Intellectual and developmental disability

the intellectual and developmental disability (DIyD) is the most common personal disability condition in the population and among students.

Concept of intellectual disability

The term “intellectual and developmental disabilities” was adopted in June 2006, after being voted on by members of the American Association of Intellectual and Developmental Disabilities (AIDD). It was previously called the American Association on Mental Retardation (AAMR).

At least three names of this group are known: “mental disability”, “mental retardation” and “intellectual and developmental disability”.

AIDD has changed its name, definition, diagnosis and classification as a result of the progress of the various disciplines involved in this subject: medicine, psychology and education.

A term that avoids stigma

The previous concept is replaced by this new so that social labels or prejudices are minimized such as: deficit-focused visions, slow and mismatched mental functioning, and so on.

The new name aims to take advantage of a new conception of development which draws on the contributions of socio-cultural and ecological theories.

allows a functional vision of development, Which refers to how a person can have different contexts and throughout the life cycle. In turn, it provides the concept of disability which draws on the contributions of the International Classification of Functioning, Disability and the WHO, and which recognizes the social origin of the difficulties experienced by the person suffering from DIyD.

On the other hand, he also understands intellectual disability as a developmental disorder which has a lot in common with other developmental issues that can affect children.

Objectives of this monograph

In this article we will try to provide a current vision of intellectual disability and development based on the accompaniment paradigm and in a conception of this handicap according to the interaction between the autonomous functioning of the person and the contexts in which the person lives, learns, works and enjoys; provide a general framework and some tools for the assessment of students with DIyD; and propose answers to promote their development.

What do we mean by intellectual and developmental disabilities?

First, we will define intellectual disability and the categories that constitute it.

What is intellectual disability?

they exist four approximations in this field:

  • social approach: Historically, these people were defined as mentally retarded or retarded people because they were unable to socially adapt to their environment. The focus on intellectual difficulties only came later and for a while, what worried them the most was inappropriate social behavior.
  • clinical approach: With the rise of the clinical model, the objective of the definition has been varied. He switched to focusing on the symptoms and clinical manifestations of the various syndromes. More attention has been paid to the organic and pathological aspects of ID.
  • intellectual approach: From the interest in intelligence as a construct and intelligence tests, the approach to identification undergoes another change. It emphasizes measuring the intelligence of these people expressed in terms of IQ. The most important consequence has been the definition and classification of persons with an identity on the basis of scores obtained on intelligence tests.
  • Intellectual and social approach: It was not until 1959 that the importance of these two components in the design of ID was recognized: poor intellectual functioning and difficulties in adaptive behavior, which have remained to this day.

Theoretical and practical models on intellectual disability

Models with which people with intellectual disabilities were conceptualized and which justified certain professional practices. stand out three big models:

Charitable wellness model

From the end of the 19th century and through almost the middle of the 20th century, people with disabilities were removed from society and placed in large charitable asylum institutions. The care they received was of the welfare type and obeyed the charitable design public performance. They didn’t think it was like a social or rehabilitative thing.

Therapeutic rehabilitation model

It extends to Spain from the end of the IIGM, in the decade of the 70. It supposes adoption of the clinical model in the diagnosis and treatment of people with ID, And the predominance of specialization. The model coincides with the rise of the aforementioned clinical approach. Diagnosis of ID focuses on the individual’s deficit and is categorized based on their CI. The problem is considered to be relevant to the topic and specialized institutions are created according to the nature of the problem to deal with it.

educational model

It began in our country in the 80s. It is characterized by the adoption of the standardization principle at all stages of these people’s lives. They are beginning to be seen as having the same rights as their peers in education, health, work and a life of dignity. Education will be provided if possible in ordinary schools, the diagnosis will have to prioritize the capacities of these people and focus on the supports they will need to meet the requirements of different living environments.

Concept definition story

The AAIDD has changed the definition of DI up to 10 times. The last one dates from 2002. This is a definition which goes beyond 1992 but which retains some of its main exceptions: the fact that mental retardation is not seen as an absolute trait of the person, but as the expression of the interaction between the person, With intellectual and adaptive limitations, and the environment; and the emphasis on the media.

In the 1992 definition, the categories disappear. They are explicitly rejected and it is stated that people with mental retardation should not be classified on the basis of traditional categories, but should consider what supports they might need to increase their social participation.

Despite this, the 1992 definition meant a significant improvement for people it was not without criticism:

  • Inaccuracy for diagnostic purposes: It did not make it possible to clearly establish who was or not a person with mental retardation, who was eligible for certain services.
  • Lack of operational definitions for research.
  • The fact that evolutionary aspects are not sufficiently taken into account of these people.
  • inaccuracy and the inability to measure the intensity of the support these people need.

Therefore, the AAIDD proposes a new definition built from 1992. A system is created to diagnose, classify and plan supports for people with mental retardation.

The current definition

The new definition of mental retardation proposed by the AAMR is as follows:

“Mental retardation is a disability characterized by significant limitations in both intellectual functioning and adaptive behavior expressed in conceptual, social and practical skills.

  • “Mental retardation is a handicap”: a handicap is the expression of limitations in the functioning of the individual in a social context which present significant disadvantages.
  • “… which is characterized by significant limitations in both intellectual functioning”: intelligence is a general mental capacity which includes reasoning, planning, problem solving, abstract thinking, etc. The best way to represent them is to use the IQ, which is two standard deviations below the mean.
  • “… as in adaptive behavior expressed in conceptual, social and practical skills”: adaptive behavior is the set of conceptual, social and practical skills that people acquire to function in daily life, their limitations affect their typical performance , although they do not make everyday life impossible.
  • “This ability begins before the age of 18”: 18 years corresponds to the age at which, in our society, individuals assume the roles of adults.

With this definition it reassigns the cognitive basis of the problem, But from a model that emphasizes social and practical competence, which result in the recognition of the existence of various types of intelligence; a model that reflects the fact that the essence of mental retardation is close to the difficulties of coping with everyday life, and the fact that the limitations of social and practical intelligence explain many of the problems of people with ID in the community and at work.

Extends the concept to other population groups, especially the Forgotten Generation: a phrase that includes people with borderline intelligence.

the aspects that change with this last definition son:

  • It includes a criterion of two standard deviations for the measurement of intelligence and adaptive behavior.
  • It includes a new dimension: participation, interaction and social role.
  • A new way of conceptualizing and measuring media.
  • Expands and expands the three-step assessment process.
  • A closer relationship between System 2002 and other diagnostic and classification systems such as DSM-IV, ICD-10 and ICF is promoted.

As in 1992, the definition incorporates the following five assumptions:

  1. The limits of current functioning must be seen in the context of community environments typical of peers of my age and culture.
  2. An appropriate assessment must take into account cultural and linguistic diversity, as well as differences in communication, sensory, motor and behavioral factors.
  3. Within the same individual, limits often coexist with strengths.
  4. An important goal when describing limitations is to develop a profile of the supports needed.
  5. With appropriate personalized supports over an extended period of time, the lifestyle of people with mental retardation will generally improve.

the Mental retardation it is understood within the framework of a multidimensional model which makes it possible to describe the person through five dimensions which encompass all aspects of the individual and of the world in which he lives.

The model includes three key elements: the person, the environment in which they live and the supports.

These elements are represented within the framework of the five dimensions which are projected into the daily functioning of the person through the supports. Supports play a mediating role in the lives of people with intellectual disabilities.

A broader concept of identity has come to involves understanding that the explanation of people’s daily behavior is not exhausted by the effect of the five dimensions, But the supports they can receive in their living environment.

Trends that have prevailed in the field of identification

  • An approach to identity from an ecological point of view that emphasizes the interaction between the person and his environment.
  • Disability is characterized by functional limitations, rather than a permanent trait of the person.
  • The multidimensionality of the ID is recognized.
  • The need to link assessment and intervention more firmly.
  • Recognize that an accurate diagnosis of ID often requires, in addition to the information available from the assessment, sound clinical judgment.

Characteristics and causes of intellectual and developmental disability

There are three important characteristics: limitations in intellectual functioning, limitations in adaptive behavior, and the need for support.

1. Limitations of intellectual functioning: Intelligence refers to the student’s ability to solve problems, pay attention to relevant information, think abstractly, remember important information, generalize knowledge from one scenario to another, etc.

It is usually measured by means of standardized tests. A student has DI when his score is two standard deviations below the mean.

The specific difficulties presented by people with an identity document

they generally present difficulties in these three areas:

a) Memory: People with an identity often show limitations in their memory, especially something called MCP, which has to do with their ability to remember information that needs to be stored for seconds or hours, as it happens. usually produced in the classroom. This is more evident in the cognitive aspects than in the emotional aspects. Strategies can be used to improve capacity.

b) generalization: Refers to the ability to transfer knowledge or learned behaviors from one situation to another. (From school to home, for example).

vs) motivation: Research shows that lack of motivation is associated with previous experiences of failure. Difficulties in successfully overcoming certain challenges of daily life at home and at the center make them more vulnerable. If you can change the sign of your experiences, your motivation will improve as well.

re) Limitations of adaptive behavior: People with ID often have limitations when it comes to adaptive behavior. Adaptive behavior refers to the ability to respond to changing demands of the environment; people learn to adjust / self-regulate their behavior to different life situations and contexts based on age, expectations, etc.

To identify a student’s skills in this area, conceptual, social, and practical skills are often explored through purpose-built scales. From the results, they can design educational activities that should be integrated into the program.

Self-determination is the most central expression of the capacities inherent in adaptive behavior and which is of particular importance to people with ID. Its development is associated with a perception of greater or lesser quality of life.

Causes of intellectual disability

Regarding the causes, there are four categories:

  1. Biomedical: Factors related to biological processes, such as genetic disorders or malnutrition.
  2. social: Factors related to the quality of social and family interaction, such as stimulation or sensitivity of parents to the child’s needs.
  3. behavioral: Factors that refer to behavior that can potentially cause a disorder, such as accidents or the use of certain substances.
  4. educative: Factors related to access to educational services that provide supports to promote cognitive development and coping skills.

It should be noted that these factors can be combined in different ways and in different proportions.

Intellectual disability and quality of life

One of the four characteristics of the emerging disability paradigm is the well-being of the person which closely associates the concept of quality of life.

The recognition of the rights of people with an identity card implies the recognition of the right to a quality life.

Over time, the concept of quality of life has been applied to people with an identity. This implies access to services, the efficiency and quality of these services which allow them to take advantage of the same opportunities as others.

Access to a quality life is recognizing the right to be different and the need for the services offered to be responsive to their particular conditions.

People with ID present certain characteristics that generate specific needs throughout their development, these needs draw on the type of support they need to access services allowing optimal living conditions.

Quality of life is defined as a concept reflecting the living conditions desired by a person in relation to his life at home and in the community; at work, and in relation to health and well-being.

Quality of life is a subjective phenomenon based on a person’s perception of a set of aspects related to their life experience.

The concept of quality of life

According to Schalock and Verdugo, the concept of quality of life (CV) is used in three different ways:

  • As an awareness raising concept that serves as a benchmark and guide from an individual’s perspective, indicating what is important to them.
  • As a unifying concept that provides a framework for conceptualizing, measuring and applying the CV concept.
  • As a social construct which becomes a predominant principle to promote the well-being of the person.

Promote the well-being of people with intellectual disabilities

In the work of promoting the well-being and quality of life of people with ID, the importance of eight central dimensions and certain indicators are recognized:

  • emotional well-being: Happiness, self-concept, etc.
  • interpersonal relationships: Intimacy, family, friendships, etc.
  • material well-being: Relevance, safety, work, etc.
  • personal development: Education, skills, competences, etc.
  • physical well-being: Health, nutrition, etc.
  • self-determination: Elections, personal control, etc.
  • inclusion of partnersl: Acceptance, participation in the community, etc.
  • rights: Privacy, freedoms, etc.

Services and Resources for People with Developmental Disabilities

The services and resources offered to people with ID throughout the life cycle must aim to meet their needs in order to be able to meet the requirements of the different contexts in which they operate and allow a quality life.

Features that define a optimal environment:

  • Presence in the community: Share ordinary places that define community life.
  • elections: The experience of autonomy, decision-making, self-regulation.
  • competition: The opportunity to learn and carry out functional and meaningful activities.
  • the respect: The reality of being valued in the community.
  • Community involvement: The experience of being part of a growing network of families and friends.

About people with an identity document in the educational context: “Students with intellectual disabilities: assessment, monitoring and inclusion”

Bibliographical references:

  • Gilman, CJ, Morreau, LI ALSC; Adaptive skills curriculum. Personal skills. Messenger editions.
  • Gilman, CJ, Morreau, LI ALSC; Adaptive skills curriculum. Home life skills. Messenger editions.
  • Gilman, CJ, Morreau, LI ALSC; Adaptive skills curriculum. Community life skills. Messenger editions.
  • Gilman, CJ, Morreau, LI ALSC; Adaptive skills curriculum. Professional skills. Messenger editions.
  • FEAPS. Positive behavioral support. Some tools to manage difficult behavior.
  • FEAPS. Person-centered planning. Experience of the Sant Francesc de Borja foundation for people with intellectual disabilities.

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