INTELLECTUAL

DISABILITY
Prepared by: Saba Ahmed
What is
Intellectual
disability
A term used when there are
limits to a person's ability to
learn at an expected level and
function in daily life
INTELLECTUAL DISABILITY
◦ DEFINITION • THE AMERICAN ASSOCIATION OF INTELLECTUAL & DEVELOPMENTAL DISABILITIES (AAIDD) HAS DEFINED
INTELLECTUAL DISABILITY AS A DISABILITY CHARACTERIZED BY SIGNIFICANT LIMITATIONS IN BOTH INTELLECTUAL
FUNCTIONING AND IN ADAPTIVE BEHAVIOUR, WHICH COVERS MANY EVERYDAY SOCIAL AND PRACTICAL SKILLS WHICH
ORIGINATES BEFORE THE AGE OF 18. • THE DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS, FIFTH
EDITION (DSM-V) 7 DEFINES INTELLECTUAL DISABILITY AS FOLLOWS: • “INTELLECTUAL DISABILITY (INTELLECTUAL
DEVELOPMENTAL DISORDER) IS A DISORDER WITH ONSET DURING THE DEVELOPMENTAL PERIOD THAT INCLUDES BOTH
INTELLECTUAL AND ADAPTIVE FUNCTIONING DEFICITS IN CONCEPTUAL, SOCIAL, AND PRACTICAL DOMAINS.” 2
HISTORICAL OVERVIEW
1. THE OLDEST PHYSIOLOGICAL VIEW OF INTELLECTUAL DISABILITY IS IN THE WRITINGS OF HIPPOCRATES IN THE LATE
FIFTH CENTURY B.C. WHO BELIEVED THAT IT WAS CAUSED BY AN IMBALANCE IN THE FOUR HUMORS IN THE BRAIN.
2. UNTIL THE ENLIGHTENMENT IN EUROPE, CARE AND ASYLUM WAS PROVIDED BY FAMILIES AND THE CHURCH (IN
MONASTERIES AND OTHER RELIGIOUS COMMUNITIES), FOCUSING ON THE PROVISION OF BASIC PHYSICAL NEEDS SUCH
AS FOOD, SHELTER AND CLOTHING. NEGATIVE STEREOTYPES WERE PROMINENT IN SOCIAL ATTITUDES OF THE TIME. • IN
THE 13TH CENTURY, ENGLAND DECLARED PEOPLE WITH INTELLECTUAL DISABILITIES TO BE INCAPABLE OF MAKING
DECISIONS OR MANAGING THEIR AFFAIRS. GUARDIANSHIPS WERE CREATED TO TAKE OVER THEIR FINANCIAL AFFAIRS.
CONT….
IN THE 17TH CENTURY, THOMAS WILLIS PROVIDED THE FIRST DESCRIPTION OF INTELLECTUAL DISABILITIES AS A DISEASE.
HE BELIEVED THAT IT WAS CAUSED BY STRUCTURAL PROBLEMS IN THE BRAIN. ACCORDING TO WILLIS, THE ANATOMICAL
PROBLEMS COULD BE EITHER AN INBORN CONDITION OR ACQUIRED LATER IN LIFE. • IN THE 18TH AND 19TH CENTURIES,
HOUSING AND CARE MOVED AWAY FROM FAMILIES AND TOWARDS AN ASYLUM MODEL. CHILDREN WITH INTELLECTUAL
DISABILITIES AND BEHAVIOURAL ABNORMALITIES WERE REMOVED FROM THEIR FAMILIES AND PLACED IN SPECIALIZED
INSTITUTIONS WHICH PROVIDED VERY MINIMAL BASIC EDUCATION AND SURVIVED ON THE SERVICES PROVIDED THE RESIDENTS.
JEAN-MARC ITARD IS CREDITED WITH CREATING THE FIRST SYSTEMATIC INTERVENTION PROGRAM FOR A PERSON WITH
INTELLECTUAL DISABILITY IN LATE 18TH CENTURY FRANCE, AND THE FIRST RESIDENTIAL FACILITY WAS FOUNDED IN THE MID-
19TH CENTURY IN SWITZERLAND. • IN THE LATE 19TH CENTURY, IN RESPONSE TO CHARLES DARWIN'S ON THE ORIGIN OF
SPECIES, FRANCIS GALTON PROPOSED SELECTIVE BREEDING OF HUMANS TO REDUCE INTELLECTUAL DISABILITIES. •
PSYCHOLOGICAL TESTS TO ASSESS INTELLIGENCE WERE DEVELOPED IN THE 20TH CENTURY, WHICH INCREASED CASE
IDENTIFICATION. 
Cont..

◦ THE TERM 'MENTAL RETARDATION' WAS INTRODUCED BY THE AMERICAN ASSOCIATION ON

MENTAL RETARDATION IN 1961, AND SOON AFTERWARDS WAS ADOPTED BY THE AMERICAN
PSYCHIATRIC ASSOCIATION (APA) IN ITS DIAGNOSTIC AND STATISTICAL MANUAL FOR MENTAL
DISORDERS (DSM). • MENTAL RETARDATION REPLACED OLDER TERMS SUCH AS
‘FEEBLEMINDEDNESS’, ‘IDIOCY’, AND ‘MENTAL SUB NORMALITY’ THAT HAD BECOME
PEJORATIVE.(criticize)
THE JOURNEY FROM MENTAL RETARDATION
TO INTELLECTUAL DISABILITY
◦ ROSA MARCELLINO, AN 8-YEAR-OLD GIRL WITH DOWN SYNDROME FROM MARYLAND, WAS TAUNTED
FREQUENTLY AND PEJORATIVELY CALLED 'RETARD' IN A DEMEANING MANNER. • WITH SUPPORT FROM
HER STATE REPRESENTATIVE AND U.S SENATOR BARBARA MIKULSKI, LEGISLATION WAS INITIATED
LEADING TO THE CHANGE IN THE LAW. • THE TERM 'MENTAL RETARDATION' HAS BEEN ELIMINATED IN
THE UNITED STATES, A FEDERAL STATUTE (PUBLIC LAW 111-256, ROSA'S LAW) REPLACES THE TERM
'MENTAL RETARDATION' WITH 'INTELLECTUAL DISABILITY' AND REQUIRES THAT PERSON FIRST
LANGUAGE BE USED WHEN REFERRING TO THOSE AFFECTED IN ALL FEDERAL LAWS.
INTELLECTUAL DISABILITY (ID).
◦ THE NEW TERM PROPOSED IN DSM-5 IS INTELLECTUAL DISABILITY (ID). • THE NEW DSM-5 CATEGORY IS
SYNONYMOUS WITH THE PROPOSED ICD-11 DIAGNOSIS OF IDDS, IN THAT IT REFERS TO A HEALTH
CONDITION OR DISORDER. • THE ICD-11 WORKING GROUP HAS PROPOSED REPLACING MENTAL
RETARDATION WITH INTELLECTUAL DEVELOPMENTAL DISORDERS (IDDS), A TERM IT DEFINES AS 'A
GROUP OF DEVELOPMENTAL CONDITIONS CHARACTERIZED BY SIGNIFICANT IMPAIRMENT OF COGNITIVE
FUNCTIONS, WHICH ARE ASSOCIATED WITH LIMITATIONS OF LEARNING, ADAPTIVE BEHAVIOUR AND
SKILLS'.
WHO ARE THE INTELLECTUALLY DISABLED ? 
◦ DSM V CRITERIA • THE FOLLOWING THREE CRITERIA MUST BE MET:
◦ • DEFICITS IN INTELLECTUAL FUNCTIONS, SUCH AS
◦ REASONING
◦ • PROBLEM SOLVING
◦ • PLANNING
◦ • ABSTRACT THINKING
◦ • JUDGMENT
◦ • ACADEMIC LEARNING
◦ • LEARNING FROM EXPERIENCE
◦ CONFIRMED BY BOTH CLINICAL ASSESSMENT AND INDIVIDUALIZED, STANDARDIZED INTELLIGENCE
TESTING.
Levels of ID
◦ If child has an intellectual disability (ID), their brain hasn’t developed properly or has been injured in some way. Their brain
may also not function within the normal range of both intellectual and adaptive functioning. In the past, medical professionals
called this condition “mental retardation.”
◦ There are four levels of ID:
• mild
• moderate
• severe
• profound
Sometimes, ID may be classified as:

• “other”
• “unspecified” (Unspecified Intellectual Disability is a diagnosis for individuals over the age of 5 years when assessment of the
degree of intellectual disability (intellectual developmental disorder) by means of locally available procedures is difficult or
impossible because of sensory or physical impairments
◦ ID involves both a low IQ and problems adjusting to everyday life. There may also be learning, speech, social, and physical
disabilities.
◦ Severe cases of ID may be diagnosed soon after birth. However, you might not realize child has a milder form of ID until they
fail to meet common developmental goals. Almost all cases of ID are diagnosed by the time a child reaches 18 years of age.
         
Specific intellectual disability
◦ intellectual disability (or ID) is a term used when a person has certain limitations in cognitive functioning and skills, including
communication, social and self-care skills. These limitations can cause a child to develop and learn more slowly or differently
than a typically developing child
Symptoms of intellectual disability
◦ Symptoms of ID will vary based on your child’s level of disability and may include:
• failure to meet intellectual milestones
• sitting, crawling, or walking later than other children
• problems learning to talk or trouble speaking clearly
• memory problems
• inability to understand the consequences of actions
• inability to think logically
• childish behavior inconsistent with the child’s age
• lack of curiosity
• learning difficulties
• IQ below 70
• inability to lead a fully independent life due to challenges communicating, taking care of themselves, or interacting with others
BEHAVIOURAL ISSUES WITH ID
◦ fchild has ID, they may experience some of the following behavioral issues:
• aggression
• dependency
• withdrawal from social activities
• attention-seeking behavior
• depression during adolescent and teen years
• lack of impulse control
• passivity
• tendency toward self-injury
• stubbornness
• low self-esteem
• low tolerance for frustration
• difficulty paying attention
◦ Some people with ID may also have specific physical characteristics. These can include having a short stature or facial abnormalities.
Mild intellectual disability

Some of the symptoms of mild intellectual disability include:

• taking longer to learn to talk, but communicating well once they know how
• being fully independent in self-care when they get older
• having problems with reading and writing
• social immaturity
• increased difficulty with the responsibilities of marriage or parenting
• benefiting from specialized education plans
• having an IQ range of 50 to 69
Moderate intellectual disability

◦ If child has moderate ID, they may exhibit some of the following symptoms:
• are slow in understanding and using language
• may have some difficulties with communication
• can learn basic reading, writing, and counting skills
• are generally unable to live alone
• can often get around on their own to familiar places
• can take part in various types of social activities
• generally having an IQ range of 35 to 49
Severe intellectual disability

◦ Symptoms of severe ID include:

• noticeable motor impairment
• severe damage to, or abnormal development of, their central nervous system
• generally having an IQ range of 20 to 34
Profound intellectual disability

◦ Symptoms of profound ID include:

• inability to understand or comply with requests or instructions
• possible immobility
• incontinence
• very basic nonverbal communication
• inability to care for their own needs independently
• the need of constant help and supervision
• having an IQ of less than 20
Rate of prevalence
What causes intellectual disability?

Doctors can’t always identify a specific cause of ID, but causes of ID can include:
• trauma before birth, such as an infection or exposure to alcohol, drugs, or other toxins
• trauma during birth, such as oxygen deprivation or premature delivery
• inherited disorders, such as phenylketonuria (PKU) or Tay-Sachs disease
• chromosome abnormalities, such as Down syndrome
• lead or mercury poisoning
• severe malnutrition or other dietary issues
• severe cases of early childhood illness, such as whooping cough, measles, or meningitis
• brain injury
COMMON TYPES OF INTELLECTAUL
DISABILITIIES
◦ Most Common Types of Intellectual Disabilities
◦ The common types of intellectual disabilities include
◦ autism,
◦ Down syndrome,
◦ fragile x syndrome,
◦ fetal alcohol syndrome,
◦ Prader-Willi syndrome.
GENERAL INFORMATION
◦ Intellectual disability is the impairment of cognitive functioning, characterized by having an IQ of less than 70, given
the average IQ is 100. It is also characterized by impairment in adaptive functioning where individuals experience
difficulties carrying out daily activities such as communication, socialization, and independent living.  
◦ Individuals diagnosed with intellectual disabilities tend to experience general learning challenges and may take a
little longer to develop social and practical skills.
How is intellectual disability diagnosed?

◦ To be diagnosed with ID child must have below-average intellectual and adaptive skills. doctor will perform a three-part
evaluation that includes:
• interviews with you
• observations of child
• standard tests
◦ WAIS
◦ WISC
◦ Achievement test
◦ Visual Motor Integration Tests
◦ Language Tests
Autism

◦ Autism is an intellectual disability affecting the nervous system and the structure and function of the brain. The
disability affects the way an individual communicates, acts, learns, and interacts with other people. An individual
with autism has social skills challenges, including interacting with other people, communication, repetitive
behaviors, and restricted interests. Different individuals with autism can show different symptoms, making the
disability referred to as a spectrum disorder.
A spectrum disorder is a group of disorders with a
range of similar characteristics. Some of the
common signs and symptoms of autism include:
• Difficulty communicating 
• Restricted behaviors 
• Avoiding social groups and relationships 
• Challenges with abstract thinking 
• Dislike for changes in routine 
• Repetitive behavior or stimming 
• Challenges following social norms 
Down’s Syndrome 

1. DEFINITION:
Down’s syndrome is an intellectual disability stemming from having a part of or an extra copy of chromosome
21 in the DNA. It is the most common chromosomal cause of mild to moderate intellectual disabilities in children.
Down syndrome affects development in children with down syndrome reaching key developmental stages later than
the rest of the same age children.
COMMON SYMPTOMS OF DOWN
SYNDROME
◦ Down syndrome’s common symptoms include
◦ slow learning,
◦ short attention span,
◦ impulsive behavior,
◦ poor judgment,
◦ delayed language and speech development
◦ Children with Down syndrome have poor muscle tone, making them take longer to learn how to make some
movements such as turning over, walking, standing, and sitting.
Physical characteristics of individuals with
Down syndrome
Physical characteristics of individuals with Down syndrome include:
flattened facial profile and nose,
upward slanting eyes, and small head, ears, and mouth. 
Additionally, individuals with Down syndrome are prone to other
health factors such as
heart abnormalities,
hearing loss,
vision problems,
and respiratory conditions.
CONTI…
◦ Although children with down syndrome have a slower development rate, they will eventually meet all or any of the
development milestones. Lifespan of individuals with Down syndrome has increased due to increased research
and technology in the area.
FACIAL FRATURES
TREATMENT
Fragile X Syndrome

◦ Fragile X Syndrome is the most prevalent form of inherited developmental and intellectual disability. This genetic
disorder results from a change or mutation in the X chromosome. The disability affects the development of a
person, more so in the areas of learning and behavior. What’s more, it can affect physical appearance,
communication skills, and sensitivity to the individual’s light and noise with intellectual disability.  It is worth noting
that the fragile x syndrome disability is more prevalent in boys than girls.  
ALSO KNOWN AS
SIGN AND CAUSES
◦ Individuals with fragile x syndrome do not exhibit the same signs and symptoms. However, they have common
signs, including:
• Problems with speech and language 
• Attention disorders Problems with hyperactivity 
• Anxiety  Developmental delay 
• Problems processing sensory information 
• Aggressiveness (ADHD)
• Trouble making eye contact 
FACIAL FEATURES
EVALUATON
◦ FOR THE DAIGNOSOIS OF FAGILE X SYNDROEME
◦ AMNIOCYNTESYS:
◦ Amniocentesis is a procedure used to take out a small sample of the amniotic fluid for testing. This is the fluid that surrounds
the fetus in a pregnant woman. Amniotic fluid is a clear, pale yellow fluid that: Protects the fetus from injury. Protects against
infection.
◦ Chorionic villus sampling, sometimes called "chorionic villous sampling", is a form of prenatal diagnosis done to determine
chromosomal or genetic disorders in the fetus.
◦ Diagnostic tests that can identify Down syndrome include: Chorionic villus sampling (CVS). In CVS, cells are taken from the
placenta and used to analyze the fetal chromosomes. This test is typically performed in the first trimester, between 10 and 13
weeks of pregnancy.
TREATMENT PLANS
◦ What are the treatments for Fragile X syndrome?
◦ There is no single treatment for Fragile X syndrome, but there are treatments that help minimize the symptoms of the
condition. Individuals with Fragile X who receive
◦ appropriate education,
◦ therapy services,
◦ medications have the best chance of using all of their individual capabilities and skills. Even those with an intellectual or
developmental disability can learn to master many self-help skills.
Fetal Alcohol Syndrome 

◦ Fetal alcohol syndrome is an intellectual disability caused by exposure to alcohol during pregnancy. Women who
drink alcohol during pregnancy expose their children the risk of this disability. The severity of the disability depends
on the child’s level of exposure to alcohol during pregnancy, where mothers who drink large quantities of alcohol
during pregnancy increase the risk of severe symptoms in their children. 
 Fetal alcohol syndrome
◦ The common symptoms found in children with fetal alcohol syndrome include:
• Facial, limb, and joint deformities
• Poor memory and judgment
• Learning disabilities
• Poor social skills
• Sensory difficulties, including hearing and vision
• Heart problems and defects 
• Behavioral problems
• Slow physical growth 
CONTI…
◦ To avoid the possibility of having cases of fetal alcohol syndrome, pregnant women are advised to avoid alcohol at
all costs. Also, in some countries such as the United States, mothers who give birth to children with fetal alcohol
syndrome are at risk of their children being taken away from them, as stated by the law. Most of the symptoms of
the disability can be reversed if early intervention is considered, such as surgeries to correct heart and neurological
problems. 
TREATMENT PLAN FASDs,
◦ There is no cure for FASDs, but research shows that early intervention treatment services can improve a child's development.
Early intervention services help children from birth to 3 years of age (36 months) learn important skills. Services include
therapy to help the child talk, walk, and interact with others.
Prader-Willi Syndrome (PWS)

◦ Prader-Willi (PRAH-dur VIL-e) syndrome is a rare genetic disorder that results in a number of physical, mental and
behavioral problems. A key feature of Prader-Willi syndrome is a constant sense of hunger that usually begins at
about 2 years of age.
◦ People with Prader-Willi syndrome want to eat constantly because they never feel full (hyperphagia), and they
usually have trouble controlling their weight. Many complications of Prader-Willi syndrome are due to obesity.
Signs and symptoms of Prader-Willi
.

syndrome can vary among individuals.

Symptoms may slowly change over time
from childhood to adulthood.
Symptoms of individuals with Prader-Willi
syndrome include:
• Intellectual disability (problem-solving, language, and math difficulties)
• Poor muscle tone
• Diabetes Obesity 
• Short stature 
• Hyperphagia
• Emotional difficulties
•  Hormone deficiencies 
• Sleep issues such as sleep apnea
• Underdeveloped genitals.
Conti..
◦ Children below the age of two tend to exhibit developmental delays, weak cry, feeding difficulties, and
undernourishment. During the teenage years, Prader-Willi syndrome leads to delayed puberty, increased risk of
scoliosis, and increased social skill deficiencies.  Interventions at an early age can help manage the symptoms of
Prader-Willi, more so in the areas of intellectual ability of the child.
Is Prader-Willi syndrome curable?

◦ Currently, there is no cure for PWS. The lives individuals with PWS can be improved with an early diagnosis and
careful management of symptoms but more effective therapies are needed. 

TEST FOR EVELUATION: blood test done to evaluate PWD

Methylation analysis
Growth hormone deficiency is present in almost all children and many adults with PWS. In multiple studies, human growth
hormone (HGH) has been found to be beneficial for those with Prader-Willi syndrome