Intellectual Disability
Basic Information
Neurodevelopmental illness with multiple etiologies, depicted by deficits in intellectual and adaptive functioning
Presents before 18 years of age
Kids with global developmental uncertainty at younger ages are more likely to be deduced with intellectual disability at an older age, when more reliable IQ testing can be accomplished.
Evaluation and Diagnosis
Evaluation and Diagnosis
Detailed medical history, and prenatal and birth records.
Full family chronology of at least three or more generations.
Full physical and neurologic examinations, paying attention to dysmorphic and neurologic or behavioural signs that may point to a specific recognizable syndrome or diagnosis.
IQ/cognitive testing.
Clinical hereditable evaluation, including chromosomal microarray, screening for inborn errors of metabolism: serum total homocysteine, acyl-carnitine profile, amino acids; and urine organic acids, glycosaminoglycans, oligosaccharides, purines, pyrimidines, GAA/creatine metabolites; fragile X testing.
Brain magnetic resonance imaging (MRI) is not a routine part of examination but is done if the workup described previously reveals microcephaly, macrocephaly, or abnormal findings on neurologic examination.
Treatment
The keystone of management for intellectual disability is a multidisciplinary comprehensive plan developed by the child’s special educators, language therapists, behavioural therapists, occupational therapists, teachers, parents, and medical professionals.
Early sign of children with developmental delays is important.
Start early intervention services for children from birth to 3 years of age, and start early childhood education services for children aged 3 to 5 years.
Adaptive equipment, individualized education programs, extra time, family or other support persons
Treatment of pain (constipation, neuropathic pain, dental caries), emotional distress, maladaptive behaviours (kicking, rocking, screaming)
Written, verbal, and/or picture communication.
Attention to dosing of anaesthetics to avoid adverse effects common in children with intellectual disability.
Protection from and close surveillance for sexual abuse/assault.
