Intellectual Disability Neurodevelopmental Disorder Paper

My study guide for intellectual disability begins with the general DSM-5 definition and signs and symptoms as classified by the DSM-5 criteria. I have also used mnemonics and color-coding to ensure visual aiding. This study guide is meant to provide a rough overview of the topics to be studied before the examination. The study guide follows the information arrangement by the DSM-5 but another input has been derived from scholarly book chapters and organizational websites for up-to-date current trends. 

Intellectual Disability Neurodevelopmental Disorder Paper

Study Guide
Intellectual Disability Definition   Deficiency in the domains of mental capabilities and functioning (American Psychiatric Association, 2013)
Signs and symptoms according to the DSM-5(Symptoms in Criteria A, B, and C must be met) Intellectual function deficits(Criterion A) (American Psychiatric Association, 2013) Problem-solving, reasoning, judgment, abstract thinking, learning deficits, lower standardized intellectual tests
Adaptive functioning deficits(Criterion B) (American Psychiatric Association, 2013) Social participation, communication, living independently, poor adaptation to change in physical settings
Criterion C (American Psychiatric Association, 2013) Onset during the development period
Differential diagnoses M2AS2C3M

M

A

S

S

C

C

C

 

Major neurocognitive disorder Alzheimer’s disease, downs syndrome
Mild neurocognitive disorder Alzheimer’s disease, downs syndrome
Autism spectrum disorder Social, communication, and behavior deficits
Specific learning disorder No deficits in intellectual and adaptive behaviors
Communication disorder No deficits in intellectual and adaptive behaviors
Child abuse Can cause developmental delays
Speech disorder Aphasia
Cerebral palsy Poor vision, improper muscle coordination, and reduced hearing
Incidence and prevalence 1 percent of the general population6 per 1000 cases are severe  (American Psychiatric Association, 2013)

In 2014 – 3.4% in the US (CDC, 2019)

In 2016 – 3.57% in the US (CDC, 2019)

Risks and Prognosticators ¾    Genetics – CNS malformations, inborn errors of metabolism,¾    Acquired – meningitis, seizure disorders, neonatal encephalopathy

¾    Teratogens – alcohol, toxins, drugs in utero

¾    Hypoxic-ischemic injury

¾    Placental diseases

¾    Traumatic brain injury

¾    Toxic metabolism syndromes

¾    Chronic social deprivation

Development and course ¾    Starts in the development period¾    Age at onset is determined by severity and comorbidities

¾    Severe types can be diagnosed by age 2 (American Psychiatric Association, 2013)

¾    Severity can be mild, moderate, and severe depending on presentation and assessment

¾    The course is nonprogressive, sometimes with fluctuating periods

¾    Intellectual deficits precede adaptive function deficits

¾    Language and motor skills are seen first (Schaepper et al., 2021)

¾    The concept is loss of previously acquired skills during development or lack of acquisition of these skills at all in the development period

Cultural & Gender considerations ¾    Need to understand the ethnic, cultural, and linguistic background of the patient¾    All races and cultures are afflicted

¾    Family history is essential as well as the genogram

¾    Male more than females – 1.6/1 (American Psychiatric Association, 2013)

¾    X-linked genetic disease responsible for the variations in gender

Pharmacotherapy ¾    No pharmacotherapy approved by the food and drug administration (FDA) (Schaepper et al., 2021)¾    Medications may be used to treat particular disease presentations of comorbidities such as ADHD – methylphenidate, clonidine, atomoxetine

¾    Risperidone has been used for aggressive behavior

¾    Aripiprazole for aggression  

Non-pharmacotherapy ¾    Special education to the patients¾    Parental psychoeducation

¾    Family therapy and support

¾    Vocational training and support

¾    Housing, residential, and social support

¾    Childhood to adulthood transition support services (Schaepper et al., 2021)

Diagnostics ¾    Clinical judgment is the first step to suspicion¾    Mental state examination

¾    Full IQ score tests, nowadays not mandatory (American Psychiatric Association, 2013)

¾    The IQ tests should be:

o   Psychometrically valid

o   Psychometrically sound

o   Culturally appropriate 

¾    Adaptive Behavior Assessment System for adaptive function assessment (Lee et al., 2021)

¾    Other tests:

o   Karyotyping

o   Urine analysis

o   Neuroimaging

o   Enzyme deficiency blood tests . Intellectual Disability Neurodevelopmental Disorder Paper

Comorbidities Most common¾    Bipolar disorder 

¾    Autism spectrum disorders

¾    Stereotypic movement disorder

¾    Major neurocognitive disorder

¾    Anxiety disorders

¾    Depression disorders

(American Psychiatric Association, 2013) 

More common¾    Epilepsy

¾    Mental disorders

¾    Cerebral palsy

¾    Motor disorders

¾    Impulse control disorder

¾    Attention deficit disorders

(Schaepper et al., 2021)

Legal and ethical considerations ¾    Individuals have the rights to access appropriate knowledge – justice¾    Parents to teach their afflicted children the necessary laws for the land – legal

¾    Need to fair and just access to community resources and services – ethical justice

¾    Promote independence and responsibility in the patients – respect autonomy

¾    Susceptibility to physical and sexual abuse  (Tomsa et al., 2021)

Pertinent patient education considerations  ¾    Functional skills¾    Behavioral skills

¾    Vocational skills

¾    Communication skills

¾    Including the family in patient education beyond the classroom

¾    Creation of the least restrictive environment for education

¾    Seeking assistance¾    Social skills

¾     Rule out other causes of learning disabilities

¾    Screen for visual and hearing problems

(Lee et al., 2021)

Intellectual Disability Neurodevelopmental Disorder Paper References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5 (R)) (5th ed.). American Psychiatric Association Publishing.
  • CDC. (2019, June 6). Products – data briefs – number 291 – November 2017. Cdc.Gov. https://www.cdc.gov/nchs/products/databriefs/db291.htm
  • Lee, K., Cascella, M., & Marwaha, R. (2021). Intellectual Disability. StatPearls Publishing.
  • Schaepper, M. A., Hauser, M., & Kagadkar, F. (2021, August). What is intellectual disability? The Psychiatry of Intellectual Disability; CRC Press.