What’s new with intellectual disability?

It turns out the very name itself is new, according to Ann Reynolds, MD, associate professor of pediatrics, University of Colorado School of Medicine, Children’s Hospital Colorado, Aurora.

In her session “More common than autism: Identification and management of children with intellectual disability,” held Sunday, October 27, Reynolds explained that the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition(DSM-5), released in May of this year, changed a diagnosis of mental retardation to a diagnosis of intellectual disability.

Reynolds noted that the way the disability is diagnosed has also changed with DSM-5. “You can’t give a diagnosis of intellectual disability with cognitive testing alone. You also have to have deficits in adaptive function as well,” she said.

DSM-5 defines adaptive function as the individual’s ability to function in everyday life, or the capacity to function independently and meet expectations of social responsibility. The latest version of the manual emphasizes the need to use both clinical assessment and standardized intelligence tests, with the severity of impairment based on adaptive functioning rather than IQ.

Reynolds also discussed how chromosomal microarrays are now being used instead of G-banded karyotyping as the first-tier tests to detect genetic abnormalities in postnatal evaluations.

She also mentioned the role of psychopharmacology, stressing “the importance of looking for underlying medical conditions, as well as environmental conditions, that might be contributing to behavior.” She said that although “there is a higher rate of psychiatric disorders in children with intellectual disability compared with children who don’t have it,” all possible reasons for behavior problems should be examined before trying a medication.