4.6: Intellectual Disabilities/Cognitive Delays

Image Source: Andrea's Photography. Flickr. August 2008. CC-BY 4.0

Fig. 4.6. Preschool girl with Down's Syndrome playing with toy.

What is an Intellectual Disability?

Intellectual disability is a term used when a person has certain limitations in mental functioning and skills (communicating, taking care of themselves, and social skills). These limitations will cause a child to learn and develop more slowly than a typical child. It is not a disease, it's not contagious. It's also not a form of mental illness. While there are no cures for intellectual disabilities, most children can learn to do many things given the time, effort, and encouragement.

Children with intellectual disabilities (sometimes called cognitive disabilities) may take longer to learn to speak, walk, and take care of their personal needs such as dressing or eating. They are likely to have trouble learning in school. They will learn, but it will take them longer. With ongoing support, the child's functioning can be improved but there may be some things they cannot learn.

What Causes an Intellectual Disability?

Doctors have found many causes of intellectual disabilities. The most common are:

• Genetic conditions.
  • abnormal genes inherited from parents, errors when genes combine, or other reasons.
  • examples: Down syndrome, fragile X syndrome, and phenylketonuria (PKU).
• Problems during pregnancy. An intellectual disability can result
  • when the baby does not develop inside the mother properly
  • examples: problems with the way the baby’s cells divide as it grows, infections such as rubella during pregnancy, alcohold or durg use while pregnant
• Problems at birth.
  • problems during labor and birth
  • example: not getting enough oxygen
• Health problems.
  • diseases: whooping cough, measles, or meningitis
  • extreme malnutrition
  • inadequate medical care
  • exposure to poisons like lead or mercury

Definitions

There are three primary definitions of intellectual disabilities.

1. Individuals with Disabilities Education Act (IDEA)

• significantly subaverage general intellectual functioning
  • defined as a score on a standardized intelligence test below 68 (significantly below an average score of 100)
• exists concurrently with deficits in adaptive behavior
• manifests during the developmental period - between birth and 18 years of age
• adversely affects a child’s educational performance

2. American Association on Intellectual and Developmental Disabilities (AAIDD)

• characterized by significant limitations in intellectual functioning and adaptive behavior as expressed in conceptual, social, and practical skills.
• originates during the developmental period, defined as before the age of 22

3. Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association

• includes both intellectual and adaptive functioning deficits
• three criteria must be met for a child to be diagnosed with an intellectual disability
  • deficits in intellectual functions - reasoning, problem solving, planning, abstract thinking, judgment, academic learning, and learning from experience,
  • deficits in adaptive functioning that result in failure to meet developmental and sociocultural standards for personal independence and social responsibility.
  • onset of intellectual and adaptive deficits during the developmental period
• four severity levels of intellectual disability: mild, moderate, severe, and profound
  • diagnosed on the basis of adaptive functioning
    • educators and clinicians provide appropriate interventions for students.

Adaptive Behaviors

Adaptive behaviors are “learned behaviors." These behavior's encompass the child's conceptual social and practical behaviors - the skills and tasks needed to function in everyday life.

The purpose of definitions is provide criteria to support the identification of students with an intellectual disability. However, it is important to recognize that adaptive behaviors are malleable and with appropriate ongoing interventions and supports, children with intellectual disabilities can improve their adaptive behaviors.

Conceptual skills:

• memory
• language
• reading
• writing
• math reasoning
• acquisition of practical knowledge
• problem solving
• judgment in novel situations.

Social skills:

• empathy
• awareness of others’ thoughts, feelings, and experiences.
• interpersonal communication
• friendship abilities
• social judgment

Practical skills:

• learning and self-management across life settings
  • personal care
  • self-management of behavior
  • school tasks

Image Source: Christi Warren. Santa Rosa Preschool Celebrate World Down Syndrome Day. Press Democrat. 2018

Fig. 4.6.1. Preschool boy with Down's Syndrome and preschool girl coloring with markers and laughing.

Inclusion Strategies for the Classroom

• Give more time and practice than usual
  • Students with mild intellectual disabilities may be able to learn the basics of what's being taught, but may need more time to accomplish goals than other students. Giving extra help takes time and perseverance, and can try the patience of the student (and of you, too). To deal with this problem, it may help to reward the student frequently for effort and successes with well-timed praise, especially if it is focused on specific, actual achievements. Giving appropriate praise is easier if you set reasonable, "do-able" goals by breaking skills or tasks into steps that the student is likely to learn without becoming overly discouraged.
• Embed activities into the context of daily life or functioning where possible (adaptive and functional skills)
  • Select activities that relate to the learning goals in the child's everyday life and activities, just as you would with all students. For example, try encouraging the student to learn words that are especially useful to the student's own life such as naming things or pointing to the named thing: foods, clothing, furniture parts of their body, animals, shapes, colors, etc. Often the student, not you yourself, is the best person to decide what these words actually are.
• Include the child both in social and in academic activities, rather than just one OR the other
  • The key word here is inclusion: the child should participate in and contribute to the life of the class as much as possible - playing a group game, singing, clapping, outdoor play, etc. The changes resulting from these inclusions can be positive for everyone and foster acceptance and helpfulness toward the child with the disability. Classmates learn that school is partly about providing opportunities for everyone. This type of inclusion also stimulates the child with the disability to learn as much as possible from classmates, socially and academically. These group activities can give the student chances to practice "belonging" skills— how to greet classmates appropriately, or when and how to ask the teacher a question.

Sources

• Definitions of Intellectual Disabilities. The Psychology of Exceptional Children (Zaleski). LibreTexts, Social Sciences Library. Definitions of Intellectual Disabilities is shared under a CC BY 4.0 license and was authored, remixed, and/or curated by Diana Zaleski (Consortium of Academic and Research Libraries in Illinois (CARLI)) .
• Intellectual Disabilities. Educational Psychology (Seifert and Sutton). LibreTexts, Social Sciences Library. Intellectual Disabilities is shared under a CC BY 3.0 license and was authored, remixed, and/or curated by Kelvin Seifert & Rosemary Sutton (Global Text Project) via source content that was edited to the style and standards of the LibreTexts platform.