Unit 5 Intellectual Disabilities

Prepared by: Cicilia Evi GradDiplSc., M. Psi

The Term

• On 2007, American Association for Mental Retardation (AAMR) changed its name to American Association for Intellectual and Developmental Disabilities (AAIDD)

• Negative connotations imbecile, moron, idiot, retardate due to social stigma

• Simply changing a name does not change the systemic reason for bias

Introduction

• Impaired intellectual functioning, limited adapted behavior, need for supports, and initial occurrence before age 18

• They make very special effort to learn all the skills needed in adult life

• People first … • Normalization (by Benjt Nirje, 1960) making

available ordinary patterns of life and conditions of everyday living

Introduction (2)

• Dignity of risk (Bob Perske) the principle that taking ordinary risks and chances is part of the human experience avoid being overprotective

• How society reacts can create obstacles or opportunities for those with intellectual disabilities

Challenges

• Learning is difficult • Normal task is overwhelming • Mostly come from bias, prejudice and stigma

from others • Any kind of name-calling can be personally

hurtful to the individuals • We need to erase negative terms

feebleminded, MR, handicapped or idiot

Best Buddies

• Anthony Shriver 1989 at Georgetown University

• Foster one-on-one friendships structured around social activities relationships, friendships and opportunities for supports

Definition

• Five assumptions on Intellectual Disabilities p. 269• Intellectual disabilities is conceptualized in terms of

adaptive behavior that they have and the intensity of supports needed to be able to function independently in the community (Luckasson et al, 1992, 2002; Polloway, 1997)

• Three major elements:– Intellectual Functioning– Adaptive Behavior– Systems of supports

Intellectual Functioning

• Significantly below average face challenges in cognitive performance

• Not typical learners at least 2 SD below the mean need extra help to master skills needed in adult life

• Cutoff score is 70 category p. 270• Story of AL

Adaptive Behavior

• Performance in everyday life skills expected of adults (see figure 8.1, p. 270)

• Difficulties from lack of skills needed in different situations or don’t know what skill is needed in particular situation

• Conceptual skills language, self-direction, reading and writing, money concepts

• Practical skills eating, dressing, toileting• Social skills social conventions, how to terminate

conversation

Systems of Supports

• Networks of friends, family, members and coworkers, social services and government agencies that help them manage their daily life

• Life is a network of support • Levels of intensity intermittent, limited,

extensive, pervasive• Vary for every person

Characteristics: Cognition

• Impaired cognition make tasks difficult interfere communicative competence

• Degree of cog impairments define curriculum content academic, life skills or both (p. 272)

• Hard to learning new skills and generalized mastered skills to new situation

• Impaired STM and trouble with LTM esp when the events not identified as important

• Reduce ability in incidental learning through observation, without instruction

Characteristics: Adaptive Behavior

• They are all facing difficulties in one area of adaptive skills area

• IEP goals for them stress independence• But … goals should be thought of in terms of

interdependence, at least two peers work together, providing each other with assistance and support

Characteristics: Need of Supports

• Natural supports from family, friend, neighbors, coworkers, peers at school

• Nonpaid supports community supports• Generic supports available for everyone

public transport and facilities by state• Specialized supports disability-specific • Support fluid concept provide them as

much as needed, when it is necessary …

Prevalence

• Identified less than 1% of all students far less than expected number: 3% of students have their IQ score below the cut-off score why so?– Social stigma professional reluctant to label – Not all cognitive disabilities students are having

intellectual disabilities as their primary problem– Students of color being overrepresented

Causes

• 1/3 are unknown (The Arc, 2005)• The ravages of poverty and its risk factors

(limited health care, disrupted lives and fewer early intervention opportunities

• A connection between child abuse and neglect – intellectual disabilities

Causes (2)

• Based on onset:– Prenatal genetic (PKU, fragile X, Down Syndrome),

heredity, toxins (incld. tobacco, alcohol, drug), disease, neural tube defects

– Perinatal birth injuries, O2 deprivation, head trauma, umbilical cord accidents, obstetrical trauma

– Postnatal due to the environment lead poisoning, child abuse and neglects, accidents

• Based on specific reasons genetic/heredity, toxins, child abuse/neglect

Genetic Cause

• Fragile X Syndrome mutation of X chromosomes affecting 1 on 4,000 males and 1 in 8,000 females

• Down Syndrome the 21st chromosomes contains three chromosomes, not a pair

• Phenylketonuria (PKU) from buildup of toxins from food containing amino acids (like milk)– Need controlled diet

Toxins

• Prenatal and postnatal causes of intellectual disabilities

• Lead poisoning from gasoline, toys or paint of old houses

• Playing in contaminated dirt, breathing lead directly from a paint source, eating paint chips, or touching old paint and puttingtheir fingers to their mouth

Toxins (2)

• Fetal Alcohol Spectrum congenital conditions due to alcohol consumption during pregnancy

• Cause of learning problems, language impairments, difficulties generalizing learning across situations and also behavioral issues: hyperactivity, inattention, low self-esteem, aggression and impulsivity (Duquette et al., 2006)

• Average IQ score is 79 (Bennington & Thomson, 2006)

Prevention

• By directly addressing the cause • Vaccines, immunization• Education, medical technology, access to

health care • Terminate the pregnancy (80% - 90% due to

Down Syndrome), adopting • Strategy p. 279

Assessments

• IQ tests common, but with many controversy • Early identification family, doctor, preschool

teachers• Assess adaptive abilities to evaluate the actual

skills mastered with typical skills expected in a typical environment

• Alternate assessment portfolio for students who don’t go for general classroom (story of ‘Zero to Five’ homeschooling program)

Early Intervention

• Can reduce the severity – even prevent them • Essential for young children with disabilities

and who are at-risk for developmental delay or school failure

• Benefits of high-quality inclusive preschool p. 283

• Read story of Geri A. Nicholas p. 273• Key features of preschool settings p. 283

Teaching

• Modification of instruction p. 286 – Assignments or tests are reduced or altered – Alternative assignments photo essay instead of

writing report • Self-determination ability to make decision,

choosing preferences, and exercising self-advocacy needed for independent living – Adult directed reward system – More likely to graduate from HS, hold job and

experience success in adult life p. 287

How to Help?

• Technology using internet can help• Functional curriculum p. 288 • Employment – Vocational rehabilitation– Supported rehabilitation– Job coach p. 290

• Friendships married??? • Independent Living

Quality of Life

• A person’s satisfaction with life, which includes a sense of contentment that results in part from feelings of dignity, value, worth and respect (Wolfensberger, 2002)

• An assessment of QoL helps to determine how well the individual’s needs and desires are being met and reflects outcomes: empowerment, self-determination, independence, social belonging, community presence and life satisfaction (Schalock, Gardner, & Bradley, 2007)