# A nurse is conducting a developmental assessment on a 7-year-old child suspected of having intellectual disability. Which assessment finding would be most indicative of intellectual disability in this child? > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=542465 > language: ko > subject: Child Health ## 문제 A nurse is conducting a developmental assessment on a 7-year-old child suspected of having intellectual disability. Which assessment finding would be most indicative of intellectual disability in this child? The nurse is evaluating cognitive and adaptive functioning in a 6-year-old child referred for developmental concerns. ## 보기 1. The child can count to 10 but has difficulty with simple addition problems 2. The child shows occasional temper tantrums when frustrated with tasks 3. The child prefers to play alone rather than with other children 4. The child cannot dress independently and requires assistance with basic self-care tasks **✔ 정답** **정답: 4** ## 해설 Intellectual disability is defined by deficits in adaptive functioning, such as inability to perform age-appropriate self-care tasks like dressing at age 6. Other findings (e.g., counting difficulty, temper tantrums, solitary play) are less specific and may occur in other developmental conditions. ## 심화 해설 Core Distinction: Intellectual Disability Assessment When assessing a child for a potential intellectual disability, it is essential to understand that the diagnosis rests on deficits in two key domains: intellectual functioning and adaptive functioning. While academic skills like counting and addition relate to intellectual functioning, the most indicative findings in a clinical setting often involve adaptive behavior—the collection of conceptual, social, and practical skills that people learn to function in their everyday lives. A screening tool like the SCIL (Screener for Intelligence and Learning Disabilities) is designed to capture this dual challenge, as its validation process involves comparing its results against assessments of both general intellectual functioning and adaptive behaviour [1]. Option 4, the inability to dress independently and requiring assistance with basic self-care, is a direct reflection of a significant deficit in practical adaptive skills. For a 7-year-old, independent dressing is a well-established developmental milestone. A failure to master this skill points to a substantial limitation in personal care, which is a hallmark criterion for intellectual disability. This contrasts sharply with the other options, which can represent normal variations in development or behavioral concerns that are not specific to intellectual disability. Analysis of Assessment Findings Let's break down why the other options are less indicative of a core intellectual disability: - **Option 1: Difficulty with simple addition.** This finding reflects a potential delay in academic or conceptual skills. While it may signal a learning disorder in mathematics (dyscalculia), it does not, by itself, indicate a global deficit in adaptive functioning. A child can struggle with math but still independently manage self-care and social routines. - **Option 2: Occasional temper tantrums.** This describes a behavioral response to frustration. While children with intellectual disabilities may exhibit challenging behaviors, tantrums are common in typically developing children as well. This is a non-specific finding and not a diagnostic criterion for the disability itself. - **Option 3: Preference for solitary play.** This pattern might suggest difficulties with social adaptive skills or could be a temperamental trait. While social skill deficits are part of the adaptive functioning domain, a simple preference for playing alone is not a definitive sign of a clinically significant deficit. Many children without disabilities prefer solitary activities at times. The critical difference lies in the severity and pervasiveness of the deficit. The screening and diagnostic process for intellectual disabilities, as supported by tools like the SCIL, requires evidence that limitations in reasoning, problem-solving, and adaptive skills are substantial enough to impair daily life across multiple environments [1]. Needing help with basic self-care at age 7 is a clear, observable marker of such a pervasive impairment in practical adaptive functioning, making it the most indicative finding among the options provided. References (research sources) - [1]Preliminary Testing of the English Version of the Adolescent Screener for Intelligence and Learning Disabilities (SCIL) Among Adolescents in Nigeria.Research articleNwokolo EU, Murphy GH, Mensink AM, Moonen X, Langdon PE. (2026) · DOI: 10.1111/jir.70136 ## 임상 시나리오 Assessing Adaptive Functioning in ChildrenFocus on practical skills over academic ability for intellectual disability screening A diagnosis of intellectual disability requires deficits in both intellectual and adaptive functioning. For a 7-year-old, inability to perform self-care tasks like dressing independently is a critical red flag, as this milestone is expected by age 5 to 6. Always evaluate practical skills (self-care, safety) alongside conceptual (academics) and social skills. A child who can count but cannot manage basic needs demonstrates the hallmark gap between intellectual potential and daily application. CautionDo not rule out intellectual disability based solely on isolated academic skills like counting. Temper tantrums or a preference for solitary play are often behavioral or temperamental variations and do not constitute core diagnostic criteria. ## 핵심 개념 - **Adaptive Functioning** — The collection of conceptual, social, and practical skills learned to function in everyday life; deficits in this domain are a core criterion for intellectual disability. - **Intellectual Disability** — A neurodevelopmental disorder characterized by deficits in both intellectual functioning (e.g., reasoning, problem-solving) and adaptive functioning, with onset during the developmental period. - **Developmental Milestone** — A set of functional skills or age-specific tasks that most children can do at a certain age range; independent dressing is typically mastered by age 5-6. - **SCIL** — Screener for Intelligence and Learning Disabilities, a tool designed to capture deficits in both general intellectual functioning and adaptive behavior. ## 같은 주제 문제 - [A nurse is conducting a developmental assessment on a 5-year-old child suspected of having…](https://mymerci.kr/pages/nclex_q.php?qn_id=542466) - [A nurse is caring for a 10-year-old child with mild intellectual disability who is being p…](https://mymerci.kr/pages/nclex_q.php?qn_id=542467) - [A nurse is caring for a 12-year-old adolescent with mild intellectual disability who is be…](https://mymerci.kr/pages/nclex_q.php?qn_id=542468) - [A nurse is caring for a 10-year-old child with mild intellectual disability who is being a…](https://mymerci.kr/pages/nclex_q.php?qn_id=542469) --- More free questions: [기출문제](https://mymerci.kr/) _학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요._