Chapter 11 Mental Retardation (Intellectual Disabilities) TRUE OR FALSE 1. In 2010, President Obama signed Rosa’s Law. This law changed the terminology in federal law from mental retardation to intellectual disability. Answer: True 2. The American Association on Intellectual and Developmental Disabilities (AAIDD) defines subaverage intellectual functioning as having intelligence test scores that fall about two or more standard deviations below the mean on standardized tests of intelligence. Answer: True 3. The American Association on Intellectual and Developmental Disabilities classifies retardation according to four levels of severity of retardation. Answer: False 4. According to the DSM-IV classification of intellectual disability, about 85 percent of cases of MR fall into the mild level of retardation. Answer: True 5. Historically, intellectual functioning was considered low enough for intellectual disability when the intelligence test score fell only one standard deviation below the mean. Answer: True 6. Alfred Binet viewed intelligence as a stable, biologically predetermined attribute of the individual. Answer: False 7. Scores from intelligence tests such as the Stanford Binet and the Wechsler tests are moderately stable, with test-retest correlations averaging 77. Answer: True 8. The everyday behaviors of people, which are measured by adaptive behavior scales, are unrelated to their intelligence as measured by general tests of intelligence. Answer: False 9. Abnormalities in physical appearance and function are especially associated with more severe levels of intellectual disability. Answer: True 10. Children with moderate or high levels of disability are able to learn through operant conditioning but youngsters of lower levels of retardation lack this disability. Answer: False 11. The kinds of behavioral problems shown by youth with retardation are notably different than those shown by the general population of youth. Answer: False 12. When children below school age are identified with intellectual disability, they tend to display mild delay. Answer: False 13. A person who is diagnosed with intellectual disability might only meet that criteria for a certain portion of his or her lifetime. It is possible to develop adequate intellectual or adaptive skills so that the criteria for the disorder are no longer met. Answer: True 14. The rate of development in intellectual disability is slower than typical development, but often steady. Answer: True 15. Research has proven that children with intellectual disability do not follow the Piagetian model of cognition. Answer: False 16. Biological or organic risk is more strongly related to severe intellectual disability than to mild intellectual disability. Answer: True 17. The Kallikak family study conducted by Goddard was designed to prove that intellectual disability is an inherited trait that runs in families. Answer: True 18. Research indicates that the IQ scores of siblings of individuals with intellectual disability are more consistent (similar to the person with ID) when the level of impairment is mild. Answer: True 19. Parenting is not a strong predictor of cognitive and academic performance. Answer: False 20. Most cases by far of Down syndrome are caused by the presence of three, instead of two, copies of chromosome 21. Answer: True 21. Research by Bailey et al., (2009) found that individuals with Fragile X tend to have strong daily living skills and weak communication skills. Answer: True 22. Individuals with Williams syndrome tend to have IQs in the severe range of intellectual disability. Answer: False 23. Williams syndrome is associated with musical aptitude and an outgoing personality. Answer: True 24. Prader-Willi syndrome is the most common cause of intellectual disability. Answer: False 25. Reconstructive facial surgery for children with Down syndrome is a widely accepted practice. Answer: False 26. Research clearly indicates that facial reconstruction surgery for children with Down syndrome decreases the stigmatization they may encounter. Answer: False 27. When comorbid with behavioral problems, intellectual disability in children is often correlated with parental stress, depression and anxiety. Answer: True 28. The Wechsler Preschool and Primary Scales of Intelligence III (WPPSI-III) is a comprehensive cognitive measure for children birth to age 4. Answer: False 29. Communication, daily living skills, motor skills, and socialization are areas evaluated by the Vineland Adaptive Behavior Scales. Answer: True 30. The case of the “Wild Boy of Aveyron” did much to delay progress and discussion in the treatment of intellectual disability. Answer: False 31. The concept of normalization contends that each individual has the right to life experiences that are as normal and least restrictive as possible. Answer: True 32. Detection of PKU has aided in efforts to prevent intellectual disabilities. Answer: True 33. Recent research concludes that premature newborns receiving body massage and exercise gain weight and leave the hospital faster than preemies receiving no intervention. Answer: True 34. Research on Head Start found that children in the program did not differ from children who did not receive services in regard to cognitive and social benefits. Answer: False 35. As a result of IDEA, most young people diagnosed with ID are solely into regular education classrooms, spending 60% or more of their day with general education students. Answer: False 36. The case study on Jim, the young man with multiple disabilities at birth, demonstrates the importance of parents advocating for their children. Answer: True 37. Research on parents of children with severe intellectual disability indicates that 90% believe full inclusion for their child is a good idea. Answer: False 38. Being in the presence of normally developing peers has been shown to facilitate social interaction for intellectually disabled children. Answer: True 39. There is no evidence that participation in the Special Olympics has a significant impact on self- esteem. Answer: False 40. Positive Behavioral Support (PBS) relies heavily on functional assessment. Answer: True 41. When Jimmy bites himself, his teacher withdraws her request that he complete an in-class assignment. This is an example of a positive reinforcer. Answer: False 42. Jimmy’s teacher decides to begin reinforcing Jimmy’s on-task behavior and ignoring him when he bites himself. She is monitoring his reactions to these interventions. This is called functional analysis. Answer: True 43. The aim of Functional Communication Training is to teach children to replace a maladaptive behavior with an adaptive behavior. Answer: True 44. There is a great deal of research to support the use of psychotherapy with individuals who have intellectual disability. Answer: False MULTIPLE CHOICE 45. In their study on the term “retard”, Siperstein, Pociask and Collins (2010) found A. 10 percent of study participants had heard a person call someone a “retard”. B. None of the study participants had ever heard a person call someone with intellectual disabilities a “retard”. C. 20 percent of the participants reported they had used to term to refer to a person with intellectual disabilities. D. Males were more likely to oppose the term than females. Answer: C 46. The AAIDD diagnosis of intellectual disability requires A. the onset of symptoms prior to age 12. B. a score of 80 or less on a standardized test of intelligence. C. neurological findings suggesting retardation. D. adaptive skill deficits in at least two areas. Answer: D 47. The relatively recent paradigm shift taken by the AAIDD argues that A. ID must be understood as interactions between a person with limited intelligence and his or her environment. B. ID must be understood as a problem in motivation by a person with limited intelligence. C. most cases of intellectual disability are attributable to organic variables. D. most cases of intellectual disability are attributable to family variables. Answer: A 48. The AAIDD no longer categorizes individuals with cognitive impairment by levels of delay but rather by A. age groups. B. social class. C. levels of needed environmental supports. D. levels of brain dysfunction. Answer: C 49. Most present definitions of ID suggest which approximate criterion on tests of general intelligence? A. One or more standard deviations below the mean B. Two or more standard deviations below the mean C. A score of about 85 D. A score of about 65 Answer: B 50. Which of the following is a level of intellectual disability set by the DSM-IV on the basis of intelligence test scores? A. Medium intellectual disability B. Significant intellectual disability C. Trainable retardation D. Moderate retardation Answer: D 51. The DSM-IV category of moderate ID is equivalent to which category in the education system? A. Trainable B. Profoundly handicapped C. Educable D. Severely handicapped Answer: A 52. Alfred Binet A. believed that intelligence was somewhat malleable. B. focused on the biological causes of mental deficiency. C. adopted the idea of the intelligence quotient as an indicator of intelligence test performance. D. argued for the usefulness of eugenics. Answer: A 53. The _________ approach focuses more on the products of intellectual and cognitive abilities and views intelligence as consisting of a general ability and numerous specific abilities. A. AAIDD B. educational C. psychometric D. information processing Answer: C 54. The term eugenics refers to A. the origins of individual differences. B. improvement of a species through control of inheritance. C. the effort to normalize the experiences of youth with ID. D. the effort to create ideal environments for youth with ID. Answer: B 55. Who was responsible for construction of the first Stanford-Binet test of intelligence? A. Binet B. Simon C. Stanford D. Terman Answer: D 56. Nina is an 8-year-old who has an IQ of 75. What is her mental age? A. 6 B. 7 C. 8 D. 9 Answer: A 57. Which case resulted in restrictions on the use of intelligence tests for placing black children in special education in California? A. Buck v. Bell B. Brown v. Board of Education C. Collins v. Delano D. Larry P. v. Riles Answer: D 58. Which of the following is true of intelligence tests? A. The tests are criticized for being culturally biased. B. Tests scores do not predict academic achievement. C. Tests scores are not related to later employment and income. D. Test scores in the population remain stable over time. Answer: A 59. Intelligence test performance is _________ stable for persons with intellectual disability than for nondisabled persons, especially for _________. A. more; the mildly disabled B. more; the severely disabled C. less; the mildly disabled D. less; the severely disabled Answer: B 60. Intelligence tests are to _________ as adaptive behavior scales are to _________. A. Binet; Doll B. Doll; Terman C. Terman; Stanford D. Stanford; Binet Answer: A 61. What is the relationship between measures of adaptive behavior and intelligence? A. There is no relationship at all. B. There is some overlap, but adaptive behavior and intelligence are not identical. C. There is a strong relationship, which implies that these measures tap the same abilities. D. There is no evidence about this relationship. Answer: B 62. Danny displays mild intellectual disability. Thus, Danny A. has an IQ in the 35-40 to 50-55 range. B. will probably achieve no more than second grade academic skills. C. will probably attend a residential school. D. will probably achieve adult vocational and social skills for self-support. Answer: D 63. The case study on Annalise who exhibited profound intellectual delay, demonstrated which of the following? A. The fact that profound intellectual delay is not typically recognized until the child enters school. B. The fact that profound intellectual delay is often most attributed to socio-cultural factors. C. The fact that individuals with profound intellectual delay often perform fairly well socially. D. The fact that individuals with profound intellectual delay often have significant medical problems. Answer: D 64. Which is true of individuals with intellectual delay? A. Cognitive processing has been studied primarily in individuals with severe disability. B. Of the many processing abilities examined, attention is one for which there are few deficits. C. Their lifespan is typically shorter than the average lifespan. D. Social skills are significantly delayed for all individuals with intellectual disability. Answer: C 65. The rate of behavioral problems for youth with intellectual disability is _________ the rate found in the general population. A. half B. 2 to 4 times C. 6-8 times D. 10-12 times Answer: B 66. Behavioral and emotional disorders in youngsters with intellectual disability A. may be difficult to identify due to overshadowing. B. follow a different developmental trajectory. C. are consistent across levels of intellectual disability. D. are easy to identify due to the severe nature of the problems. Answer: A 67. Research indicates that the prevalence of ID is A. no different for boys and girls. B. no different across socioeconomic groups. C. higher for school-age youth than for other age groups. D. consistent across geographic areas in the U.S. Answer: C 68. Etiology is unknown for what percentage of the more severe cases of intellectual disability? A. 75 B. 45 to 50 C. 5 to 10 D. 10 to 20 Answer: C 69. Which level of ID has been associated with the terms garden variety or undifferentiated delay? A. Mild B. Moderate C. Severe D. Profound Answer: A 70. About what percentage of the variation in intelligence test scores in the general population is due to inheritance? A. 25 B. 50 C. 65 D. 75 Answer: B 71. Which of the following is a bio-medical cause or risk for intellectual disability? A. Poverty B. Maternal malnutrition C. Parental drug use D. Prematurity Answer: D 72. Research has documented the association of certain genetic syndromes with specific sets of behaviors. Which term has been applied to this finding? A. Behavioral genotype B. Behavioral phenotype C. Genetic variance D. Genetic mutuality Answer: B 73. Which of the following is true regarding Down syndrome? A. These individuals tend to have enlarged brains. B. There is evidence that synaptic pruning does not occur. C. Abnormal plaques and tangles are common in these individuals by age 40. D. Additional heath problems are rare. Answer: C 74. Research on Down syndrome has established that A. cognitive impairment is usually in the moderate to severe range. B. the prevalence of cases decreases with maternal age. C. life expectancy is about 40 years. D. pragmatic language and social skills are especially impaired. Answer: A 75. Which is of the following is true of fragile X syndrome? A. Males inherit the disorder from their fathers. B. The range of impairment id dependent on the number of repeats on the FMR1 gene. C. It is the number one known cause of intellectual disability. D. Females tend to have a more severe form of the syndrome. Answer: B 76. “The Down Syndrome Advantage” pertains to A. the idea that individuals with Down Syndrome tend to grow out of the cognitive impairment. B. the idea that individuals with Down Syndrome tend to have a longer life span than the average person. C. the idea that individuals with Down Syndrome collect more from social security/disability than those with other syndromes. D. the idea that individuals with Down Syndrome are easier to parent than children with other syndromes. Answer: D 77. Which genetic syndrome is especially associated with striking deficits in visual-spatial skills and fluent language skills? A. Fragile X syndrome B. Down syndrome C. Polygene syndrome D. Williams syndrome Answer: D 78. Which is true regarding Prader-Willi syndrome? A. The intellectual deficits are in the severe range. B. Hyperphagia is often present. C. Most cases are caused by both chromosome 15s being inherited from the mother. D. Cases due to paternal deletion on chromosome 15 demonstrate higher intellectual functioning. Answer: B 79. Developmental (infant) tests of intelligence A. may substitute for intelligence tests when the impairment is severe. B. correlate strongly with later performance on intelligence tests. C. rely heavily on language skills. D. rely heavily on abstract thinking skills. Answer: A 80. On which intelligence test does the examinee achieve scores in Fluid Reasoning, Knowledge, Quantitative Reasoning, Visual –Spatial Processing, and Working Memory? A. Wechsler B. Bayley C. Stanford-Binet D. Vineland Answer: C 81. Which two basic information-processing skills does the Kaufman Assessment Battery for Children evaluate? A. Language and motor B. Motor and perceptual C. Perceptual and sequential D. Sequential and simultaneous Answer: D 82. The case of Victor, the Wild Boy of Aveyron, is important because A. Itard showed that the deficits were caused by genetic abnormalities. B. Itard showed that the deficits were caused by environmental deprivation. C. it stimulated interest in intellectual disability. D. it was among the earliest successful interventions for ID. Answer: C 83. The middle to late 1800s witnessed optimistic views about intellectual disability. Which of the following was detrimental to these attitudes? A. The development of behaviorism B. The belief that intellectual disability was caused by lack of stimulation C. The misuse of intelligence tests D. The development of residential schools designed to educate children with ID Answer: C 84. In regard to the living arrangements of youth with intellectual disability, A. most live with their families. B. approximately 47 percent live in out of home placements. C. most live with families in the early years and then move to institutions in their late teens or early 20s. D. there has been little change in living arrangements since the early 1900s. Answer: A 85. Project Head Start is an example of a(n) A. direct instruction program. B. genetic mapping project. C. early intervention program. D. job placement program. Answer: C 86. Which is true concerning the education of youngsters with ID? A. Full inclusion into general education classrooms is now occurring for most children with ID. B. IDEA was designed to exclude children with ID. C. Classroom variables (e.g., quality of instruction) may be more important to student outcome than actual placement into types of classrooms. D. Controversy over educational placement has dwindled because evidence for academic and social benefits of full inclusion is now indisputable. Answer: C 87. Which characterizes discrete trial learning with youngsters with intellectual disability? A. Learning trials are initiated by the child. B. Learning is designed to occur in natural situations, such as during at-home parent-child interactions. C. It is believed to be particularly useful for enhancing generalization of skills. D. Learning is structured with the trainer strongly directing the tasks and consequences to the child. Answer: D 88. Behavioral treatment for intellectual disability A. has focused almost exclusively on academic training. B. has relied most heavily on classical conditioning. C. has often involved the training of caregivers in various settings. D. has been unsuccessful in the training of social skills. Answer: C 89. Which of the following is true regarding self-injurious behavior in individuals with intellectual disability? A. Approximately 50% of individuals with intellectual disability exhibit self-injurious behaviors. B. There is evidence that self-injurious behavior can be difficult to change. C. Medication and aversive techniques have been the most effective for treating self-injurious behaviors. D. There is little evidence that self-injurious behaviors are influenced by environmental variables. Answer: B 90. In Newsom’s approach to comprehensive analysis of maladaptive behavior, what term is applied to the most distal variables that might influence behavior, such as a child’s fatigue or prior unpleasant social interaction? A. setting events B. negative consequences C. antecedent stimuli D. escape or avoidance events Answer: A 91. A basic premise of Functional Communication Training is that a child’s maladaptive behavior A. serves a function for the child and can be reduced by teaching the child an adaptive behavior that serves the same function. B. originates from some biological disturbance that can be reduced either through medication or classical conditioning. C. functions in some way that is positive to caretakers and thus is unlikely to be reduced without dealing with caretakers’ needs. D. usually develops over a long period of time and its reduction thus requires lengthy intervention. Answer: A 92. With regard to intervention for intellectual disability, A. the consensus in the field is that talk therapy is useful for individuals with intellectual disability. B. there is evidence that individuals with intellectual disability may have more medication side effects than other individuals. C. medications are primarily used to reduce the intellectual deficits of ID. D. significant evidence exists for the effectiveness of medications. Answer: B BRIEF ESSAY QUESTIONS 93. Identify the AAIDD and the DSM criteria for intellectual disability and describe how the two approaches differ. Answer: The American Association on Intellectual and Developmental Disabilities (AAIDD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM) provide criteria for diagnosing intellectual disability (ID), but they differ in their approach. AAIDD Criteria: 1. Intellectual Functioning (IQ): Significantly below average intellectual functioning, typically indicated by an IQ of approximately 70 or below. 2. Adaptive Behavior: Significant limitations in adaptive behavior, which includes conceptual, social, and practical skills necessary for everyday life. 3. Onset Before Adulthood: The limitations in intellectual functioning and adaptive behavior must be present before the age of 18. DSM Criteria (DSM-5): 1. Deficits in Intellectual Functioning: IQ score approximately two standard deviations below the mean (usually around 70 or below). 2. Deficits in Adaptive Functioning: Significant limitations in adaptive behavior in at least one of the following areas: conceptual, social, or practical. 3. Onset During the Developmental Period: The intellectual and adaptive deficits must have onset during the developmental period, which is defined as before the age of 18. Differences: 1. IQ Cutoff: The AAIDD does not specify a strict IQ cutoff, while the DSM-5 uses an IQ of approximately 70 as a guideline. 2. Adaptive Behavior: The AAIDD emphasizes adaptive behavior and its limitations, while the DSM-5 includes adaptive functioning as part of the diagnostic criteria but focuses more on intellectual deficits. 3. Approach: The AAIDD approach is more comprehensive, considering intellectual functioning, adaptive behavior, and age of onset, while the DSM-5 approach is more structured and diagnostic-oriented, focusing on specific criteria for diagnosis. In summary, while both the AAIDD and DSM criteria consider intellectual functioning, adaptive behavior, and onset before adulthood, they differ in their specific guidelines and emphasis, with the AAIDD taking a broader and more holistic approach to diagnosing intellectual disability. 94. Describe the stability over time of intelligence test scores of both the general population and those with intellectual disability. Answer: General Population: Intelligence test scores of the general population tend to be relatively stable over time, especially after childhood. Studies have shown that IQ scores remain fairly consistent from childhood to adulthood, with correlations between childhood and adult IQ scores typically ranging from 0.65 to 0.85. However, there can be some variability, and factors such as education, health, and life experiences can influence IQ scores over time. Intellectual Disability (ID): In individuals with intellectual disability, the stability of intelligence test scores can vary more widely. While some individuals with ID may show stable IQ scores over time, others may experience fluctuations. Factors such as the severity of ID, the presence of other developmental disabilities or mental health conditions, and the availability of supportive interventions and environments can all impact the stability of IQ scores in individuals with ID. 95. Describe the Flynn effect. How do we control for this effect? Answer: The Flynn effect refers to the observed phenomenon of increases in intelligence test scores over time, across generations. This means that individuals in later generations tend to score higher on IQ tests than those in earlier generations, even when the tests are the same. The effect is named after psychologist James Flynn, who extensively researched and popularized this phenomenon. Several explanations have been proposed for the Flynn effect, including improvements in education, nutrition, health care, and living conditions, as well as increased access to information and technology. These factors are believed to contribute to cognitive stimulation and the development of cognitive skills, leading to higher IQ scores over time. To control for the Flynn effect in research, researchers often use "renorming" or "restandardizing" procedures. This involves periodically updating the norms or standards used to score IQ tests to account for the increase in scores over time. By doing this, researchers can ensure that IQ scores are interpreted relative to the performance of individuals in the same time period, rather than compared to individuals from earlier generations. 96. What domains are evaluated for adaptive functioning? How are intelligence and adaptive functioning related? Answer: Adaptive functioning refers to the collection of conceptual, social, and practical skills that individuals need to effectively function in everyday life. These skills are typically divided into several domains, which may include: 1. Conceptual Skills: This domain includes skills related to language and literacy, money, time, and number concepts, as well as the ability to solve practical problems. 2. Social Skills: Social skills involve the ability to interact and communicate with others, form relationships, and understand social cues and norms. 3. Practical Skills: Practical skills encompass activities of daily living, such as personal care (e.g., dressing, bathing), home living (e.g., cooking, cleaning), health and safety, and use of transportation. Assessment of adaptive functioning involves evaluating an individual's abilities in these domains to determine their level of independence and need for support in daily life. Intelligence and adaptive functioning are related but distinct constructs. Intelligence, as measured by IQ tests, reflects cognitive abilities such as reasoning, problem-solving, and abstract thinking. Adaptive functioning, on the other hand, reflects how well an individual can apply their cognitive abilities to everyday tasks and situations. While there is a correlation between intelligence and adaptive functioning, they are not synonymous. It is possible for an individual to have intellectual deficits (e.g., low IQ) but still demonstrate adequate adaptive functioning, especially with appropriate support and accommodations. Conversely, some individuals may have average or above-average intelligence but struggle with adaptive skills, such as those with certain autism spectrum disorders or specific learning disabilities. Overall, intelligence and adaptive functioning are interrelated aspects of an individual's overall functioning, with each contributing to their ability to navigate and succeed in the world. 97. Pick a level of functioning (mild, moderate, severe, or profound) and describe the functioning common to that level. Answer: Moderate Intellectual Disability: Intellectual Functioning: Individuals with moderate intellectual disability typically have IQ scores ranging from 35 to 49. They often have delays in language development and may have difficulty with abstract thinking and problem-solving. Adaptive Functioning: In terms of adaptive functioning, individuals with moderate intellectual disability often require support in various domains. They may be able to perform some activities of daily living independently, such as feeding and dressing themselves, but they may need assistance with more complex tasks. They may have some communication skills but may struggle with more advanced language and social skills. Social and Practical Skills: Individuals with moderate intellectual disability may have basic social skills and can form relationships with others, but they may struggle with understanding social cues and norms. They may also have some basic practical skills, such as simple household chores, but they may need supervision and support to complete more complex tasks. Educational and Occupational Skills: In terms of education, individuals with moderate intellectual disability may benefit from special education programs that focus on functional skills and life skills. They may be able to learn basic reading, writing, and math skills, but they may require additional support and accommodations. In terms of employment, individuals with moderate intellectual disability may be able to work in supported environments, where they receive assistance and supervision. Overall Functioning: Individuals with moderate intellectual disability typically require some level of support in all areas of life, including personal care, communication, social interactions, and daily activities. With the right support and interventions, they can lead meaningful and fulfilling lives, but they may require ongoing assistance and accommodations to achieve their full potential. 98. What is diagnostic overshadowing? Answer: Diagnostic overshadowing refers to the phenomenon where the presence of a known condition or disability influences the assessment and diagnosis of other conditions. In the context of intellectual disability, diagnostic overshadowing occurs when a person's intellectual disability leads healthcare professionals to overlook or misattribute symptoms of other conditions, such as mental health disorders or physical illnesses. For example, a healthcare provider may attribute symptoms of depression or anxiety in a person with intellectual disability solely to their intellectual disability, without considering that these symptoms may indicate a separate mental health disorder that requires specific treatment. Diagnostic overshadowing can lead to underdiagnosis or misdiagnosis of co-occurring conditions, which can have significant implications for the individual's overall health and well-being. It underscores the importance of comprehensive and careful assessment, especially in individuals with intellectual disabilities, to ensure that all potential conditions are identified and appropriately addressed. 99. Review the social-psychological factors that contribute to the psychological problems of individuals with intellectual disability. What predicts the continuance of externalizing disorders in young children who are developmentally delayed? Answer: Social-Psychological Factors Contributing to Psychological Problems in Individuals with Intellectual Disability: 1. Stigma and Discrimination: Individuals with intellectual disability may face stigma and discrimination, which can impact their self-esteem, social interactions, and access to resources and opportunities. 2. Social Isolation: Limited social skills and difficulties in forming relationships can lead to social isolation, which can contribute to feelings of loneliness and depression. 3. Communication Challenges: Communication difficulties can lead to frustration, misunderstandings, and difficulties in expressing needs and emotions, which can contribute to behavioral problems and psychological distress. 4. Limited Social Support: Lack of social support networks can exacerbate feelings of loneliness and isolation, as well as limit access to coping mechanisms and resources. 5. Environmental Factors: Adverse environmental conditions, such as poverty, family dysfunction, and lack of access to quality healthcare and education, can contribute to psychological problems in individuals with intellectual disability. Predictors of Continuance of Externalizing Disorders in Young Children with Developmental Delay: 1. Severity of Developmental Delay: Children with more severe developmental delay may be at higher risk for continuance of externalizing disorders, as they may have greater difficulty in regulating emotions and behaviors. 2. Family Environment: Family factors, such as parenting style, family stress, and the presence of other psychosocial stressors, can impact the continuance of externalizing disorders in young children with developmental delay. 3. Peer Relationships: Negative peer relationships or social rejection can contribute to the continuance of externalizing disorders, as children may struggle to develop positive social skills and relationships. 4. Co-occurring Mental Health Disorders: The presence of co-occurring mental health disorders, such as anxiety or depression, can increase the risk of continuance of externalizing disorders in young children with developmental delay. 5. Access to Interventions and Support: Early intervention programs and access to appropriate support services can mitigate the risk of continuance of externalizing disorders by addressing underlying issues and promoting positive development. 100. What is the prevalence of intellectual disability? How is prevalence impacted by age, gender and socio-economic status? Answer: The prevalence of intellectual disability (ID) varies depending on the definition and criteria used for diagnosis. According to the World Health Organization (WHO), the global prevalence of ID is estimated to be around 1-3% of the population. However, prevalence rates can differ across age groups, gender, and socio-economic status. Age: The prevalence of ID tends to be higher in children than in adults. This is partly due to the fact that some developmental disabilities may be outgrown or compensated for as individuals mature. Additionally, early intervention programs and advancements in healthcare have improved outcomes for children with intellectual disabilities, reducing the overall prevalence in older age groups. Gender: The prevalence of ID is slightly higher in males than in females. This difference is more pronounced in some specific syndromes or conditions that are associated with intellectual disability, such as fragile X syndrome or Down syndrome. However, the reasons for this gender difference are not entirely clear. Socio-economic Status (SES): There is evidence to suggest that there is a higher prevalence of intellectual disability among individuals from lower socio-economic backgrounds. This may be due to factors such as limited access to quality healthcare, nutrition, and educational resources, as well as higher rates of exposure to environmental risk factors. Overall, while the prevalence of intellectual disability is influenced by age, gender, and socio-economic status, it is important to note that each individual's experience of intellectual disability is unique, and factors such as early intervention, supportive environments, and access to resources can significantly impact outcomes for individuals with ID. 101. Describe the stability, rate and sequence of development for individuals with intellectual disability. Answer: Individuals with intellectual disability (ID) may experience slower or inconsistent development compared to typically developing individuals. Their development can be non-linear, with periods of rapid progress followed by plateaus. The rate and sequence of development vary widely depending on the individual and the specific challenges they face. Early intervention and supportive environments are crucial for promoting positive development and improving outcomes for individuals with ID. 102. Describe the two-group approach to intellectual disability. What are some common characteristics of each group? Answer: The two-group approach categorizes intellectual disability (ID) into mild/moderate and severe/profound. Mild/Moderate ID: • IQ: 50-70 (mild), 35-49 (moderate) • Adaptive Functioning: Better than severe/profound, may need support in complex situations • Communication: Varies, basic to advanced • Social Skills: Basic to moderate, struggles with complex interactions Severe/Profound ID: • IQ: Below 35 (severe), below 20 (profound) • Adaptive Functioning: Extensive support needed in daily life • Communication: Limited, relies on nonverbal or basic language • Social Skills: Limited, struggles with relationships and social situations 103. Discuss how psychosocial variables might play a role in the etiology of intellectual disability, especially mild intellectual disability. Answer: Psychosocial variables can play a significant role in the etiology of intellectual disability, particularly in cases of mild intellectual disability (ID). These variables can interact with genetic, neurological, and environmental factors to influence cognitive development and functioning. Some key psychosocial factors include: 1. Prenatal and Early Childhood Experiences: Exposure to toxins, infections, or trauma during pregnancy can impact brain development and lead to intellectual impairments. Additionally, early childhood experiences, such as neglect, abuse, or lack of stimulation, can affect cognitive development. 2. Parenting Style and Family Environment: The quality of parenting and the family environment can have a profound impact on cognitive development. Positive and supportive environments can promote healthy cognitive development, while negative or stressful environments can hinder it. 3. Socioeconomic Status (SES): Low SES is associated with an increased risk of intellectual disabilities. Factors such as limited access to quality healthcare, nutrition, and educational resources can contribute to cognitive impairments. 4. Education and Stimulation: Adequate education and cognitive stimulation are essential for optimal cognitive development. Lack of access to quality education and intellectual stimulation can contribute to intellectual disabilities. 5. Peer Relationships and Social Integration: Positive peer relationships and social integration can support cognitive development. Individuals with limited social interactions may experience delays in cognitive development. 6. Nutrition and Health: Proper nutrition and overall health are critical for brain development. Malnutrition, exposure to toxins, and untreated medical conditions can contribute to intellectual disabilities. In cases of mild intellectual disability, these psychosocial factors may play a more significant role, as individuals with mild ID often have higher levels of cognitive functioning and may be more susceptible to environmental influences. Early intervention programs that address these psychosocial factors can help mitigate the impact of intellectual disabilities and support optimal cognitive development. 104. List and give examples of the four AAIDD categories of risk and etiology pertaining to intellectual disabilities. Answer: 1. Biological Factors: Genetic conditions (e.g., Down syndrome), prenatal factors (e.g., infections), perinatal factors (e.g., birth complications), and postnatal factors (e.g., head injuries) can contribute to intellectual disabilities. 2. Psychosocial Factors: Neglect, abuse, poor nutrition, and limited educational opportunities can increase the risk of intellectual disabilities. 3. Environmental Factors: Socioeconomic status, exposure to toxins, and lack of early intervention can impact the development of intellectual disabilities. 4. Idiopathic Factors: In some cases, the cause of intellectual disabilities is unknown despite thorough evaluation. 105. Describe the etiology and clinical manifestations of two of the following: Down syndrome, Fragile X syndrome, Williams syndrome, or Prader Willi syndrome. Answer: Down Syndrome: • Etiology: Down syndrome is caused by the presence of an extra copy of chromosome 21, known as trisomy 21. This additional genetic material alters the course of development and results in the characteristics associated with Down syndrome. • Clinical Manifestations: Individuals with Down syndrome often have characteristic physical features, such as a flat facial profile, upward slanting eyes, and a small nose. They may also have developmental delays, intellectual disabilities, and an increased risk of certain medical conditions, such as heart defects, hearing loss, and thyroid problems. Despite these challenges, individuals with Down syndrome can lead fulfilling lives with appropriate support and interventions. Fragile X Syndrome: • Etiology: Fragile X syndrome is caused by a mutation in the FMR1 gene on the X chromosome. This mutation leads to a deficiency in the FMRP protein, which is important for brain development and function. • Clinical Manifestations: Individuals with Fragile X syndrome may have intellectual disabilities ranging from mild to moderate. They may also exhibit behavioral and emotional challenges, such as hyperactivity, anxiety, and social difficulties. Physical features may include a long face, large ears, and a prominent jaw. Additionally, individuals with Fragile X syndrome may have sensory sensitivities and may be at risk for certain medical conditions, such as seizures and connective tissue disorders. Williams Syndrome: • Etiology: Williams syndrome is caused by the deletion of genetic material from chromosome 7. This deletion affects the genes responsible for the development of various systems in the body, including the cardiovascular system and the brain. • Clinical Manifestations: Individuals with Williams syndrome often have a unique combination of traits, including a distinctive facial appearance, cardiovascular abnormalities (such as supravalvular aortic stenosis), intellectual disabilities, and a friendly and outgoing personality. They may also have specific cognitive strengths, such as strong language skills and an affinity for music. However, they may also experience challenges with spatial tasks and abstract reasoning. Prader-Willi Syndrome: • Etiology: Prader-Willi syndrome is caused by the loss of genetic material from a specific region of chromosome 15, which is inherited from the father. This loss leads to a variety of physical, cognitive, and behavioral abnormalities. • Clinical Manifestations: Infants with Prader-Willi syndrome may have poor muscle tone (hypotonia) and feeding difficulties. As they grow older, they may develop an insatiable appetite, which can lead to obesity if not controlled. Individuals with Prader-Willi syndrome may also have intellectual disabilities, behavioral problems (such as obsessive-compulsive behaviors), and hormonal imbalances (such as growth hormone deficiency and hypogonadism). In summary, each of these syndromes has a distinct genetic cause and presents with unique clinical manifestations. Early diagnosis and appropriate interventions can help individuals with these syndromes reach their full potential and improve their quality of life. 106. Report on the stressors that parents and siblings of individuals with intellectual disabilities often face. What factors can affect parent coping? Answer: Stressors Faced by Parents and Siblings of Individuals with Intellectual Disabilities: 1. Emotional Stress: Parents and siblings may experience feelings of grief, guilt, and worry about the future of their loved one with an intellectual disability. 2. Financial Strain: The costs associated with caring for a person with an intellectual disability, including medical expenses, therapy, and specialized education, can be significant and add to financial stress. 3. Social Isolation: Caring for a person with an intellectual disability can be demanding and time-consuming, leading to social isolation as parents and siblings may have limited time for social activities. 4. Uncertainty about the Future: Parents and siblings may be concerned about the long-term care and independence of their loved one with an intellectual disability, especially as they age and may no longer be able to provide care. 5. Stigma and Discrimination: Families of individuals with intellectual disabilities may face stigma and discrimination, which can be stressful and impact their mental health and well-being. Factors Affecting Parent Coping: 1. Social Support: Having a strong support network of family, friends, and professionals can help parents cope with the challenges of caring for a person with an intellectual disability. 2. Access to Resources: Access to resources such as respite care, support groups, and educational materials can provide parents with the tools they need to manage stress and caregiving responsibilities. 3. Coping Strategies: Developing healthy coping strategies, such as mindfulness, exercise, and seeking professional help when needed, can help parents manage stress and maintain their mental health. 4. Attitudes and Beliefs: Parents' attitudes and beliefs about their child's disability can impact their coping abilities. Positive attitudes and acceptance can help parents better navigate the challenges of caregiving. 5. Personal Resilience: Personal resilience, or the ability to bounce back from adversity, can play a significant role in how parents cope with the stressors of caring for a person with an intellectual disability. Overall, understanding the stressors faced by parents and siblings of individuals with intellectual disabilities and identifying factors that can affect coping can help support families in providing the best possible care for their loved ones. 107. List the common rewards often experienced by families with child who has intellectual disability. Answer: Families with a child who has an intellectual disability often experience a variety of rewards, including: 1. Unconditional Love: The bond between parents and their child with an intellectual disability can be incredibly strong, characterized by unconditional love and acceptance. 2. Personal Growth: Caring for a child with an intellectual disability can lead to personal growth and development, as parents learn to be more patient, empathetic, and resilient. 3. Increased Empathy: Siblings and other family members often develop increased empathy and understanding through their interactions with a child with an intellectual disability. 4. Sense of Purpose: Many families find a sense of purpose and fulfillment in caring for their child with an intellectual disability, knowing that they are making a positive difference in their life. 5. Stronger Family Bonds: The shared experience of caring for a child with an intellectual disability can strengthen family bonds and create a sense of unity and togetherness. 6. Celebration of Milestones: Families often celebrate even small milestones and achievements, such as a new word or a new skill, which can bring great joy and pride. 7. Community Support: Families of children with intellectual disabilities often find support and camaraderie within the disability community, creating a sense of belonging and solidarity. 8. Perspective on Life: Caring for a child with an intellectual disability can provide families with a unique perspective on life, helping them to appreciate the simple joys and challenges of everyday life. Overall, while caring for a child with an intellectual disability can be challenging, many families find that the rewards far outweigh the difficulties, enriching their lives in profound and meaningful ways. 108. Discuss the changing views of intellectual disability from the late 1700s to present. Answer: Late 1700s - Early 1800s: • Perceived as Moral Deficiency: In the late 1700s and early 1800s, intellectual disability was often viewed as a moral deficiency or a result of divine punishment for sin. This led to the segregation and institutionalization of individuals with intellectual disabilities. Late 1800s - Early 1900s: • Emergence of Medical Models: Towards the late 1800s and early 1900s, there was a shift towards viewing intellectual disability as a medical condition rather than a moral failing. This period saw the rise of eugenics movements, which promoted selective breeding to eliminate intellectual disabilities from the gene pool. Mid-1900s: • Focus on Education and Rehabilitation: In the mid-1900s, there was a growing recognition of the importance of education and rehabilitation for individuals with intellectual disabilities. This led to the establishment of special education programs and the deinstitutionalization movement, which aimed to integrate individuals with disabilities into the community. Late 1900s - Present: • Shift towards Inclusion and Rights: In the late 1900s and continuing into the present day, there has been a strong push towards inclusion and the recognition of the rights of individuals with intellectual disabilities. This has been driven by movements such as the disability rights movement, which advocates for equal rights and opportunities for individuals with disabilities. Current Views: • Focus on Diversity and Inclusion: Today, intellectual disability is increasingly viewed through a lens of diversity and inclusion. There is a greater emphasis on supporting individuals with intellectual disabilities to live fulfilling lives in the community, access education and employment opportunities, and participate fully in society. Overall, the changing views of intellectual disability reflect broader shifts in society's understanding of disability, moving away from a medical or moral model towards a more inclusive and rights-based approach. 109. Review the pros and cons of inclusion for students with intellectual disabilities. Answer: Pros of Inclusion: 1. Social Interaction: Inclusion provides opportunities for students with intellectual disabilities to interact with their peers without disabilities, potentially reducing social isolation and fostering friendships. 2. Improved Self-Esteem: Being included in regular classrooms can boost the self-esteem of students with intellectual disabilities, as they feel accepted and valued by their peers. 3. Academic Benefits: Inclusion can lead to improved academic outcomes for students with intellectual disabilities, as they may have access to the same curriculum and educational resources as their peers. 4. Enhanced Communication Skills: Interacting with peers and teachers in inclusive settings can help students with intellectual disabilities develop their communication skills. 5. Promotes Diversity and Understanding: Inclusion promotes a culture of diversity and understanding, teaching all students to appreciate individual differences. Cons of Inclusion: 1. Lack of Individualized Attention: In inclusive settings, students with intellectual disabilities may not receive the individualized attention and support they need to succeed academically. 2. Negative Peer Interactions: Some students without disabilities may exhibit negative behaviors towards their peers with intellectual disabilities, leading to bullying or social exclusion. 3. Curriculum Challenges: The general curriculum in inclusive classrooms may not always be appropriate or accessible for students with intellectual disabilities, requiring significant modifications. 4. Teacher Preparedness: Teachers may not always have the training or resources needed to effectively support students with intellectual disabilities in inclusive settings. 5. Potential for Stigmatization: Despite efforts to promote inclusivity, there is a risk that students with intellectual disabilities may feel stigmatized or different from their peers in inclusive settings. It's important to note that the effectiveness of inclusion for students with intellectual disabilities can vary depending on individual needs, the level of support available, and the overall school environment. 110. Review the following treatments and discuss the usefulness/effectiveness in regard to the ID population: Positive Behavioral Support (be sure and address functional assessment) and Behavioral Intervention to Enhance Adaptive Behavior or Reduce Maladaptive Behavior (be sure and mention discrete trial learning vs. naturalistic learning). Answer: Positive Behavioral Support (PBS) is a comprehensive approach to addressing challenging behaviors in individuals with intellectual disabilities (ID). It focuses on understanding the function or purpose of a behavior and using this information to develop interventions that teach alternative, more appropriate behaviors. PBS includes a functional behavior assessment (FBA), which is a process used to identify the function of a behavior by examining the antecedents (triggers), behavior itself, and consequences. Functional Assessment: The FBA is a critical component of PBS. It involves collecting data to understand the specific triggers and consequences of a behavior. This helps in developing a behavior support plan that targets the underlying function of the behavior, rather than just trying to suppress the behavior itself. By understanding why a behavior occurs, interventions can be more targeted and effective. Behavioral Intervention to Enhance Adaptive Behavior or Reduce Maladaptive Behavior: This type of intervention focuses on teaching new skills to replace maladaptive behaviors or enhance adaptive behaviors. There are two main approaches to behavioral intervention: discrete trial learning and naturalistic learning. 1. Discrete Trial Learning: This is a structured, teacher-led approach that breaks down skills into smaller, more manageable components. It involves presenting a stimulus, prompting a response, and providing reinforcement for correct responses. Discrete trial learning is often used to teach foundational skills and is highly structured and controlled. 2. Naturalistic Learning: This approach focuses on teaching skills in natural settings and situations. It emphasizes capturing teachable moments and using natural reinforcers. Naturalistic learning is less structured than discrete trial learning and aims to promote generalization of skills to real-life settings. Usefulness/Effectiveness: • Positive Behavioral Support (PBS) has been shown to be effective in reducing challenging behaviors and improving quality of life for individuals with ID. • Functional behavior assessments (FBA) are crucial in developing effective behavior support plans as they help identify the function of the behavior. • Behavioral interventions, including both discrete trial learning and naturalistic learning, can be effective in teaching new skills and reducing maladaptive behaviors. • Discrete trial learning is often used for teaching foundational skills, while naturalistic learning promotes generalization of skills to natural settings. • Both approaches should be tailored to the individual's needs and preferences for the best outcomes. Overall, both Positive Behavioral Support (PBS) and behavioral interventions to enhance adaptive behavior or reduce maladaptive behavior can be highly useful and effective in improving outcomes for individuals with intellectual disabilities. Test Bank for Abnormal Child and Adolescent Psychology Rita Wicks-Nelson, Allen C. Israel 9781317351344, 9780205036066, 9780205901128
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