Understanding intellectual disability

Prakash is a ten-year-old boy, studying in Class 4. He goes to school regularly and likes to play and meet his friends. His teachers try to make him learn to read, write and do simple mathematical operations. Yet, he seems lost and disinterested. He appears confused generally and gives wrong answers, and when asked about it, he says he does not remember the answers. He cannot recognise simple words or even the basic alphabet, and cannot count.

His social development is also inadequate. He has difficulty understanding his own and others’ feelings. This has started affecting his social interactions. His friends are finding it difficult to adjust to him. His teachers refer him to a psychologist where an intelligence quotient (IQ) assessment reveals a score of 60 which indicates mild to moderate intellectual disability.

What does this mean? How is it related to the difficulties that Prakash is experiencing in his studies and in his day-to-day life? What can be done to help and support him?

The concept of IQ

We have all heard the term IQ. People refer to themselves or others as having high, low or medium IQ. What exactly does this mean?

IQ is a number used to express an individual’s intelligence level based on standardised psychological tests. Several tests have been designed to measure IQ. Most IQ tests focus on a person’s reasoning, language, mathematical, visuospatial ability, memory and processing speed. IQ tests are used for different purposes including diagnosis of intellectual disabilities, evaluating cognitive abilities like attention, memory, problem-solving and response time, and sometimes in job placements.

Most of us have an average IQ, which is a score between 90 to 110. Very few people have a high IQ which is 120 or above. Very few have a very low IQ which is 70. Individuals with below-average intelligence (IQ below 70) have been classified as having mild, moderate, severe or profound intellectual disability. People with profound and severe disabilities need continuous care and support and are dependent on others for almost all their needs.

There is no known treatment to increase IQ. It is a condition and we have to find ways to use the intelligence that we are born with. Parents of children like Prakash, in their desperate hopes of finding solutions, often spend time, energy and money on useless medicines or superstitious rituals which falsely claim to increase the children’s learning ability.

The support plan

Approximately 3% of the population has an intellectual disability. Every classroom and every school has children who need a special approach. Unrealistic expectations from parents and teachers can become a burden on the child. Sometimes, teachers may behave in ways that are difficult and embarrassing to parents. These pressures increase the child’s anxieties and reduce the child’s confidence.

Children with Intellectual disabilities need supportive rehabilitation rather than treatment. Each child needs an individualised support plan to assess her needs and abilities. It is important to focus on the strengths of the child and reduce the impact of limitations. It is also important to keep in mind the child’s environment to match it with his or her abilities. Parents, teachers and psychologists have to discuss the family situation or context, and the child’s strengths and limitations and try to support the child to maximize their potential.

In the absence of proper understanding and a supportive system, children with intellectual disabilities may develop other psychological problems due to frustration. They may exhibit sadness, and anger and may start avoiding activities and social interaction. It is the responsibility of the community to respond to their needs with compassion, understanding and proper interventions that will allow them to learn, work and live as healthy members of society.

(The author is a counsellor)