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PS - Intellectual Disability

The document provides an overview of intellectual disability, detailing its classification as a neurodevelopmental disorder, epidemiology, aetiology, clinical features, course, and prognosis. It highlights the prevalence rates, diagnostic criteria, and the importance of early intervention for improving adaptive functioning. The prognosis varies based on the level of support and intervention provided, with potential for significant improvement or stabilization in functioning.

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27 views2 pages

PS - Intellectual Disability

The document provides an overview of intellectual disability, detailing its classification as a neurodevelopmental disorder, epidemiology, aetiology, clinical features, course, and prognosis. It highlights the prevalence rates, diagnostic criteria, and the importance of early intervention for improving adaptive functioning. The prognosis varies based on the level of support and intervention provided, with potential for significant improvement or stabilization in functioning.

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oelofsenadine
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© © All Rights Reserved
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Pathology study

Name of Pathology
Intellectual disability
Intellectual disability falls within the neurodevelopmental disorders according to the classification in the DSM-V
diagnostic criteria (Association, 2013, p. 31). The main characteristics of Intellectual disability includes deficits in
general metal abilities; reasoning as well as problem solving; planning; abstract thinking, judgement, academic
learning and learning from experience.

Epidemiology
In a destructive, retrospective study of clinical records of state patients admitted to forensic psychiatric hospital in
KwaZulu-Natal in 2016, the following statistics were recorded (Houidi, Paruk, & Sartorius, 2018, p. 2):
With regards to the clinical assessment at observation at the admission as a state patient, it was found that 34, out
of 91 newly admitted male and female state patients between the ages of 15 and 65 years, was diagnosed with
intellectual disability, and only 5 patients with no mental illness upon screening for the observation report. After
admission of these state patients it was recorded that 43 patients denied committing a crime, and 19 expressed
regretting committing a crime. Through this a correlation of the diagnoses upon admission that was made, and
during observation (Houidi, Paruk, & Sartorius, 2018, p. 3).

A more general prevalence of intellectual disability is indicative of around 1%, although the prevalence rates does
vary with age and gender. Severe intellectual disability occurs within approximately 6 out of 1,000 people
(Association, 2013, p. 38). Moreover, males are more likely be diagnosed with both mild (males: females, ratio 1.6:1),
and serve forms (males: females, ratio 1.2:1), of intellectual disabilities (Association, 2013, p. 39).

Aetiology
There are multiple causes that can contribute and cause intellectual disability. The contributing factors of the
diagnoses of intellectual disability includes social judgement, assessment of risk, self-management of behaviour,
emotions, or interpersonal relationship, motivation in school and work environment and the lack of communication
skills that proposes disruptive and aggressive behaviours (Association, 2013, p. 38).

The causing factors however are not always by choice or exposer-dependent on the environment, as mentioned
factors above. This dynamic condition with heterogeneous group of conditions, can result from a range of genetic
and metabolic disorders to functional changes in the brain occurring later in the developmental period. Thus,
diagnostic heterogeneity, each person with intellectual disability must be considered individually according to
whether or not there is an associated syndrome, for example. (Harris, 2006, p. 12)

Clinical Features and diagnosis


The diagnostic criteria include three main criteria that has to be met, in order for a intellectual disability to be
diagnosed (Association, 2013, p. 33). This includes, firstly, a deficit in intellectual functioning such as reasoning,
problem solving, planning, abstract thinking, judgement, academic learning and so forth. This has to be assessed
clinically and with individualized, standardized intelligence testing. Secondly, deficit in the adaptive functioning that
result in the inability to meet developmental and social-cultural standards for personal independence and social
responsibility. One or more areas of daily living will be limited by deficit in the functioning, if no external support is
put in place. Lastly, the onset of the intellectual and adaptive deficits must occur during the developmental period
(Association, 2013, p. 33).

The clinical features walk close to the diagnostic criteria, reason being that the specifiers of the criteria serve as
clinical features in the areas of the conceptual, social, practical domain. The mild, moderate, severe and profound
intellectual disability-classification, under the specifiers of the disorder, have unique traits within these domains
mentioned (Association, 2013, p. 36).
For the purpose of this pathology study, a more in-depth discussion will not be followed for each one of these
specifiers, but just taking in consideration that all these domains include an impact either mildly, or more severe.
The deficits in the conceptual domain manifests in academic performance, reading, writing, time, abstract thinking,
executive functioning and short-term memory. The social domain is compared with the typically developing age-
mates, and social interactions, communication and conversation as well as language are impacted. Risk-judgement,
social judgement as well as gullibility also falls under the social domain and is impacted according to the severity of
the disability. Lastly, the practical domain is influenced with regards to activities of daily living and instrumental
activities of daily living, which includes recreational skills and participation (Association, 2013, pp. 34-36).

Course
The onset of an intellectual disability occurs within the developmental period. The severity of the brain dysfunction
as well as the aetiology are determining factors in the onset of the illness. If the illness has an occurrence of delayed
motor, language and social milestones, it will be identifiable within the first two years of life, and will be classified as
a severe intellectual disability. The mild intellectual disabilities are identifiable when school going activities, in terms
of learning difficulties arises. The development of an intellectual disability may affect the physical appearance, for
example Down Syndrome (Association, 2013, p. 38). Furthermore, intellectual disabilities are unique to each person,
and can be associated with a behavioural phenotype, in other words, it is specific behaviours associated with the
particular genetic disorder. In some intellectual disability disorder, there is also an abrupt following of an illness,
after the onset, such as meningitis or encephalitis during the developmental period of the disability (Association,
2013, p. 38).

In general, an intellectual disability is non-progressive, however there is certain genetic disorders that have periods
of worsening, followed by stabilization, or if stabilization does not occur, the decline of functioning is progressive
with time (Association, 2013, p. 39).

Prognosis and Medical/ Other Intervention


Early and ongoing interventions withhold hope and the ability to improve adaptive functioning throughout childhood
and adulthood. This is indicative of significant improvement of intellectual functioning that can take place, to such an
extent that the diagnoses are no longer appropriate (Association, 2013, p. 39). How amazing is this!
However, for older children and adults, the extend of support and therapy provided will just result in a stable,
generalized skill acquisition condition of functioning.
The above-mentioned factors thus result in either a good prognosis, where the diagnoses can be eradicated and
overcome by adaptive means of functioning, or a fair prognosis of a stable, non-progressive state. The emphasize
and the main determining factor with these prognoses is the intervention and support provided for the person with
an intellectual disability. Thus, a poor prognosis is evident if no support and quality intervention is provided.

Bibliography
Association, A. P. (2013). Diagnostic and Statistical Manual of Mental Disorders. Arlington, VA: American Psychiatric
Association.

Crouch, R., & Alers, V. (2014). Occupational Therapy in Psychiatry and Mental Health. In R. Crouch, Occupational
Therapy in Psychiatry and Mental Health (pp. 435-444). Johannesburg: John Wiley and Sons.

Harris, J. C. (2006). Intellectually disabled: Understanding Its Development, Causes, Classification, Evaluation, and
Treatment. New York: Oxford University Press.

Houidi, A., Paruk, S., & Sartorius, B. (2018). Forensic psychiatric assessment process and outcome in state patients in
KwaZulu-Natal, South Africa. South Africa Journal of Psychiatry, a1142.

Schindler, V. P. (2004). Occupational Therapy in Forensic Psychiatry. London: Hawarth Press.

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