Intellectual Disability(ID)

Definition

Intellectual Disability, Mental sub-normality, Mental Retardation, Mental Deficiency, Mentally Handicapped or Mentally Challenged all mean the same.

Intellectual Disability means a condition of arrested or incomplete development of mind of a person which is speciallycharacterized by
'sub-normality of intelligence'.


Characteristics

The Child

  • Sleeps longer, has feeding difficulties, lacks control over bowel movements.
  • Cannot comprehend easily and has difficulty in decision making.
  • Has short attention span and is slow in learning.
  • Will have difficulty in adaptive behaviour like failure to eat, bathe and dress on his own.

Causes


Like all Disabilities, intellectual disability can also be Congenital or Acquired.

Congenital

Conditions such as Down's syndrome, Cerebral Palsy, Hydrocephaly, etc. are associated with intellectual disability and are congenital.

Down's syndrome (Mongolism)

Down's syndrome is associated with chromosomal abnormality. There is an extra chromosome present. The child with Down's syndrome is easy to recognize because of his physical features. The nose is short and flat. The eyes have an upward slant giving them an oriental appearance, thus giving them the name, Mongol. The IQ level rarely exceeds 50, but because of their placid temperament, they are easy to train and educate. The child will have Delayed Milestones. e.g. failure to sit, utter few words in the first year.

Acquired

In Acquired Cases of intellectual sub-normality, the child is born quite normally, but due to some diseases like Meningitis or Encephalitis or an accident, there is permanent brain damage, which results in sub-normality of intelligence.


Classification

The classification is done on the basis of IQ (Intelligence Quotient). There are many definitions of intelligence, but according to Binet and Simon, who are pioneers of IQ tests

Intelligence is judgment, good sense, initiative, the ability tocomprehend and to reason well and to adapt oneself to circumstances.



Intelligence Quotient(IQ)

IQ represents the degree of brightness possessed by an individual and it is obtained through tests based on reasoning ability. They are in the form of questions, puzzles and exercises

IQ is derived by using the following formula.

IQ = {

     Mental Age(MA)

} X 100 

Chronological Age (CA)

 


 

Mental age is an individual's level of performance, whereas chronological age is his physical age.
A child of 8 years who has mental age of 4 will have an IQ of 50.

A normal or an average child's IQ is in the range of 90 -110.

Mental Retardation level is based on I.Q and classified as under:-  

     
  70 - 89 borderline
  50 - 59 mild
  35 - 49 moderate
  20 - 34 severe
  Below 20 Profound
     

 


Treatment & Management

The child is assessed by a team of professionals like a physician, neurologist, psychologist and an educationist to study the type of physical abnormality, level of learning ability, general adaptation, speed of learning etc. Then they will group him accordingly and develop treatment & educational plan.

Medical Treatment

Mostly, children with I.D. require treatment for epilepsy, speech therapy and also physiotherapy if they have C.P.

Physical Fitness

These children tend to put on weight especially children with Down Syndrome. Physical exercise is a must to keep it in check. They can be introduced to some type of recreational game, competitive sport or any form of dance to which they respond better.

Educational Management

While devising Individualised Educational Plan(IEP), the Psychologists and Educationists will be looking at the Educational categories.

Those are as follows:

  • The Slow Learning child - (I.Q.75-90)
  • The Educable child - (I.Q.50-75)
  • The Trainable child - (I.Q.25-50)
  • The Totally Dependent child - (I.Q.upto 25)


  • Remember that a

    is not intellectually disabled and ideally, should be in the regular school with support services, modifications to suit his learning rate, strategies to make him independent and assistance to have adequate social adjustment.

    The Educable Child requires a special educational plan to develop his potential for minimum academic educability, minimum occupational skill which will make him self-supporting.

    The Trainable Child will not much benefit from academic program but will benefit largely in learning self-care activities, adjustments in home, neighbourhood and sheltered workshops.

    The Totally Dependent child will constantly require supervision, continuous help even in self - care.

    Educationist will also prepare an Individualised Educational Plan (IEP) & Short Term, Long Term Goals by evaluating the child's developmental profile, his strengths

    and weaknesses. The teacher, the special educator will make use of different instructional material, specialised instructional procedures, application of special learning principles, improvisations, adjustments to suit the pace of the child.

    Tips to Parents - (Educational)

    • 1) Help the child to learn by connecting concrete to abstract e.g. the spelling of an ‘Apple’ will be learnt better by showing him a real apple & then teaching the spelling. This will also aid in developing the concept of fruit, the red colour and round shape.
    • 2) Use lot of repetitions; explain the same thing in different ways.
    • 3) One thing at a time. Break up the task in simple steps and link them later.
    • 4) Make use of different sense modalities and use different mediums e.g. while teaching alphabets, let him write in the sand, make them with clay, make use of stencils, write with chalk, sketch pens, sing them tunefully.
    • 5) Be in touch with the teacher to know what is his IEP and his Short Term, Long Term Goal.
    • 6) Reward him; praise him not only when he learns the task but also for the efforts.
    • 7) Teaching ‘Adaptive skills’ to the child is very important. These refer to skills needed for daily life. They include the ability to produce and understand language (communication), home-living skills, use of community resources, health, safety, leisure, self-care, and social skills, self-direction, functional academic skills (reading, writing, and arithmetic) and job-related skills. Teaching personal accountability/ responsibility, routines, interactions, team rules, how to take turns, sharing, be polite is also very vital.


    Family therapy

    In Family therapy coping skills for the entire family/ parents are suggested & the desired goal is positive change & development of the whole family.



    We can not label a child as intellectually disabled on the basis of IQ alone because performance is always a decisive factor and depends on combination of IQ and application. Training and support from home enhances application. Though the child’s IQ is below average, proper management, appropriate educational plan can nurture the child's maximum potential making him a useful member of the society. Here, we would like to mention ‘Theory of Structural Cognitive Modifiability (SCM) & Mediated Learning Experience (MLE)’ which can aid & enhance the child’s potential. SCM proposes that Intelligence is dynamic & modifiable, not static or fixed. This theory is put forward by Reuven Feuerstein, an Israeli clinical, developmental, cognitive psychologist, the founder and director of the International Center for the Enhancement of Learning Potential (ICELP) in Jerusalem, Israel.(www.icelp.org)