Intellectual Disability

This pioneering book, in considering intellectually disabled peoples lives sets out a care ethics model of disability that outlines the emotional caring sphere, where love and care are psycho-socially questioned, the practical caring sphere, where day-to-day care is carried out and the socio-political caring sphere, where social intolerance and aversion to difficult differences are played out. It does so by discussing issue based everyday life, such as family, relationships, media representations and education in an evocative and creative manner. This book draws from an understanding of how intellectual disability is represented in all forms of media, a feminist ethics of care, and capabilities, as well as other theories, to provide a critique and alternative to the social model of disability as well as illuminate care-less spaces that inhabit all the caring spheres. The first two chapters of the book provides an overview of intellectual disability, the debates and outlining of the model. Having begun to develop an innovative theoretical framework for understanding intellectual disability and being human, the book moves onto empirical and narrative driven issue based chapters. The following chapters builds on the emergent framework and discusses the application of particular theories in three different substantive areas: education, mothering and sexual politics. A concluding remarks draws together the common themes across the applied chapters and links them to the overarching theoretical framework.

An important read for all those studying and researching intellectual or learning disability, this book will be an essential resource in sociology, philosophy, criminology (law), social work, education and nursing in particular.

What is community participation and how do we measure it? These questions are important as people with intellectual and developmental disabilities continue to experience exclusion, as policymakers design national funding schemes, and as researchers evaluate the success of interventions. A measurable definition of community participation enables people to know which interventions work, why, and where to target funding. Yet there may be good reasons to resist a universal definition of community participation. Building on work in feminist theory, this article shows the benefits of community participation as an essentially contested concept as contestation spurs innovative research. But even if contested concepts are good for researchers, are they good for people with intellectual and developmental disabilities, their families, and professionals in the field? Aligning the goals of research with practice may be an important yet unattainable goal.

Abstract  As increased attention has been directed toward the disparities experienced by people with intellectual disabilities in achieving positive health outcomes, the importance of promoting the active involvement of people with intellectual disabilities in efforts to reduce such disparities and promote positive health and wellness outcomes has been acknowledged by researchers and policymakers. This parallels the larger movement within the disability field to promote the self-determination and empowerment of people with intellectual disabilities. The authors more explicitly discuss the implications of self-determination, as it has been conceptualized in the disability field, for promoting positive health and wellness outcomes in people with intellectual disabilities. They review the current research on self-determination and its impact on health, as well as the implications of this research for the development of strategies that promote self-determination in the achievement of health and wellness outcomes in people with intellectual disabilities. The authors posit the need to extend an understanding of the implications of self-determination for promoting health in people with disabilities not only to the disability field, but also to the medical and public health fields. They also provide recommendations for future research and practice.

We compared the effectiveness of two extinction interventions, extinction by omission and noncontingent delivery of reinforcement, to treat aggressive behavior with a 10-year-old boy. Before the intervention, a functional analysis revealed that aggression was maintained by positive reinforcement in the form of attention. The extinction by omission intervention consisted of ignoring aggressive behavior. Noncontingent reinforcement involved delivering attention to the boy on a fixed-time schedule. Both treatments were compared using a multielement research design. Noncontingent reinforcement produced a more rapid elimination of aggression. Additionally, the schedule of noncontingent reinforcement was gradually thinned during the intervention. Finally, both parents successfully implemented the noncontingent schedule of reinforcement independently for up to 5 weeks after treatment.

The term intellectual disability refers to the level of cognitive functioning that is demonstrated by particular children. It is the circumstance in which a children's cognitive functioning is impeded to the point of causing a significant disability in receiving information from his or her environment, then effectively processing, problem solving and adapting to this information. This paper provides an overview of children with intellectual disability incorporating definition, causes and classification for conceptual understanding. Intellectual disability is characterized by significant limitations in intellectual functioning and adaptive behaviour, the latter expressed as conceptual, social and practical adaptive skills. An intellectual disability is defined as an IQ below 70 and deficits in adaptive behaviour or daily living skills (eating, dressing, communication, participate in group activity). People with intellectual disability learn slowly and have difficulty with abstract concepts. This paper also throws some light on the characteristics of people with intellectual disabilities.

Two angiotensin II (Ang II)–specific receptors, AGTR1 and AGTR2, are expressed in the mammalian brain. Ang II actions on blood pressure regulation, water electrolyte balance, and hormone secretion are primarily mediated by AGTR1. The function of AGTR2 remains unclear. Here, we show that expression of the AGTR2 gene was absent in a female patient with mental retardation (MR) who had a balanced X;7 chromosomal translocation. Additionally, 8 of 590 unrelated male patients with MR were found to have sequence changes in the AGTR2 gene, including one frameshift and three missense mutations. These findings indicate a role for AGTR2 in brain development and cognitive function.

The prevalence of obesity is higher in those with intellectual disabilities than the general population. The aim of the study was to understand the determinants of physical activity and dietary patterns in this population during their final year of school. Qualitative data were generated from 10 interviews with adolescents with mild-moderate intellectual disabilities. Data were analysed using deductive thematic analysis, employing Self-Determination Theory as a theoretical framework. Adolescents' environment and social interactions play a pivotal role in influencing physical activity and dietary patterns. Three themes emerged from the analysis: situatedness, motivation and wider environmental influences. School structure, high self-efficacy and social connectedness facilitate increased physical activity and healthier diet in adolescents with intellectual disabilities. Home life, low self-efficacy and a lack of social connectedness can serve as a barrier to PA and a healthy diet.

Mental health outcomes for survivors of critical congenital heart disease (CHD) remain under-investigated. We sought to examine psychiatric disorders and psychosocial functioning in adolescents with single ventricle CHD and to explore whether patient-related risk factors predict dysfunction. This cohort study recruited 156 adolescents with single ventricle CHD who underwent the Fontan procedure and 111 healthy referents. Participants underwent comprehensive psychiatric evaluation including a clinician-rated psychiatric interview and parent- and self-report ratings of anxiety, disruptive behavior, including attention-deficit/hyperactivity disorder (ADHD), and depressive symptoms. Risk factors for dysfunction included IQ, medical characteristics, and concurrent brain abnormalities. Adolescents with single ventricle CHD had higher rates of lifetime psychiatric diagnosis compared with referents (CHD: 65%, referent: 22%; P < .001). Specifically, they had higher rates of lifetime anxie...

The instructional scheduling arrangements of simulated and community-based instruction across an equivalent set of functional and vocational skills were examined. Five secondary age students with moderate intellectual disabilities participated in four instructional scheduling arrangements measuring skill acquisition, generalization, and maintenance of functional tasks. The four instructional scheduling arrangements examined were simulated-only instruction (SOI), community-based instruction only (CBI), combination of SOI and CBI on consecutive school days (CCD), and combination of SOI and CBI on the same school day (CSD). The CSD schedule was significantly more effective for student acquisition performance than SOI, CBI, and CCD schedules. Although the CBI schedule resulted in the fewest number of instructional sessions for students to acquire the targeted skill, fewer sessions for skill generalization were required for students during the combined simulation and community instruction CSD schedule. Overall, both combined instructional scheduling arrangements (e.g., CCD, CSD) produced more efficient outcomes for generalization than SOI and CBI scheduling arrangements.

Intellectual disability is known to be associated with a high incidence of psychiatric co-morbidity and problem behaviours. However, there are many challenges in trying to meet the mental health needs of people with an intellectual disability, and these are often not adequately addressed in Singapore's current healthcare system. This article outlines the present service provisions for this area in the country and details the importance of, as well as difficulties in the integration of health and social care measures in service development and delivery.

Active support, a package of procedures which includes activity planning, support planning and training on providing effective assistance, was introduced in five community residences serving 19 adults with severe intellectual disability following a multiple baseline design. The ...

We reviewed 45 patients with a deletion of the long arm of chromosome 4. Forty-one were previous reports (25 terminal deletions and 16 interstitial deletions) and 4 are new cases with terminal deletions. Of the 29 patients with terminal deletions, 18 with deletion at 4q31 and 4 at 4q32 qter had an identifiable phenotype consisting of abnormal skull shape, hypertelorism, cleft palate, apparently low-set abnormal pinnae, short nose with abnormal bridge, virtually pathognomonic pointed fifth finger and nail, congenital heart and genitourinary defects, moderate-severe mental retardation, poor postnatal growth, and hypotonia. Six patients with a deletion at 4q33 and one patient with deletion 4q34 were less severely affected. In general, patients with various interstitial deletions proximal to 4q31 had a phenotype that was less specific, although mental retardation and minor craniofacial anomalies were also present. There were 3 patients with piebaldism and one with Rieger syndrome. We conclude that terminal deletion of chromosome 4q (4q31 qter) appears to produce a distinctive malformation (MCA/MR) syndrome in which the phenotype correlates with the amount of chromosome material missing and which differs from the more variable phenotype associated with interstitial deletions of 4q.

An apparently new X-linked syndrome is presented. It occurred in four male first cousins. The main manifestations of this syndrome are severe mental retardation, bilateral congenital hip luxation, and short stature. Three of the affected males showed a new glucose-6-phosphate dehydrogenase variant.

A brief positive practice overcorrection procedure was used as a method of eliminating head-banging in a profoundly mentally retarded adult. Treatment produced an immediate reduction in head-banging episodes, with near zero occurrence of behavior during the third phase of treatment. One year later data collection was resumed on the subject for an 11-week period. Data from the long-term follow-up revealed that head-banging continued to occur, but mean weekly levels of episodes (M = 5.8) were still well below those recorded during the baseline period (M = 18.8). The overcorrection procedure produced immediate short-term effects and, in this case, was also effective in the long-term. Variables related to the maintenance of response suppression are discussed with respect to this intervention's success.

The Health Insurance Board (CVZ) initiated a study of the functioning of the dental care system for mentally disabled people in the Netherlands.Two independent samples were used for the study, each drawn from a subpopulation of people with a mental disability in the age-group 15-45: people who have always lived at home (n = 60) and people who have been at some time been institutionalized and as a result of decentralization now live outside of the institution (n = 52). Dental visits were in both samples remarkably frequent (95-100%) and relatively few problems with daily dental care were identified. However, the health insurance regulations were unclear to many parents and carers, and there were doubts regarding dentists' specific expertise. At first sight the results of this study do not give cause to assume that there are special barriers to access to professional dental care for adult people with special needs. For a definitive conclusion regarding the long-term effects of the...

The discomfort reported by the general public at the prospect of personal contact with marginalised groups is an expression of the stigma they experience. This has been widely studied in relation to ethnic minorities and immigrants but less so for persons with disabilities. A national survey with a representative sample of over 1100 Irish adults provided an opportunity to examine reported discomfort with persons who had different impairments, including mental health conditions, with four other minority groups. Moreover, the personal and situational variables associated with expressions of discomfort were identified. Respondents were most comfortable having persons with physical and sensorial disabilities living in their neighbourhood or in their workplace but less so for persons with intellectual disabilities and even less for people with mental health conditions. They were much less comfortable with the four other social groups: gay, lesbian or bisexual people; Eastern European mig...

Since the birth of the Irish State, there have been three official terms for children with mental disabilities, ‘mental deficiency’, ‘mental handicap’ and ‘intellectual disability’. Each new term replaced the previous one; ‘mental deficiency’ became ‘mental handicap’, subsequently ‘mental handicap’ became ‘intellectual disability’. This thesis applied a Foucauldian Discourse analysis to the history of Irish Education to expose the hidden conditions that underpinned the aforementioned concepts, in order to answer the following questions: What factors brought a particular conceptual configuration in the classification of intellectual disability into play in the first instance? What made that configuration seem plausible and socially desirable? What changes or events happened that caused the conceptual configuration to be replaced? And did these changes cultivate marginalisation or demarginalisation? The first part of the analysis divided the history of Irish education into three different epistémè and labelled them, the Institution, the Birth of Special Education and the Birth of Social Inclusion. Foucauldian tools of analysis were applied to allow for the surfaces of emergence to be exposed and identified; thus, in turn revealing the frameworks of knowledge that were hidden underneath. This Webinar will discuss how the discourse analysis was applied and the main findings of the research.

Over the past thirty years theatre involving people with intellectual disabilities has gone from a marginalized practice in institutional settings and a therapeutic context to the centre of the stage where Back to Back Theatre and Jérôme Bel/ Theater HORA’s Disabled Theater headline at international arts festivals.  How can the history of this increasingly visible form of theatre be told given the marginalization and exclusion from hegemonic discourses of actors who are deemed to be intellectually disabled?

I wish to examine a number of theatrical performances in specific historical and geographical contexts involving actors with intellectual disabilities. These include John Cassavetes’ 1963 film "A Child is Waiting", Robert Wilson’s collaboration with Christopher Knowles on "A Letter for Queen Victoria", 1974, and "Einstein on the Beach",1976, the performance documented in Christopher Noonan’s 1980 film "Stepping Out": a documentary of ‘the birth of a mentally handicapped theatre’ at the Sydney Opera House and the transversal connections these earlier productions make with more contemporary performance including Christoph Schlingensief’s "FreakStars 3000", 2000, recent productions by Back to Back Theatre (2005 – 2011) and Jerome Bel/Theater HORA’s "Disabled Theater," 2013. 

I wish to investigate how these works from different periods speak to each other: how they intersect with wider histories of theatre and with the history or mythology of the aesthetic and political representation of people with intellectual disabilities as either a teleological narrative of progression toward utopian inclusion or a melancholy mourning of trauma, loss and lack. Is it possible to construct a history of theatre involving people with intellectual disabilities that does not resemble a colonial account of the discovery of newfound, exotic Others? How is it possible to assemble histories of such theatrical performance that do not reproduce the historical exclusion and exclusion from history of people with intellectual disabilities?