Intellectual Disabilities

Intellectual Disabilities

A fitness instructor in a gym working with a teenage girl with down syndrome. They are sitting on the floor, stretching.Intellectual disabilities impact the skills children use in everyday life, such as learning, reasoning, problem solving, planning, judgment, academic learning, and learning from experience.

According to the American Association on Intellectual and Developmental Disabilities, children may need support in adaptive skills such as:

  • Conceptual skills: Language and literacy; money, time, and number concepts; and self-direction
  • Social skills: Interpersonal skills, social responsibility, self-esteem, gullibility, social problem solving, and the ability to follow rules and obey laws
  • Practical skills: Personal care, work skills, travel or transportation, schedules and routines, safety, and use of money

(Also adapted in part from American Psychiatric Association, 2013.)

What You Might Notice

The practical skills of children with intellectual disabilities vary widely. Some children are able to use money, tell time, and read, while some are not able to dress or feed themselves, or use the toilet independently.

Children with this disability may not be able to understand situations that are dangerous, and generally have some difficulty with abstract concepts. In addition, children with intellectual disabilities:

  • often want to please others, especially if they have been taught from early childhood on to comply with authority
  • may make impulsive decisions
  • have more difficulties in thinking and reasoning than the typically developing child
  • do have normal sexual development
  • also have a high rate of undiagnosed hearing and speech disorders
  • may sometimes understand more than they can express

(Adapted in part from the Oregon Department of Justice & New York State Office on Child and Family Services.)

Before Meeting the Child

  • Learn from the child’s teacher, Individual Education Plan (IEP), parents, or caregivers about the child’s intellectual disability and how it affects them in practical terms.
  • Ask about what adaptations help the child function in school and at home, and modify them for your interaction.
  • Find out the child’s regular schedule, including times of regular television shows, school, therapies, and other activities.
  • If the child has difficulty understanding written or spoken language, consult with teachers or caregivers beforehand about how to make your questions as understandable as possible.
  • Have visual aids available, such as anatomically correct dolls, drawings, or other objects.
  • Ask if the child has a hearing or speech disorder.

During the Meeting

Tell the child who you are and why you are there. Use plain and concrete language. Keep questions as short and uncomplicated as possible.

If the child does not answer a question, say their name and repeat the question exactly the same way. It is sometimes helpful for children with intellectual disabilities to hear the question several times. When you rephrase it too soon, it may be more confusing.

In addition:

  • There is no need to “talk down” to a child with disabilities. Match your language to the child’s.
  • Speak directly to the child. Make eye contact before you speak, and say the child’s name often, particularly before asking a question.
  • Introduce everybody in the room. Explain what will happen and how long it will take.
  • Allow children to speak at their own pace, with time for silence.

Assessing

  • Spend extra time establishing rapport to become familiar with the child’s language abilities.
  • To gauge the child’s ability to understand abstract questioning, ask a potentially difficult question, such as, "What time do you go to bed?" or "Where do you live?"
  • Adults often treat children with intellectual disabilities as if they were younger than their age, but developmental functioning can be complicated. For example, a child of 12 may have strong social skills and a broad vocabulary but not be able to think abstractly (Shelton, et al.).

You may have to explain 4 important things:

  1. What happened to them was a crime.
  2. Someone else broke the law.
  3. That what happened was not their fault.
  4. They are not in trouble.

Pay Attention

Notice changes in behavior, such as humming, groaning, withdrawal, or fixation on one topic. Any of these changes may be a sign that the child is becoming anxious or tired.

If the child shows signs of fatigue, anxiety, or distraction, take a break from the interview or the topic. A pressure-free way to do this: "I think we need a break, would you like one?"

Also give permission to take a break or use the restroom if needed.

In addition:

  • Be sensitive to the child’s possible feelings of guilt, self-blame, and fear.
  • Pay attention to the child’s non-verbal cues, being too eager to please, and body language.
  • Be fully present with the child. As you show that you are caring and want to understand, they will be more likely to open up to you.
  • Some children are conditioned to comply with authority figures. Others may be fairly isolated and eager to please and to connect. These experiences may affect the way the child responds to questions.

Pacing and Questions

  • Speak in your usual tone of voice and slow your pace.
  • Give one instruction at a time. Ask only one question at a time.

Types of questions

  • Ask who, what, or where questions. When, how, and particularly why questions may be difficult.
  • Avoid yes/no questions. Children may say yes to please, or because they are afraid or do not understand.
  • Pose questions in different ways to see what works best: Open-ended, yes-or-no, and multiple choices.
  • Avoid instructions and questions that involve abstract reasoning, such as time. Many children with disabilities follow routine activities, which can help you establish the time of events: before school, after dinner, during a TV show.
  • Ask for concrete details. "How long was the girl's hair?" "What color was the car?"

Other Communication

  • If the child is unable to respond verbally, explore other ways to communicate, such as visual aids (objects, pictures, or drawings).
  • Perpetrators may convince child victims that sexual abuse is something special between them or use a euphemism for abuse. For example, if a child says he and the abuser went on a “picnic”, ask what they did on the picnic; if the child cannot explain, ask him to show you.
  • If the child keeps repeating, walk through what happened with them, breaking it down step by step.

(The above sections adapted in part from New York State Office of Child and Family Services, Office for Victims of Crime, & Oregon Department of Justice.)