Neurodevelopmental and Behavioral Pediatrics

Intellectual Disabilities - General Overview

Description

Intellectual Disability (ID) is below-average cognitive ability with significant limitations in adaptive skills areas. 

Diagnosis 

The diagnosis of Intellectual Disability is made based on testing of cognitive and adaptive skills.  Cognitive skills are things like memory, reasoning, and learning.  Adaptive skills are those skills needed in daily live, such as self-care, home living, social skills, leisure skills, health and safety, community participation and employment.  In order to have a diagnosis of Intellectual Disability, a child must have below-average cognitive ability (Usually defined as an Intelligence Quotient, IQ, of below 70), along with below-average adaptive skills.  These deficits must be present before age 18.  Because intelligence testing is not reliable in young children, young children often are not diagnosed with Intellectual Disability before school age.  Children often first are noted to have developmental delays in language, motor, social, adaptive and/or cognitive areas.  These children may catch up, may go on to have intellectual disabilities, or may not meet criteria for intellectual disabilities but instead have a domain specific disorder (communication disorder or motor skills disorder).

How Many People Have Intellectual Disability 

Somewhere between 1 and 3 of every 100 Americans have intellectual disabilities. 

What Causes Intellectual Disability

Intellectual disabilities can be caused by any condition that impairs development of the brain before birth, during birth or during the early childhood years. In about 1/3 of people with intellectual disabilities, the cause is unknown.  The most common known causes of intellectual disabilities are fetal exposures Fetal Alcohol Spectrum Disorder (FASD) and genetic conditions including Down syndrome and Intellectual Disability syndrome.

Associated Developmental and Learning Issues

The impact of having an Intellectual Disability varies considerably, just as the range of abilities varies considerably among all people.  Children may take longer to learn to speak, walk and take care of their personal needs, such as dressing or eating.  It may take longer to learn in school. As adults, some people are able to lead independent lives in the community, while others require more formal supports.

There is no cure for Intellectual Disability, but with treatment and supports, those with intellectual disabilities can lead satisfying lives in the community. 

Associated Health Conditions 

For a variety of reasons, certain health conditions are more common in children with intellectual disability. It is important that these are recognized and treated.  A child with Intellectual Disability who is physically healthy is more likely to do well in school and in other treatments.  This contributes to more independence, better daily functioning, and better quality of life. 

  • Seizures
  • otitis media (ear infections),
  • GI problems (gastroesophageal reflux disease (GERD), constipation)
  • dysmenorrhea (painful menstruation)
  • sleep problems
  • vision and hearing problems
  • Feeding and growth problems
  • Musculoskeletal problems including hypotonia, scoliosis
  • oral health problems 

Associated Behavioral Conditions

Some, but not all, children with intellectual disability have behavioral challenges such as:

  • Tantrums
  • ADHD
  • Aggression, self-injury
  • Anxiety

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