{"id":27,"date":"2019-01-09T14:21:57","date_gmt":"2019-01-09T19:21:57","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/jengle\/chapter\/putting-it-all-together-descriptions-diagnoses-recommendations\/"},"modified":"2021-11-09T17:52:58","modified_gmt":"2021-11-09T22:52:58","slug":"putting-it-all-together-descriptions-diagnoses-recommendations","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/jengle\/chapter\/putting-it-all-together-descriptions-diagnoses-recommendations\/","title":{"raw":"Evaluating level of Intellectual Disability","rendered":"Evaluating level of Intellectual Disability"},"content":{"raw":"<div class=\"putting-it-all-together:-descriptions,-diagnoses-&amp;-recommendations\">\r\n<div class=\"textbox textbox--learning-objectives\"><header class=\"textbox__header\">\r\n<p class=\"textbox__title\">Learning Objectives<\/p>\r\n\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n<ul>\r\n \t<li>Understand the complexities in evaluating level of Intellectual Disability<\/li>\r\n<\/ul>\r\n<\/div>\r\n<\/div>\r\n<h2><strong><a id=\"#level\"><\/a>Diagnosing level of disability (mild, moderate, severe, profound)<\/strong><\/h2>\r\n<strong>Why is it important?<\/strong> Under the British Columbia (BC) Ministry of Education Special Needs Categories, the designation of Mild Intellectual Disabilities (\u201cK\u201d) is funded through School-based funding. It does not bring extra funding to the district, while Moderate to Profound Intellectual Disabilities (\u201cC\u201d) does bring extra funding to the district. The level of disability may also be relevant to the child\u2019s classroom placement. Thus, if you think the child has a moderate or more severe disability it is essential to be explicit in the level of disability. In contrast, the level of intellectual disability is irrelevant for access to community services in British Columbia outside of the schools.\r\n\r\n<strong>What is the challenge?<\/strong> Standardized IQ and adaptive functioning tests do not differentiate well between moderate, severe and profound intellectual disabilities. The DSM-5 is the go-to place to find descriptions of the levels of disability. However, outside of the Conceptual domain, level of disability is mostly described in terms of adult-attained competency. Level of disability is more difficult to evaluate in children who are still developing. Further, the level of disability may vary in an individual over time. In addition to the DSM-5, Tasse and colleagues (2019[footnote] Tasse et al (2019). Developing behavioural indicators for intellectual functioning and adaptive behaviour for ICD-11 disorders of intellectual development. Journal of Intellectual Disability Research, 63(5): 386-407.[\/footnote]) elaborate on the DSM-5 criteria for levels of intellectual disability. They list what individuals at each level of disability can typically do \"by the end of the developmental period.\" Also helpful is the work of Schalock &amp; Luckasson (2015[footnote]Schalock &amp; Luckasson (2015). A Systematic Approach to Subgroup Classification in Intellectual Disability. Intellectual and Developmental Disabilities, 53(5): 358-366.[\/footnote]).\r\n\r\nThus, while we need to be very clear about the distinction of intellectual disability versus <em>not<\/em> intellectual disability, it is OK to state \"moderate to severe range\" or \"severe to profound range.\" For those under age 5 who have multiple disabilities, a DSM-5 diagnosis of Global Developmental Delay (GDD) may be most appropriate. A formal diagnosis of GDD allows a child to access Children and Youth with Special Needs (CYSN) in BC. To continue to receive CYSN services past age 7, the child must be re-evaluated. DSM-5 also allows for \u201cUnspecified Intellectual Disability\u201d for \u201cindividuals over the age of 5 years when assessment of the degree of intellectual disability (intellectual developmental disorder) by means of locally available procedures is rendered difficult or impossible because of associated sensory or physical impairments, as in blindness or prelingual deafness; locomotor disability; or presence of severe problem behaviours or co-occurring mental disorder\u2026 Requires reassessment after a period of time.\u201d If you use this category, be sure to state (if appropriate) that the individual clearly has an Intellectual Disability (&amp; meets DSM-5 criteria) and whether you think re-assessment is necessary. Under current regulations, BC's community services (CYSN and CLBC) will accept a diagnosis of \"Unspecified Intellectual Disability.\"\r\n\r\n<\/div>\r\n<div class=\"putting-it-all-together:-descriptions,-diagnoses-&amp;-recommendations\">\r\n<div class=\"textbox textbox--key-takeaways\"><header class=\"textbox__header\">\r\n<p class=\"textbox__title\">Key Takeaways<\/p>\r\n\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n<ul>\r\n \t<li>IQ tests and measures of adaptive functioning do not differentiate well between moderate, severe, and profound Intellectual Disabilities.<\/li>\r\n \t<li>The DSM-5 is a great resource for descriptions of the various levels of disability.<\/li>\r\n<\/ul>\r\n<\/div>\r\n<\/div>\r\n&nbsp;\r\n\r\n<\/div>","rendered":"<div class=\"putting-it-all-together:-descriptions,-diagnoses-&amp;-recommendations\">\n<div class=\"textbox textbox--learning-objectives\">\n<header class=\"textbox__header\">\n<p class=\"textbox__title\">Learning Objectives<\/p>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>Understand the complexities in evaluating level of Intellectual Disability<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<h2><strong><a id=\"#level\"><\/a>Diagnosing level of disability (mild, moderate, severe, profound)<\/strong><\/h2>\n<p><strong>Why is it important?<\/strong> Under the British Columbia (BC) Ministry of Education Special Needs Categories, the designation of Mild Intellectual Disabilities (\u201cK\u201d) is funded through School-based funding. It does not bring extra funding to the district, while Moderate to Profound Intellectual Disabilities (\u201cC\u201d) does bring extra funding to the district. The level of disability may also be relevant to the child\u2019s classroom placement. Thus, if you think the child has a moderate or more severe disability it is essential to be explicit in the level of disability. In contrast, the level of intellectual disability is irrelevant for access to community services in British Columbia outside of the schools.<\/p>\n<p><strong>What is the challenge?<\/strong> Standardized IQ and adaptive functioning tests do not differentiate well between moderate, severe and profound intellectual disabilities. The DSM-5 is the go-to place to find descriptions of the levels of disability. However, outside of the Conceptual domain, level of disability is mostly described in terms of adult-attained competency. Level of disability is more difficult to evaluate in children who are still developing. Further, the level of disability may vary in an individual over time. In addition to the DSM-5, Tasse and colleagues (2019<a class=\"footnote\" title=\"Tasse et al (2019). Developing behavioural indicators for intellectual functioning and adaptive behaviour for ICD-11 disorders of intellectual development. Journal of Intellectual Disability Research, 63(5): 386-407.\" id=\"return-footnote-27-1\" href=\"#footnote-27-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a>) elaborate on the DSM-5 criteria for levels of intellectual disability. They list what individuals at each level of disability can typically do &#8220;by the end of the developmental period.&#8221; Also helpful is the work of Schalock &amp; Luckasson (2015<a class=\"footnote\" title=\"Schalock &amp; Luckasson (2015). A Systematic Approach to Subgroup Classification in Intellectual Disability. Intellectual and Developmental Disabilities, 53(5): 358-366.\" id=\"return-footnote-27-2\" href=\"#footnote-27-2\" aria-label=\"Footnote 2\"><sup class=\"footnote\">[2]<\/sup><\/a>).<\/p>\n<p>Thus, while we need to be very clear about the distinction of intellectual disability versus <em>not<\/em> intellectual disability, it is OK to state &#8220;moderate to severe range&#8221; or &#8220;severe to profound range.&#8221; For those under age 5 who have multiple disabilities, a DSM-5 diagnosis of Global Developmental Delay (GDD) may be most appropriate. A formal diagnosis of GDD allows a child to access Children and Youth with Special Needs (CYSN) in BC. To continue to receive CYSN services past age 7, the child must be re-evaluated. DSM-5 also allows for \u201cUnspecified Intellectual Disability\u201d for \u201cindividuals over the age of 5 years when assessment of the degree of intellectual disability (intellectual developmental disorder) by means of locally available procedures is rendered difficult or impossible because of associated sensory or physical impairments, as in blindness or prelingual deafness; locomotor disability; or presence of severe problem behaviours or co-occurring mental disorder\u2026 Requires reassessment after a period of time.\u201d If you use this category, be sure to state (if appropriate) that the individual clearly has an Intellectual Disability (&amp; meets DSM-5 criteria) and whether you think re-assessment is necessary. Under current regulations, BC&#8217;s community services (CYSN and CLBC) will accept a diagnosis of &#8220;Unspecified Intellectual Disability.&#8221;<\/p>\n<\/div>\n<div class=\"putting-it-all-together:-descriptions,-diagnoses-&amp;-recommendations\">\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<p class=\"textbox__title\">Key Takeaways<\/p>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>IQ tests and measures of adaptive functioning do not differentiate well between moderate, severe, and profound Intellectual Disabilities.<\/li>\n<li>The DSM-5 is a great resource for descriptions of the various levels of disability.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-27-1\"> Tasse et al (2019). Developing behavioural indicators for intellectual functioning and adaptive behaviour for ICD-11 disorders of intellectual development. Journal of Intellectual Disability Research, 63(5): 386-407. <a href=\"#return-footnote-27-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><li id=\"footnote-27-2\">Schalock &amp; Luckasson (2015). A Systematic Approach to Subgroup Classification in Intellectual Disability. Intellectual and Developmental Disabilities, 53(5): 358-366. <a href=\"#return-footnote-27-2\" class=\"return-footnote\" aria-label=\"Return to footnote 2\">&crarr;<\/a><\/li><\/ol><\/div>","protected":false},"author":620,"menu_order":10,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[59],"license":[],"class_list":["post-27","chapter","type-chapter","status-publish","hentry","contributor-jen-3"],"part":3,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/jengle\/wp-json\/pressbooks\/v2\/chapters\/27","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/jengle\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/jengle\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/jengle\/wp-json\/wp\/v2\/users\/620"}],"version-history":[{"count":25,"href":"https:\/\/pressbooks.bccampus.ca\/jengle\/wp-json\/pressbooks\/v2\/chapters\/27\/revisions"}],"predecessor-version":[{"id":825,"href":"https:\/\/pressbooks.bccampus.ca\/jengle\/wp-json\/pressbooks\/v2\/chapters\/27\/revisions\/825"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/jengle\/wp-json\/pressbooks\/v2\/parts\/3"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/jengle\/wp-json\/pressbooks\/v2\/chapters\/27\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/jengle\/wp-json\/wp\/v2\/media?parent=27"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/jengle\/wp-json\/pressbooks\/v2\/chapter-type?post=27"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/jengle\/wp-json\/wp\/v2\/contributor?post=27"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/jengle\/wp-json\/wp\/v2\/license?post=27"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}