31: Intellectual Disability - Sieleni Flashcards Preview

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3 criteria for diagnosis of ID

onset during the developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, practical domains

1. Deficits in intellectual functions
2. Deficits in adaptive functioning
3. Onset of intellectual and adaptive deficits during the developmental period


what is an deficit in adaptive functioning?

without ongoing support there are limits in function in one or more ADLs (communicaiton, independent living, social participation)


now specifiers are strongly influenced by ____________ not __

adaptive functioning; IQ

adaptive functioning determines the level of supports required


Mild Specifier (85% ID diagnoses) =

50-70 IQ

- school age children and adults difficulties but no difference in preschoolers
- express concrete responses to problems and solutions compared to age appropriate mates
- immature in social interactions
- at risk of being manipulated (***gullibility)
- complex daily living needs assistance
- personal care is age appropriate
- health care and legal decisions need support
- raising a family needs support


Moderate Specifier (10% ID diagnoses) =

IQ 35-50

- conceptually lag behind peers throughout development
- adult academics are at elementary level
- capacity for long-term relationships with fam and friends and sometimes romantic
- work settings need significant social and communication support
- with extended period of teaching, time, and reminders an individual may become independent
- maladaptive behavior in a significat minority


Severe Specifier (3-4% of diagnoses) =

20-40 IQ

- caretakers provide extensive support throughout life
- limited vocabulary and grammar, single words or phrases and they may need augmentation ( fam and caregivers may translate for provider)
- support for all activities of daily living
- maladaptive behaviors including self injury is present in significant minority


Profound Specifier (1-2% of diagnoses) =

below 20 IQ

- physical world rather than symbolic process
- objects may be used in goal directed fashion for self-care, work, and recreation
- non verbal non symbolic communication
- enjoys relationships with family and others, may initiate and respond to interactions with gesture and emotional cues
- co-occurring sensory and physical impairments may prevent social activities
- dependent for all aspects of daily physical care, health, and safety
- maladaptive behaviors present in significant minority


suicide risks exist in __ metal health disorders and it is essential to screen for this risk factor



co-morbid symptoms for following mental disorders...
A. Fragile X syndrome
B. Prader-Willi syndrome
C. William's syndrome

A. increased risk for ADHD and social phobia
B. hyperphagia and compulsivity
C. increased risk for ADHD and anxiety disorders


mental disorders due to a general medical condition (down's syndrome**) are at a higher risk for ...

alzheimer's type dementia with pathological changes in the early 40s, clinical symptoms appear later


Prevalence, Course and Familial patterns of ID

- 1% prevalence rate
- Before age 18
- familial patterns do not exist due to heterogenity of the disorder


ID are not _____ and even those with failure in academics can be altered by training which improves adaptive skills in other domains changing the diagnosis



early onset of delay in motor language or social milestones (first two years of life) =



school age onset with difficulty in academics



why is san philippo unique?

progressive worsening

ID is non-progressive
Rett's syndrome worsens then stabilization


predisposing hereditary factors

- errors in metabolism that are mostly autosomal recessive (Tay-Sachs disease)
- single gene abnormalities with Mendelian inheritance and variable expression (tuberous sclerosis)
- Chromosomal aberrations (translocation down syndrome, fragile X syndrome)


_____ no clear etiology for cause of ID


specific etiologies are more common in severe or profound ID


prenatal v. perinatal v. postnatal risk and prognostic factors

- genetic syndromes
- inborn errors of metabolism
- brain malformations
- maternal disease
- environmental influences

- labor and delivery events

- hypoxic ischemic injury
- traumatic brain injury
- infections
- demyelinating disorders
- seizures
- severe and chronic social deprivation
- toxic metabolic syndromes
- intoxication


in _________ IDs lower socioeconomic classes are overrepresented


due to social drift


gender consideration in the mild and severe from show a male:female ratio of ______ and ______ for severe

1.6 : 1

1.2 : 1


prevalence of co-morbid conditions like mental health disorders, cerebral palsy, and epilepsy may be ______ the gen pop

3-4 X