Intellectual Disability (ID) Lecture Set 10 - PDF

Intellectual Disability (ID) § Controversies surround definition The Definition Dilemma § In part because support is linked to definition § IQ of 70 or 75? § IQ alone? § Characterized by Definition of ID (AAIDD, 2010) significant limitations both in intellectual functioning and in adaptive...

Intellectual Disability (ID) § Controversies surround definition The Definition Dilemma § In part because support is linked to definition § IQ of 70 or 75? § IQ alone? § Characterized by Definition of ID (AAIDD, 2010) significant limitations both in intellectual functioning and in adaptive behaviour expressed in conceptual, social, and practical adaptive skills. § The following assumptions are essential to the application of this definition… 1. Limitations in functioning Definition of ID (AAIDD, 2010) must be considered within the context of community environments typical of the individual’s age, peers and culture. 2. Valid assessment considers cultural and linguistic diversity as well as differences in communication, sensory, motor, and behavioral factors. 3. Within an individual, limitations often coexist with strengths. 4. An important purpose of Definition of ID (AAIDD, 2010) describing limitations is to develop a profile of needed supports. 5. With appropriate personalized supports over a sustained period, the life functioning of the person with ID generally will improve. Definition of ID (AAIDD, 2010) Adaptive Behaviour 1. Conceptual: Language, reading & writing, money, time, number concepts 2. Social: Interpersonal skills, Three (3) Adaptive Behaviour Categories social responsibility, selfesteem, gullibility, following rules, obeying laws, and avoiding victimization 3. Practical: ADL (personal care), occupational skills, use of money, safety, health care, travel/transportation, schedules/routines, use of the telephone § Resources and strategies What are Supports? AAIDD, 2010 that aim to promote the development, education, interests, and personal wellbeing of a person and that enhance individual functioning. § Support needs are psychological constructs referring to the pattern and intensity of supports necessary for a person to participate in activities linked with normative human functioning. § Services are one type of support provided by agencies and professionals What are Supports? AAIDD, 2010 § Individual functioning results from interaction of supports § Appropriate supports will improve functioning § Prenatal: § Chromosomal disorders § Brain formation disorders Causes of ID (i.e. Neural Tube fails to form properly) § Errors of metabolism (i.e. protein synthesis) § Environmental (i.e. toxins, drug/alcohol use) § Perinatal: Causes of ID (Around childbirth especially 5 months before and one month after) § Postnatal: Causes of ID § Head injuries § Infections § Degenerative § Seizure disorders § Toxic-metabolic § Malnutrition § Environmental deprivation − i.e. disease-producing conditions, inadequate medical care, isolation, and environmental health hazards § 22 are autosomes, and one (1) sex chromosome § Chromosomal abnormalities affect about 7 in every 1000 births Chromosomal Abnormalities § Usually result from chance errors in cell division § With each cell division 23 pairs of chromosomes should be passed on, each carrying the full DNA and genes to determine further development § Of the 23 pairs in each cell, 22 are autosomes (important for specific genetic markers) and one is the sex chromosome pair, designated XX (female) or XY (male) Chromosomal Abnormalities § Abnormalities can occur in either autosomes or sex chromosomes § Most common autosomal chromosome disorder is Down Syndrome § A common sex linked chromosome disorder is Turner Syndrome § A chromosomal Trisomy 21 (Down Syndrome) abnormality that affects intellectual and physical development § Trisomy 21 (most common) § Translocation (when one chromosome breaks off and attaches to another) § Mosaicism (very rare) § Detected through amniocentesis § Risk is about 1 in 800, but varies with maternal age: − Age 25 = 1/1000 − Over 35 = 1/400 − Over 45 = 1/35-40 Trisomy 21 (Down Syndrome) 47, XY, +21 Common Features: § Flattened back of skull, short neck § Small oral cavity § Hypotonic muscle tone during childhood Trisomy 21 (Down Syndrome) § Joint looseness (hypotonicity & lax ligaments) § Short stature § Short limbs with short, broad hands and feet § Almond-shaped, slanted eyes (strabismus, myopic) § Flattened facial features § Hypotonia (lack of muscle mass) and skeletal concerns § Motor development delays § Balance deficits Trisomy 21 (Down Syndrome) § Left-handedness and asymmetrical strength § Visual and hearing concerns § Heart and lung problems § Fitness and obesity § Health and temperament § 17% of persons with DS § Atlantoaxial is a joint between first 2 cervical vertebrae § Ligaments and muscles Trisomy 21 (Down Syndrome) surrounding the joint are ‘lax’ which can cause instability § Because of instability, the vertebrae can slip out of alignment easily § Particular sports that cause forceful bending of neck (gymnastics, swimming, diving, soccer) can cause damage to spinal cord § Persons with DS are required to have x-rays to determine if the condition is present or not § Seizures ID with Associated Conditions § Cerebral palsy § Dual diagnosis (mental health) § Pain insensitivity and indifference § Communication and SelfDirection § Augmentative/alternative communication § Range from low-tech Considerations for Physical Activity alternatives like picture boards and notebooks to high-tech devices that use synthetic or digitized speech § Time delay to respond − 10 seconds without prompting Cognitive Ability § Attention (pay attention to one aspect of a task or pay attention to everything including irrelevant stimuli) § Memory or Retention (long term memory Considerations for Physical Activity is equal to peers. May have difficulties with short term memory) § Add rehearsal strategies and provide multiple trials § Modeling, verbal rehearsal, self talk and imagery § Feedback § Feedback should include questioning about process as well as product. i.e. Did the movement feel good, did you tuck your head when you did the forward roll etc. § Task Analysis, Repetition, Generalization § Might require more time and/or attempts § Motor Performance § Motor development and delays (slowness) − Slowness in the use of righting, propping, postural reactions and processing instruction Considerations for Physical Activity § Influence of physical constraints § Height; Weight § Obesity § Physical fitness and active lifestyle § Low intensity and long duration activities like walking, dancing and water activities § Movement difficulties are due to five (5) sources: 1. Deficiencies in knowledge base or lack of access to it 2. Failure to use spontaneous Considerations for Physical Activity strategies (need cues) 3. Inadequate metacognitive knowledge and understanding (need to ‘think’ throughout the day) 4. Executive control and motor planning weaknesses (start/stop actions, adapt to change) 5. Low motivation and inadequate practice KnowledgeBased Model § Use of a knowledge-based model to guide instruction implies: