Definitions and Causes of Intellectual Disabilities

Task 1
1.1 Give 2 definitions of intellectual disability in accordance with a recognized source.
Definition 1:
“Intellectual disability means a significantly reduced ability to understand new or complex information and to learn and apply new skills (impaired intelligence). This results in a reduced ability to cope independently (impaired social functioning), and begins before adulthood, with a lasting effect on development.” (World Health Organization, 2014)
Definition 2:
“Intellectual disability is a disability characterized by significant limitations both in intellectual functioning and in adaptive behaviour as expressed in conceptual, social, and practical adaptive skills. This disability originates before the age of 18.” (American Association on Intellectual and Development Disabilities, 2008)
1.2 Using a definition of intellectual disability give 2 examples of how this impacts on the person’s adaptive skills:

Conceptual skills such as reading time, counting money, reading and writing, expressing something are affected.
Practical skills such as mobility, meal preparation, using telephone or mobile and daily living skills such as eating and dressing up are also impaired.

Using a definition of intellectual disability give 2 explanations of how this impacts on the person’s cognitive ability:

An intellectually disabled person has problems in thinking and reasoning things to make sense of them and utilize that information or advise in the daily living.
Such as person also has problems in interpreting the tone in the voices speaking to them and communicating properly with other people.

Task 2
2.1 Give 2 examples of causes of intellectual disability that occur before birth and describe two (2) main characteristics of the effects.
E.g.1 Genetic Disorder
Chromosome abnormality or disorder in the genes can lead to intellectual disability before birth.
(American Association on Intellectual and Development Disabilities, 2008)
Main Characteristics:

One of the examples of Intellectual Disabilities due to genetic disorder is Downs Syndrome. Downs Syndrome occurs due to abnormality in chromosome 21 whereby there is an additional Chromosome 21. It can occur in any family of any race, religion or culture. Babies or children with Downs Syndrome depict small chin, almond shaped eyes and a around face as physical characteristics. Such children will also have a oversized tongue and much shorter limbs.

Another type of disability caused by genetic disorder is Prada Willi Syndrome. With Prada Willi Syndrome, there is abnormality in chromosome 15. There is a minute gene deletion in the chromosome 15. The reason for this deletion is remains unknown. People with such disability tend to suffer from food craving and weight gain mainly.

E.g. 2 Brain development
Caused by environmental factors such as consumption of alcohol by the mother during pregnancy, drugs, infection, other environmental toxins and unknown factors. Brain or portion of it is damaged due to exposure to such elements.
(American Association on Intellectual and Development Disabilities, 2008)
Main Characteristics:

An example of such is Foetal Alcohol Syndrome, caused by exposure to alcohol intake during pregnancy by the mothers. There is interference by alcohol in the delivery of food (nutrition) and oxygen to the brain, which affects the brain development and the connection of brain to the other organs of the body. These children have shorter than average height, have small head and small eyes with low birth weight and have flat face too.

Exposure to environmental toxins such as methyl in the air (whereby methyl molecules replace hydrogen in the air) leads to Fragile X Syndrome. Children with Fragile X-Syndrome would have been affected by DNA rearrangements and this is more common in males. These children or males generally tend to have large testicles.

2.2 Give 2 examples of causes of intellectual disability that occur during or immediately following birth and describe 2 main characteristics f the effects.
E.g. 1 Low Birth Weight
Children with low birth weight can also be impaired and classed under intellectual disability.
Source: (Centre for Disease Control, 2013)
Main Characteristics:

The child with low birth weight of basically below 2.5kg but especially below 1.5kg have great risks and chances of having cerebral palsy. It is not really a c cause rather a risk factor. Such a child has problems in balancing her/himself due to cognitive impairment.

Children with low birth weight can also develop or be affected by epilepsy (World Health Organization, 2012). Perinatal injury factors such as low birth weight leads to brain damage. These people tend to have involuntary episodes of seizure, which can be several at times.

E.g. 2 Trauma
Brain injuries or trauma can also lead to many intellectual disabilities. This can vary in degree yet leave a huge impact. Traumas at times can be prevented but there are certain times it can not be.
Source: Auckland Goldstar Institute (2014), Powerpoint slides 23-27)
Main Characteristics:

One of it is epilepsy. The brain damage due trauma can lead to epilepsy.

People with epilepsy have involuntary movements of the body. This could be referred to as episodes of seizures. Such children/clients may be devoid of awareness of their environment and can also be unconscious for sometime.

Another of the intellectual disabilities caused by trauma is cerebral palsy. The brain injury during birth affects a persons’ ability to move and coordinate.

Such clients have problems with bladder or bowel movements. It is difficult to control these.
2.3 Give 2 examples of causes of intellectual disability that occur during childhood years and describe the impact of the day-to-day support needs of the person.
E.g. 1 Infections
Infections such as Meningitis can lead to epilepsy. Meningitis affects the brain directly and can be taken as a cause of epilepsy.
(Source: Auckland Goldstar Institute (2014), Powerpoint slide 23)
Impact:

The client will have convulsions now and again. This is due to the brain damage from meningitis infection.

There could be partial seizures, which would be eventuating from a small part of the brain being affected.

E.g. 2 Exposure to Environmental Factors
We are exposed to many factors or toxins in the environment on daily basis. Some of these factors can lead to Autism.
(Source: Auckland Goldstar Institute(2014), Powerpoint slide 33)
Impact:

Have difficulty in speaking, can be repetitive with words or have flat tone of voice. Hence, they experience hardships in communicating with many people.

They find it hard to socialize with large groups of people. This can lead to these clients feelings isolated and as they are unable to develop or make friends.

Task 3
Describe conditions frequently associated with intellectual disability.
Condition 1: Epilepsy
Cause: Epilepsy, another of those common intellectual disabilities has been related to many causes. While some times it is unknown, the known factors are:

genetics
serious head injuries or severe head trauma
hypoxia or lack of oxygen during birth
infections such as encephalitis and meningitis

Main Characteristic 1:
Such clients can experience convulsions or seizures. Seizures may be partial. This happens due to injuries to the brain whereby the part of the brain controlling body movements is affected.
Main Characteristic 2:
The person/client may also lose awareness of presence in a place and happenings around it. This also happens due to brain effects resulting from any of the causes.
Physical Support:
Need help in ensuring correct administration of medications, monitoring of that these medications are taken, tending to any effects or side effects.

Safety of such clients is paramount as these clients have seizures and involuntary body movements. Thus, these clients as well as the family (or whanau) need to be educated on what it is and the management (this includes ensuring safety, taking care of other needs, medication intake, taking appropriate steps when a person has seizures) a of epilepsy.
A safe environment that is free of and hazards is also needed. The airways of any person having seizures should always be kept open.

Social support:

Clients need encouragement and positive response to help them maintain their dignity during and after seizures.
These clients also need motivation and support to help them get into studies and be educated.
Since epileptic clients can get socially shy and may not mix around with others, they need constant support and encouragement to help them be in contact and maintain communication with her/his friends and co-workers.

Cognitive support:

Epileptic clients can end up losing a lot of learning hours and opportunities due to seizures. They thus experience difficulties in learning. This can and often leads to needing additional teaching support in terms of using devices such as visual aids, diary for appointments, calendars, memory aids and even a 1 to 1 teacher support. These support modes will be really helpful to them.

Condition 2: Spinal bifida
Cause(s): Spinal bifida, which is a before birth is a condition whereby a person has incomplete brain, spinal cord and/or meninges development. The type and location of the malformation denotes the severity of the condition as to where it is mild or severe. While the cause is generally unknown, it can be possibly related to genetics, folic acid deficiency in diet and also environmental factors.
Main Characteristic 1:
People with spinal bifida can experience bladder or bowel control loss. They have lack of control on them urinating or defecating, on the amount and when they do it.
Main Characteristic 2:
Feeling of muscle weakness or paralysis below the region where the incomplete closure (cleft) or malformation has occurred. Thus, as a result they can also feel loss of sensation in the region below the affected area.
Physical support:
A person with spinal bifida needs assistance with mobility. Walkers or wheelchairs will be required for such people as they have affected lower limbs or are paralytic. Additional support from occupational therapists or physiotherapists may be required together with additional environmental adaptation. Medical or surgical interventions can be required for such clients.
Social support:
Accessibility to community based activities and appropriate transportation support is required for such people.
Education and work opportunities support also need so that they receive similar treatment as other people and so that these people can also advance in life.
As they may feel shy because of their condition, they will need activities of sports or recreation so that it can espouse them to make friends and socialize with other people.
Cognitive support:
Hydrocephalous (build up of fluid in the brain) can interfere in learning process. Even surgical interventions can lead to missing school whereby learning is disrupted. Hence, additional support in the forms of having home based learning with tutors and supplementary efforts from teachers in school become mandatory.
Condition 3: Foetal Alcohol Syndrome
Cause: the prime cause of this condition is alcohol exposure to the foetus while in the utero. The leads to brain damage and problems with growth. The delivery of oxygen and necessary nutrition is disrupted by alcohol and this affects tissue and organ development including the brain.
Main characteristic 1:
Some of the physical characteristics of the such people are low birth weight, small head and small eyes. This can be basically happening due to lack of nutrition to the foetus.
Main characteristic 2:
Language and speech delays are also experienced by these people as brain functions and development had been affected by lack of oxygen.
Physical Support:
Health care staff support in forms of physiotherapists and speech therapists will be required to assist such people. These staff will help to overcome the difficulties of language, pronunciation and speech.
Social support:
As these people have problems with their speech and language they could hesitate in interacting and socializing with other people. Trainings for social skills, interaction and communication with family, friends and others could be very helpful. The clients could improve in confidence and interact with them more. Boosting of confidence and encouraging independency related activities could also provide the necessary support.
Cognitive support:
Supportive educational activities could be organized with these clients to enable them overcome their speech problems and learning. Language problems can also be addressed through this support. Special education teachers and speech therapists could play vital roles in addressing the needs of such clients.
References:

American Association of Intellectual and Developmental Disabilities (2008), Frequently Asked Questions on Intellectual Disability and the AAIDD Definition, AAIDD Information, American Association of Intellectual and Developmental Disabilities, pg. 1
Auckland Goldstar Institute (2014), Intellectual Disability, Powerpoint Slides4-36
Centre for Disease Control and Prevention (2013), Celebral Palsy, Division of Birth Defects and Developmental Disabilities, National Centre on Birth Defects and Developmental Disabilities. Retrieved from www.cdc.gov
CCS Disability Action (2013), Spinal Bifida, Types of Disabilities. Retrieved from http://www.ccsdisabilityaction.org.nz
Prader Willi Association of New Zealand (2014), What is Prader Willi Syndrom? Retrieved from www.everybody.co.nz
World Health Organization (2012), Epilepsy, Fact Sheet No999, Geneva. Retrieved from www.who.int
World Helath Organisation (2014), Mental Health, World Health Organization, Geneva. Retrieved from www.euro.who.int