Intellectual Disability | 마이메르시 MyMerci

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Intellectual Disability

NCLEX Review Guide: Child Health - Neurologic & Cognitive Disorders: Intellectual Disability

Definition and Classification

Intellectual Disability Overview

Intellectual disability is characterized by significant limitations in both intellectual functioning and adaptive behavior, manifesting before age 18.
Diagnosis requires IQ below 70-75 and deficits in adaptive functioning across conceptual, social, and practical domains.
Classification levels include mild (IQ 50-70), moderate (IQ 35-50), severe (IQ 20-35), and profound (IQ below 20).

Memory Aid: "CAP" for Adaptive Functioning

Conceptual (academic skills, reasoning)
Adaptive social skills (communication, interpersonal)
Practical skills (self-care, occupational)

Key Points

Early identification and intervention improve long-term outcomes significantly
Focus on child's abilities and potential rather than limitations
Family-centered care is essential for optimal development

Etiology and Risk Factors

Common Causes

Genetic disorders account for approximately 30-40% of cases, including Down syndrome, fragile X syndrome, and fetal alcohol spectrum disorders.
Prenatal factors include maternal infections (TORCH), substance abuse, malnutrition, and chromosomal abnormalities.
Perinatal complications such as hypoxia, prematurity, birth trauma, and severe jaundice can result in intellectual disability.
Postnatal causes include head trauma, infections (meningitis, encephalitis), lead poisoning, and severe malnutrition.

Clinical Scenario

A 3-year-old child with Down syndrome is brought for developmental assessment. The nurse should expect delays in which areas and prioritize which interventions?

Assessment and Clinical Manifestations

Developmental Assessment

Comprehensive assessment includes standardized developmental screening tools such as Denver II, Ages and Stages Questionnaire (ASQ).
Physical examination should assess for dysmorphic features, neurological abnormalities, and associated medical conditions.
Behavioral observations focus on social interaction, communication patterns, and adaptive responses to environment.

Obtain detailed developmental history from caregivers
Administer age-appropriate screening tools
Conduct comprehensive physical examination
Assess family dynamics and support systems
Collaborate with interdisciplinary team for comprehensive evaluation

Developmental Milestones: Typical vs. Delayed

Age	Typical Development	Concerning Signs
12 months	First words, walking	No babbling, not sitting
24 months	2-word phrases, follows commands	No words, no pointing
36 months	3-word sentences, toilet training	No phrases, aggressive behaviors

Nursing Interventions and Family Support

Therapeutic Interventions

Early intervention services are crucial and should begin as soon as possible, ideally before age 3 years.
Individualized Education Program (IEP) development ensures appropriate educational accommodations and support services.
Promote independence through structured learning opportunities and positive reinforcement strategies.
Address associated medical conditions such as cardiac defects, hearing impairments, and seizure disorders promptly.

Memory Aid: "SPECIAL" Care Approach

Safety first - prevent injuries
Positive reinforcement
Early intervention
Consistent routines
Individualized care plans
Adaptive equipment
Life skills training

Key Points

Maintain realistic expectations while encouraging maximum potential
Provide respite care resources for families to prevent caregiver burnout
Transition planning for adulthood should begin during adolescence

Commonly Confused Concepts

Intellectual Disability vs. Learning Disabilities

Aspect	Intellectual Disability	Learning Disabilities
IQ Level	Below 70-75	Average or above average
Adaptive Function	Significantly impaired	Generally intact
Academic Impact	Global delays	Specific skill deficits
Onset	Before age 18	School-age identification

Common Pitfalls

⚠️ Don't assume all children with intellectual disabilities have the same capabilities
⚠️ Avoid using person-first language incorrectly (say "child with intellectual disability" not "intellectually disabled child")
⚠️ Don't overlook associated medical conditions that require ongoing management

Study Tips and Quick Checks

NCLEX Success Tips

Remember that safety is always the priority - these children are at higher risk for accidents
Focus on promoting independence and dignity in all care approaches
Family education and support are key components of nursing care
Early intervention significantly improves outcomes - this is frequently tested

Quick Check Questions

□ Can you identify the three domains of adaptive functioning?
□ Do you know the IQ cutoff for intellectual disability diagnosis?
□ Can you list at least 3 early intervention strategies?
□ Do you understand person-first language principles?

Final Key Points

Intellectual disability is a lifelong condition requiring ongoing support and advocacy
Nursing care focuses on maximizing potential while ensuring safety and dignity
Interdisciplinary collaboration is essential for comprehensive care

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Intellectual Disability

NCLEX Review Guide: Child Health - Neurologic & Cognitive Disorders: Intellectual Disability

Definition and Classification

Intellectual Disability Overview

Memory Aid: "CAP" for Adaptive Functioning

Key Points

Etiology and Risk Factors

Common Causes

Clinical Scenario

Assessment and Clinical Manifestations

Developmental Assessment

Developmental Milestones: Typical vs. Delayed

Nursing Interventions and Family Support

Therapeutic Interventions

Memory Aid: "SPECIAL" Care Approach

Key Points

Commonly Confused Concepts

Intellectual Disability vs. Learning Disabilities

Common Pitfalls

Study Tips and Quick Checks

NCLEX Success Tips

Quick Check Questions

Final Key Points