INTELLECTUAL DISABILITY

Intellectual Disability
Tiffany Wieland
California State University, Fresno

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Intellectual Disability

Intellectual Disability
Intellectual Disability refers to the impairments that affect cognitive functioning and
adaptive skills, usually during the developmental stages. Most people are familiar with the term
mental retardation which continues to be used in the International Classification of Disease but
has been questioned because it labels and stigmatizes an individual. Intellectual disability
consists of different types of disabilities that are determined by genetics, metabolic disorders or
functional changes due to trauma to the nervous system. Being that there are different severities
of cognitive, intellectual and developmental disorders under the intellectual disability
umbrella, it is important treat each case differently based the individuals needs. Each person
may require a different treatment program to help enhance their skills needed in the everyday
life. Harris (2006) uses three different models to define intellectual disability. The first being the
statistical model, which focuses on psychometric test scores as well as an assessment to identify
their adaptive function. The second model is the pathological model which focuses on the causes
of the intellectual disability. This would include those individuals with Down syndrome, FragileX syndrome and intraventricular hemorrhage that happens during post-partum. The third is the
social systems model which includes those with a mild disability. The disability typically isnt
recognized until a child starts school and is labeled by the social system. They may potentially
leave school without the disability depending on how they develop their social and physical
skills so may successfully interact in society (Harris 2006). Being that there are different
intellectual disabilities I will choose to focus on Down syndrome throughout this paper. It is a
disorder that I would like to better understand and would love to share the information that I find.
I will discuss the cause, treatment modalities and different settings were Recreational Therapist

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might work with some with Down syndrome. I will also include useful interventions and the
health and safety to consider when providing service.
Down Syndrome
Down syndrome is considered an intellectual disability because it involves a slower
intellectual and cognitive development from birth. Down syndrome is something that happens
when either the womans egg or males sperm is produced or just after fertilization. According to
Cunningham (2010) this happens when there is either an extra chromosome 21 or extra material
from chromosome 21. This is also referred to as trisomy 21, being that there are three
chromosomes instead of two. There is no real evidence in what causes this cell this chromosomal
fault and there have been studies on environmental factors, contraceptives and fertility drugs but
none have succeeded on proving the cause. This chromosome non-disjunction can occur in either
the egg or the sperm and is found in all races. As of 2010 there are approximately 1 and 1000
babies born with Down syndrome in developed countries (Cunningham 2010).
Anyone who has Down syndrome will typically share very similar distinct characteristics.
These include upward slanted eyes with a narrow eye slit, the face will most likely have a flat
appearance with a smaller than average head and the ears will appear smaller and set low. They
also have a larger than normal soft spot, low muscle tone and a deep crease across their palm.
Everyone is unique and the characteristics do vary. One with Down syndrome will also have a
higher risk of certain health problems like sleeping problems, upper airway obstruction and
hearing impairments. They do have a delay in cognitive development so it is very important for
them to practice social, communication and daily living skills (Cunningham 2010)
Treatment Modalities

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Early interventions are crucial in intellectual and cognitive development along with
grooming the adaptive skills. According to the National Down Syndrome Society, the first years
in a childs life is when they experience rapid developmental skills and being that children with
Down syndrome experience delays its highly recommended that one gets started with therapy as
soon as possible. Some of the therapies offered are physical therapy, occupational therapy and
speech therapy. Physical therapy helps improve and strengthen the motor skills to gain head
control and succeed in the sitting up position. Occupational therapy can help them gain the skill
of independence. They learn to dress and feed themselves along with learning social interaction.
Even though a child with Down syndrome may not say their first word until two or three, they
will still gain a great benefit from Speech therapy. It helps improve their visual and auditory
skills, their tactile and oral skills, and their cognitive skills. An individual with Down syndrome
may also require a psychologist or a behavioral pediatrician due do behavioral issues. These
include wandering off, obsessive compulsive behaviors, attention problems and stubborn
behaviors.
Down Syndrome in Pakistan
Anyone in any country can give birth to a baby with Down syndrome. Experiences of
parents with a child with Down syndrome in Pakistan and their views on termination consisted
several interviews of mothers who have a child or knows someone with child who has Down
syndrome. Most of them gave answers that involved their religious beliefs. The mothers that
were interviewed considered their children to be a gift from Allah while others in the larger
community considered them to be a punishment for their sins. One mother believed that they
were being blessed with wealth and success due to how well she takes care of her daughter with
Down syndrome. It is not uncommon for people to stare with pity and look down on them as if

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they were abnormal. Another mother even mentioned that someone asked her what kind of child
her son was. Most of the women interviewe=d had great support from their families and received
the love they needed. There was also a few that were opposite and believed that they should be
hidden away. When asked about their views on termination almost all of them viewed it as
acceptable knowing Islam wouldnt allow abortion.
Therapeutic Recreation Interventions
There are several different interventions that can be used to help improve the functioning
and quality of life for a person with Down syndrome but I will only be discussing a couple. The
first one is dancing. Clumsiness is very common in children and if you are one with Down
syndrome your movement might appear jerky and hesitant. Being able to dance may
help improve balance and quality of movement. Also having to memorize dance moves can help
their coordination and provide visual stimulation.

In this journal Children with Down

Syndrome, Discovering the Joy of Movement, they discuss the opportunity of learning weight,
flow, space awareness and build confidence which in turn may lower frustration. Finding joy in
dancing may improve the quality of life for someone and that would reach a desired goal.
The second intervention that I will discuss is gymnastics. Popecsu did a study on a group of
individuals with Down syndrome utilizing strategic training and assessment to determine the
balance component, under the Special Olympic system. This type of intervention should
address balance ability, adaptiveness and social integration. They were able to confirm the
usefulness in gaining better overall balance and coordinative abilities. Every intervention may
not work well for all, which is why assessments are performed to help discover which
interventions should be provided. The role of a Recreational Therapist with a person with

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Down syndrome would be to assist in the assessment to determine a treatment plan. The goal
would be to provide service to help improve their social skills, cognitive and physical
development all while improving their quality of life.

Health and Safety

There are different health concerns that a person with Down syndrome may experience.
Heart defects, gastrointestinal issues and thyroid conditions. If they are taking any sort of
medications for their heart or thyroid you might want to be aware of any interactions they have.
If they have any anxiety issues you would probably want to know any triggers that could
potentially upset the client. They might also have specific behavioral issues to consider as well.
Cunningham (2010) suggests providing positive interactions. Sometimes a person with Down
syndrome may struggle with dealing with failure and frustration. It would be very important for a
Recreational Therapist to be well educated in knowing how to deal with this type of situation. It
is also important to reduce distraction when teaching them something being that they get easily
distracted. Cunningham suggests helping as little as possible, being helpful but not distracting.
Also, doing everything for them limits development. You also have to consider the assessment
on the individual being that the severities vary. If they have any sort of medical condition you
might want to get the doctors approval before going forth with any intervention you feel is best.

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References

Ahmed, S., Bryant, L. D., Ahmed, M., Jafri, H., & Raashid, Y. (2013). Experiences of parents
with a child with Down syndrome in Pakistan and their views on termination of pregnancy.
Journal of Community Genetics, 4(1), 107114. http://doi.org/10.1007/s12687-012-0124-y
Anne Jobling , Naznin Virji-Babul , Doug Nichols. (2006). Children with Down
Syndrome .Journal of Physical Education, Recreation & Dance Vol. 77, Iss. 6
Cunningham, C. (2006). Down Syndrome: An Introduction for Parents and Carers. London:
Souvenir Press.
Harris, J. (2006). Intellectual Disability: Understanding Its Development, Causes, Classification,
Evaluation, and Treatment. New York: Oxford University Press.
http://www.ndss.org
Popescu, G. (2014). Performance, reference systems and strategies for balance training in
syndrome down subjects beginning gymnastics. Procedia - Social and Behavioral Sciences, 117,
553-558.

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