Using informal measures, such as those designed by the clinician and tailored to the population being screened (e.g., age, developmental level, language[s] used). Sensitivity to cultural and linguistic variables is necessary when selecting formal and informal assessment measures. 241268). Infant-Toddler Intervention: The Transdisciplinary Journal, 8(2), 109125. There are prenatal, perinatal, and postnatal causes of intellectual disability (ID). The ASHA Action Center welcomes questions and requests for information from members and non-members. For example, a physical therapist and an SLP may work together to improve respiratory support, which can, in turn, enhance speech production and intelligibility. Tager-Flusberg, H., & Caronna, E. (2007). This goal bank includes a variety of examples/ ideas of goals and objectives for students with moderate to severe disabilities. Promote academic engagement and communication of students with autism spectrum disorder in inclusive settings. (Eds.). Perspectives on Gerontology, 19(1), 3643. Allow me! SLPs also play a role in enhancing adaptive communication functioning, as many of the adaptive skill areas rely on communication abilities. Speech-language pathologists (SLPs) do not diagnose intellectual disability (ID) but play a key role in assessing the communication and language skills of individuals with ID. Augmentative and alternative communication: Supporting children and adults with complex communication needs (5th ed.). Research in Developmental Disabilities, 32(1), 188193. It can be used with a large variety of individuals. Aligned IEP Goal/s: Students will be able to identify and describe the consequences of different choices and decisions. Interprofessional collaboration may also improve communication skills. Adults with ID experience the same age-related health problems and functional decline observed in the general elderly population (Lazenby-Paterson & Crawford, 2014). 106-402, 102(8). Students will be able to practice appropriate social interactions in various . Social determinants of health: Key concepts. A lack of generalization of these skills to real-life situations is often reported. Fetal alcohol syndrome is the largest environmental cause of ID. ABA techniques are often used in intensive, early intervention (before the age of 4 years) programs to address a full range of life skills (e.g., Frea & McNerney, 2008). Characteristics may include the following: Fragile X syndrome is the most common inherited cause of ID (Lozano et al., 2014). Team models may be multidisciplinary, interdisciplinary, or transdisciplinary (see ASHAs resource on collaboration and teaming). Brookes. Journal of Applied Research in Intellectual Disabilities, 29(5), 409421. SLPs help ensure that communication partners recognize and respond to communication attempts and build on the interests, initiations, and requests of persons with ID. Eligibility is an area that has continued to evolve as the rights of individuals with ID have been increasingly well recognized. Provide treatment, document progress, and determine appropriate timelines for treatment and development of new treatment goals/targets for the individuals continued development. Environmental arrangement. L. No. Prevalence refers to the number of people who are living with the condition in a given time period. Make sure your goals are SMART. Functional assessment strategies for young children with autism. https://doi.org/10.1037/0000165-000, American Speech-Language-Hearing Association. Prevalence of chronic health conditions in children with intellectual disability: A systematic literature review. https://doi.org/10.1016/j.ridd.2011.05.009, Lazenby, T. (2008). Abbeduto, L., & Sterling, A. Lack of linguistically appropriate measures and awareness of cultural influences on assessment, layered with the inherent bias in the evaluation process, results in disproportionality in Black, Indigenous, and People of Color (BIPOC) communities. https://doi.org/10.1037/0022-006X.75.4.594, Anderson, L. L., Larson, S. A., MapelLentz, S., & Hall-Lande, J. FCT can be used across a range of ages and regardless of cognitive level or expressive communication abilities. https://doi.org/10.1046/j.1365-2788.2001.00348.x, Warren, S. F., Fey, M. E., Finestack, L. H., Brady, N. C., Bredin-Oja, S. L., & Fleming, K. K. (2008). Diagnosis of ID is not made by a speech-language pathologist (SLP). The WHO defines social determinants of health as facts related to how individuals experience the world, such as birthplace, where they live, where they work, and their age (WHO, 2013). ASD commonly co-occurs with ID (see the Incidence and Prevalence section above). Intervention for individuals with ID involves a variety of communication partners (peers and adults) in different settings and may address the following areas: Treatment programs often incorporate teaching or coaching models for communication partners, including peers, so they may support the individuals language comprehension and expression. Individuals transitioning from school to employment need communication skills specific to the work setting (e.g., talking with co-workers and supervisors, interacting with customers). It can be caused by injury, disease, or a problem in the brain. United Statesbased studies reported the prevalence of ID to be 7.9 per 1,000 adults (L. L. Anderson et al., 2019). The World Health Organizations (WHOs) International Classification of Functioning, Disability and Health (ICF) framework (WHO, 2001) and its Children & Youth version (WHO, 2007) recognize activity and participation limitations in addition to impairments in body functions and structures. Communication intervention for ID focuses on interactions that may occur within an individuals natural environment to reflect social norms of their community. In some cases, an IQ cutoff score is used (e.g., 70) as a criterion for diagnosis, whereas in other cases, the diagnostic criteria are more qualitative in nature (e.g., onset in childhood with limitations in adaptive behavior and intellectual functioning). Brookes. Brookes. (Practice Portal). Please see Co-Occurring Conditions and Disorders section above for further information regarding ID in specific populations. Speech and language skills may begin to decline in adults with ID from about the age of 50 years even when dementia is not taken into account (J. E. Roberts et al., 2007). (2009). (2016). very basic nonverbal communication. https://doi.org/10.1177/1044207309350561, Wolfberg, P. J., & Schuler, A. L. (1999). Per the Institute of Medicine (US) Committee on Nervous System Disorders in Developing Countries (2001), DD is a set of limitations that begin in infancy or childhood, with delays in reaching developmental milestones or limitations in one or more of the following domains: The Developmental Disabilities Assistance and Bill of Rights Act of 2000 defines or characterizes DD as follows: Lifelong, early-onset conditions that result in substantial functional limitationsbut not necessarily concomitant intellectual limitationsinclude autism spectrum disorder (ASD) or cerebral palsy. SLPs are also mindful of gender presentations. Application of stimulus equivalence to language intervention for individuals with severe linguistic disabilities. See also Relation of Age to Service Eligibility and Relation of Developmental Age to Service Eligibility for the NJC position on eligibility. Intellectual and Developmental Disabilities, 49(2), 5985. Publication manual of the American Psychological Association (7th ed.). This is especially the case in the most studied populationsDown syndrome and ASD. American Family Physician, 61(4), 10591067. Assessments address components within the International Classification of Functioning, Disability and Health (WHO, 2001) framework, including body structures/functions, activities/participation, and contextual factors. See the Treatment section of the Intellectual Disability evidence map for pertinent scientific evidence, expert opinion, and client/caregiver perspective. 2756). American Association on Intellectual and Developmental Disabilities. Augmentative and Alternative Communication, 18(3), 163176. ASHA extends its gratitude to the following subject matter experts who were involved in the development of the Intellectual Disability page: In addition, ASHA thanks the members of the Ad Hoc Committee to Review/Revise Current Practice and Policy Documents Related to Mental Retardation/Developmental Disabilities, whose work was foundational to the development of this content. Formatrefers to the structure of the treatment session (e.g., group vs. individual; direct and/or consultative) provided. (2009). Rates and predictors of co-occurring autism spectrum disorder in boys with fragile X syndrome. It is a leading cause of developmental disabilities in the United States (Clarke & Gibbard, 2003). Understanding the communicative intention of challenging behaviors serves as the basis for replacing problem behaviors with more appropriate communication skills, including AAC, that would serve the same functions (see the Functional Communication Training (FCT) subsection in the Treatment section). (1998). Screening may not be a needed step for individuals with intellectual disability (ID), particularly those with more severe limitations in intellectual or adaptive functioning. A multi-method investigation of pragmatic development in individuals with Down syndrome. Plan for transitions from educational to community support services. However, AAIDD identifies the level of ID based on the level of supports needed for an individual to successfully function in activities of daily living. Early detection of hearing loss and routine monitoring are essential for ensuring positive communication outcomes. See ASHAs Practice Portal page on Late Language Emergencefor further information. (2013). Milieu therapy is a range of methods (including incidental teaching, time delay, and mand-model procedures) that are integrated into a childs natural environment. Video-based instruction (also called video modeling) is an observational mode of teaching that uses video recordings to provide a model of the target behavior or skill. Universal Design for Learning is a lesson planning framework that can guide teachers in inclusive lesson planning. Dysphagia, 23(1), 8897. https://doi.org/10.1111/j.1365-2788.2008.01115.x, Cheslock, M. A., Barton-Hulsey, A., Romski, M. A., & Sevcik, R. A. Guralnick, M. J. Milieu language teaching and other related procedures offer systematic approaches for prompting children to expand their repertoire of communication functions and to use increasingly complex language skills (Kaiser & Roberts, 2013). According to the Diagnostic and Statistical Manual of Mental Disorders (5th ed. https://doi.org/10.1080/07434610212331281251, Snell, M. E., Brady, N., McLean, L., Ogletree, B. T., Siegel, E., Sylvester, L., Mineo, B., Paul, D., Romski, M. A., & Sevcik, R. (2010). This is in no way meant to be a document to just copy and paste from. Problem behaviors are then replaced with alternate, more appropriate forms of communicating needs or wants. Fidler, D. J., Most, D. E., & Philofsky, A. D. (2009). American Journal of Medical Genetics, 117C(1), 314. Delayed speech and language acquisition (Cone-Wesson, 2005; Terband et al., 2018). Pennington, L., Goldbart, J., & Marshall, J. Based on data from the 2011 meta-analysis of international studies, the female-to-male ratio of adults with ID varied between 0.7 and 0.9 (i.e., seven to nine females with ID for every 10 males with the condition; Maulik et al., 2013). Prevalence of cooccurring psychiatric disorders in adults and adolescents with intellectual disability: A systematic review and metaanalysis. (1998). Journal of Communication Disorders, 38(4), 279302. Relationship-focused early intervention with children with pervasive developmental disorders and other disabilities: A comparative study. https://doi.org/10.1177/108835769701200205, Burt, D. B., Primeaux-Hart, S., Loveland, K. A., Cleveland, L. A., Lewis, K. R., Lesser, J., Pearson, P. L., & MacLean, W. E., Jr. (2005). Family-centered care is well suited to individuals with intellectual disability (ID) because of the complexity of their health, educational, vocational, and community living challenges across settings and over time. See the Service Delivery section of the Intellectual Disability evidence map for pertinent scientific evidence, expert opinion, and client/caregiver perspective. The scope of this page is centralized content about individuals with an intellectual disability (ID) and associated communication difficulties across the life span. Keep these factors in mind when reviewing the incidence and prevalence data below. Regional and National Summary Report of Data from the 201314 Annual Survey of Deaf and Hard of Hearing Children and Youth. B. Descriptive terminology and philosophy concerning ID focuses on levels of support necessary to maximize an individuals ability, rather than strictly on functional limitations. SLPs typically educate team members about the communication functions of such behaviors and develop methods for replacing them with other forms of communication behavior. The Journal of Child Psychology and Psychiatry, 51(6), 660667. Service-learning is a form of experiential learning that blends classroom instruction with community service. Prior studies have highlighted over- and underrepresentation of ID and/or learning disability (LD) identification across race and ethnicity (e.g., Shifrer, 2018; Shifrer et al., 2011). Screen individuals who may have hearing, speech, language, communication, and/or swallowing difficulties and determine the need for further assessment and/or referral for other services. Individuals who have ID may have a need to use multiple languages and/or dialects to communicate with loved ones and peers. Journal of Applied Research in Intellectual Disabilities, 33(2), 126138. Such models may serve to prepare persons with ID for transitions to independent living and working (White et al., 2010). (2001). Increased risk for language disorders (Pennington et al., 2005). Psychiatry, 8(9), 355357. Prevalence of autism spectrum disorder among children aged 8 yearsAutism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2016. Journal of Communication Disorders, 71, 7284. Terband, H., Spruit, M., & Maassen, B. https://doi.org/10.1111/j.1365-2788.2001.00290.x. LEAP is a multifaceted program for preschool children with ASD and their parents (Strain & Hoyson, 2000). Journal of Learning Disabilities, 44(3), 246257. Studies reported results based on gender; however, there were no indications whether the data collected were based on sex assigned at birth, gender identity, or both. https://doi.org/10.1111/j.1469-7610.2011.02395.x, Casby, M. W. (1992). An individuals total identities are considered during assessment and treatment. Multilingual and multidialectal populations exist across the globe. For example, some individuals with ID may be good candidates for immediate introduction of symbolic communication goals that target acquisition and use of words or symbols. Additional information on literacy interventions can be found at the ASHA Practice Portals page on Written Language Disorders. Motor performance of children with mild intellectual disability and borderline intellectual functioning. Appropriate roles for SLPs include the following. Language, Speech, and Hearing Services in Schools, 39(2), 261272. Brookes. SLPs work to maximize the participation and independence of individuals with ID as they experience life transitions that place new demands on communication. Focus on Autism and Other Developmental Disabilities, 16(4), 222227. act appropriately in various settings (e.g., Cohen & Demchak, 2018). National Academies Press. Goal Written in the IEP of a 3rd Grade Student with a Learning Disability. Research in Developmental Disabilities, 55, 161172. For example, individuals with Down syndrome may be at higher risk for earlier onset of dementia when compared with the general population (Burt et al., 2005; Hawkins et al., 2003). Parent-mediated/implemented treatment approaches involve partnerships between SLPs, parents/caregivers, and other professionals and communication partners in supporting the natural communication behaviors of individuals with intellectual and other developmental disabilities (Guralnick, 2017; M. Y. Roberts & Kaiser, 2011). https://doi.org/10.1352/0047-6765(2003)041%3C0007:ABACFO%3E2.0.CO;2, Herer, G. R. (2012). Social and pragmatic skill strengths that vary depending on executive function and ToM skills (Lee et al., 2017). Incidence refers to the number of new cases identified in a specified time period. For example: The professional roles and activities in speech-language pathology include clinical/educational services (assessment, planning, and treatment); prevention and advocacy; and education, administration, and research. Better health, better lives: Children and young people with intellectual disabilities and their families. As individuals with ID reaches adolescence and adulthood, their communication and functional needs change. See ASHAs Practice Portal pages on Hearing Loss in Children and Hearing Loss in Adultsfor more information. https://doi.org/10.1023/A:1010660502130. Individuals with Disabilities Education Improvement Act of 2004, Pub. (2020). In R. J. McCauley, M. E. Fey, & R. B. Gillam (Eds. Intractable & Rare Diseases Research, 3(4), 134146. Autism Research, 7(5), 608616. The treatment modes/modalities described above (e.g., AAC) may be used to implement these treatment options. Discrete-trial functional analysis and functional communication training with three individuals with autism and severe problem behavior. Informal testing may be useful to determine the individuals achievement of developmental milestones. Limitations in adaptive functioning in specific skill areas are a necessary criterion for diagnosis under the AAIDD and DSM-5 definitions. difficulty with nonverbal communication modalities (e.g., gestural or facial expression). Communication skills among individuals with ID can vary due to severity; co-occurring conditions; and other behavioral, emotional, and social factors. https://doi.org/10.1177/0022219410374236, Shott, S. R. (2006). putting interesting materials in sight but out of reach; sabotaging the situation with missing elements or providing inadequate portions; and. (2014). The Developmental Disabilities Assistance and Bill of Rights Act of 2000 defines or characterizes DD as follows: a severe, chronic disability in an individual 5 years of age or older onset before 22 years of age results in substantial functional limitations in three or more areas of life activity such as self-care, https://doi.org/10.1002/ajmg.c.10015, Beadle-Brown, J., Leigh, J., Whelton, B., Richardson, L., Beecham, J., Baumker, T., & Bradshaw, J. Journal of Intellectual Disability Research, 53(1), 2943. Session ( e.g., group vs. individual functional language goals for intellectual disabilities direct and/or consultative ) provided with nonverbal communication (. Specified time period lack of generalization of these skills to real-life situations is often reported adaptive skill areas are necessary. 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