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Signs of an intellectual disability


Intellectual Disability in Children: Causes, Symptoms, and Treatments

Written by Florence Byrd

In this Article

  • What is intellectual disability?
  • What are the signs of intellectual disability in children?
  • What causes intellectual disability?
  • Can intellectual disability be prevented?
  • How is intellectual disability diagnosed?
  • What services are available for people with intellectual disability?
  • What can I do to help my intellectually disabled child?

Intellectual disability (ID), once called mental retardation, is characterized by below-average intelligence or mental ability and a lack of skills necessary for day-to-day living. People with intellectual disabilities can and do learn new skills, but they learn them more slowly. There are varying degrees of intellectual disability, from mild to profound. The term "mental retardation" is no longer used, as it's offensive and has a negative tone.

What is intellectual disability?

Someone with intellectual disability has limitations in two areas. These areas are:

  • Intellectual functioning. Also known as IQ, this refers to a person’s ability to learn, reason, make decisions, and solve problems.
  • Adaptive behaviors. These are skills necessary for day-to-day life, such as being able to communicate effectively, interact with others, and take care of oneself.

IQ (intelligence quotient) is measured by an IQ test. The average IQ is 100, with the majority of people scoring between 85 and 115. A person is considered intellectually disabled if they have an IQ of less than 70 to 75.

To measure a child’s adaptive behaviors, a specialist will observe the child’s skills and compare them to other children of the same age. Things that may be observed include how well the child can feed or dress themselves; how well the child is able to communicate with and understand others; and how the child interacts with family, friends, and other children of the same age.

Intellectual disability is thought to affect about 1% of the population. Of those affected, 85% have mild intellectual disability. This means they are just a little slower than average to learn new information or skills. With the right support, most will be able to live independently as adults.

What are the signs of intellectual disability in children?

There are many different signs of intellectual disability in children. Signs may appear during infancy, or they may not be noticeable until a child reaches school age. It often depends on the severity of the disability. Some of the most common signs of intellectual disability are:

  • Rolling over, sitting up, crawling, or walking late
  • Talking late or having trouble talking
  • Slow to master things like potty training, dressing, and feeding themselves
  • Difficulty remembering things
  • Inability to connect actions with consequences
  • Behavior problems such as explosive tantrums
  • Difficulty with problem-solving or logical thinking

In children with severe or profound intellectual disabilities, there may be other health problems as well. These problems may include seizures, mood disorders (anxiety, autism, etc.), motor skills impairment, vision problems, or hearing problems.

What causes intellectual disability?

Anytime something interferes with normal brain development, intellectual disability can result. However, a specific cause for intellectual disability can only be pinpointed about a third of the time.

The most common causes of intellectual disability are:

  • Genetic conditions. These include things like Down syndrome and fragile X syndrome.
  • Problems during pregnancy. Things that can interfere with fetal brain development include alcohol or drug use, malnutrition, certain infections, or preeclampsia.
  • Problems during childbirth. Intellectual disability may result if a baby is deprived of oxygen during childbirth or is born extremely premature.
  • Illness or injury. Infections like meningitis, whooping cough, or the measles can lead to intellectual disability. Severe head injury, near-drowning, extreme malnutrition, infections in the brain, exposure to toxic substances such as lead, and severe neglect or abuse can also cause it.
  • None of the above. In two-thirds of all children who have intellectual disabilities, the cause is unknown.

Can intellectual disability be prevented?

Certain causes of intellectual disability are preventable. The most common of these is fetal alcohol syndrome. Pregnant women shouldn’t drink alcohol. Getting proper prenatal care, taking a prenatal vitamin, and getting vaccinated against certain infectious diseases can also lower the risk that your child will be born with intellectual disabilities.

In families with a history of genetic disorders, genetic testing may be recommended before conception.

Certain tests, such as ultrasound and amniocentesis, can also be performed during pregnancy to look for problems associated with intellectual disability. Although these tests may identify problems before birth, they cannot correct them.

How is intellectual disability diagnosed?

Intellectual disability may be suspected for many different reasons. If a baby has physical abnormalities that suggest a genetic or metabolic disorder, a variety of tests may be done to confirm the diagnosis. These include blood tests, urine tests, imaging tests to look for structural problems in the brain, or electroencephalogram (EEG) to look for evidence of seizures.

In children with developmental delays, the doctor will perform tests to rule out other problems, including hearing problems and certain neurological disorders. If no other cause can be found for the delays, the child will be referred for formal testing.

Three things factor into the diagnosis of intellectual disability: interviews with the parents, observation of the child, and testing of intelligence and adaptive behaviors. A child is considered intellectually disabled if they have deficits in both IQ and adaptive behaviors. If only one or the other is present, the child is not considered intellectually disabled.

After a diagnosis of intellectual disability is made, a team of professionals will assess the child’s particular strengths and weaknesses. This helps them determine how much and what kind of support the child will need to succeed at home, in school, and in the community.

What services are available for people with intellectual disability?

For babies and toddlers, early intervention programs are available. A team of professionals works with parents to write an Individualized Family Service Plan, or IFSP. This document outlines the child’s specific needs and what services will help the child thrive. Early intervention may include speech therapy, occupational therapy, physical therapy, family counseling, training with special assistive devices, or nutrition services.

School-age children with intellectual disabilities (including preschoolers) are eligible for special education for free through the public school system. This is mandated by the Individuals With Disabilities Education Act (IDEA). Parents and educators work together to create an Individualized Education Program, or IEP, which outlines the child’s needs and the services the child will receive at school. The point of special education is to make adaptations, accommodations, and modifications that allow a child with an intellectual disability to succeed in the classroom.

What can I do to help my intellectually disabled child?

Steps to help your intellectually disabled child include:

  • Learn everything you can about intellectual disabilities. The more you know, the better advocate you can be for your child.
  • Encourage your child’s independence. Let your child try new things and encourage your child to do things by themselves. Provide guidance when it’s needed and give positive feedback when your child does something well or masters something new.
  • Get your child involved in group activities. Taking an art class or participating in Scouts will help your child build social skills.
  • Stay involved. By keeping in touch with your child’s teachers, you’ll be able to follow their progress and reinforce what your child is learning at school through practice at home.
  • Get to know other parents of intellectually disabled children. They can be a great source of advice and emotional support.

Intellectual Disability in Children: Causes, Symptoms, and Treatments

Written by Florence Byrd

In this Article

  • What is intellectual disability?
  • What are the signs of intellectual disability in children?
  • What causes intellectual disability?
  • Can intellectual disability be prevented?
  • How is intellectual disability diagnosed?
  • What services are available for people with intellectual disability?
  • What can I do to help my intellectually disabled child?

Intellectual disability (ID), once called mental retardation, is characterized by below-average intelligence or mental ability and a lack of skills necessary for day-to-day living. People with intellectual disabilities can and do learn new skills, but they learn them more slowly. There are varying degrees of intellectual disability, from mild to profound. The term "mental retardation" is no longer used, as it's offensive and has a negative tone.

What is intellectual disability?

Someone with intellectual disability has limitations in two areas. These areas are:

  • Intellectual functioning. Also known as IQ, this refers to a person’s ability to learn, reason, make decisions, and solve problems.
  • Adaptive behaviors. These are skills necessary for day-to-day life, such as being able to communicate effectively, interact with others, and take care of oneself.

IQ (intelligence quotient) is measured by an IQ test. The average IQ is 100, with the majority of people scoring between 85 and 115. A person is considered intellectually disabled if they have an IQ of less than 70 to 75.

To measure a child’s adaptive behaviors, a specialist will observe the child’s skills and compare them to other children of the same age. Things that may be observed include how well the child can feed or dress themselves; how well the child is able to communicate with and understand others; and how the child interacts with family, friends, and other children of the same age.

Intellectual disability is thought to affect about 1% of the population. Of those affected, 85% have mild intellectual disability. This means they are just a little slower than average to learn new information or skills. With the right support, most will be able to live independently as adults.

What are the signs of intellectual disability in children?

There are many different signs of intellectual disability in children. Signs may appear during infancy, or they may not be noticeable until a child reaches school age. It often depends on the severity of the disability. Some of the most common signs of intellectual disability are:

  • Rolling over, sitting up, crawling, or walking late
  • Talking late or having trouble talking
  • Slow to master things like potty training, dressing, and feeding themselves
  • Difficulty remembering things
  • Inability to connect actions with consequences
  • Behavior problems such as explosive tantrums
  • Difficulty with problem-solving or logical thinking

In children with severe or profound intellectual disabilities, there may be other health problems as well. These problems may include seizures, mood disorders (anxiety, autism, etc.), motor skills impairment, vision problems, or hearing problems.

What causes intellectual disability?

Anytime something interferes with normal brain development, intellectual disability can result. However, a specific cause for intellectual disability can only be pinpointed about a third of the time.

The most common causes of intellectual disability are:

  • Genetic conditions. These include things like Down syndrome and fragile X syndrome.
  • Problems during pregnancy. Things that can interfere with fetal brain development include alcohol or drug use, malnutrition, certain infections, or preeclampsia.
  • Problems during childbirth. Intellectual disability may result if a baby is deprived of oxygen during childbirth or is born extremely premature.
  • Illness or injury. Infections like meningitis, whooping cough, or the measles can lead to intellectual disability. Severe head injury, near-drowning, extreme malnutrition, infections in the brain, exposure to toxic substances such as lead, and severe neglect or abuse can also cause it.
  • None of the above. In two-thirds of all children who have intellectual disabilities, the cause is unknown.

Can intellectual disability be prevented?

Certain causes of intellectual disability are preventable. The most common of these is fetal alcohol syndrome. Pregnant women shouldn’t drink alcohol. Getting proper prenatal care, taking a prenatal vitamin, and getting vaccinated against certain infectious diseases can also lower the risk that your child will be born with intellectual disabilities.

In families with a history of genetic disorders, genetic testing may be recommended before conception.

Certain tests, such as ultrasound and amniocentesis, can also be performed during pregnancy to look for problems associated with intellectual disability. Although these tests may identify problems before birth, they cannot correct them.

How is intellectual disability diagnosed?

Intellectual disability may be suspected for many different reasons. If a baby has physical abnormalities that suggest a genetic or metabolic disorder, a variety of tests may be done to confirm the diagnosis. These include blood tests, urine tests, imaging tests to look for structural problems in the brain, or electroencephalogram (EEG) to look for evidence of seizures.

In children with developmental delays, the doctor will perform tests to rule out other problems, including hearing problems and certain neurological disorders. If no other cause can be found for the delays, the child will be referred for formal testing.

Three things factor into the diagnosis of intellectual disability: interviews with the parents, observation of the child, and testing of intelligence and adaptive behaviors. A child is considered intellectually disabled if they have deficits in both IQ and adaptive behaviors. If only one or the other is present, the child is not considered intellectually disabled.

After a diagnosis of intellectual disability is made, a team of professionals will assess the child’s particular strengths and weaknesses. This helps them determine how much and what kind of support the child will need to succeed at home, in school, and in the community.

What services are available for people with intellectual disability?

For babies and toddlers, early intervention programs are available. A team of professionals works with parents to write an Individualized Family Service Plan, or IFSP. This document outlines the child’s specific needs and what services will help the child thrive. Early intervention may include speech therapy, occupational therapy, physical therapy, family counseling, training with special assistive devices, or nutrition services.

School-age children with intellectual disabilities (including preschoolers) are eligible for special education for free through the public school system. This is mandated by the Individuals With Disabilities Education Act (IDEA). Parents and educators work together to create an Individualized Education Program, or IEP, which outlines the child’s needs and the services the child will receive at school. The point of special education is to make adaptations, accommodations, and modifications that allow a child with an intellectual disability to succeed in the classroom.

What can I do to help my intellectually disabled child?

Steps to help your intellectually disabled child include:

  • Learn everything you can about intellectual disabilities. The more you know, the better advocate you can be for your child.
  • Encourage your child’s independence. Let your child try new things and encourage your child to do things by themselves. Provide guidance when it’s needed and give positive feedback when your child does something well or masters something new.
  • Get your child involved in group activities. Taking an art class or participating in Scouts will help your child build social skills.
  • Stay involved. By keeping in touch with your child’s teachers, you’ll be able to follow their progress and reinforce what your child is learning at school through practice at home.
  • Get to know other parents of intellectually disabled children. They can be a great source of advice and emotional support.

What is mental retardation?

Mental retardation is a delay in the development of the psyche, which manifests itself as a violation of the intellect and leads to social maladaptation. Unlike other mental disorders such as depression or autism, this condition is so severe that it is called a “disease” in psychiatry. Mental retardation can be either congenital or acquired.

Symptoms of mental retardation

Mental retardation is mainly manifested in a violation of the intellect and, as a result, in the absence or deterioration of functioning in society. The milder the form of mental retardation, the less impaired the cognitive functions of the child and the more independent he is and can adequately communicate with other people. With deep mental retardation, a person, even in adulthood, can walk in diapers, his speech will never develop, and he can only eat with the help of others. Such people should always be under the constant supervision of specialists and accompanying persons. Children with all forms of mental retardation, except borderline, are kept in special institutions. In the West, these are hostels or boarding schools in which they are monitored and try to develop their intelligence as much as possible. But each such child has his own "ceiling", above which it is no longer possible to develop cognitive functions. The deeper the mental retardation and the later the development of the child begins, the less opportunities for development. If a child with severe mental retardation at least does not fight or bite, this is already a great achievement.

The deeper the mental retardation, the more serious the physiological disorders, and the more such children and adults suffer from various physical diseases.

In some cases, focusing on certain signs and symptoms, mental retardation can be confused with autism. At the same time, the difference between patients with mental retardation and those suffering from ASD is that the former are always sociable and make contact. However, this contact does not meet generally accepted standards. Very often, first of all, mentally retarded children are taught the rule of "arm's length": no one has the right to approach them closer than a distance equal to an outstretched arm. Except, for example, mom or a nurse and a doctor. Such children do not feel boundaries in communication with others so much that people with bad intentions can take advantage of this, and for example, commit violent acts against them. Such a child can approach a completely unfamiliar adult person, sit on his knees, kiss him and hug him.

See also

Myths about autism

With a mild or borderline degree of mental retardation, external physical changes are not always obvious, but even with an average and deep form, dysmorphism can be noticed - a violation of the symmetry of the body and face. The deeper the mental retardation, the more serious the physiological disorders, and the more such children and adults suffer from various physical diseases.

One of the main causes of mental retardation is genetic mutations. There is an assumption that they affect both the physiology and the human intellect. Physiological disorders begin to manifest themselves most pronouncedly in adolescence - one after another, the child develops diseases. In such people, teeth often grow incorrectly, immunity is reduced, and colds often occur. The older a person with mental retardation gets, the more he gets sick. There is also an assumption that the matter is not only in genetics, but also in violation of the development of the fetus during pregnancy. An expectant mother may have a child with mental retardation, especially if she smoked, drank alcohol or drugs during pregnancy.


Diagnosis of mental retardation

Given certain external signs that are characteristic of patients with mental retardation, in some cases a specialist can quickly determine whether a person has this disease. It is possible to diagnose this disease in the first two years of life, except, perhaps, for the borderline level of mental retardation - at this stage, the disease is a little more difficult to detect. Mental retardation is often confused with autism spectrum disorders, since autism in some cases is accompanied by a delay in the development of cognitive functions. Up to 9-10 years of age, diagnosis is carried out using various clinical observations, and after this age, it is already possible to determine the disease on the IQ scale. In accordance with this scale, IQ level from 0 to 70 defines different degrees of mental retardation: borderline, mild, moderate and severe.

Specialists identify mental retardation in a child by tests and methods that a child should be able to perform at a certain age, for example, building a tower of three cubes or being interested in games.

Most often, mental retardation is diagnosed in childhood. In adulthood, it can be detected only if up to this point the person has not been in society and has not been shown to a doctor. There were cases when people who had lived for many years in the jungle were brought for diagnostics and they were diagnosed with mental retardation at the age of 30. For some types of genetic disorders, this disorder can be diagnosed before birth by testing the mother's amniotic fluid.

See also

How is Asperger's syndrome different from autism?

A special set of psychological tests is used to diagnose this disease. When a psychiatrist or neurologist sees signs of mental retardation and makes a general diagnosis, he or she will refer the patient to a psychological evaluation for a final diagnosis. Only after the final diagnosis, made by a psychiatrist and psychologist, can a patient be given a disability.

Specialists identify mental retardation in a child by tests and techniques that a child should be able to perform at a certain age, such as building a tower of three blocks or being interested in games. If a child does not cope with the tasks of tests for the diagnosis of mental retardation at a certain age, but at the same time always makes contact with other children, which excludes ASD, he is diagnosed with mental retardation. After that, specialists begin to observe the child and treat him.


Treatment of mental retardation

The treatment, or rather, the correction of mental retardation, is to start developing the child's cognitive functions as early as possible and raise his IQ as high as possible. The way children with mental retardation develop cognitive functions is very similar to working with children with autism spectrum disorders. With autism, correction is mainly aimed at improving social interaction skills, and in mentally retarded children, at developing cognitive functions and functioning as close to normal as possible in society. Speech therapists, ergotherapists, ABA-therapists work with them.

The most important thing in the correction of mental retardation is not to miss the so-called "windows of development", when only up to a certain age you can develop specific cognitive functions - reading, writing, speaking,

Each of the specialists sets himself the task of developing certain functions: counting, reading, writing, speaking, daily behavior at home, at school, in kindergarten. For example, at one stage of treatment the goal might be to be able to go to the toilet on their own, and at the next stage to learn to speak five words.

Similar functions are developed with the help of special educational tools, games and toys. Specialists also develop the ability to wash in the shower, distinguish between friends and strangers, and behave correctly with other children. The most important thing in the correction of mental retardation is not to miss the so-called “windows of development”, when only up to a certain age you can develop specific cognitive functions – reading, writing, speaking, understanding colors, counting, and so on. And if you miss these time periods, then you will no longer be able to develop certain skills and functions. For example, when Mowgli children were found in the forest after the age of 14, their cognitive functions could no longer be developed beyond the psychological age of 12 years. In this case, the child develops acquired mental retardation, because it is quite possible that initially he was born healthy, but due to circumstances he grew up divorced from civilization. If you show the child to the doctor in time, diagnose the disease and start correction with qualified specialists, it is possible to develop his cognitive functions to a certain level laid down by nature, and increase intellectual abilities.

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  3. Mental retardation in children.

Mental retardation in children is attributed to the underdevelopment of all processes of mental development, which manifests itself in a low level of intelligence, when a child is not able to learn about the world around him, learn, acquire knowledge in accordance with his biological age. According to congenital or acquired factors, such children can develop up to a certain limit of their capabilities. In the medical reference book, the disease is called "oligophrenia". The sooner the parents of a child diagnosed with mental retardation accept his individual characteristics, the sooner they can begin corrective and supportive measures.

Inhibited perception of individual objects not only requires more time, but also does not allow making a corresponding relationship between them. Graphic objects, letters, numbers, similar-sounding words in children with this diagnosis, in addition to slow and limited perception, are confused and mixed. The child cannot perceive important information, snatching out only fragments. He cannot give an analysis or description of a picture or an object. Having paid attention to a certain subject, the child does not move on to the study of the next, therefore, he needs to be encouraged to act.

The main difference from healthy children lies in the difficulty of reproducing the received information due to impaired mental activity and a speech defect. Mastering reading and writing is a rather difficult process. Children with this disease are inattentive, unable to complete what they started. Underdevelopment is also displayed on the emotional sphere, when emotions are absent or limited, and various experiences do not appear. Violated volitional processes, children are not active. Later they begin to hold their heads, crawl, walk, show interest in objects and distinguish them, babble, recognize relatives or strangers.

  • Mild mental retardation . Outwardly, such people may not differ at all from healthy people. They usually experience learning difficulties due to a reduced ability to concentrate. At the same time, their memory is quite good. The vast majority of them also achieve complete independence in personal care and in practical and domestic skills, even if development is much slower than normal. The main difficulties are usually observed in the area of ​​school performance. However, for those with mild mental retardation, education designed to develop their skills and develop compensatory abilities can be of great help. In most favorable cases of mild mental retardation, employment is possible, requiring abilities not so much for abstract thinking as for practical activity. Experience shows that in children who have experienced the trauma of losing their biological parents, who are brought up in orphanages, who have been subjected to violence, abuse, it is often difficult to distinguish between symptoms of mental retardation and socio-pedagogical neglect. When living conditions change to more favorable ones, these children, as a rule, give good dynamics in development and their diagnosis can be withdrawn or revised.
  • Moderate mental retardation . People with this diagnosis are able to experience affection, distinguish between praise and punishment, they can be taught basic self-care skills, and sometimes reading, writing, and the simplest account. Educational programs can give them opportunities to develop their limited potential and acquire some basic skills. In adulthood, persons with moderate mental retardation are usually capable of simple practical work with careful construction of tasks and the provision of qualified support. Completely independent living is rarely achieved. However, such people are generally fully mobile and physically active, and most of them show signs of social development, which is the ability to establish contacts, communicate with other people and participate in basic social activities.
  • Severe mental retardation. People with this diagnosis can partially master speech and learn basic skills for serving themselves. Vocabulary is very poor, sometimes it does not exceed ten or twenty words, thinking is very concrete, chaotic and unsystematic. Almost all children in this category have major motor impairments.
  • Profound mental retardation. In people with deep brain damage, the structures of internal organs are very often disturbed. Their speech does not develop - it is completely impaired. From early childhood, their developmental lag is noticeable, the kids begin to sit up and hold their heads late. With a severe form of mental retardation, children are inactive. With such a diagnosis, medical care for the child, social nanny services come first.

Primary manifestations of mental deficiency in children usually include symptoms and signs such as mental retardation, infantile behavior, and insufficient self-care skills. This gap becomes very noticeable by the preschool age. However, with mild mental retardation, such symptoms may not appear until school age. Much earlier, mental retardation is diagnosed in the presence of a moderate and severe degree of this disorder, as well as when mental retardation is combined with developmental defects and physical defects. Among preschool children, a clear sign is the presence of a reduced level of IQ, combined with a limited manifestation of adaptive behavioral skills. Although the individual characteristics of this disorder may vary, more often in children with intellectual deficiencies, gradual progress is noted rather than a complete cessation of development.

It is important to remember that the sooner you start rehabilitation, the better. It is also important to detect the disease early. However, the problem is that it is very difficult to diagnose mental retardation in the early stages of a child's development. As a rule, parents' suspicions arise from the age of two, when the child does not speak or speaks poorly. And only closer to three or four years is the diagnosis of “mental retardation” diagnosed, since the problem becomes apparent.

Parents should note:

  • how well and confidently the child holds the head;
  • when he learned to sit on his own;
  • how a child crawls;
  • as he pronounces the first sounds, babbles.

The main medical advice for and parents of children with mental retardation is as follows: