INTELLECTUAL DISABILITY
- Introduction:
DEFINITION:
There are many definitions of Intellectual Disability the most
comprehensive and among them is the one is given by the American
Association on Mental Retardation (AAMR). The definition As given
in 1983 is
" Mental retardation refers to significantly Sab average general
intellectual functioning resulting in are associated with concurrent
impairments in adaptive behavior and manifested during the
developmental period "
GENERAL INTELLECTUAL FUNCTIONING is defined as the results
obtained by assessment with one or more of the individually
administered standardized intelligence tests developer for the
purpose and adapted to the conditions of the region or country.
SIGNIFICANTLY SUB-AVERAGE is defined as IQ of 70 or below on
standardized measures of intelligence tests. It is 2 standard
deviations below the mean obtained from Standard intelligence
tests. The upper limit is intended as a guideline, it could be extended
to 73 to 75 or more, depending upon the reliability of the
intelligence test used.
IMPAIRMENTS IN ADAPTIVE BEHAVIOUR are defined as significant
limitations in an individual's effectiveness in meeting the standards
of maturation effect learning personal Independent and social
responsibility expected his/her age level and cultural group. The
Expectations of adaptive behavior vary with the chronological age.
Depending on the chronological age the impairments in adaptive
behavior may be reflected in the following areas.
DURING INFANCY AND EARLY CHILDHOOD IN
-Sensory and motor skill development
-Communication skills (including speech and language)
-Self-help skills
-Socialisation
DURING CHILDHOOD AND ADOLESCENCE IN
-Application of basic academic skills to daily life activities.
-Application of appropriate reasoning and judgment in the mastery
of the environment.
-Socialisation
DURING LATE ADOLESCENCE AND ADULT LIFE IN
Vocational and social responsibilities and performance.
DEVELOPMENT PERIOD is defined as the period between conception
and the 18th birthday of the person.
That means that persons with mental retardation have the
following characteristics:
-IQ below 70
-Problem in performing the activities of daily living
-Both of the above occur before the age of 18.
CLASSIFICATION OF INTELLECTUAL DISABILITY:
classification of any condition has some objectives. They are
1. It helps in using an acceptable uniform system throughout the
world. 2. It is necessary for Diagnostic and Research purposes.
3. It facilitates efforts at prevention.
MEDICAL:-
1. Infections and intoxications
2. Trauma or physical agent
3. Metabolism or nutrition
4. Gross brain disease (postnatal)
5. Unknown prenatal influence
6. Chromosomal abnormality
7. Gestational disorder
8. Psychiatric disorder
9. Environmental influence
10. Other influences
EDUCATIONAL :
1. Educable
2. Trainable
3. Custodial
PSYCHOLOGICAL:
1. Mild - (50-70)
2. Moderate - (35-49)
3. Severe - (20-34)
4. Profound - below 20
PSYCHOLOGICAL CLASSIFICATION:
• Mild - Educable
• Moderate - Trainable
• Severe - Custodial
• Profound – Custodial
CHARACTERISTICS OF INTELLECTUAL DISABILITY
-The main symptoms of intellectual disability are delays in overall
development so they require regular training for daily life and other
essential adaptive skills learning activities.
The level of intellectual disability varies from mild to moderate to
deep and deep intellectual disability.
The level of intellectual disability indicates the need for placement
for training and intervention.
Education appointment, therefore,
depends on intellectual disability, age, degree of adaptability, and
current level of performance at rest.
Clinical or Medical Features:
1. Small or large head
2. Short stature
3. Protruding tongue
4. Blunt symptoms
5. druling
6. Can't walk with good coordination
Behavioral Traits:
The deficit is caused by brain damage.
It can cause challenges in expressing age, appropriate behaviors, and
sometimes abusive behaviors.
1. Responses are slow
2. It is not possible to make decisions
3. Difficulties in completing work even in short intervals
4. Difficulty in remembering
5. Difficulty in meeting their self-care needs
6. Difficulty in following group play rules or social rules
7. Difficulty in discussing skills
Educational
Characteristics :
1. Slow reaction or no reaction
2. Absence of clarity
3. Inability to learn fast
4. Inability to understand to quickly
5. Inability to decide
6. Lack of concentration
7. Short temper
8. Inability to remember
9. Lack of motor coordination
10. Delay in development container
CAUSES
Intellectual disability occurs when the mother suffers a brain injury
due to injury, infection, or delivery problems.
Sometimes genetic factors can also be the cause.
These causes can be divided into two types causes
1. Genetic
2. Non - Genetic [environmental]
GENETIC:
[A] Chromosome abnormalities:
Human life consists of 23 pairs or 46 chromosomes. An abnormality
in chromosomes is a change in number or shape
Number change [Trisomy 21]:
trisomy 21 is caused by an abnormality in the autosomes.
A chromosome addition to 21 chromosome pairs is called trisomy 21.
This leads to a condition called Down Syndrome.
• Shape change
• Deletions
• Translocations
• Ring chromosomes
Abnormalities in sex chromosomes:
a) Clinifilter Syndrome: They have an x-chromosome addition
The result is 47 chromosomes instead of 46 chromosomes
They are males with female characteristics.
b) Turner's Syndrome: One who lacks a sex chromosome who has 45
chromosomes who are female but have fewer female characteristics.
B] Dominant inheritance: In which one of the parents suffers from
an abnormality or illness.
Example: tubaracus, sclerosis
C] Recessive in Heritance: In which parents are not exposed to any
abnormalities, only children are exposed to abnormalities.
Example: Phenyl tutorial, galaxymia, tesaseb disease. These diseases
are abnormalities caused by a defect in the metabolism.
NON-GENETIC
- [A] Pre-natal causes:
a] Maternal Infections:
Maternal infections are also known as torch
infections.
1. Congenital rubella: It is a viral infection
It is dangerous for the unborn baby to arrive in the first 3 months
By 5 months the baby will have rubella symptoms. Occasional
miscarriage, stillbirth. There may be some abnormalities in the
newborn.
Example: Symptoms may include heart disease, hearing and vision
impairment, growth retardation, childhood, and dementia. This
condition in a child is called rubella syndrome
2. Congenital taxoplasis: It is dangerous for the baby to have it in the
first 3 months. Different types of neurological disorders, vision
disorders, calcium deficiency in the brain, small head or large head.
Abnormalities in muscle contraction and fits and abnormalities in the
mother's infected baby within 3 months
3. Congenital cytomegalovirus: causes dementia, visual impairment,
and physical disorders. fits also occur and die within a month of birth
4. Congenital herpes virus: Symptoms include severe vision and
hearing impairments or neurological disorders.
5. Territogen: Territorial disease is caused by the mother taking
drugs, alcohol, tobacco, narcotics, seduction, radiation, etc.
b] The child is more likely to have an intellectual disability when the
mother has a hormonal deficiency
Example: Iodine deficiency in the thyroid gland during maternal
pregnancy causes a condition called gaiter, which in turn causes a
condition called cretinism in the baby.
c] Medications taken by the mother: The use of certain dangerous
drugs can cause neurological disorders in children.
d] Radiation: Frequent use of x-rays by a pregnant woman can put
the baby at great risk. The first 3 months of it are very dangerous.
e] Malnutrition: If the mother is malnourished, the effect can fall on
the baby and lead to dementia and other disorders.
f] Maternal inability to breathe: For any reason, a pregnant woman
may not be able to breathe, the baby may be brain damaged due to
inhalation of toxins, etc.
g] Injuries: When the uterus is injured by any accident to the mother,
the baby is more likely to be born with brain damage with
intellectual disability.
h] Maternal-Rh differentiation:
Rh is a protein in the blood. There are 26 types of Rh-positive and
Rh-negative. Rh incompatibility is when the mother is separated
from the children. If the mother is Rh-negative and the baby is Rh-positive, it could put the unborn baby at risk. To prevent this, the
baby should be given an injection called immunoglobulin within 72
hours of birth. If not, the baby will need a blood transfusion.
B] NATAL CAUSES:
• Premature delivery
• Months more
• Prolonged and difficult childbirth
• Impairment of pelvic bones
• The body parts other than the head are down in the uterus
• Abnormal condition
• Blisters wrap around the neck
• Weaning using weapons
• Placental abruption
• Bleeding in the brain
• Oxygen deprivation
C] POST-NATAL CAUSES:
Mental intellectual disability can be caused
by any disease or head injury in infancy or childhood after childbirth.
They are:
1. Inflammation of the brain: Excessive fever due to diseases such
as pneumonia can lead to encephalitis which can lead to brain
damage.
2. Meningties: The layers that cover the brain are called meningitis
where there is an infection. People with the disease may have
symptoms such as high fever, headache, and tightness in the back.
Fits also come in high
3. T.B MENINGTIES: Frequent T.B. exposure to the central nervous
system causes about 15% of intellectual disability.
4. Metabolic disorders: Although these defects occur before birth,
these symptoms appear after birth.
5. Malnutrition: This weakens the immune system, resulting in a
variety of infections, protein deficiency, and impaired brain
development.
6. Hormonal deficiency: Critinisam is caused by thyroxine deficiency
7. Fitz not treated: Fits stop supplying oxygen to the brain as fits
occur, which can lead to brain cell death.
8. Injuries: There is a risk of brain injury due to head injuries.
PREVENTIONS OF INTELLECTUAL DISABILITY
It is important to prevent intellectual disability before it occurs due
to various reasons.
PRE-NATAL CARE:
Precautions taken during pregnancy are very
important. Incomplete childbirth and low birth weight can occur if
parents do not take adequate care.
Maternal diseases, infections,
and other hazards are dangerous for the unborn child.
• Abnormalities and infections should be detected early and
treated appropriately promptly
• Provide good nutrition
• The mother should use only the medications that are necessary
and prescribed during pregnancy
• Proper precautions should be taken to avoid physical accidents
• The x-ray can be dangerous to the baby for the first three
months, so care must be taken
• Care should be taken not to infect infected rubella syphilis, is, etc.
• Attempts to abort should not be made, especially by the
unskilled.
NATAL PREVENTIONS:
It is important to be careful before and after
the baby is born.
• Pregnant women should be advised to observe childbirth at a
primary health center by a medical professional trained for
their delivery.
• All types of complicated pregnancies and deliveries should be
performed in a hospital setting only.
NEO-NATAL PREVENTIONS:
Rh incompatibility is one reason for
intellectual disability. Therefore, if the mother is Rh-negative
and the baby is Rh-positive, the mother can be vaccinated with
immunoglobulin within 72 hours of delivery to prevent
subsequent intellectual disability in the unborn child.
• Appropriate care should be taken against such babies born
prematurely, those born with low birth weight, and babies born
with severe labor pains who are at higher risk of mental
retardation.
POST-NATAL PREVENTION:
Getting Protected From Infections:
• Infectious diseases such as diphtheria, whooping cough,
typhoid, polio, and rubella can be prevented by active
protection against active infections.
• Protection programs protect against specific viral and bacterial
infections
• Infections can be detected early and treated promptly to
reduce the spread of the disease
• Accidents and poisons can injure the brain and cause severe
damage and mental retardation
Therefore, the public should be made aware of the hazards and
toxicity mechanisms and the various safety principles, safety
equipment, and urgent needs of the public.
Brain growth is impaired due to a lack of proper nutrition for mother
and baby.
As the calf grows older, all nutrients must be balanced.
Intellectual disability can be prevented by informing the public of
information that can be used to prevent intellectual disability.
"Intellectual disability can be prevented to some extent, especially by
avoiding blood marriages.
PARENTS OF CHILDREN WHO ARE RETARDED Parents of children with intellectual disability need much more
help than the parents of other handicapped children. A child who is
mentally retarded will an a profound impact on the family. No one
likes to have an imperfect child. Children are a source of pride, thus
parents of children with intellectual disability may progress through
a series of stages from Awareness to acceptance. Detail is a common
parental reaction.
-
Families with a child whose family is mentally retarded must be able to
maintain as nearly normal functioning as possible.
-Shock and grief or impact on the parents. When parents get a
child who is mentally retarded it is a big shock to them. No parents
like to have a child who is retarded. In case they get a child who is
retarded, in extreme cases, the parents would like to admit the child
to an Institution and forget all about the existence of such a child.
Professionals or persons who have experience can help them at this
stage.
-Parents of children who are retarded choose to isolate themselves
because of their feeling of shame and guilt. In problematic situations,
parents tend to approach some of their friends, for emotional
support. But in case they have a child who is retarded, they don't like
to share this problem with anyone and so they keep it as a secrete.
That trend isolates the retarded from society by leaving him in a
home for persons with intellectual disability.
-Like all people, individuals with intellectual disability need to feel
accepted. Hence parents need to be aware of the facilities and
programs available.
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