Developmental Delay and Intellectual Disability Summary
Mental retardation: Some conceptions and dilemmas.
Uncertainties about causes, expression, and treatment of mental retardation will not yield to simplistic unidimensional models that fail to take into account a vast array of dynamically interacting biological, social, and ecological variables. Issues concerning mental retardation cut across major conceptual dilemmas that have long confronted psychology, biology, and sociology: What is the nature of intelligence? To what extent can the environment influence the outcome? What level of theoretical construction will produce our most useful bases for social policy? The problems are complex: The solutions can be no less. The time has come to develop a new definition of mental retardation, accompanied by reliable methods to assess and classify children’s intellectual and social competence in relation to a valid taxonomy of environments. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Developmental Delay and Intellectual Disability Summary
Etiology and Epidemiology
According to Vasudevan and Suri (2017), developmental delay(global developmental delay-GID) and intellectual disability are phenotypically and genetically heterogeneous, and as such, a unique diagnosis is not reached in multiple cases. Shapiro and Batshaw (2013) define global developmental delay as the most commonly used diagnosis in young children at risk of developing developmental disabilities and intellectual disabilities characterized by neurodevelopmental milestones in motor, language, and social-adaptive development. On the other hand, Baumeister (1987) indicates that intellectual disability has lately replaced the classic term mental retardation. Intellectual disability relates to a sub average intellectual functioning and impairments in adaptive abilities at the start of the developmental period. Liao et al. (2019) report that ID/GDD has an incidence rate of 1%-3%, affecting approximately 150 million children worldwide, and that language impairment is the most common primary symptom of mild ID/GDD. Additionally, 11.6% of children with ID/GDD are affected by prenatal factors. Zablotsky et al. (2019) indicate that in the US, the prevalence of children with ID/GDD aged 3-17 years has increased between the years 2009-2017.
As mentioned earlier, Vasudeven and Suri (2017) indicate that intellectual disability is a heterogeneous group of conditions, and as such, it arises from different causes and has many different expressions. Shapiro and Batshaw (2013) suggest that ID has two overlapping populations: mild intellectual disability, which is associated with racial, social, and familial factors, and ID that has biological or genetic origins. The specific origins of mild ID are identifiable in less than half of the affected individuals, and the most common causes are specific genetic/chromosomal syndromes such as Klinefelter Syndrome, encephalopathy infection, fetal deprivation, and intrauterine exposure to drugs of abuse Shapiro and Batshaw (2013, p. 297). With severe ID, the common causes include Down’s syndrome, Fragile X syndrome, and fetal alcohol spectrum. Additionally, developmental delay and intellectual disability are associated with comorbid conditions such as cerebral palsy, epilepsy, hearing problems, vision problems, ADHD, Anxiety disorder, conduct disorder, PDD, and oppositional defiant disorder.
Diagnostic Criteria, Assessment, Treatment, Societal Views, and Community Support Programs
Shapiro and Batshaw (2013) argue that no single medical method exists for detecting all causes of ID/GDD, and as such diagnostic testing should be based on medical history and physical examination. Additionally, the degree of the Child ID also classifies whether ID/GDD is mild or severe. Regarding psychological testing, the most commonly used test in children with ID/GDD is the Bayley Scales of Infant Development-3rd edition (BSID-III), Stanford Binet Intelligence Scales, and the Wechsler Preschool and Primary Scales of Intelligence. Other tests involve MRI scans, in-depth history, physical examination, Karyotype, and Fragile X screening. Treatment approaches include multimodal efforts geared towards many aspects of a child’s life. These include education, social and recreational activities, behavior problems, and associated impairments. Additionally, other treatment programs such as behavior therapy, family counseling, and medication focus on treating comorbid behavioral and emotional disorders (Srour & Shevell, 2014). Conclusively, in Bronx, NY, there are some community programs such as Day Habilitation Safety Plan and Pre-Vocational Safety Plans that focus on helping both adults and children with disabilities (Belvin, 2020). Additionally, clinicians and parents need to understand that the early identification of ID.GDD will ensure appropriate treatment and enable children to develop and use all the capabilities they possess.
Baumeister, A. A. (1987). Mental Retardation: Some Conceptions and Dilemmas. American Psychologist, 42(8), 796–800. https://doi.org/10.1037/0003-066X.42.8.796
Belvin, C. (2020). Community programs for people with intellectual or developmental disabilities. Rising Ground. https://www.risingground.org/program/community-services/
Liao, L. H., Chen, C., Peng, J., Wu, L. W., He, F., Yang, L. F., Zhang, C. L., Wang, G. L., Peng, P., Ma, Y. P., Miao, P., & Yin, F. (2019). Diagnosis of intellectual disability/global developmental delay via genetic analysis in a central region of China. Chinese Medical Journal, 132(13), 1533–1540. https://doi.org/10.1097/CM9.0000000000000295
Shapiro, B. K., & Batshaw, M. L. (2013). Developmental Delay and Intellectual Disability. In M. L. Batshaw, N. J. Roizen, & G. R. Lotrecchiano (Eds.), Children with Disabilities (7th ed.). Paul H. Brookes Publishing Co.
Srour, M., & Shevell, M. (2014). Global Developmental Delay and Intellectual Disability. In Rosenberg’s Molecular and Genetic Basis of Neurological and Psychiatric Disease (5th ed., pp. 151–161). Elsevier Inc. https://doi.org/10.1016/B978-0-12-410529-4.00014-0
Vasudevan, P., & Suri, M. (2017). A clinical approach to developmental delay and intellectual disability. Clinical Medicine, Journal of the Royal College of Physicians of London, 17(6), 558–561. https://doi.org/10.7861/clinmedicine.17-6-558
Zablotsky, B., Black, L. I., Maenner, M. J., Schieve, L. A., Danielson, M. L., Bitsko, R. H., Blumberg, S. J., Kogan, M. D., & Boyle, C. A. (2019). Prevalence and trends of developmental disabilities among children in the United States: 2009–2017. Pediatrics, 144(4). https://doi.org/10.1542/peds.2019-0811