children s health issues
Intellectual Disability
Diagnosis of Intellectual Disability
Prenatal screening Developmental screening Formal intellectual and skills testing Imaging tests Genetic and other laboratory tests Screening before birth (prenatal screening) can be done to determine whether the fetus has certain abnormalities, including certain genetic disorders, that may cause intellectual disability. From birth on, Childhood Development , including cognitive ability, are routinely assessed at well-child visits. When doctors suspect intellectual disability, children are evaluated by teams of professionals, including early intervention or school staff, a primary care doctor, a pediatric neurologist or developmental pediatrician, a psychologist, speech pathologist, occupational or physical therapist, special educator, social worker, or nurse. These professionals evaluate a child suspected of having intellectual disability by testing intellectual functioning and looking for a cause. Even though the cause of the child's ID may be irreversible, identifying a disorder that caused the disability may allow doctors to predict the child's future course, prevent further loss of skills, plan any interventions that can increase the child's level of functioning, and counsel parents on the risk of having another child with that disorder. Certain tests, such as Ultrasonography , Measuring the mother's blood level of Second-Trimester Screening is a helpful screening test for Because mild developmental problems are not always noticed by parents, doctors routinely do developmental screening tests during well-child visits. Doctors use simple questionnaires, such as the Ages and Stages Questionnaires or Child Development Inventories, to quickly evaluate the child's cognitive, verbal, and motor skills. Parents can help the doctor determine the child's level of functioning by completing a Parents' Evaluation of Developmental Status (PEDS) test. Children who perform significantly below their age level on these screening tests are referred for formal testing. Formal testing has three components: Interviews with parents Observations of the child Tests in which the child's performance is compared with scores of many children of the same age Some tests, such as the Stanford-Binet Intelligence Test and the Wechsler Intelligence Scale for Children, are done to measure intellectual ability. Other tests, such as the Vineland Adaptive Behavior Scales, are done to assess areas such as functional communication, daily living skills, social abilities, and motor skills. Generally, these formal tests accurately compare a child's intellectual and social abilities with those of others in the same age group (called norm-referenced tests). However, children of different cultural backgrounds, non–English-speaking families, and very low socioeconomic status are more likely to do poorly on these tests. For these reasons, a diagnosis of ID requires that the doctor integrate the test data with information obtained from parents and direct observations of the child. A diagnosis of ID is appropriate only when both intellectual and adaptive skills are significantly below average. Newborns with physical abnormalities or other symptoms suggestive of a condition associated with intellectual disability often need certain tests. Imaging tests, such as Magnetic Resonance Imaging (MRI) , may be done to look for structural problems within the brain. An Genetic tests, such as chromosomal microarray analysis, may help identify disorders. Doctors may recommend genetic testing for people who have a family member or other child with a known inherited disorder, particularly ones related to ID, such as Phenylketonuria (PKU) , Other urine and blood tests are done depending on what doctors suspect is the cause. Some children who are delayed in learning language and mastering social skills have conditions other than ID. Because hearing problems interfere with language and social development, a Screening and Diagnosis is typically done. Emotional problems and Learning Disorders also can be mistaken for ID. Children who have been severely deprived of normal love and attention ( see 