Intellectual Disability (Mental Retardation) In Children

The World Health Organisation (WHO) has estimated that as many as 10-20% of all children and adolescents have some form of mental disability, with half of them occurring by the age of 14. Parenting itself is a tough job, and those with children who are intellectually disabled can be in a difficult spot. However, due to the negative stigma attached, most people are unaware that there are different degrees of intellectual disability, which we shall discuss in this article. We will also shed some light on the issues involved in dealing with children with intellectual disability and how you can help intellectually-abled children lead a better life.

What Is Intellectual Disability?

This classification is given to children with poor IQ, typically in the range of 70-75 or less. They have low adaptive behaviour or daily living skills (eating, dressing, communication and social skills they are slower than their peers in acquiring life skills such as speech development or logic.

Types of Intellectual Disability in Kids

Intellectual disability has been stereotyped by movies and television shows. They have made people believe that a mentally disabled person is slow and dim-witted, often ridiculed as the village idiot. In reality, this disability is nuanced with different scales of limitation, and there is room for improvement for those afflicted.

Here are the different levels of intellectual disability:

• Mild Intellectual Disability: More than 85% of kids with the disability fall in this category and have no trouble until shortly before high school. With an IQ of around 50-69, they are sometimes unable to grasp abstract concepts but can, by and large, learn at a considerably fast rate and function independently. 
• Moderate Intellectual Disability: Falling under the IQ range of 36-49, they constitute about 10% of the children that are afflicted with intellectual disability. These children can be integrated into society as they can pick up speech and essential life skills; however, their academic performance is likely to be dismal, and they would perform poorly in school. These children can have some amount of autonomy but cannot remain independent for a long duration.
• Severe Intellectual Disability: With an IQ of 20-35, these kids are in a minority of 3-4%. Through extensive training, kids with severe intellectual disability may be able to learn necessary life skills, but because they have an abnormal development, they would need frequent assistance.
• Profound Intellectual Disability: This is the most severe form of disability and is also the rarest, with only 1-2% of mentally challenged children constituting this group. They have IQ less that 20. They are severely handicapped and require extensive supervision due to poor life skills. However, with regular training and setting a routine, they may be able to pick up some essential skills.

Causes of Intellectual Disability in Children

Although most causes of intellectual disability cannot be identified, there are some that can be related to this disability. Some of them are:

• Genetic: Over 30% of mental retardation is attributed to genetics. These children are likely to suffer from problems such as Down Syndrome and fragile X syndrome.
• Head Trauma: A severe head injury can cause inflammation in the brain. This can change the mental state of the child and lead to difficulties in memory, attention and reasoning.
• Pregnancy-Related Issues: Pregnant women who do recreational drugs, smoke and drink alcohol can severely affect the brain development of the foetus.
• Illness: Children suffering from measles can develop encephalitis, which causes intellectual disabilities. Infants suffering from congenital hyperthyroidism are also at the risk of poor brain development.
• Exposure to Toxic Materials: Elements such as mercury, lead and cadmium are known to affect intellectual growth and cause intellectual disability.
• Many cases of intellectual disability are due to unknown aetiology.

Signs and Symptoms of Intellectual Disability in Children

Not every child is the same. Thus, even children with intellectual disability show different signs and symptoms. These signs depend completely on the level of their disability. The most important thing in children with an intellectual disability is their inability to navigate the tasks of daily living, and participation in family, school, and community activities. Other symptoms and signs of intellectual disability in children:

• Difficulty in articulating a point
• Learning speech at a slower rate
• Misplacing objects
• Having trouble remembering things
• Poor academic performance
• Overall low intelligence
• Poor performance in IQ tests
• Particular attention required to learn simple skills
• Have trouble putting on clothes

Other than these, intellectually disabled children also show behavioural symptoms like –

• Aggression
• Depression
• Anxiety
• A tendency to inflict injury on self
• Are impulsive
• Have suicidal thoughts
• Have poor interpersonal relationships
• Depend excessively on parents
• Are unable to respond to situations in a measured manner
• Have a low attention span

Characteristics of Intellectually Disabled Children

Intellectually disabled, also known as differently-abled children, portray the following characteristics:

• Bad Memory: These kids have a short-term memory recall. However, when doing a task repeatedly, they can recall information without displaying any symptoms of mental retardation.
• Slow Learning Curve: Their ability to process new information is relatively lower than the normal, but that does not mean they are incapable of learning. Some educationists are of the view that slowing down the speed of instructions can help in better reception of information.
• Attention Deficiency: They are unable to sustain their attention for too long on a single task. A good way of tackling this deficiency is by making them aware of the most crucial aspect of their work and then building their attention from thereon.
• Disinterest: Due to repeated failures, some children don’t trust their skills, even if they are correct. Over time, they lose faith in their abilities and become disinterested in learning.
• Independent Living: On the brighter side, children with special needs can be trained in repetitive tasks which they can master over time. This can help them stay independent for a short duration of time and also prepare them for adulthood.
• Inability to Restrain Emotions: As children grow older, they can give measured responses when they come face-to-face with unknown situations. Children with mental disabilities are unable to do this and may respond unpredictably, usually displaying aggression. Once the episode is over, they can sense that they have misbehaved and are capable of feeling like they are a burden.
• Social Development: Due to bizarre outbursts and poor language skills, they may be unable to have healthy social interactions.
• Application of New Ideas: They are unable to incorporate any newly acquired skills innovatively.

Diagnosis of Intellectual Disability

There a few ways to diagnose intellectual disability in kids. Blood tests, urine tests and imaging can be done if there are physical abnormalities. Other tests, like the ones given below, are done to gauge skills like reasoning, language, cognitive, etc. Here’s a brief of the different tests that can help identify the level of intellectual disability in a child:

• Stanford-Binet Intelligence Scale: This test gauges quantitative reasoning, knowledge, fluid reasoning, visual-spatial processing and memory. It is one of the primary tests that identify learning disorders in children.
• Kaufman Assessment Battery for Children: This test is used to assess the cognitive development of a child. The types of tests carried out are wide-ranging and vary based on the age of the child. This test is not a stand-alone test, meaning that the results of this analysis must be seen in conjunction with other tests.
• Bayley Scale of Infant Development: This is a standardised test for infants between 1-42 months of age, wherein the child’s motor, language and cognitive skills are tested. This test can help to screen out children who are prone to having development problems in the future.
•  DSM 5 Diagnostic Criteria – Its components are reasoning, problem-solving, planning, abstract thinking, judgement, academic learning and learning from experience. In this test, a score of 65 to 75, is indicated as Intellectual disability.

Treatment of Intellectual Disability

There is no medical “cure” for intellectual disability. However, there are therapies with the help of which you can enrich the lives of intellectually disabled children and help them live a pleasant childhood. Read on to know some of them.

• Replacement: Replacement of deficient molecules like thyroxine, Enzyme replacement in MPS etc is the most important treatment intervention.
• Stem Cell Therapy: This therapy can be beneficial for children who have Down Syndrome. While it cannot eliminate the disability, it can help repair any damaged cells that affect their cognitive abilities. Post the treatment, a considerable improvement in the cognitive abilities has been observed in several children who have Down Syndrome.
• Acupuncture: Studies have shown that children who are given this form of treatment saw a marked increase in their IQ scores and observed improved social skills as well.
• Home Schooling: As the pace of learning is slow, homeschooling is a good option where the child can thrive in a protected environment. If the child has better auditory skills than visual, the entire learning experience can be changed based on the child’s needs. This flexibility would not be available in schools.
• Special Needs Schools: These schools are specially made for children with disabilities to study under the same roof. The classes are conducted at a slower pace, and hence the children can grasp concepts quickly and apply them in their day-to-day lives.

Prevention of Intellectual Disability

Most cases of intellectual disability are genetic; however, there are some cases wherein the parents have had the ability to prevent it. Here are some ways you could prevent intellectual disability in your child:

• Pregnant women should avoid doing drugs, smoking or drinking as it can lead to neural defects in the foetus.
• Children should be immunised against diseases that cause mental disorders such as measles.
• Women suffering from hyperthyroidism need to get treated as it can also lead to a foetus with neural defects.

Problems Faced by Intellectually Disabled Children

Intellectual disability majorly affects the overall development of the child. He/she may find it challenging to cope with several problems as well which are not only related to the development of the brain but also include psychological and social issues. Here are some common challenges faced by intellectually disabled children:

• Social Isolation: Perceived as slow, these kids are often ostracised by their peers. All it takes is one rumour, and most kids would start avoiding a mentally disabled child. Not just them, even the ones who try to befriend them are ridiculed.
• Bullying: Many kids with disabilities are bullied by their peers and are often called unflattering names. Most of these cases occur due to hatred, contempt and lack of patience and empathy towards the intellectually disabled children.
• Low Self-Esteem: Consistently poor academic performance can have a negative impact on the psyche of intellectually disabled children. Complex topics might be difficult to grasp for any child; however, poor academic performance in subjects that their peers outclass them easily may make them have a low opinion of themselves.
• Loneliness: Due to social isolation and bullying, many children with mental disabilities suffer from loneliness.
• Medical Problems: Children who suffer from profound mental retardation are likely to have other health complications as well. These could include reduced vision, hearing issues, poor motor function, etc., which may be present from birth or develop eventually during the growth years.

Parenting Tips to Help Raise a Child With Intellectual Disability

Parents can play a significant role in treating and raising a child with an intellectual disability. Here are a few tips to help build a differently-abled child:

• Encourage Independence: Children with mental disabilities have a slow learning curve. A parent telling their child that he/she cannot do anything will make him even more dependent and foster low self-esteem. One method to make kids independent is by breaking down complex tasks/ideas into simple ones and encouraging children to do them independently. Allow them as much time as they need and be patient through the entire task.
• Follow Up On Academic Progress: Be active at parent-teacher meetings to find out what the strengths and weaknesses of your child are. Parent-teacher conferences can be an excellent forum through which you can keep track of your child’s development. Always strive for a healthy exchange of ideas with the teachers to bring about the much-required development in your child.
• Let the Child Socialise: Many parents limit their child’s interactions with others in a bid to protect them. Then, there are some who wish to avoid unpleasant situations. While these are legitimate reasons, making a child socially active would foster a sense of normalcy. So, let your socialise and even fight his/her own battles.
• Support Groups and Networking: Taking care of a child with disabilities is difficult for parents. The stress could lead to arguments and put them in a depressive state of mind. It can be helpful to know that there are other parents out there who are going through the same ordeal. Networking helps parents a lot, as it not just acts as a support group, but also becomes a place where parents can share their experiences and ideas to come up with new ways of raising kids with intellectual disabilities.
• Educate Yourself: Raising a mentally challenged child may be difficult, and counselling sessions with experts can help in overcoming these difficulties. Even if you are unable to meet an expert, you can refer to some books that can help you deal with certain issues parents face with their intellectually disabled kids. Here are some good books that can help you deal with intellectually disabled children:
  • When Your Child Has Disabilities by M.L. Batshaw
  • A Parent’s and Teacher’s Guide to the Special Needs Child by Darrell M. Parker
  • Caring for your disabled child by Benjamin Spock.

• Routine: Develop a habit that can be followed by your child. School can be stressful, and a safe environment at home with a predictable routine can help them feel secure. Routines also help intellectually disabled children get used to and build the skills that they can use in their adulthood.
• Praise and Reward: Due to the challenges the intellectually disabled children face every day, low self-esteem issues are typical, and they need constant appreciation and affection to overcome this issue. Encouragement through a reward system can help boost their self-confidence. However, avoid any negative punishments as it is likely to demotivate them.
• Behaviour Management: Children with mental disabilities may find it difficult to cope with certain situations. It is essential that they don’t dwell on their inability to comprehend things. Diverting their mind would be a good idea in such situations. Something as simple as giving them headphones and making them listen to music or playing their favourite game would help in diverting their mind.

Many children who have intellectual challenges have, in time, learned to overcome their disability and live near-normal lives. Even in the most difficult cases, children have responded well to proper treatment with many showing a semblance of normalcy.

References: Webmd

Also Read: How to Deal with Dizziness in Children