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Intellectual disability (ID), also known as general learning disability[3] and mental retardation (MR),[4][5] is a generalized neurodevelopmental disorder characterized by significantly impaired intellectual and adaptive functioning. It is defined by an IQ under 70, in addition to deficits in two or more adaptive behaviors that affect everyday, general living. Once focused almost entirely on cognition, the definition now includes both a component relating to mental functioning and one relating to an individual's functional skills in their daily environment. As a result of this focus on the person's abilities in practice, a person with an unusually low IQ may still not be considered to have intellectual disability. Intellectual disability is subdivided into syndromic intellectual disability, in which intellectual deficits associated with other medical and behavioral signs and symptoms are present, and non-syndromic intellectual disability, in which intellectual deficits appear without other abnormalities. Down syndrome and fragile X syndrome are examples of syndromic intellectual
disabilities. Intellectual disability affects about 23% of the general population.[6] Seventy-five to ninety percent of the affected people have mild intellectual disability.[6] Non-syndromic, or idiopathic cases account for 3050% of these cases.[6] About a quarter of cases are caused by a genetic disorder,[6] and about 5% of cases are inherited from a person's parents.[7] Cases of unknown cause affect about 95 million people as of 2013.[8] Contents 1 Signs and symptoms 1.1 Co-morbidity 2 Causes 3 Diagnosis 3.1 Intelligence quotient 3.2 Distinction from other disabilities 3.3 Limitations in more than one area 4 Management 5 Epidemiology 6 History 6.1 Terminology 7 Society and culture 8 Health disparities 9 See also 10 References 11 Further reading 12 External links Signs and symptoms



Intellectual disability (ID) becomes apparent during childhood and involves deficits in mental abilities, social skills, and core activities of daily living (ADLs) when compared to same-aged peers.[9] There often are no physical signs of mild forms of ID, although there may be characteristic physical traits when it is associated with a genetic disorder (e.g., Down syndrome).[10] The level of impairment ranges in severity for each person. Some of the early signs can include:[10] Delays in reaching, or failure to achieve milestones in motor skills development (sitting, crawling, walking) Slowness learning to talk, or continued difficulties with speech and language skills after starting to talk Difficulty with self-help and self-care skills (e.g., getting dressed, washing, and feeding themselves) Poor planning or problem-solving abilities Behavioral and social problems[11] Failure to grow intellectually, or continued infant childlike behavior Problems keeping up in school Failure to adapt or adjust to new situations Difficulty understanding and following social rules[9] In early childhood, mild ID (IQ 5069) may not be obvious or identified until children begin school.[6] Even when poor academic performance is recognized, it may take expert assessment to distinguish mild intellectual disability from specific learning disability or emotional/behavioral disorders. People with mild ID are capable of learning reading and mathematics skills to approximately the level of a typical child aged nine to twelve. They can learn self-care and practical skills, such as cooking or using the local mass transit system. As individuals with intellectual disability reach adulthood, many learn to live independently and maintain gainful employment.[6] Moderate ID (IQ 3549) is nearly always apparent within the first years of life. Speech delays are particularly common signs of moderate ID. People with moderate intellectual disability need considerable supports in school, at home, and in the community in order to fully participate. While their academic potential is limited, they can learn simple health and safety skills and to participate in simple activities. As adults, they may live with their parents, in a supportive group home, or even semi-independently with significant supportive services to help them, for example, manage their finances. As adults, they may work in a sheltered workshop.[6] People with Severe (IQ 2034) or Profound ID (IQ 19 or below) need more intensive support and supervision for their entire lives. They may learn some ADLs, but an intellectual disability is considered severe or profound when individuals are unable to independently care for themselves without ongoing significant assistance from a caregiver throughout adulthood.[6] Individuals with profound ID are completely dependent on others for all ADLs and to maintain their physical health and safety. They may be able to learn to participate in some of these activities to limited degree.[10] Co-morbidity Autism and intellectual disability Intellectual disability and autism spectrum disorder (ASD) share clinical characteristics which can result in confusion while diagnosing.[12] Overlapping these two disorders, while common, can be detrimental to a person's well being. Those with ASD that hold symptoms of ID may be grouped into a co-diagnosis in which they are receiving treatment for a disorder they do not have. Likewise, those with ID that are mistaken to have ASD may be treated for symptoms of a disorder they do not have. Differentiating between these two disorders will allow clinicians to deliver or prescribe the appropriate treatments. Comorbidity between ID and ASD is very common; roughly 40% of those with ID also have ASD and roughly 70% of those with ASD also have ID.[13] Both ASD and ID require shortfalls in communication and social awareness as defining criteria.[12] Both ASD and ID are classified by severity; mild, moderate, severe. In addition to those three levels, ID has a fourth classification known as profound. Defining differences In a study conducted in 2016 surveying 2816 cases, it was found that the top subsets that help differentiate between those with ID and ASD are, "...impaired non-verbal social behavior and lack of social reciprocity, [...] restricted interests, strict adherence to routines, stereotyped and repetitive motor mannerisms, and preoccupation with parts of objects".[12] Those with ASD tend to show more deficits in non-verbal social behavior such as body language and understanding social cues. In a study done in 2008 of 336 individuals with varying levels of ID, it was found that those with ID display fewer instances of repetitive or ritualistic behaviors. It also recognized


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