🧠 Intellectual Disabilities and Communication

Disorders in Children
📜 Historical Perspective on Intellectual Disabilities
 Ancient Greek Society: Individuals with low self-care abilities and
community participation were referred to as “idiots.” These individuals
were often killed or abused (Barr, 1905).
 Middle Ages: The concept of intellectual disabilities expanded to
include emotional, medical, psychological, and physical impairments.
They were often treated harshly, as people believed their conditions
were caused by witchcraft.

📚 Definitions and Terminology

“Intellectual disability typically involves an IQ score that is at least
two standard deviations below the population mean (approximately
70).”
Characteristics of Intellectual Disabilities:
1. Significant limitations in intellectual functioning
2. Significant limitations in adaptive behavior:
o Conceptual skills
o Social skills (interpersonal skills, self-esteem)
o Practical skills (daily living activities, self-care, using a phone)
3. Onset before age 18.
Examples of Adaptive Behavior
 Conceptual skills: Literacy, mathematical ability
 Social skills: Ability to interact with others
 Practical skills: Self-care in daily life

📊 Distribution of Intellectual Functioning

 Intelligence Distribution:
o Average IQ = 100
o Range 85-115 = approximately 68%
o IQ below 70 = approximately less than 3%

Severity of Intellectual Disabilities

Population
Severity Proportion IQ Range
Mild 85% 50 to about 69
 Population
Severity Proportion IQ Range
Moderate 10% 35-49
Severe 3-4% 20-34
Profound 1-2% Below 20

⏳ Delays and Deviations

 Delay: Developmental progress is similar to that of typical children but
at a slower pace.
 Deviation: Developmental progress differs in speed and sequence
from that of typical children.

How to Discuss Age?

 Chronological Age
 Mental Age (obtained through intelligence testing)
 Language Age (obtained through language testing)

🧬 Causes of Intellectual Disabilities

 Genetic Conditions:
o Down syndrome
o Fragile X syndrome
o Williams syndrome
 Prenatal Issues:
o Fetal alcohol syndrome
 Perinatal Issues:
o Low birth weight, hypoxia, etc.
 Postnatal Issues:
o Infections, trauma, mercury poisoning
o Poverty and malnutrition

🔍 Today’s Focus
 Discuss the relationship between general intellectual functioning and
language development
 Does language learning depend on our overall cognitive abilities?
 Or is language independent of general cognition?
Language Development in Special Populations
 Down Syndrome: Presence of an extra 21st chromosome, occurring
in about 1 in 800 newborns, accounting for about 1/3 of the population
with moderate to severe disabilities.
 Williams Syndrome: Associated with a deletion on chromosome 7,
occurring in about 1 in 7500-20000 of the population.
🌐 Language Development in Down Syndrome
 Continuity of Intellectual Functioning: Language abilities are often
more impaired than cognitive functioning, particularly expressive
abilities are more difficult than receptive abilities.
Specific Manifestations of Language Abilities
 Phonology:
o Babbling is delayed by about 2 months
o Phonological development is delayed
 Semantics:
o Vocabulary comprehension is commensurate with mental age,
but vocabulary production lags
 Syntax:
o Most significantly impaired, expressive syntax stagnates by age
12

🌈 Language Development in Williams Syndrome

 Separability of Language Ability and Cognition: Language
abilities are significantly better than visual-spatial abilities,
demonstrating strong social skills.
 Semantics and Syntax:
o Use of complex sentences, but show significant deficits in
standardized testing.

📖 Case Studies
 Individuals with Intellectual Disabilities and High-Level
Language Skills: Some individuals with very low IQs possess
relatively intact language skills, but their abilities are typically not on
par with their typical peers.
Characteristics of Language Use
 Longer gaze at the listener’s face
 Telling coherent and complex stories but struggling to answer
questions
 Difficulty understanding non-literal language

🎥 Videos on Williams Syndrome

 Introduction to Williams Syndrome
 Note His Reading Strategies

🧠 Fragile X Syndrome
“Fragile X syndrome is one of the most common genetic causes of
intellectual disability.”
Basic Information on Fragile X Syndrome
 Prevalence: 1 in every 1250 to 2500 births
 Severity of Intellectual Disability: Ranges from mild to severe
 Defective Gene: A single gene defect or deletion on the X
chromosome
Characteristics in Males
 Facial Features: Long and narrow face
 Ear Features: Long and thick protruding ears
 Associated Symptoms:
o Attention deficits
o Autism
o Attention Deficit Hyperactivity Disorder (ADHD)
o Anxiety
o Emotional issues
o Auditory and visual problems

Delays in Language Development

 Delay in First Words: Language development starts later
 Delay in Phonological Acquisition: The degree of delay in
phonological acquisition is less than that in Down syndrome (DS)
 Delay in Syntactic Development: Syntactic development is delayed,
but less so than in children with Down syndrome
 Pragmatic Language Difficulties: Frequent difficulties in pragmatic
language
 Gender Differences: Females typically outperform males in language
skills
Related Videos
 Brief Introduction to Fragile X Syndrome
 Causes, Diagnosis, and Management of Fragile X Syndrome

👶 Factors Related to Language Disorders in Children with

Intellectual Disabilities
 Cognitive Function
 Memory Abilities
o Short-term memory
o Long-term memory
 Attention
 Specific Language Impairment
 Family Environment: Typically not a cause of language disorders
Key Points Review
 Intellectual disabilities (ID) may result from genetic and other factors
occurring before, during, and after birth
 Language deficits manifest as delays or deviations
 There are variations in language skills among individuals with
intellectual disabilities
 Cognitive impairments play a role in language disorders but cannot
explain all the language difficulties that children with intellectual
disabilities may experience

📝 Identifying Individuals with Intellectual Disabilities

Assessment Content
 Cognitive/Intellectual Abilities
 Language Abilities
 Non-verbal Abilities
 Adaptive Behavior Functioning
Common Measures for Assessing Cognitive Abilities
Assessment Tool Description
WISC Series (WISC-V; WAIS-IV; Intelligence tests
WPPSI-IV, etc.)
Stanford-Binet V Stanford-Binet Intelligence Test
Raven’s Progressive Matrices A non-verbal intelligence test
Bayley Scales of Infant Assessment of infant development
Development
Kaufman Assessment Battery for Tools for assessing children’s
Children intelligence

📊 Assessment of Adaptive Behavior

Areas of Adaptive Skills and Behaviors
Adaptive Skills Description
Communication Language and listening skills needed to communicate
with others, including vocabulary, answering
questions, and conversation skills
Community Use Skills needed to operate in the community, including
using community resources, shopping skills, and
community navigation
Functional Basic reading, writing, math, and other academic skills
Academics needed for daily life
Home Living Basic skills for home management and care of the
Adaptive Skills Description
living environment
Health and Safety Skills needed to protect health and cope with illness
and injury
Leisure Skills needed to participate in and plan leisure
activities
Self-Care Personal care skills, including eating, dressing,
bathing, toileting, grooming, and hygiene
Self-Direction Skills for independence, responsibility, and self-control
Social Skills for interacting and getting along with others
Work Occupational skills

Three Major Areas of Adaptive Behavior and Related Skills

Behavior Area Related Adaptive Skills
Conceptual Includes communication, functional academics, self-
direction, and health and safety skills
Practical Includes social skills and leisure skills
Social Includes self-care, home/school living, community use,
health and safety, and work skills

Assessment of Communication Skills

 Case History: Discussing daily communication with family members
 Assessment Content:
o Non-symbolic and/or symbolic communication
o Play
o Social interaction and social communication
o Oral and written language
o Speech production and fluency
o Oral motor skills
o Swallowing

💡 Principles of Intervention
 Treatment goals should be based on assessing language in different
communication contexts
 Early intervention is effective
 Provide interventions to enhance language clarity
 Consider augmentative and alternative communication (AAC) tools for
some children, such as gestures, body language, etc.
Intervention Methods
Method Type Description
Highly Structured Imitation, modeling, and reinforcement, which may
Methods not transfer to new environments
Naturalistic Methods Promote transfer in natural environments (e.g.,
cafeteria)

Strategies to Enhance Language and Communication Skills in

Children with Intellectual Disabilities
 Related Video