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Treatment Principles for Individuals With an Intellectual Disability

Use family-centered and culturally appropriate practices.

Family-centered care is particularly well suited to individuals with ID and their families because of the complexity of their health and educational issues across settings and over time.

Individuals with ID demonstrate persistent adaptive impairments that often require them to live at home or to have substantial family support.

Recognition of the role of families in the development and learning of individuals with ID requires SLPs to provide ongoing support and resources to ensure that individuals and their families have a way to communicate with each other.

See also ASHAs resource page on family-centered practice.

Form collaborative teams.

SLPs work on teams with the individual, parents, other caregivers, and other professionals to coordinate services and to plan and implement goals and strategies that recognize the unique worldview of the individual with ID and to capitalize on his or her strengths.

The most contemporary approach to collaboratation is the concept of interprofessional education/interprofessional practice (IPE/IPP), where multiple service providers learn from each other and work together to provide comprehensive, high-quality services.

Follow a strength-based perspective.

A strengths-based perspective encourages practitioners to consider the potential and dreams of an individual and his or her family (American Association of Intellectual and Developmental Disabilities [AAIDD], 2013). Challenges are acknowledged, yet strengths create a bridge to achieving valued life outcomes.

A strengths-based perspective emphasizes building trusting relationships with families in the natural environment with natural supports (Trivette & Dunst, 2000).

Maximize self-sufficiency.

The need to develop and maintain functional communication to maximize self-sufficiency in individuals with ID has become even more critical, as more persons with ID reside within the community and interact on a daily basis with peers, shopkeepers, co-workers, and the like.

SLPs play an important role in promoting communication abilities that further the independence and self-advocacy of persons with ID.

Recognize individual variability.

The group of people designated as persons with ID is not homogeneous. Behavioral profiles across individuals or even etiologies are not similar or predictable from the diagnostic category (e.g., Dykens, Hodapp, & Finucane, 2000). Each individual has his or her own personal likes, dislikes, strengths, and needs, and these can change over time and across living environments (Zigler, 2001).

Recognition of variability across individuals, etiologies, or diagnostic categories is essential to understanding and responding to persons with ID as functioning individuals (Zigler, Bennett-Gates, Hodapp, & Henrich, 2002).

Foster a community environment of respect and inclusion.

Community-based living provides more opportunity for communicating with a variety of individuals, improving quality of life, and offering new learning opportunities. Educational and community programs, employment opportunities, and more independent living options for persons with ID are now the norm.

A community environment of respect for persons with ID

  • recognizes the importance of effective communication;
  • provides greater access to culturally and linguistically appropriate services; and
  • invites family participation in assessment and treatment planning.

Use natural environments.

To the extent possible, services for persons with ID are provided within natural environments (e.g., homes, child care, and educational, vocational, and community settings that include typical peers).

To capitalize on teaching and learning opportunities throughout the day, SLPs teach caregivers, teachers, and others to embed communication intervention strategies at childcare, school, or job settings; in the car, yard, laundromat, or doctor's office; at the park or the soccer game; at home, at grandma's house, or at the neighbor's house; or anywhere families go (Woods-Cripe & Venn, 1997).

Involve peers as communication partners.

Involving peers in intervention has several advantages for individuals with ID. For example, typical peers

  • are taught to initiate and respond as persistent communication partners as well as to serve as models for appropriate communication skills (Goldstein, English, Shafer, & Kaczmarek, 1997; Guralnick & Paul-Brown, 1989; Paul-Brown & Caperton, 2001) and
  • use learned strategies to effectively promote social communication in classmates with ID (Goldstein & Cisar, 1992; Guralnick, 1990, 1994; Strain & Kohler, 1998).

Peer interaction is as important for adults as it is for children and adolescents. Interventions designed to enhance peer interactions in the settings in which adults live, work, or socialize have shown that continued support can lead to enriched social functioning. For example, interventions such as job coaching, partner training, and social facilitation can improve interactions in the workplace (Mautz, Storey, & Certo, 2001).

References

American Association on Intellectual and Developmental Disabilities. (2013). Frequently asked questions on intellectual disabilities. Retrieved from http://aaidd.org/intellectual-disability/definition/faqs-on-intellectual-disability#.VmBFnIIo75o

Dykens, E. M., Hodapp, R. M., & Finucane, B. M. (2000). Genetics and mental retardation syndromes: A new look at behavior and interventions. Baltimore, MD: Brookes.

Goldstein, H., & Cisar, C. L. (1992). Promoting interaction during sociodramatic play: Teaching scripts to typical preschoolers and classmates with disabilities. Journal of Applied Behavior Analysis, 25, 265–280.

Goldstein, H., English, K., Shafer, K., & Kaczmarek, L. (1997). Interaction among preschoolers with and without disabilities: Effects of across-the-day peer interaction. Journal of Speech, Language, and Hearing Research, 40, 33–48.

Guralnick, M. J. (1990). Peer interactions and the development of handicapped childrens social and communicative competence. In H. Foot, M. Morgan, & R. Shure (Eds.), Children helping children (pp. 275–305). Sussex, England: Wiley.

Guralnick, M. J. (1994). Social competence with peers: Outcomes and process in early childhood special education. In P. L. Safford (Ed.), Yearbook in early childhood education: Early childhood special education (pp. 45–71). New York, NY: Teachers College.

Guralnick, M. J., & Paul-Brown, D. (1989). Peer-related communicative competence of preschool children: Developmental and adaptive characteristics. Journal of Speech and Hearing Research, 32, 930–943.

Mautz, P., Storey, K., & Certo, N. (2001). Increasing integrated workplace social interactions: The effects of job modification, natural supports, adaptive communication instruction, and job coach training. Journal of the Association for Persons With Severe Handicaps, 26, 257–269.

Paul-Brown, D., & Caperton, C. (2001). Inclusive practices for preschool children with specific language impairment. In M. J. Guralnick (Ed.), Early childhood inclusion: Focus on change (pp. 433–463). Baltimore, MD: Brookes.

Strain, P. S., & Kohler, F. W. (1998). Peer-mediated social intervention for young children with autism. Seminars in Speech and Language, 19, 391–405.

Trivette, C. M., & Dunst, C. J. (2000). Recommended practices in family-based practices. In S. Sandall, M. E. McLean, & B. J. Smith (Eds.), DEC recommended practices in early intervention/early childhood special education (pp. 39–46). Longmont, CO: Sopris West.

Woods-Cripe, J., & Venn, M. L. (1997). Family-guided routines for early intervention services. Young Exceptional Children, 1(1), 18–26.

Zigler, E. (2001). Looking back 40 years and still seeing the person with mental retardation as a whole person. In H. N. Switzky (Ed.), Personality and motivational differences in persons with mental retardation (pp. 3–55). Mahwah, NJ: Erlbaum.

Zigler, E., Bennett-Gates, D., Hodapp, R., & Henrich, C. C. (2002). Assessing personality traits of individuals with mental retardation. American Journal on Mental Retardation, 107, 181–193.

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