Applying the developmental perspective in the psychiatric assessment and diagnosis of persons with intellectual disability: part I--assessment.
Add emotional and social age to every ID assessment, not just IQ.
01Research in Context
What this study did
The author asked a simple question. When we assess a person with intellectual disability, do we look at more than IQ?
The paper lays out a checklist. Add emotional age, personality growth, and social milestones to every psychiatric work-up.
It is a roadmap, not a data set. No new numbers, just a better lens for the tests you already run.
What they found
The main point: cognitive level alone hides key facts. A young learners with mild ID may have the social skills of a young learners.
If you miss that gap, you may set goals that are too high or too low.
How this fits with other research
DiStefano et al. (2020) picks up the same torch. They show that severe-profound ID needs even more tweaks. Floor effects and motor limits can make the best tests useless.
Barisnikov et al. (2019) gives you a tool. Their 28-item social-adaptive scale turns the paper’s idea into numbers you can track.
Holburn (2001) adds another layer. Sensory loss often hides behind behavior. A hearing check may explain more than a mood scale.
Flapper et al. (2013) sounds like a clash. They say we still lack clear growth curves for Down syndrome. The two papers do not fight. Dosen (2005) tells you what to look for; T et al. shows the data are still thin.
Why it matters
Next time you open an assessment file, add one line: emotional age and social age. If the client is 20 with a social age of 6, teach friendship skills before job skills. This small shift can save months of off-target therapy.
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02At a glance
03Original abstract
BACKGROUND: In generic psychiatry there has been increasing interest among scientists for the developmental perspective. However, professionals active in the mental health care of people with intellectual disability (ID) have not shown the same degree of interest. The author of this article, who has had a liberal amount of rewarding experiences with the developmental approach in the field of ID, considers the developmental perspective to be innovative and very useful in psychiatric assessment, diagnosis and treatment of this population. The aim of the article is to stimulate a wider application of the developmental perspective as well as to challenge a professional discussion on this issue. METHODS: Basic assumptions of the developmental perspective are discussed and assessment tools and methods are described. RESULTS: In a case vignette, the advantages of developmentally based assessment are emphasized. Emotional development and personality development are viewed as the developmental components that play an important role in adaptive and maladaptive behaviour as well as in the onset and presentation of psychopathology. It is clear that interpretative insight into the totality of the psychosocial aspects of these individuals cannot only be obtained by measuring the level of cognitive development. A wider frame of mind is needed for unambiguous psychiatric diagnostics. Therefore, a replacement of the three dimensional paradigm (bio-psycho-social) by a four dimensional one (bio-psycho-socio-developmental) for the assessment and diagnosis of persons with ID is proposed.
Journal of intellectual disability research : JIDR, 2005 · doi:10.1111/j.1365-2788.2005.00656.x