5 - Intellectual disability

Summary

Case

Ranjit was brought by his father to the clinic because Ranjit was very slow to learn. At 5 years most of his skills were more like those of a boy half his age. He had only just learned to feed himself with a spoon. He still soiled and wet himself day and night. His language was more like that of a 2-year-old. He could say single words but had no sentences. He had been able to walk by 18 months and, although he was a bit floppy, his leg and arm movements were more or less up to his age level. No one else in the family had been slow to learn. His father was a junior clerk in the civil service. Ranjit's behaviour was generally good. He was an obedient, rather passive boy. What should the health professional do?

Information about intellectual disability

In Chapter 4 we described children whose development was slow in just one or two areas. In this chapter we describe children whose development is slow or very slow in all or nearly all areas.

As children grow older, they develop a range of abilities, skills and capacities, and become more adapted to their environments. The main skills acquired are to do with movement, language and social relationships. Some are slower to acquire these skills than others and some children never acquire skills at an adult level.

Children whose abilities are at or below the level of children half their age have severe intellectual disability. Children who are more intelligent than this but are only at or below the level of children about three-quarters of their age have mild intellectual disability. For example, a 12-year-old child who is functioning at or below the level of a 6-year-old has severe intellectual disability. A 12-year-old child who is at a level between 6 and 9 years old has mild intellectual disability. A child of 12 years who is at a 9- to 11-year level may be a little slow but is within the normal range. Severe and, to a lesser degree, mild intellectual disability affect the way children function in a variety of ways:

1. • ability to walk and use hands

2. • self-care, such as feeding, washing, using the toilet independently

3. • talking and understanding language

4. • social functioning, such as playing with other children.