L2: Disabilities under the Neurodevelopmental Disabilities

• Intellectual disability - formerly known as mental retardation, is a developmental disorder characterized by limitations in intellectual functioning and adaptive behavior, which manifest before the age of 18
• People with intellectual disability will have significant limitations in:

  • Substantial limitations in present functioning - difficulty in performing everyday activities.
  • Significant sub-average intellectual functioning - significantly below average intelligence.
  • Limited in the adaptive skills or behavior - they fail to meet the standards of personal independence.
  • Related limitations in adapting skills areas
• Related limitations in adaptive skills areas for people with intellectual disability include difficulties in:

  • Communication - ability to understand and communicate information by speaking and writing.
  • Self-care - ability to take care of one's need in hygiene
  • Home living - ability to function n the home
  • Community use - specifically use of community facilities
• Related limitations in adaptive skills areas for people with intellectual disability include difficulties in:

  • Social skills - initiating and terminating interactions
  • Self- directions - refers to making choices
  • Health & safety - maintaining own health
  • Functional academics - learn basic skills taught in school
  • Work - employment appropriate to one's age
• Causes of intellectual disabilities:

  • Prenatal or Biological
  • Perinatal
  • Postnatal
• Models of assessment for intellectual disability include:

  • Traditional assessment - the parents fill in a pre-referral form about the family history and the developmental history of the child.
  • Team-based assessment approaches - described as multi-disciplinary, inter-disciplinary, and transdisciplinary in nature.
  • Activity-based assessment - involves parents as well as the development of meaningful, child centered, etc.
  • Cognitive/developmental assessment tool - DAS, WPPSI-R, WISC-III
  • Adaptive behavioral assessment - ability to perform daily activities required for personal and social sufficiency.
• Classifications of intellectual disabilities:

  • Mild ID with IQ scores from 55 to 70
  • Moderate ID with IQ scores from 40 to 54
  • Severe ID with IQ scores from 25 to 39
  • Profound ID with IQ score below 25
• Prenatal or Biological Causes

  1. Down Syndrome - named after Dr. Langdon Down. Caused by chromosomal abnormality, the most common is the trisomy 21 in which the 21st set of chromosomes is a triplet rather than a pair.
  2. Fragile X Syndrome - triplet or repeat mutation on the X chromosome interferes with the production of FMR-1 protein which is essential for normal brain functioning.
  3. Williams Syndrome - caused by the deletion of the seventh chromosome.
  4. Prader-Willi Syndrome - a syndrome disorder caused by the deletion of a portion of chromosome 15.
• Perinatal Causes

  1. Intrauterine Disorders such as maternal anemia, premature delivery, abnormal presentation, umbilical cord accidents and multiple gestation in the case of twins, triplets and other multiple births. Birth trauma may result from anoxia or cutting off of oxygen supply to the brain.
  2. Neonatal Disorder such as intracranial hemorrhage, neonatal seizures, respiratory disorders, meningitis, encephalitis, head trauma at birth.
• Postnatal Causes include

  1. Head Injuries
  2. Infections
  3. Demyelinating Disorder
  4. Degenerative Disorder/ Rett Syndrome
  5. Seizure Disorder
  6. Malnutrition
  7. Environmental Deprivation