Treatment Plan for Intellectual Development Disorder
Biological treatment of ID is currently not a viable option. Generally, the treatment
of individuals with ID parallels that of people with more severe forms of autism spectrum
disorder, attempting to teach them the skills they need to become more productive and
independent. For individuals with mild ID, intervention is similar to that for people with
learning disorders. Specific learning deficits are identified and addressed to help the
student improve such skills as reading and writing. At the same time, these individuals
often need additional support to live in the community. For people with more severe
disabilities, the general goals are the same; however, the level of assistance they need
is often more extensive. Remember that the expectation for all people with ID is that
they will in some way participate in community life, attend school and later hold a job,
and have the opportunity for meaningful social relationships. Advances in electronic and
educational technologies have made this goal realistic even for people with profound
intellectual disability.
Individuals with ID can acquire skills through the many behavioral innovations
first introduced in the early 1960’s to teach such basic self-care as dressing, bathing,
feeding, and toileting to people with even the most severe disabilities (Durand, 2014).
The skill is broken into its component parts (a procedure called a task analysis), and
people are taught each part in succession until they can perform the whole skill.
Performance on each step is encouraged by praise and by access to objects or
activities the people desire (reinforcers). Success in teaching these skills is usually
measured by the level of independence people can attain by using them. Typically,
most individuals, regardless of their disability, can be taught to perform some skills.
Communication training is important for people with ID. Making their needs and
wants known is essential for personal satisfaction and for participation in most social
activities. The goals of communication training differ, depending on the existing skills.
For people with mild levels of ID, the goals may be relatively minor (for example,
improving articulation) or more extensive (for example, organizing a conversation)
(Berney, 2012; Sigafoos, et. al, 2009). Some, like James have communication skills that
are already adequate for day-to-day needs.
For individuals with most severe disabilities, communication skills training can be
particularly challenging, because they may have multiple physical or cognitive deficits
that make spoken communication difficult or impossible. Creative researchers, however,
use alternative systems that may be easier for these individuals, including sign
language, used primarily by people with hearing disabilities, and augmentative
communication strategies. Augmentative strategies may use picture books, teaching a
person to make a request by pointing to a picture – for instance, pointing to a picture of
a cup to request a drink (Sigafoos, et. al, 2009). A variety of computer-assisted devices
including tablet computers can be programmed so that the individual presses a button
to produce complete spoken sentences (for example, “Would you come here? I need
your help.”) People with limited communication skills can be taught to use these
devices, which help them reduce the frustration of not being able to relate their feelings
and experiences to other people (Durand, 2011).
Concern is often expressed by parents, teachers, and employers that some
people with ID can be physically or verbally aggressive or may hurt themselves.
Considerable debate has ensued over the proper way to reduce these behavior
problems; the most heated discussions involve whether to use painful punishers (Repp
& Singh, 1990). Alternatives to punishment that may be equally effective in reducing
behavior problems such as aggression and self-injury include teaching people how to
communicate their need or desire for such things as attention that they seem to be
getting with their problem behaviors (Durand, 2012). Important advances are being
made in significantly reducing even severe behavior problems for some people.
In addition to ensuring that people with ID are taught specific skills, caretakers
focus on the important task of supporting them in their communities. “Supported
employment” involves helping an individual find and participate satisfactorily in a
competitive job (Hall, Butterworth, Winsor, Gilmore, & Metzel, 2007). Research has
shown not only that people with ID can be placed in meaningful jobs but also that,
despite the cost associated with supported employment, it can be cost-effective
(Sandys, 2007). The benefits to people who achieve the satisfaction of being a
productive part of society are incalculable.
There is general agreement about what should be taught to people with ID. The
controversy in recent years has been over where this teaching should take place.
Should people with ID, especially the severe forms, be taught in specially designed
separate classrooms or workshops, or should they attend their neighborhood public
schools and work at local businesses? Increasingly, teaching strategies to help these
students learn are being used in regular classrooms and in preparing them to work at
jobs in the community (Foley, Dyke, Girdler, Bourke, & Leonard, 2012). The current
prevention and treatment efforts suggest that meaningful changes can be achieved in
the lives of those with ID.
