What IQ Is Considered Intellectual Disability In A Child?

11 Jan 2022
Understand diagnosing intellectual disability in children, its impact, and the path to support and care.

Understanding Intellectual Disability

As we begin discussing the subject of diagnosing intellectual disability in children, it is essential to first understand what intellectual disability is, its prevalence, and its potential causes.

Definition and Prevalence

Intellectual disability, also known as intellectual developmental disorder, is characterized by significant limitations in intellectual functioning and adaptive behavior, which covers a range of everyday social and practical skills. This disability originates before the age of 18.

According to the National Institute of Child Health and Human Development (NICHD), intellectual disability affects about 1% to 3% of the population in the US, with the majority of cases being mild. Interestingly, intellectual disability is found to be more common in boys than in girls.

Causes of Intellectual Disability

The causes of intellectual disability can generally be classified into three categories: prenatal, perinatal, and postnatal, with some cases remaining unknown.

  1. Prenatal Causes: These are issues that occur during or before pregnancy, such as genetic conditions like Down syndrome or fragile X syndrome, or exposure to alcohol, drugs, or other toxins during pregnancy.
  2. Perinatal Causes: These are problems that occur during birth, such as oxygen deprivation or premature birth.
  3. Postnatal Causes: These are problems that occur after birth, such as serious infections like meningitis, severe head injury, or exposure to environmental toxins like lead.

Genetic conditions, problems during pregnancy and birth, and health problems like whooping cough or lead exposure are some possible causes of intellectual disability.

Understanding the potential causes of intellectual disability is crucial in early detection and diagnosis. The sooner a child is diagnosed, the sooner appropriate support and intervention can be initiated, which can significantly improve the child's development and quality of life.

Diagnosing Intellectual Disability in Children

The process of diagnosing intellectual disability in children is multifaceted, involving a comprehensive evaluation of medical history, physical examination, developmental history, and psychological testing, among other elements.

Diagnostic Criteria

The evaluation for diagnosing intellectual disability in children should involve a detailed medical history, physical exam, and a thorough developmental history. This includes prenatal and perinatal history, medical and surgical history, social history, family history, psychosocial history, and school performance history [2].

Assessment Tools and Tests

The assessment for diagnosing intellectual disability should include standardized developmental and psychological testing, screening for common comorbid conditions such as attention-deficit/hyperactivity disorder (ADHD), autism, and anxiety disorders. In addition, genetic testing, neuroimaging studies, and laboratory tests like lead levels and chromosome analysis are also part of the diagnostic process.

Some of the standardized developmental and psychological tests used in diagnosing intellectual disability in children include:

  • Bayley Scales of Infant Development
  • Mullen Scales of Early Learning
  • Differential Ability Scales
  • Stanford-Binet Intelligence Scale
  • Wechsler Intelligence Scale for Children

These tools provide insights into a child's cognitive abilities and developmental progress [2].

The adaptive functioning of a child—consisting of conceptual skills, social skills, and practical skills—is another critical component in diagnosing intellectual disability. Assessment tools used to evaluate adaptive skills include:

  • Vineland Adaptive Behavior Scales
  • Adaptive Behavior Assessment System
  • AAMR Adaptive Behavior Scales

These tools measure the child's ability to adapt to and manage everyday tasks and challenges.

Importance of Early Diagnosis

Early diagnosis of intellectual disability in children is crucial. It opens the door to early intervention, which can significantly improve the child's developmental outcomes and quality of life. Early diagnosis provides the opportunity for parents, caregivers, and professionals to start implementing the appropriate support and intervention strategies sooner rather than later. This can make a significant difference in the child's potential for learning, development, and overall well-being.

In conclusion, diagnosing intellectual disability in children is a thorough and complex process that requires a comprehensive evaluation of the child's medical history, developmental history, and adaptive functioning, among other aspects. A timely diagnosis is crucial to ensure that the child receives the necessary support and intervention at the earliest possible stage.

Role of IQ in Intellectual Disability

One of the key factors in diagnosing intellectual disability in children is the assessment of intellectual functioning, commonly measured through IQ (Intelligence Quotient) tests. This is a crucial aspect of the diagnostic process, as it provides insights into a child's cognitive abilities and areas where they may be experiencing difficulties.

IQ and Intellectual Functioning

Intellectual disability is diagnosed by looking at two main areas - intellectual functioning, or IQ, and adaptive behaviors. These areas determine a child's ability to learn, reason, make decisions, and adapt to the environment. They are essential in assessing a child’s overall development and whether they are reaching the developmental milestones expected for their age.

IQ tests are designed to measure intellectual functioning. These tests assess various cognitive abilities such as memory, attention, language, and problem-solving skills. The results of these tests can help professionals understand how a child processes information, their learning style, and their intellectual potential.

IQ Categories for Disability

The levels of intellectual disability can range from mild to profound, as categorized by the American Association on Intellectual and Developmental Disabilities (AAIDD). These levels are primarily based on the child's IQ score. The following table illustrates the IQ score ranges associated with each level of intellectual disability:

In addition to IQ scores, adaptive behaviors, which include conceptual, social, and practical skills, are also assessed. These skills are necessary for everyday life and are typically learned and developed as a child grows. Evaluating both the child's IQ and adaptive behaviors provides a comprehensive view of their abilities and areas of challenge.

It's important to note that diagnosing intellectual disability in children is a complex process that involves various assessments and evaluations. It is not solely based on a child's IQ score. Other factors, such as the child's adaptive behaviors, developmental history, and educational performance, are also considered as part of the diagnostic process.

While an IQ test can provide valuable insights, a holistic approach that considers the child's overall abilities and development is the most effective way to diagnose and support children with intellectual disabilities. This comprehensive approach ensures that children receive the appropriate interventions and supports to help them reach their full potential.

Adaptive Functioning in Intellectual Disability

In the process of diagnosing intellectual disability in children, the adaptive functioning of a child plays a crucial role. It encompasses various skills, including conceptual skills, social skills, and practical skills. Comprehensive assessment of these skills can help in accurately identifying intellectual disability.

Conceptual Skills Assessment

Conceptual skills refer to a child's ability to perform tasks that require mental activities. This includes reading, writing, mathematics, reasoning, knowledge, and memory. These skills are vital for a child's ability to understand, interpret, and interact with the world around them.

Assessment of conceptual skills involves standardized developmental and psychological testing. This can include tests like the Bayley Scales of Infant Development, the Mullen Scales of Early Learning, the Differential Ability Scales, the Stanford-Binet Intelligence Scale, and the Wechsler Intelligence Scale for Children. These tests can provide a comprehensive view of a child's cognitive abilities, helping identify any potential areas of concern.

Social and Practical Skills Assessment

Social skills refer to a child's ability to interact with others and navigate social situations. This includes communication, social responsibility, self-esteem, gullibility, naïveté, social problem-solving, and the ability to follow rules and laws and to avoid being victimized.

On the other hand, practical skills are those necessary for daily living. This includes activities of daily living (personal care), occupational skills, healthcare, travel, schedules/routines, safety, use of money, use of the telephone.

Assessing these skills can be accomplished using tools like the Vineland Adaptive Behavior Scales, the Adaptive Behavior Assessment System, and the AAMR Adaptive Behavior Scales. These tools can provide detailed information about a child's ability to function in everyday life, which is critical for diagnosing intellectual disability [2].

Understanding a child's adaptive functioning is an important part of the diagnostic process for intellectual disability. By assessing a child's conceptual, social, and practical skills, professionals can gain a clear picture of the child's strengths and weaknesses, which is necessary for planning appropriate interventions and support.

Intervention and Support for Children

Once a diagnosis of intellectual disability (ID) is made, the focus shifts to interventions and support to help the child thrive. This process involves a multidisciplinary team and family-centered care.

Role of Multidisciplinary Team

The process of diagnosing intellectual disability in children and subsequent interventions should involve a multidisciplinary team to ensure a comprehensive evaluation and appropriate interventions. This team typically includes pediatricians, psychologists, neurologists, speech therapists, occupational therapists, and special education teachers.

Each professional brings a unique perspective and set of skills to the table. For example, a psychologist may focus on developmental and psychological testing, a neurologist may conduct neuroimaging studies, while a speech therapist works on enhancing communication skills. The collaboration of these professionals ensures a well-rounded approach to support the child's needs.

Importance of Family-Centered Care

Family-centered care is particularly beneficial for children with intellectual disability due to the complexity of their health, educational, vocational, and community living challenges. These children require substantial family support and advocacy.

In this approach, speech-language pathologists (SLPs) play a significant role. They offer ongoing support and resources to facilitate communication between children with ID and their families. SLPs collaborate with individuals with ID, parents, family members, support staff, and other professionals to coordinate services and develop goals that recognize and utilize their strengths.

The family-centered approach emphasizes the importance of the family's role in a child's development and wellbeing. It acknowledges that parents and family members are the constant in a child's life, while the service systems and personnel are secondary and intermittent. Therefore, supporting the family's ability to meet their child's needs is paramount to ensuring the child's health, development, and learning.

Interprofessional education/practice (IPE/IPP) facilitates collaboration among service providers to deliver comprehensive, high-quality services. It encourages learning from and about each other to improve collaboration and the quality of care [4].

By adopting a multidisciplinary and family-centered approach, we can ensure that children with intellectual disability receive the comprehensive support they need to lead fulfilling lives.

Living with Intellectual Disability

Living with an intellectual disability can present unique challenges and experiences for children and their families. It can impact various aspects of daily life, including a child's ability to learn, interact with others, and function independently. However, numerous support services and interventions can significantly improve a child's quality of life and help them reach their full potential.

Impact on Daily Life

Intellectual disability can have a significant impact on a child's ability to function in daily life. It can affect their learning, social interactions, and ability to perform everyday tasks independently. Intellectual disability is associated with high morbidity and increased costs of care [4].

Available Support and Services

There are numerous support programs available to help individuals with intellectual disabilities lead independent lives [6]. These services aim to support the child's development and help them learn skills needed for daily living. For example, the Ministry of Children and Family Development (MCFD) in British Columbia provides support and services to children with intellectual disabilities and their families, aiming to ensure the best possible outcomes for these children.

Family-centered care is particularly beneficial for individuals with intellectual disabilities due to the complexity of their health, educational, vocational, and community living challenges [4]. In this approach, the family's needs and preferences guide the planning and delivery of care.

Professionals such as speech-language pathologists (SLPs) play a vital role in promoting communication abilities to enhance the independence and self-advocacy of individuals with intellectual disabilities. These professionals can provide tailored interventions to help the child improve their skills and reach their potential.

Early diagnosis and intervention for children with intellectual disabilities can significantly enhance their quality of life and ability to reach their full potential [7]. Therefore, understanding the signs and diagnosing intellectual disability in children is of utmost importance.

References

[1]: https://www.nichd.nih.gov/health/topics/idds/conditioninfo/causes

[2]: https://emedicine.medscape.com/article/1180709-workup

[3]: https://www.cdc.gov/ncbddd/developmentaldisabilities/facts-about-intellectual-disability.html

[4]: https://www.asha.org/practice-portal/clinical-topics/intellectual-disability/treatment-principles-for-individuals-with-an-intellectual-disability/

[5]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345136/

[6]: https://my.clevelandclinic.org/health/diseases/25015-intellectual-disability-id

[7]: https://www2.gov.bc.ca/gov/content/health/managing-your-health/child-behaviour-development/support-needs/intellectual-disabilities

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