Behavioral intervention, vocational training, family education and
government resources were recommended as the management techniques based on the research
done. Most individuals with intellectual disabilities have comorbid psychiatric conditions.
Individuals are at higher risk of developing depression because they are prone to developing
negative self-images as they have difficulty interacting with others and meeting social
expectations. Thus, an interprofessional approach is the optimal means by which to address
patients with intellectual disabilities.

Results

The findings indicate a major and expanding increase in the service requirements of this aging,
intellectually disabled population during the past two generations. An interprofessional approach
is the optimal means by which to address patients with intellectual disabilities. This presents a
significant gap in the literature in contrast to other areas of parenting intervention research where
the influence of family and the broader community context has been shown to influence the
effectiveness of parent training interventions.

Conclusion

The findings of this study underscore a critical and ever-expanding demand for services within
the aging population of individuals with intellectual disabilities over the past few decades. The
growing needs of this population represent a significant challenge that requires a comprehensive,
interprofessional approach for effective addressing. While this approach has proven successful in
other fields, there appears to be a notable gap in the literature concerning parenting interventions
for individuals with intellectual disabilities. Unlike other areas of research focused on parenting
interventions, where the influence of family dynamics and the broader community context has
been well-documented in shaping the effectiveness of such interventions, the field of intellectual
disability appears to lack a comparable depth of research in this regard.
In conclusion, it is imperative that future research and interventions in the field of intellectual
disabilities consider the crucial role of interprofessional collaboration, acknowledging the
multifaceted nature of the challenges faced by this aging population. Moreover, the influence of
family and community contexts on the effectiveness of interventions should not be
underestimated. Bridging this gap in the literature will not only enhance the quality of care
provided to individuals with intellectual disabilities but also contribute to a more comprehensive
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and compassionate understanding of their needs and experiences. Addressing the evolving
service requirements of this population is a pressing concern that calls for collaborative efforts
across disciplines and an integrated approach to care and support.
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References

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental

Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

CDC. (2020). Data & Statistics on Intellectual Disability. Centers for Disease Control and
Prevention. https://www.cdc.gov/ncbddd/intellectualdisability/data.html

Crawford, K., Tipping, C., & Vonderharr, A. (2019). Intellectual Disabilities and Race: A
Disproportionate Racial Disparity. SAGE Open, 9(1), 2158244019832235.

Durkin, M. S., Davidson, L. L., Desai, P., Hasan, Z. M., Khan, N., Shrout, P. E., et al.
(2011). Validity of the Ten Questions Screen for Childhood Disability: Results from
Population-based Studies in Bangladesh, Jamaica, and Pakistan. Epidemiology, 22(3), 486-
493.

Emerson, E., & Hatton, C. (2007). The Socioeconomic Circumstances of Families

Supporting a Child with Intellectual Disability in the United Kingdom. Journal of
Intellectual and Developmental Disability, 32(4), 219-227.

Lee, K., Cascella, M., & Marwaha, R. (2019). Intellectual disability.

Rosenberg, R. E., Anderson, C., Nathan, O., Bishop, J., Bradley, C., Daniels, T., et al.
(2020). Autism Spectrum Disorder, Developmental and Behavioral Outcomes in Children.
Autism Research, 13(3), 531-542.

Schendel, D. E., Diguiseppi, C., Croen, L. A., Fallin, M. D., Reed, P. L., Schieve, L. A., et
al. (2012). The Study to Explore Early Development (SEED): A Multisite Epidemiologic
Study of Autism by the Centers for Autism and Developmental Disabilities Research and
Epidemiology (CADDRE) Network. Journal of Autism and Developmental Disorders,
42(10), 2121-2140.
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Wade, C., Llewellyn, G., & Matthews, J. (2008). Review of parent training interventions
for parents with intellectual disability. Journal of applied research in intellectual
disabilities, 21(4), 351-366.