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COPE Crisis Hotline: 1-800-542-2673

Frequently Asked Questions

Who might use our services?
When might you need our services?
Who can refer individuals to this program?
What is an intellectual disability?
What causes intellectual disability?
How is intellectual disability diagnosed?
How common is intellectual disability?
What are the signs of intellectual disability?
Can children with intellectual disabilities attend school?
How can I best help my intellectually disabled child?
How can I best help my intellectually disabled students?
Are psychiatric disorders common in those with intellectual disability?



Who might use our services?

The Community Options Division of the Middle Peninsula-Northern Neck Community Services Board (MPNNCSB) provides support to individuals who have been diagnosed with intellectual disability, as well as those who have cognitive developmental delays and related conditions, such as autism and cerebral palsy.

When might you need our services?

Community Options assists anyone who has intellectual disability or a related condition and needs help navigating the multiple systems of everyday life. Services may include but are not limited to: application for Section 8 housing, assistance with the special education Individual Education Plan (IEP), job placement, vocational training, housing, and medical appointments.

We offer a wide range of case management, residential, and day support services designed to ensure that people with intellectual disabilities can live in their own home communities, in an environment that encourages:
  • Personal growth
  • Access to community resources
  • Lifestyles enhancement
  • Genuine personal choice and self direction
Who can refer individuals to this program?

Anyone who cares about a person with intellectual disability can request services; however, the requester must have the individual’s (or his parent’s or guardian’s) permission to make the referral.

What is an intellectual disability?

Intellectual disability is a term used when a person has certain limitations in mental functioning and in skills such as communicating, taking care of oneself, and social skills. These limitations cause a child to learn and develop more slowly than a typical child. Children with intellectual disability may take longer to learn to speak, walk, and tend to personal needs such as dressing or eating. They are likely to have trouble learning in school. They will learn, but it will take them longer. There may be some things they cannot learn.

The definition for intellectual disability is found in Public Law 101-476, the Individuals with Disabilities Education Act (IDEA) of 1990:

Mental retardation [intellectual disability] means significantly subaverage general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period that adversely affects a child's educational performance. [Federal Register, 57(189), September 29, 1992, p.44801]

In its 1992 manual on definition and classification, the American Association on Mental Retardation (AAMR) offers the following definition:

Mental retardation [Intellectual disability] refers to substantial limitations in present functioning. It is characterized by significantly subaverage intellectual functioning, existing concurrently with related limitations in two or more of the following applicable adaptive skill areas: communication, self-care, home living, social skills, community use, self-direction, health and safety, functional academics, leisure and work. Mental retardation [Intellectual disability] manifests before age 18.

Significantly subaverage intellectual functioning means an IQ score of 70 to 75 or below on a standardized individual intelligence test. Related limitations means adaptive skill (the skill needed to live independently) limitations that are related more to functional applications such as the ability to think and reason than other circumstances such as cultural diversity or sensory impairment.

The 1992 AAMR definition represents a significant change in the way we view those with intellectual disability. Rather than describing intellectual disability as being unable to function competently, the new definition refers to a pattern of limitations, considering how people function in various contexts of everyday life. This definition is based on four assumptions:
(1) valid assessment considers cultural and language diversity, as well as differences in communication and behavioral factors;
(2) limitations in adaptive skills occurs within the context of community environments typical of the individual's peers of the same age and is indexed to the person's individual needs for support;
(3) specific adaptive limitations often coexist with strengths in other adaptive skills or other personal capabilities;
(4) the life functioning of a person with intellectual disability generally will improve if he or she has appropriate supports over a sustained period.

What causes intellectual disability?

Doctors have found many causes of intellectual disability. The most common are:
  • Genetic conditions. Sometimes certain genetic conditions cause intellectual disability, such as abnormal genes inherited from parents, errors when genes combine, or other reasons. Examples of genetic conditions are Down syndrome, fragile X syndrome, and phenylketonuria (PKU). Newborn screening programs can prevent some cases of intellectual disability by identifying inherited conditions that may lead to it. All 50 states in the U. S. require a blood test for congenital hypothyroidism and PKU. Infants with PKU cannot metabolize the amino acid phenylalanine, found in foods that contain protein. Once identified, these infants can be given a low-phenylalanine diet that prevents intellectual disability. Some states require newborn screening for additional inherited diseases. Adult screening tests can identify carriers of other conditions before couples conceive a child.

  • Problems during pregnancy. Intellectual disability can result when the baby does not develop inside the mother properly. For example, there may be a problem with the way cells divide as the baby grows. A woman who drinks alcohol or gets an infection like rubella during pregnancy may also have a baby with intellectual disability.

  • Problems at birth. If a baby has problems during labor and birth, such as not getting enough oxygen, he or she may have intellectual disability.

  • Health problems. Diseases like whooping cough, the measles, or meningitis can cause intellectual disability. Extreme malnutrition (not eating properly), not getting enough medical care, or being exposed to poisons like lead or mercury can also cause intellectual disability.

Intellectual disability is not a disease that you can catch or a type of mental illness, like depression. There is no cure for intellectual disability; however, most children with intellectual disability can learn to do many things. It just takes them more time and effort than other children.

How is intellectual disability diagnosed?

Intellectual disability is diagnosed by evaluating both:
  • The ability of a person's brain to learn, think, solve problems, and make sense of the world (called IQ or intellectual functioning)
  • Whether the person has the skills he or she needs to live independently (adaptive skills or adaptive functioning)
Intellectual functioning, or IQ, is usually measured by a test called an IQ test. The average score is 100. A score below 70 to 75 suggests intellectual disability. To measure adaptive behavior, professionals consider what a child can do when compared to other children of her age. Certain skills are important to adaptive behavior. These are:
  • Daily living skills, such as getting dressed, going to the bathroom, and feeding oneself
  • Communication skills, such as understanding what is said and being able to answer
  • Social skills with peers, family members, adults, and others
To diagnose intellectual disability, professionals consider the person's mental abilities (IQ) and adaptive skills. Both of these are highlighted in the definition of intellectual disability (formerly called mental retardation), which comes from the Individuals with Disabilities Education Act (IDEA). IDEA is the federal law that guides how schools provide early intervention, special education, and related services to children with disabilities.

Providing services to help individuals with intellectual disability has led to a new understanding of how we define it. After the initial diagnosis is made, we evaluate a person's strengths and weaknesses, as well as how much support or help the person needs to function at home, in school, and in the community. This approach provides a realistic picture of each individual. It also recognizes that the "picture" can change. As the person grows and learns, her ability to function in the world may grow as well.

How common is intellectual disability?

As many as 3 out of every 100 people in the U.S. are intellectually disabled (The Arc, 2001). Nearly 613,000 children ages 6 to 21 have some level of intellectual disability and need special education in school (Twenty-fourth Annual Report to Congress, U.S. Department of Education, 2002). In fact, one out of every ten children who need special education has some form of intellectual disability.

The prevalence of intellectual disability is closely related to social, economic, and health conditions of the society. The American Association on Mental Retardation estimates that the general incidence of intellectual disability in the U. S. is 125,000 births per year.

Until recently, a significant number of individuals with intellectual disability were cared for in residential facilities such as state-run training centers. Currently, however, most people with developmental disabilities live in the community and use community resources for treatment and support.

What are the signs of intellectual disability?

There are many signs of intellectual disability. For example, children with intellectual disability may:
  • Sit up, crawl, or walk later than other children
  • Learn to talk later, or have trouble speaking
  • Find it hard to remember things
  • Not understand how to pay for things
  • Have trouble understanding social rules
  • Have trouble seeing the consequences of their actions
  • Have trouble solving problems
  • Have trouble thinking logically
About 87% of those with intellectual disability will only be a little slower than average in learning new information and skills. The limitations of children may not be obvious. They may not even be diagnosed as having intellectual disability until they attend school. As they become adults, many people with mild intellectual disability can live independently, without friends or colleagues even being aware that they have intellectual disability.

The remaining 13% with intellectual disability score below 50 on IQ tests. These individuals will have more difficulty in school, at home, and in the community. A person with more severe intellectual disability will need more intensive support his entire life. Every child with intellectual disability can learn, develop, and grow, and with help, can live a satisfying life.

Can children with intellectual disabilities attend school?

A child with intellectual disability can do well in school but is likely to need individual help. Fortunately, states are responsible for meeting the educational needs of children with disabilities.

For children up to age three, services are provided through an early intervention system. Staff works with the child's family to develop an Individualized Family Services Plan, or IFSP. The IFSP will describe the child's unique needs and the services the child will receive to address those needs. The IFSP will emphasize the unique needs of the family, so that parents and other family members can learn how to help their intellectually disabled child. Early intervention services may be provided on a sliding-fee basis, where costs to the family will depend upon their income.

For eligible school-aged children (including preschoolers), special education and related services are available through the school system. School staff will work with the child's parents to develop an Individualized Education Program, or IEP. The IEP is similar to an IFSP. It describes the child's unique needs and the services designed to meet those needs. Special education and related services are provided at no cost to parents.

Many children with intellectual disability need help with adaptive skills, which are needed to live, work, and play in the community. Teachers and parents can help a child work on these skills at both school and home. Some of these skills include:
  • Communicating with others
  • Tending to personal needs (dressing, bathing, going to the bathroom)
  • Health and safety
  • Home living (helping to set the table, cleaning the house, or cooking dinner)
  • Social skills (manners, knowing the rules of conversation, getting along in a group, playing a game)
  • Reading, writing, and basic math
  • Skills that will help them to function within the workplace as they get older
Supports or changes in the classroom (called adaptations) help most students who have intellectual disability. Common changes that help students with intellectual disability are described in “How can I best help my students who have intellectual disability?”

How can I best help my intellectually disabled child?
  • Learn about intellectual disability. The more you know, the more you can help yourself and your child. See the list of resources and organizations in Helpful Links.
  • Encourage independence in your child. For example, help your child learn daily care skills, such as dressing, feeding himself, using the bathroom, and grooming.
  • Give your child chores. Keep her age, attention span, and abilities in mind. Break down jobs into smaller steps. For example, if your child's job is to set the table, first ask her to get the right number of napkins. Then have her put one at each family member's place at the table. Do the same with the utensils, putting one at a time. Tell her what to do, step by step, until the job is done. Demonstrate how to do the job. Help her when she needs assistance. Give your child frequent feedback. Praise your child when she does well. Build your child's abilities.
  • Find out what skills your child is learning at school. Find ways for your child to apply those skills at home. For example, if the teacher’s lesson is about money, take your child to the supermarket with you. Help him count out the money to pay for your groceries. Help him count the change.
  • Find opportunities in your community for social activities, such as scouts, the recreation center, sports, and so on. These will help your child build social skills and have fun.
  • Talk to other parents whose children have intellectual disability. Parents can share practical advice and emotional support. Call NICHCY (1.800.695.0285) and ask how to find a parent group near you.
  • Meet with the school administrators and develop an educational plan to address your child's needs. Keep in touch with your child's teachers. Offer support. Find out how you can support your child's school learning at home.
How can I best help my intellectually disabled students?
  • Learn as much as you can about intellectual disability. The organizations listed in Helpful Links will help you identify specific techniques and strategies to support the student educationally. The following strategies may also help.
  • Recognize that you can make an enormous difference in this student's life! Find out what the student's strengths and interests are and emphasize them. Create opportunities for success.
  • If you are not part of the student's Individualized Education Program (IEP) team, ask for a copy of her IEP. The student's educational goals will be listed there, as well as the services and classroom accommodations she is to receive. Talk to specialists in your school (e.g., special educators). They can help you identify effective methods of teaching this student, ways to adapt the curriculum, and how to address the student's IEP goals in your classroom.
  • Be as concrete as possible. Demonstrate what you mean rather than just giving verbal directions. Rather than just relating new information verbally, show a picture, and then provide the student with hands-on materials and experiences that offer the opportunity to try things out.
  • Break new and longer tasks into small steps. Demonstrate the steps. Have the student perform each step, one at a time. Provide assistance as necessary.
  • Give the student immediate feedback.
  • Teach the student life skills such as daily living, social skills, and occupational awareness and exploration, as appropriate. Involve the student in group activities or clubs.
  • Work with the student's parents and other school personnel to create and implement an educational plan tailored to meet the student's needs. Regularly share information about how the student is doing at school and at home.
Are psychiatric disorders common in those with intellectual disability?

An estimated 40%-70% of individuals with intellectual disabilities have diagnosable psychiatric disorders. In addition to this group, any developmentally disabled person may present with emotional, behavioral, interpersonal, or adjustment problems that are not considered major psychiatric disorders but that may benefit from psychiatric services. Because psychiatrists generally do not encounter people with intellectual disability who live and work in the community in a normal, non-problematic manner, it is often difficult to establish a baseline to compare with current functioning. This is where family and caregiver input is so vital.

Psychiatrists called on to evaluate and treat developmentally-disabled individuals in either an emergency or inpatient setting should be aware of special considerations that set apart this population. These considerations occur mainly in two areas:
(1) working as part of a team with the patient's regular caregivers, and
(2) characteristics of intellectual disability that may confound the usual procedures for psychiatric diagnostic assessment and treatment planning.

Table 1
Levels of Severity of Mental Retardation
Levels IQ Percentage of
Intellectually Disabled Population
Mild
Moderate
Severe
Profound
 50-55 to 70
35-40 to 50-55
20-25 to 35-40
20-25
 85.0
10.0
3.5
1.5