Intellectual disability
IQ 70 and below ( as measured by a standardised IQ assessment)
Deficits in adaptive functioning
Evident before 18 years of age(DSM-IV-TR, 2000)
Communication and social skills ( Interacting and communicating with others)
Independent living skills ( Shopping, self care, budgeting, dressing and grooming)
Personal care skills ( Eating, hygiene, health and safety, dressing and grooming)
Employment/work skills (Self direction, use of own time, leisure time, following directions, completing tasks and getting to places on time)
Practical academics ( Reading, computation and telling time)
Impaired adaptive functioning
Language
Mental retardation –USA Mental handicap - Ireland Learning Disability - UK Intellectual Disability –UK 2000 onwards Specifc Learning Disability – Average IQ,
Dyslexia, dyscalculia
Common problems for ID offenders in prison Prisoners are not routinely assessed for ID or
other learning difficulties so the problem is unknown
Staff are not trained to spot or work with these difficulties
ID prisoners tend to get into trouble for not following orders – they may forget them, not understand them in the first place due to pace of conversation, take them literally or have problems initiating a behaviour
Difficulties with reading and writing and with adaptive functioning means they have trouble with choosing activities, canteen orders and food
May have difficulties putting in applications to healthcare or psychology or reading prison rules and notices. May be seen as lazy or trouble makers
Tend to ‘mask’ their behaviours e.g they give an an answer which may be incorrect – seen as rude or cheeky
May not respond to offending behaviour treatment – seen as resistant, not motivated and risky
Fear of failure Sensitivity to disability Not confident to ask for help Frustration/give up easily Desire to please Masking
Psychological impact
IQ assessment
Weschler Adult Intelligence Scale IV (WAIS IV)
Working memory Verbal Comprehension Perceptual reasoning Processing speed
Verbal expression
Receptive language problems – Difficulty understanding long or complex words, decoding sentences and understanding the meaning of language
Expressive language problems- Don’t know the right words to convey meaning, limited range of vocabulary, use words, sayings and clichés incorrectly.
Processing speed
May take longer for the brain to find meaning to what is being said
Responses are slowed because the brain is trying to decode
May lose track of things because they are trying to decode the last sentence
Very difficult to multi-task
Memory
Harder to find and recall memories Difficult to hold information in working memory
in order to use it Takes longer to record new memories e.g.
learn May forget a question asked of them and try to
mask this by answering unusually. E.g. closed answer to an open question, or provide an response that doesn’t match the question
Perceptual reasoning
Using your imagination to think things through in pictures, such as map reading, puzzles, abstract concepts
Hard to adapt to new novel situations as it is harder to anticipate what might happen
Difficult to categorise concepts – might struggle with the difference between thoughts and feelings
Difficulty with time sequencing and understanding time related concepts and words
Adapted Treatment ApproachesSelf managementIQ 60 – 80Motorway vs scenic path
ID individuals can learnIts our job to identify the best method to facilitate learningYou have to changePersonalised learning
Principles for Working with ID
Move away from exclusive use of the auditory/verbal style
Reduce need for abstract thinking and hypothetical situations
Reduce load on memory
Visual
Use pictures, drawings, symbols, posters, photos Ask them to bring in materials e.g. pictures,
books, writing Keep the visual stimuli simple and clear – i.e. Use
simple words Use timelines to mark out where things happened Visual imagery
Visual
Try to accompany all your questions with a visual aid
Draw situations you want to discuss Ask them to draw – to answer any
questions, show you what they mean Consider use of visually based
exercises
Auditory One question at a time Short sentences Use simple language - avoid words with 3 syllables
or more No clichés or dry humour Use metaphors to help them describe – ‘if your
feeling was a colour, cartoon character etc…’ Relate size of feelings to size of objects e.g. as big as
an elephant Adapt to their language needs – someone with good
receptive language may need to be asked questions verbally but answer through showing (visually or kinaesthetically) and vice versa
Auditory
Encourage group discussions Use of music if appropriate Use sound of voice to alter tone and pace of the session
– slow pace of speech Open questions Repetition of information to aid recall Frequent praise Pair auditory stimuli with visual and kinaesthetic
Kinaesthetic Exercises which help them get into a ‘state’ to
work with you – icebreakers, brain breaks during the interview
Explore things in role-plays – ‘show me’ what you would do/did do
You show them – demonstrate points or questions by role play or holding positions
Have them direct you – ‘tell me what I should do’
Put them in roles to achieve learning e.g. perspective taking
Kinaesthetic
Using hand gestures to accompany visual and auditory material
Use movement when appropriate Brain breaks Give each person in the group a specific role to
keep their attention Games that aid memory and recall
General tips
Be aware of suggestibility – try to avoid leading questions
Avoid hypothetical situations Check out learning by asking them to
tell you want they understand Use common anchors to help them
describe times e.g. meal times, birth days etc