INTELLECTUAL DISABILITY 


  • Introduction: 
      Intellectual disability is the perception of the wells expressed by the language in the conscious infancy, Having errors in expression and Have defects in skills such as socializing, learning, and adjusting The WHO's international estimates put the number of people with intellectual disability at 2% to 3% of the total population. 

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.