Essentials of Intellectual Disability Assessment and Identification

Alan W. Brue, Linda Wilmshurst, Alan S. Kaufman, Nadeen L. Kaufman

• Publisher: Wiley
• Year: 2016
• ISBN:
  9781118875537
• Edition: 1
• Topic: Psychology
• Subtopic: Research & Methodology in Psychology
• Index: Psychology

Brue's Essentials Intellectual Disability is a concise, up-to-date overview of intellectual disability evaluation and assessment. This text offers a practical, concise overview of the nature of intellectual disability and adaptive skills functioning in children, adolescents, and adults. Coverage includes the latest information on prevalence, causes, differential diagnoses, behavioral and social concerns, test instruments, and the new DSM-5 diagnostic criteria. The discussion promotes a deeper understanding of the use of assessment data to inform interventions in clinical practice.

Designed for easy navigation, each chapter highlights important points and key cautions to allow quick reference without sacrificing depth. A sample assessment report illustrates how findings should be communicated to better inform treatment, giving you a practical reference to ensure comprehensive reporting. In 2013, the DSM-5 conceptualization of intellectual disabilities was significantly changed. It's important for professionals to have access to the most current guidelines from a variety of sources, and this book compiles them all into a single reference.

Chapter One
History of Intellectual Disability

This introductory chapter provides a brief but significant discussion concerning how intellectual disability (ID) has been defined and conceptualized historically by the different classification systems: Diagnostic and Statistical Manual of Mental Disorders (DSM), American Association on Mental Retardation/American Association on Intellectual and Developmental Disabilities (AAMR/AAIDD), and Individuals with Disabilities Education Act (IDEA). This background information lays the foundation for a more complete understanding of issues associated with the diagnosis of intellectual disability and the evolution that has occurred in the ways the disorder is conceptualized today. This chapter will discuss the shift in conceptualization from variations in the degree to which the disorder is manifested (DSM: mild, moderate, severe, profound) to variations in the intensity of services needed (AAIDD: intermittent, limited, extensive, pervasive). The 2010 AAIDD Operational Definition of Intellectual Disability is addressed.

Early Beginnings

Historically, distinctions between “idiots” and the “insane” began to emerge out of necessity, at the end of the Middle Ages, as laws were being developed. Within this context, idiots were thought to be less responsible for crimes committed resulting from their lack understanding due to their state of ignorance. On the other hand, those who were insane had the ability to understand and plan but committed crimes based on their lack of adherence to moral standards, which was considered an offence that was punishable by law (Wickman, 2013). However, the first reported documentation of the distinction between mental capacity and mental illness came in 1838, when the scientist Jean Esquirol (1772–1810) published his manuscript on mental health. In his book, Esquirol devoted a large section to the topic of idiocy and stated that there was a distinction between an “idiot”, who is never able to develop his or her mental capacity, and a “mentally deranged” person, who developed normal intellectual ability but then had lost it (Sattler, 2001, p. 129). Later it was recognized that Esquirol's description of the characteristics of those with idiocy closely matched features of what we currently know as Down syndrome (Roubertouz & Kerdelhue, 2006).

The system of care and support for individuals with intellectual disabilities had its roots in the beginning of the 19th century with Jean Itard's attempts to educate Victor (the wild boy of Aveyron), a boy in his early teens who had been living on his own in the forest. Although Itard eventually abandoned his efforts due to slow progress and minimal gains, he did open the door for future efforts in the intervention and training of skills in individuals with intellectual disabilities. By the mid-1800s, advocates such as Cheyne Brady, a London lawyer, published a volume titled What Can Be Done for the Idiot, in which he wrote that although idiocy is “unquestionably one of the most fearful of the host of maladies,” modern science shows the promise that “there is no class of unfortunates of our species to whom enlightened treatment may be applied with a more cheering hope of success” (Brady, as cited in Ferguson, Ferguson, & Wehmeyer, 2013, p. 87).

In 1840, medical student and educationalist Edouard Seguin, who worked with Victor under Itard's direction, established the first private school in Paris dedicated to the education of individuals with intellectual disabilities. In 1846, he published Traitement Moral, Hygiène, et Education des Idiots (The Moral Treatment, Hygiene, and Education of Idiots and Other Backward Children). Seguin created a program, called the Physiological Method, which was a sensory-based training program (dealing with vision, hearing, taste, smell, touch) developed to enhance the senses and potentially open the channels to increased cognitive functioning (Sheerenberger, 1983). He later expanded the program to include memory, imitation, reinforcement, and vocational training. Sequin relocated to the United States in 1850, where he continued to revolutionize education for individuals with intellectual disabilities. In 1876, he became the founding father of the American Association on Mental Retardation (AAMR). The next section outlines the history of intellectual disabilities, previously known as mental retardation (MR). Some of the key milestones in the historical progression are highlighted in Rapid Reference 1.1.

---

Rapid Reference 1.1: A Historical Look at Intellectual Disabilities

1. 1838 Jean Esquirol publishes a manuscript which contains a large section devoted to determining the difference between idiocy and mentally deranged persons.
2. 1876 Seguin becomes the founding father of AAMR.
3. 1905 The Binet Simon, published in France, becomes the first instrument to assess intelligence.
4. 1910 AAMR publishes the first system of classification for MR. Henry Goddard, director of research at the Vineland Training School, publishes an American version of the Binet Simon.
5. 1916 Terman renames the Binet-Simon the Stanford Binet and revises how intelligence is derived using the intelligence quotient (IQ).
6. 1935 Edgar Doll publishes the Vineland Social Maturity Scale.
7. 1952 DSM–I (American Psychiatric Association [APA]) introduces the classification category of mental deficiency for cases primarily presenting as a defect in intelligence. The category contains three levels of severity: mild, moderate, and severe.
8. 1959 AAMR announces three criteria for establishing MR: low IQ (less than 85), impaired adaptive behavior, and onset before age 16. Five levels of severity are suggested: borderline, mild, moderate, severe, and profound.
9. 1968 DSM–II (APA) changes the name from “mental deficiency” to “mental retardation” and adopts the five levels of severity suggested by the AAMR. Criteria are low IQ (less than 85), impaired adaptive skills, and onset during the developmental period.
10. 1971 In Wyatt v. Stickney, a landmark class action suit in Alabama, Judge Johnson rules that individuals confined to residential centers have a right to treatment.
11. 1975 Public Law 94-142: Rights of all children with disabilities to have a free and appropriate education. The law, The Education of all Handicapped Children Act (EHA), provides state grants for the provision of services for children with disabilities.
12. 1979 As a result of the class action lawsuit Larry P. v. Riles, all California school districts were barred from using IQ tests as the sole means of determining placement of African American children in classes for the educable mentally retarded.
13. 1980 DSM–III (APA) reduced “subnormal” intelligence from an IQ of 85 (I standard deviation [SD] below the mean) to an IQ of 70 (2 SDs below the mean).
14. 1990 EHA is revised and renamed the Individuals with Disabilities Education Act (IDEA).
15. 1992 AAMR releases the revision of its manual replacing levels of severity of MR with patterns and intensity of supports needed: intermittent, limited, extensive, and pervasive.
16. 1994 DSM–IV (APA) retains the four levels of severity—mild, moderate, severe, profound—which are no longer comparable to AAMR criteria; however, it makes comparisons to the education system (e.g., “mild” is equivalent to “educable”; “moderate” is equivalent to “trainable”).
17. 1997 IDEA is reauthorized.
18. 2004 IDEA reauthorized and renamed the Individuals with Disabilities Education Improvement Act of 2004.
19. 2007 AAMR changes its name to the American Association on Individuals with Intellectual and Developmental Disabilities (AAIDD).
20. 2010 President Obama signs “Rosa's Law” on October 5.
21. 2010 AAIDD publishes the most recent version, the 11th edition of AAIDD's Intellectual Disability: Definition, Classification, and Systems of Support (AAIDD, 2010).
22. 2013 DSM–5 (APA) publishes the most recent criteria for intellectual disability in the section on Neurodevelopmental Disorders.

---

The Turn of the Century: 1900 to 1950

In the United States, Samuel Gridley Howe, who had worked with children who were blind and deaf-blind, began to look for ways to bring this sense of optimism from Europe to the Western world and emphasized the importance of identifying levels of idiocy. He suggested that the levels ranged from pure idiocy (the most severe form) to fools and simpletons, whom he felt had the best chances for improvement, based on education and training (Ferguson et al., 2013). In the wake of the Industrial Revolution and the influx of many street children into the schools, the French government commissioned Alfred Binet (1857–1911), a lawyer and scientist, and Theodore Simon (1873–1961) to develop a method of screening which children might be identified as “mentally retarded” in order to better assist these children with s...

Table of contents

• Cover
• Title Page
• Copyright
• Table of Contents
• Dedication
• Series Preface
• Acknowledgments
• Chapter One: History of Intellectual Disability
• Chapter Two: Prevalence, Causes, Issues, and Comorbid Disorders
• Chapter Three: Current Intellectual Disability Diagnostic and Federal Education Criteria
• Chapter Four: Legal Issues and Concerns
• Chapter Five: Theories of Intelligence and the Flynn Effect
• Chapter Six: Assessment of an Intellectual Disability
• Chapter Seven: Integration of Assessment Results
• Chapter Eight: Postassessment Planning
• Appendix A: State Departments of Special Education
• Appendix B: AAIDD and The Arc Position Statement on the Criminal Justice System
• Appendix C: American Association on Intellectual and Developmental Disabilities (AAIDD): Guidelines to Professional Conduct
• Appendix D: The ARC Position Statement on Self-Determination
• Appendix E: AAIDD and The Arc Position Statement on Self-advocacy
• Appendix F: The ARC Position Statement on Education
• Appendix G: The ARC Position Statement on Employment
• Appendix H: Helpful Websites
• References
• About the Authors
• Index
• End User License Agreement