Immaturity or deficiency? 

Intellectual disability

Intellectual disability (ID) is a disorder that appears in early childhood, and refers to severe and permanent difficulties in acquiring the behaviours and learning necessary to live independently. More specifically, ID is characterized by severe and permanent impairment of intellectual functioning and adaptive behaviours (1). In this sense, people with ID encounter major obstacles in terms of social skills, respect for social norms, daily autonomy, the ability to take care of oneself in everyday life, and to adapt to the environment. For children under the age of five, the term Global Developmental Delay (GDD) is used, before a formal diagnosis of ID is made after entering school

The causes of intellectual disability vary widely, it can be of no known origin, or even as a manifestation of a genetic syndrome. The causes can arise during the pre, peri or postnatal period. In other words, they can occur at different times in a person's development, starting with intrauterine development. The ID can be accompanied by several other conditions such as; epilepsy, a behavioural disorder, an autism spectrum disorder (ASD), dyspraxia, or conversely by particular strengths / talents in the individual.

Three types of ID are distinguished; mild ID, moderate ID, and severe ID. The characteristics of intellectual disability will be different depending on the syndrome, and lead to different profiles from one person to another.  In other words, two people with an ID of the same severity can be completely different from each other. Hence the importance of clarifying the cognitive, adaptive and academic profile of each individual through a neuropsychological assessment in order to properly orient and support them.

Common Symptoms

• Major delays in the reaching developmental milestones (language and / or motor)
• Major delays in the acquisition and control of cleanliness. 
• Significant gaps between the skills of the individual and those of his peers which increase with each new year
• Major difficulties in learning, starting from the start of preschool
• The individual seems incapable of mastering the various academic concepts
• Depending on the severity of the ID (i.e. mild, moderate or severe), the individual depends on another person for clothing, travel, food, social integration, professional integration, etc.

Assessment and intervention

The objective of the neuropsychological assessment is to decide whether the child, adolescent or adult is functioning at the level of intellectual disability, that is to say equivalent to or below the 2nd percentile in the population. We must also observe a significant impairment of adaptive behaviours, that is to say the skills necessary to get along with others and take care of oneself. With this information, it will be possible, among other things, to establish the severity of the ID (mild, moderate or severe).

The assessment also serves to describe the cognitive profile of the person, the best-developed spheres and the most marked deficits. These characteristics allow us to direct the courses of intervention and the educational or professional guidance according to the strengths on which to rely and the difficulties to be avoided.

Despite the persistent nature of this disorder, it is important to offer children, adolescents and adults with ID support that will allow them to evolve, equip themselves and learn to optimize their strengths to express their potential.

References 

1. American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders-fifth edition (the DSM-5). American Psychiatric Publishing 2013, pp. 33-41.