Autism and Intellectual Disabilities

Transcription

1 Autism and Intellectual Disabilities (DSM IV & V) Accessibility Politecnico di Milano

2 Autism (I) A total of six (or more) items from (A), (B), and (C), with at least two from (A), and one each from (B) and (C) (A) qualitative impairment in social interaction, as manifested by at least two of the following: 1. marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction 2. failure to develop peer relationships appropriate to developmental level 3. a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people, (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people) 4. lack of social or emotional reciprocity ( note: in the description, it gives the following as examples: not actively participating in simple social play or games, preferring solitary activities, or involving others in activities only as tools or "mechanical" aids )

3 Autism (I) A total of six (or more) items from (A), (B), and (C), with at least two from (A), and one each from (B) and (C). (B) qualitative impairments in communication as manifested by at least one of the following: 1. delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime) 2. in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others 3. stereotyped and repetitive use of language or idiosyncratic language 4. lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level

4 Autism (I) A total of six (or more) items from (A), (B), and (C), with at least two from (A), and one each from (B) and (C). (C) restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least two of the following: 1. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus 2. apparently inflexible adherence to specific, nonfunctional routines or rituals 3. stereotyped and repetitive motor mannerisms (e.g hand or finger flapping or twisting, or complex whole-body movements) 4. persistent preoccupation with parts of objects

5 Autism (II) Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (A) social interaction (B) language as used in social communication (C) symbolic or imaginative play (III) The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder

6 Mental Retardation Intellectual Disabilities The term "Mental Retardation" (MR) is going out of favor as it has been judged to have acquired a negative and prejudicial meaning. It has been replaced with "Intellectual Disabilities. This shedding of terms to describe the underlying phenomena associated with MR has happened before, and in all likelihood will probably one day happen again. No matter what the phenomena is called, some cruel people inevitably seem to find whatever terms are used to describe the phenomena useful as insults and taunts.

7 Nature of Intellectual Disabilities Intellectual Disabilities is a diagnostic classification denoting significantly low intellectual functioning or other brain functioning problems. It is not a disease in of itself. Classification of Intellectual Disabilities indicates that developmental immaturities are present in the form of intellectual deficits, and often emotional deficits as well. This immaturity interferes with a person s ability to function at age-appropriate levels and makes independent living a challenging proposition. Cognitive abilities of a person with intellectual disab are impaired. This means that they acquire new information slowly and have difficulty understanding complex concepts.

8 Cognitive Functioning Intellectual Disabilities is defined by sub-average intellectual ability. General intelligence quotient (IQ) scores for persons with intellectual disabilities are, by definition, seventy (70) or below. By definition, this score is set two standard deviations below the average IQ of 100, and only occurs about 2.5 percent of the time when considered against the entire distribution of IQ scores in the population. Because of these intellectual deficits, individuals' ability to learn of a person with intellectual disabilities is impaired. Language processing and logical thinking deficits are often present, as are impairments in reasoning and problem-solving abilities. Intellectual Disabilities interferes with language processing and impairs judgment and analytical skills.

9 Cognitive Functioning Although the disorder affects an individual's capacity for learning, intellectual disabilities is not a learning disorder in the academic sense. Intellectual Disability is distinguished from Specific Learning Difficulties (DSA in italian) that are specific to academic learning such as dyslexia (a reading and writing disorder), disgraphia, disortopgraphia, and dyscalculia in that it is more general in nature. In intellectual disabilities, learning abilities are impaired generally, rather than in specific areas. Learning disabilities relate to specific deficits in the ability to acquire academic skills like reading and math, while intellectual disabilities relate to basic and broad impairments in cognitive functioning that affect the individual's ability to process and retain information across the board.

10 Emotional Functioning Intellectual Disability often affects people emotionally as well as intellectually. Many intellectual disabled people function on an emotional and social level that is below what is appropriate for their age. This emotional immaturity is often considered an endearing aspect of individuals' personalities of persons with intellectual disability, however. Persons with intellectual disabilities are commonly thought of as being friendly, lovable, and possessing a child like quality in their overall personality. ANYWAY THINK THEM ADULTS!

11 Emotional Functioning The emotional maturity of persons who are diagnosed with intellectual disabilities is generally a function of how severely impaired they are. Severely persons with intellectual disability are generally more emotionally immature than are persons with mild intellectual disabilities. Intellectual disabilities are a developmental classification, defined as a severe intellectual or cognitive deficit that occurs during development. It is not a disease in itself. Intellectual Disabilities can both coexist with other disorders and be caused by other disorders. For this reason, there is no single set of symptoms that suggests intellectual disabilities.

12 Keeping this in mind, there are behavioral, physical, and medical symptoms that do suggest the presence of intellectual disabilities. In general, children with intellectual disabilities reach developmental milestones such as walking and talking much later than their peers do. Symptoms of intellectual disabilities may appear at birth or later in childhood. Time of onset depends on the suspected cause of the disability. Some cases of mild intellectual disabilities are not diagnosed until the child enters preschool. These children typically have difficulties with social, communication, and functional academic skills. Children who have a neurological disorder or illness such as encephalitis or meningitis may suddenly show signs of cognitive impairment and adaptive difficulties.

13 Intellectual disabilities are difficult to detect in infancy unless specific physical attributes associated with a syndrome that causes intellectual disabilities are present. Small children who have intellectual disabilities often have developmental delays that result in their inability to meet age-appropriate milestones including sitting up, crawling, walking, and talking. Physical traits and failure to meet developmental milestones are usually the first symptoms of intellectual disabilities that are noticed. Functional problems, not IQ (which requires testing that does not occur until school age), tend to be the cursors that prompt parents and doctors to test for intellectual disabilities.

14 Mild intellectual disabilities are often quite subtle and frequently goes undetected until the child enters the school environment. The educational setting makes demands on the child's intellectual skills and cognitive functioning. Children with intellectual disabilities tend to have difficulty retaining information. The inability to remember things inhibits the child's ability to learn. This becomes readily apparent in a school environment.. Emotional problems can always influence the detection!

15 Intellectual disabilities may also be identified when a medical syndrome is identified based on genetic or other medical testing. For example, genetic disorders such Down syndrome (Williams Syndrome, X-fragile Syndrome, ) can be identified during pregnancy thorough amniocentesis, chorionic villus sampling (CVS), and other techniques used to gather information about fetal chromosomes and genetic make-up. In such cases, the symptoms that point to the presence of a genetic disorder are also symptoms of intellectual disabilities.

16 Problem solving skills are lacking in persons with intellectual disabilities, as are deficits in logical thinking and abstract thought. The deficit in abstract thought manifests itself in the child's inability to generalize from one situation to another. Instead of being able to see relationships between similar but different things, children with intellectual disabilities tend to think in a more concrete manner and may be unable to see how things are related.

17 Deficits in social skills also come into play in a school setting. Persons with intellectual disabilities struggle with understanding social rules like taking turns and waiting until someone else finishes speaking before talking. Some social concepts are beyond the grasp of persons with intellectual disabilities. The concept of money is a good example: persons with intellectual disabilities tend to have difficulty understanding how money works. Persons with intellectual disabilities also tend to have difficulty understanding cause and effect relationships, for example, recognizing that there are consequences for actions.