About intellectual disabilities
There are three aspects to intellectual disability. All these three aspects must be present if someone is to be described as having intellectual disabilities:
- impaired intelligence;
- a reduced ability to cope independently;
- starting in childhood, with a lasting effect on development.
In the UK, ‘intellectual disabilities’ are also known as ‘learning disabilities’.
1. Impaired intelligence
Intelligence is a general mental ability which includes:
- solving problems
- thinking abstractly
- thinking logically
- comprehending complex ideas
- learning quickly
- learning from experience
People with impaired intelligence find it much more difficult to understand new or complex information, or to learn new skills. It is not difficult to see how this aspect of intellectual disabilities affects the processing of bad news, which may include abstract concepts and can be highly complex in nature.
2. Reduced ability to cope independently
People with intellectual disabilities have significant limitations in their conceptual, social and practical skills. In practice, this can mean the following:
- Conceptual skills: language, the ability to read and write, and understanding concepts of money, time and numbers.
- Social skills: interpersonal skills, understanding social rules, social responsibility, self-esteem, gullibility, naivety (lacking judgement), following rules and obeying laws, actively avoiding being victimized, and social problem solving.
- Practical skills: activities of daily living, occupational skills, use of money, safety, health care, coping with independent travel and transportation, managing schedules and routines, and use of the telephone and computer.
3. Starting in childhood, with a lasting effect on development
In order to fall within the definition of ‘intellectual disabilities’, the difficulties described above must originate before the age of 18 and be life-long.
Some important considerations
- Intellectual disability should be seen within the context of someone’s social environment and culture, taking into consideration what is typical for that person’s peers.
- Depending on the available support, it is possible for someone with intellectual disabilities to improve their ability to cope and function over time. This includes coping with bad news situations.
- It is crucial that people are not just seen in terms of their weaknesses, but also in terms of their strengths. These strengths can be considerable and may be a direct result of having intellectual disabilities.
Some people with intellectual disabilities also have autism (although not all people with autism have intellectual disabilities). People on the autistic spectrum often have difficulty in recognising other people’s feelings and emotions and expressing their own. They find it particularly hard to predict what will happen next, to prepare for change and plan for the future, and to cope in new or unfamiliar situations. People with autism often like to have a strict daily routine in order to make sense of the world. Any changes in this routine can be very difficult and need much preparation and support.
Because of these specific characteristics, people on the autistic spectrum face particular challenges when coping with bad news and change.
For further information and to see how intellectual disabilities can affect someone’s life and health, the following websites are useful:
The National Autistic Society
Understanding Intellectual Disability & Health
General Medical Council Learning Disabilities Website