The Behavior of Children with Intellectual Disability

11 Jan 2022
Demystifying the behavior of children with intellectual disability. Understand how they behave and discover effective interventions.

Understanding Child Behavior

Understanding the behavior of children with intellectual disability is essential for providing appropriate support and intervention. Two key aspects to consider are the impact of communication skills and the presence of behavior disorders in children with intellectual disability.

Impact of Communication Skills

Communication plays a crucial role in the behavior of children with intellectual disability. Research has shown that low individual communicative competences contribute to the development of challenging behaviors in these children. However, it is important to recognize that communication involves at least two partners, and outcomes can vary depending on the abilities of each interaction partner.

Higher individual communication skills have been found to be significantly related to a decrease in general challenging behavior over time. Additionally, the communication skills of classmates can indirectly influence individual communicative abilities, potentially enhancing the overall communication skills of children with intellectual disability. Classroom contextual effects have also been observed to be related to a decrease in several sub-domains of challenging behavior [1].

Behavior Disorders in Children

Behavior disorders are frequently observed in children with intellectual disability, regardless of the underlying cause. These disorders often manifest as chronic issues, with more than one behavior present in the same individual. It is important to note that many parents may not seek help for these problems, believing that they are a result of the child's disability and cannot be treated [2].

The prevalence of psychiatric disturbances in children with intellectual disability is significantly higher compared to the general population, with rates ranging from 20% to 35%. This represents a three to five times higher prevalence than that seen in the general population. These psychiatric disturbances can contribute to challenging behaviors and require appropriate assessment and intervention.

In addition to psychiatric disturbances, sleep disorders are also prevalent in children with intellectual disability, with a rate of approximately 80% regardless of age. Sleep disturbances can lead to negative side effects such as decreased alertness, mood changes, and cognitive difficulties. Addressing sleep disorders is crucial for promoting overall well-being and managing challenging behaviors in children with intellectual disability [2].

Understanding the impact of communication skills and the presence of behavior disorders is vital for effectively supporting children with intellectual disability. By addressing these aspects, caregivers, educators, and professionals can develop strategies and interventions to help manage challenging behaviors and improve the overall well-being of children with intellectual disability.

Challenges and Interventions

Children with intellectual disability often face unique challenges that can impact their behavior and overall well-being. Understanding these challenges and implementing appropriate interventions is crucial in helping them navigate daily life. In this section, we will explore three key aspects: pharmacological vs. behavioral treatment, the prevalence of psychiatric disturbances, and addressing sleep disorders.

Pharmacological vs. Behavioral Treatment

When it comes to treating behavioral challenges in children with intellectual disability, parents often have to decide between pharmacological and behavioral interventions. While pharmacological treatment is an option, research shows that behavioral intervention is a more effective and better-tolerated form of treatment [2].

Behavioral treatment focuses on teaching adaptive skills and addressing challenging behaviors through various techniques such as positive reinforcement, structured routines, and social skills training. This approach aims to improve the child's overall functioning and enhance their quality of life.

On the other hand, pharmacological treatment may be considered in specific cases where the child's behavior significantly impacts their daily functioning and poses risks to their safety or the safety of others. However, it's important to carefully weigh the potential benefits and risks of medication, as well as involve healthcare professionals who specialize in intellectual disability and behavioral management.

Prevalence of Psychiatric Disturbances

Children with intellectual disability have a higher prevalence of psychiatric disturbances compared to the general population. The prevalence rate of psychiatric disturbances in this population ranges from 20% to 35%, which is three to five times higher than that of the general population.

It is essential to rule out the possibility of psychiatric disturbances when a child with intellectual disability exhibits behavioral symptoms of recent onset, experiences exacerbation of baseline behavioral symptoms, or does not respond to well-conducted behavioral approaches. Identifying and addressing these psychiatric disturbances through appropriate interventions, such as therapy or medication, can significantly improve the child's behavior and overall functioning.

Addressing Sleep Disorders

Sleep disorders are prevalent in children with intellectual disability, with rates ranging from 20% to 30%, and potentially increasing up to 80% in children with intellectual disability [2]. Sleep deprivation in these children can have negative side effects, including decreased alertness, mood changes, and cognitive difficulties.

Addressing sleep disorders in children with intellectual disability involves implementing proper sleep hygiene practices, behavior modification techniques, and, if necessary, pharmacological treatment. Establishing a consistent sleep routine, creating a comfortable sleep environment, and promoting relaxation techniques can help improve the child's sleep quality and overall behavior.

By understanding the challenges associated with intellectual disability and implementing appropriate interventions, parents and caregivers can provide the necessary support to help children navigate their daily lives more effectively. It is important to work closely with healthcare professionals to tailor interventions to each child's unique needs and ensure their well-being and development.

Triggers of Challenging Behavior

Understanding the triggers or antecedents of challenging behavior is crucial when working with children with intellectual disability (ID). Identifying these triggers can help caregivers and professionals develop appropriate interventions and support strategies. In this section, we will explore two aspects related to the triggers of challenging behavior: contextual variables and the CATS checklist for identification.

Contextual Variables

Challenging behavior in children with ID can be triggered by various contextual variables or antecedents. These variables encompass biological, physical, genetic, psychological, psychiatric, social, and environmental factors. It is important to note that these triggers have a functional relationship to challenging behavior, meaning they play a role in the occurrence or maintenance of the behavior.

Contextual variables that may contribute to challenging behavior include:

  • Biological factors: Physical health conditions, sensory sensitivities, medication side effects, and genetic factors may influence behavior.
  • Psychological and psychiatric factors: Emotional difficulties, anxiety, depression, and other mental health conditions can impact behavior.
  • Social and environmental factors: Interactions with caregivers, peers, and the surrounding environment can influence behavior.

Understanding the specific contextual variables that contribute to challenging behavior in a child with ID is essential for developing targeted interventions and support plans.

CATS Checklist for Identification

The Comprehensive Assessment of Triggers for Behaviors of Concern Scale (CATS) is a checklist that can assist caregivers in identifying triggers or antecedents of challenging behavior in individuals with intellectual disability. CATS provides a comprehensive framework for assessing a wide range of triggers that can occur in everyday life.

The CATS checklist consists of 333 contextual triggers categorized under five main domains and 12 subdomains. These domains include:

  1. Biological and Physical: Triggers related to physical health, sensory sensitivities, and genetic factors.
  2. Psychological and Psychiatric: Triggers associated with emotional difficulties, anxiety, depression, and other mental health conditions.
  3. Social and Environmental: Triggers related to social interactions, environmental factors, and daily routines.
  4. Contextual Variables: Triggers that are specific to the individual's unique circumstances and surroundings.
  5. Trigger Situations: Specific situations or events that act as triggers for challenging behavior.

Using the CATS checklist, caregivers can systematically identify the triggers that contribute to challenging behavior in children with ID. This information can then inform the development of a person-centered positive behavior support plan tailored to the individual's specific needs.

It's important to note that further research is needed to test the psychometric properties, utility, and acceptability of CATS. However, it is a valuable tool that can assist caregivers in understanding the reasons behind challenging behavior and guide the development of effective interventions.

By recognizing the contextual variables and utilizing tools like the CATS checklist, caregivers and professionals can gain insight into the triggers of challenging behavior in children with intellectual disability. This knowledge empowers them to implement targeted interventions and support strategies that promote positive behavior and enhance the well-being of the child.

Behavioral Features in Intellectual Disability

Children with intellectual disability may exhibit certain behavioral features that are associated with their condition. Understanding these behavioral challenges is crucial for providing appropriate support and intervention. In this section, we will explore three common behavioral features seen in children with intellectual disability: impulse control challenges, frustration tolerance issues, and problems with problem-solving and self-esteem.

Impulse Control Challenges

Children with intellectual disabilities may experience difficulties with impulse control. These challenges arise from difficulties in connecting cause and effect, leading to problems with controlling impulses and avoiding negative consequences. Impulse control difficulties in individuals with intellectual disabilities can be more persistent compared to typical children.

Impulse control challenges can manifest in various ways, such as impulsive behaviors, acting without thinking, or difficulty in inhibiting immediate responses. For example, a child with intellectual disability may have difficulty refraining from touching hot objects, which can lead to burns or other injuries. Caregivers and professionals working with children with intellectual disabilities should provide guidance and support to help them develop strategies for managing and controlling their impulses effectively.

Frustration Tolerance Issues

Limited frustration tolerance is another common behavioral feature observed in children with intellectual disabilities. Frustration tolerance refers to the ability to inhibit impulses and endure everyday frustrations. Difficulties in frustration tolerance can lead to various challenges, including aggression towards caregivers and self-injurious behaviors.

The limited frustration tolerance observed in individuals with intellectual disabilities can also impact their problem-solving abilities, self-esteem, and the development of confidence. It is important to remember that frustration tolerance is an essential developmental skill that helps individuals cope with daily frustrations and enables problem-solving abilities. Supporting children with intellectual disabilities in developing healthy frustration tolerance can contribute to improved overall well-being.

Problem-Solving and Self-Esteem

Children with intellectual disabilities may encounter challenges in problem-solving due to limited intellectual functioning. Problem-solving skills, sustained attention, and persistence in the face of difficulty can be hindered by their intellectual limitations. Difficulties in problem-solving can have a significant impact on their self-esteem and confidence.

Limited problem-solving abilities can lead to feelings of frustration and helplessness, potentially contributing to the development of low self-esteem. In some cases, low self-esteem can further lead to the manifestation of psychiatric disorders, such as depression. It is essential to provide children with intellectual disabilities with appropriate support and interventions to enhance their problem-solving skills and promote positive self-esteem.

Understanding these behavioral features in children with intellectual disability is crucial for caregivers, educators, and healthcare professionals. By addressing impulse control challenges, fostering frustration tolerance, and supporting problem-solving skills and self-esteem, we can help children with intellectual disabilities thrive and reach their full potential.

Social Skills Development

Building social skills in children with intellectual disability is crucial for their overall well-being and successful interactions with others. Various effective strategies can be employed to enhance social skills, including classroom-based intervention, emotional intelligence training, peer network intervention, computer games of emotion regulation, and puppet play therapy. These strategies have shown promising results in improving communication, bridging social skills deficits, enhancing emotional recognition and regulation, and promoting adaptive behavior.

Effective Strategies

Classroom-based interventions provide a structured environment where children with intellectual disability can learn and practice social skills. These interventions often involve social skills training, role-playing, and group activities that encourage positive interactions and communication. Emotional intelligence training focuses on developing emotional recognition, understanding, and regulation skills. It helps children with intellectual disability better understand their own emotions and those of others, leading to improved social interactions.

Peer network intervention involves facilitating connections with peers and promoting positive relationships. By encouraging inclusive activities and fostering supportive peer networks, children with intellectual disability have opportunities to practice their social skills in natural social settings. Computer games of emotion regulation and puppet play therapy utilize interactive and engaging techniques to teach children with intellectual disability how to recognize and regulate emotions effectively.

Enhancing Social Skills

Enhancing social skills in children with intellectual disability requires tailored interventions that address their specific needs. It's important to consider the individual's strengths, challenges, and developmental level when designing interventions. Providing clear instructions, modeling appropriate behaviors, and offering immediate feedback are effective strategies for helping children with intellectual disability acquire and reinforce social skills.

Structured social skills training programs can be implemented in various settings, such as schools, therapy sessions, and community programs. These programs focus on teaching specific social skills, such as initiating conversations, active listening, turn-taking, and problem-solving. Role-playing and group activities provide opportunities for children to practice these skills in a supportive environment.

Importance of Family Interactions

Family interactions play a significant role in the social development of children with intellectual disability. Mothers' behaviors that encourage egalitarian problem-solving predict more engaged and skillful problem-solving by the children, while controlling and directive behaviors predict fewer of these behaviors by the children. Fathers' behaviors have mixed associations with the children's actions, possibly due to their reactive responses to children's behaviors [6].

Families of children with intellectual disability generally adapt to their circumstances without resorting to negative or ineffective styles of relating. However, children with intellectual disability have difficulty actively and effectively engaging in family problem-solving discussions compared to children without disabilities. Therefore, it is essential for families to create a supportive and inclusive environment that promotes effective social behaviors.

To promote social skills development, families can engage in activities that encourage communication, problem-solving, and cooperation. Creating opportunities for collaborative decision-making, active listening, and expressing emotions in a safe and respectful manner can enhance the social skills of children with intellectual disability. By fostering positive family interactions, children with intellectual disability can learn and practice effective social behaviors, which can then be generalized to interactions with peers and other social contexts.

By implementing effective strategies, enhancing social skills through tailored interventions, and emphasizing the importance of family interactions, children with intellectual disability can develop the social skills needed for successful peer relationships and overall social well-being.

Peer Relationships and Social Behaviors

When it comes to children with intellectual disability, their behaviors and interactions with peers are influenced by various factors. Understanding the dynamics of peer relationships and social behaviors can help create a supportive environment for these children to thrive. In this section, we will explore the risk of peer rejection, the impact of family interactions, and strategies for promoting effective social behaviors.

Risk of Peer Rejection

Children with intellectual disability and learning disabilities are at a higher risk of experiencing peer rejection compared to their typically developing peers. The functional limitations in social communication and social relationship skills can hinder positive engagement with peers [6]. From a young age, children with intellectual disability display ineffective and isolating social play behaviors, while those with learning disabilities struggle with social skills deficits that impede social problem-solving and effective peer engagement.

Family Interaction Impact

Competent social behaviors and supportive family interactions play a crucial role in children's peer adjustment during elementary school. Warmth, support, and active engagement are particularly relevant in promoting positive relationships with peers. Active listening and effective problem-solving skills are predictors of greater acceptance from peers [6].

Family interactions provide a context for children with intellectual disability and learning disabilities to develop the necessary social behaviors for effective peer relationships. Mothers who encourage egalitarian problem-solving behaviors in their children tend to promote more engaged and skillful problem-solving. On the other hand, controlling and directive behaviors from mothers tend to result in fewer of these behaviors by the children. Fathers' behaviors have mixed associations, possibly due to their reactions to children's unengaged and negative behaviors. Although children with intellectual disability may face challenges in actively and effectively engaging in family problem-solving discussions, families often adapt to their circumstances without resorting to negative or ineffective styles of relating.

Promoting Effective Social Behaviors

Given the limited success of child-focused interventions in peer settings, efforts to improve social behaviors in children with intellectual disability and learning disabilities should focus on enhancing family interactions. By creating a supportive and nurturing environment, families can play a crucial role in the development of effective social behaviors. Encouraging egalitarian problem-solving, active listening, and engagement can positively influence the social skills and peer relationships of children with disabilities [6].

In summary, children with intellectual disability face an increased risk of peer rejection due to their social communication and relationship skill limitations. However, with supportive family interactions and a focus on promoting effective social behaviors, it is possible to create an environment where these children can develop positive relationships with their peers. By nurturing warmth, support, and active problem-solving skills, families can play a vital role in helping children with intellectual disability navigate the social complexities of their lives.

References

[1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9303229/

[2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3299352/

[3]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8535692/

[4]: https://www.mentalhelp.net/intellectual-disabilities/behavioral-and-psychological-features/

[5]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9513363/

[6]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5737926/

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