What are intellectual or cognitive impairments?
The new definition of developmental disability is not based strictly on IQ. It also considers how a person handles common demands in life and how independent they are compared to others of a similar age and background.
What causes intellectual or cognitive impairments?
Intellectual or cognitive impairments can start any time before a child reaches the age of 18 years. Persons who have intellectual disabilities may have other impairments as well. Examples of coexisting conditions may include: cerebral palsy, seizure disorders, vision impairment, hearing loss, and attention-deficit/hyperactivity disorder (ADHD). Persons with severe intellectual disabilities are more likely to have additional limitations than persons with milder intellectual disabilities (EEOC, 2011).
Additional Helpful Terminology
Developmental disabilities that may also include an intellectual disability are briefly described below. Intellectual disabilities can also be caused by a head injury, stroke or illness. For some no cause is found. Intellectual disabilities will vary in degree and effect from person to person, just as individual capabilities vary considerably among people who do not have an intellectual disability. People should not make generalizations about the needs of persons with intellectual disabilities. In some instances an intellectual disability will not be obvious from a person’s appearance, nor will it be accompanied by a physical disability. Persons with intellectual disabilities successfully perform a wide range of jobs, and can be dependable workers. (EEOC, 2011)
Autism: Individuals with disabilities on the autism spectrum may have complex developmental disabilities that typically appear during the first three years of life. These disabilities are the result of a neurological disorder that affects the normal functioning of the brain, impacting development in the areas of social interaction and communication skills. Both children and adults with disabilities on the autism spectrum typically show difficulties in verbal and non-verbal communication, social interactions, and play or leisure activities.
What is Autism?
Autism is a lifelong developmental disorder that affects the way people interact and communicate with those around them. Each child and adult with an ASD is unique and has their own strengths, gifts and support needs.
First identified in 1943 by Leo Kanner, Autism Spectrum Disorder (ASD) is one of the Pervasive Developmental Disorders (PDD) of childhood onset. The symptoms of autism may be present from birth, but they may not be noticed until a child is two or three, when language normally develops. ASD is distinguished by severe impairments in communication and social interactions, a restricted range of interests and activities and stereotyped behaviours. These neurological characteristics are common to all ASD’s but symptoms can vary widely among individuals. The cause continues to elude us.
Down Syndrome is a genetic disorder that causes lifelong intellectual disabilities, developmental delays and other complications. Down syndrome varies in severity, so developmental problems range from moderate to serious. Down syndrome is the most common genetic cause of intellectual disabilities in children. Individuals with Down syndrome have a higher incidence of heart defects, leukemia, sleep apnea, and dementia later in life.
Fetal Alcohol Syndrome is a condition that results from prenatal alcohol exposure. It is a cluster of mental and physical birth defects that include intellectual disabilities, growth deficits, central nervous system dysfunction, craniofacial abnormalities and behavioral instabilities. Fetal Alcohol Effect is a less severe set of the same symptoms. It is the only form of intellectual disability that can be totally prevented and eradicated.
Fragile X Syndrome is a hereditary condition that can cause learning problems ranging from subtle learning disabilities and a normal IQ, to severe intellectual disabilities and autism. Individuals with Fragile X Syndrome may also have physical and behavioral disorders, and speech and language delays.
Prader-Willi Syndrome (PWS) is the most common known genetic cause of life-threatening obesity in children. PWS typically causes low muscle tone, short stature if not treated with growth hormone, and a chronic feeling of hunger that, coupled with a metabolism that utilizes drastically fewer calories than normal, can lead to excessive eating and life-threatening obesity. PWS is also characterized by motor development delays along with some behavior problems and unique medical issues. Intellectual deficits can be present to varying degrees, but even higher functioning individuals will have learning difficulties.
Can developmental disability be called something else?
Developmental disabilities that may also include an intellectual disability are briefly described below. Intellectual disabilities can also be caused by a head injury, stroke or illness. For some no cause is found. Intellectual disabilities will vary in degree and effect from person to person, just as individual capabilities vary considerably among people who do not have an intellectual disability. People should not make generalizations about the needs of persons with intellectual disabilities. In some instances an intellectual disability will not be obvious from a person’s appearance, nor will it be accompanied by a physical disability. Persons with intellectual disabilities successfully perform a wide range of jobs, and can be dependable workers. (EEOC, 2011)
What to say & not to say?
Don’t say |
Say |
|
|
People with intellectual or developmental disabilities may find it hard to do many things most of us take for granted.
These disabilities can mildly or profoundly limit their ability to learn, socialize and take care of their everyday needs.
You may not be able to know that someone has this disability unless you are told, or you notice the way they act, ask questions or use body language.
Tips on how to interact with people who have an intellectual or developmental disability
- Don’t assume what a person can or cannot do.
- Use plain language and speak in short sentences.
- Make sure the person understands what you’ve said.
- If you can’t understand what’s being said, don’t pretend. Just ask again.
- Provide one piece of information at a time.
- Be supportive and patient.
- Speak directly to the person, not to their companion or attendant.
Understanding Autism
Prevalence of an Autism Spectrum Disorder Spectrum
It was once thought that Autism occurs approximately in 10 to 12 people per 10,000 but studies have found the incidence to be much greater having increased tenfold over the past few decades. It is not known whether this is simply due to more thorough identification or diagnosis, or to other causes such as environmental influences. The incidence of an Autism Spectrum Disorder is now being documented at less than 1 in 100 of the population and is four times more common in boys than it is in girls. It occurs in all races, social and economic conditions globally. There are several theories, but no conclusive answer as to the cause(s). One thing that we do know is that autism is NOT caused by deficient parenting, which was put forth as a theory when first recognized as a distinct disability.
What are the Symptoms of an Autism Spectrum Disorder?
Each child and adult with an ASD is unique and has their own strengths, gifts and support needs. Parents may report that their child was an unusually good and quiet baby who rarely cried, or a very difficult baby who cried all the time, spit up excessively and slept for only short periods. One of the most frustrating and confusing characteristics may be the inability to develop appropriate affectionate relationships. He/she may resist being held and cuddled, and may not seem to recognize familiar faces, or alternately may indiscriminately display affection towards unfamiliar people. People with autism comprise a diverse group, differing in the number of characteristics they display as well as in the severity of their symptoms. The nature of the symptoms may vary depending on the developmental level of the individual and may change over time. Features frequently seen include self-injurious behaviour, aggression, hyperactivity and short attention span. People often experience sensory processing difficulties and anxiety. They may have unusual responses to sensory stimulation, such as high tolerance for pain, over or under-reaction to sounds, oversensitivity to being touched, or a fascination of lights and shiny objects. Expressions or mood are frequently abnormal. There may be an unemotional or an inappropriate reaction to the surrounding circumstance. The Autism Spectrum includes Asperger Syndrome, Autistic Disorder, Childhood Disintegrative Disorder, Rett Syndrom, Pervasive Development Disorder Not Otherwise Specified (PDD/NOS).
Diagnosis of Autism
Diagnosis often occurs between the ages of 18 to 30 months when parents notice an absence or a delay in speech development and a lack of normal interest in others or a regression of early speech and sociability. Diagnosis is based on the child’s developmental history in areas such as speech, communication, social and play interaction provided by those who know the child well. A multi-disciplinary team which may include the family doctor, psychologist, speech and language pathologist and an audiologist will provide further assessment. A diagnosis requires impairments in all of the following areas of development:
Communication styles for people with Autism
The impairment includes both spoken language and non-verbal skills. People with autism may have no speech (approximately 50%), or may have difficulty with speech production and/or conversation skills. There may be a total lack of development of speech which is also not compensated by the development of non-verbal modes of communication (e.g., no use of gestures, facial expression, body posture). In individuals who have speech, there may be a repetitive and stereotypic use of language, abnormal prosody (i.e. pitch, intonation, rate, etc.), immature grammatical structures. There may be use of metaphorical language and/or neologisms (extended meaning of a word or phrase) which is understood only by those familiar with individual’s communication style. There are also impairments in one’s ability to initiate or sustain conversation with others.
Social interaction of people with Autism
People with autism often do not relate well with other people, have difficulty learning to play with others, may not imitate well, and have difficulty learning how to respond to social games. Manifestations of impaired social interaction include avoidance of eye contact, lack of interest in simple social activities, impaired awareness of the presence of others, minimal interest in establishing friendships or lack of understanding about rules of social interaction.
Restricted repertoire of activities and interests of people wtih Autism
This includes some of the usual behaviours that are often associated with autism such as stereotyped and repetitive motor mannerisms or body movements, distress about changes in routines, preoccupations with parts of objects and a restricted range of interests.
Associated features of people with Autism
Other features associated with the disorder may include difficulties in eating, sleeping or toileting, unusual fears, learning problems, repetitive behaviours, self injury and peculiar response to sensory input. Approximately 75% to 95% of people with autism have a cognitive impairment. Moreover, the profile of cognitive skills is usually uneven, regardless of the general level of intelligence (e.g. functioning is not at the same approximate developmental level for all areas).
The Autism Spectrum
Asperger Syndrome
Children diagnosed with Asperger Syndrome usually demonstrate normal language and cognitive development (onset of speech may be slightly delayed). Social impairments are evident but more subtle that those displayed by people with autism.
Childhood Disintegrative Disorder
Childhood disintegrative disorder is a condition in which children develop normally until age 3 or 4, but then demonstrate a severe loss of social, communication and other skills. It is far less common than autism. Autism typically occurs at an earlier age than childhood disintegrative disorder.
Rett Syndrome
Rett Syndrome is a neurological condition that has been reported almost solely in girls. The onset and severity of different symptoms may vary. The child is generally apparently healthy at birth, and shows relatively normal development until 6-18 months of life, when there is a slowing down or loss of skills. A period of regression then follows in which communications skills are lost along with the loss of the purposeful use of hands and a slowing of the normal rate of head growth. Soon, stereotypical hand movements and gait disturbances are noted, as may curvature of the spine and seizures.
Pervasive Developmental Disorders (P.D.D.)
Pervasive Developmental Disorders are characterized by severe and pervasive impairments in several areas of development: reciprocal social interaction skills, communication skills or the presence of stereotyped behaviour, interests and activities. Although the complex of symptoms is comparable to that of autism, there are fewer symptoms displayed and the severity of their expression is milder.
Pervasive Developmental Disorders Not Otherwise Specified (P.D.D.N.O.S.)
The category of Pervasive Developmental Disorder Not Otherwise Specified is used when the child exhibits impairment in the development of social interaction, or verbal and non-verbal communication or when stereotyped behaviour or activities are present but the criteria for any specific pervasive developmental disorder is not met.
Why should I hire a person with a disability? Can they do the job?
A person with a disability can do the job just like anyone else providing they have been supported with reasonable accommodation. (See Case Studies section.)
Will my WSIB (formerly WCB) premiums go up?
According to the Workplace Safety Insurance Board, your premiums cannot be increased on the basis that some of your workers have disabilities. Workers with disabilities have excellent safety records on the job.
What should I know about interviewing someone with a disability?
Most people are willing to talk about their disability and how it will affect their work. If someone does not disclose their disability, keep the conversation focused on “Do you require any accommodation to assist you to be fully productive?” Also, if a potential employee is referred by one of the agencies providing employment services for persons with disabilities, a counsellor or job coach can offer to assist with the interview process. (See Tips and Solutions Section)
Will they need to take a lot of time away from work?
Actually, most persons with disabilities have the same or better record for attendance on the job. (See Case Studies) section.
What if they don’t disclose that they have a disability during the interview, but once hired, indicate that they
cannot perform one or more of the essential duties of the job?
Keep the conversation focused on accommodation them in another way or if an assistive device will provide a
solution. (See Accommodation examples and Tools and Resources section)
How do I performance manage an employee with a disability?
The same rules apply for people with or without disabilities. As long as the reason for termination is related to the job and not to the disability and you have performed all activities related to reasonable accommodation for the individual, you are within your rights to let someone go if they do not work out.
Is a developmental disability the same as a learning disability?
No they are quite unique and quite different. Persons living with learning disabilities often have very high IQs, but process information differently. Persons with a developmental disability often perform at a high school level. (See section on What is a developmental disability?)
Can I get support for training an employee with a developmental disability or autism?
Yes there are job coaches who can assist with the training and productivity of the employee. (See Job Coach section)
Where can I find qualified job seekers with disabilities?
Contact any of the partners in the It is Possible project. JOIN represents 25 agencies and can tap into all disabilities, including persons living with a developmental disability and autism and those with visible, invisible and episodic disabilities. (See the Contacts pages)
Where can I find information on interpreter services for persons who are deaf?
There are lots of resources on the website under the Tools and Resources section.
Where can I get access to employers who have hired persons with developmental disabilities and autism?
Contact any of the partnering organizations on the It is Possible website. All have had successful relationships with employers. JOIN has a large Business Leadership Network where over 50 of Canada’s top employers are represented. They share best practices and strategies for employing persons with disabilities at their quarterly breakfast series meetings and their annual fall employer conference. (See the Case Studies section for examples)
Do I need to have medical evidence of a disability?
No. A person with a disability does not have to disclose the nature of their disability—only what they require for reasonable accommodation. The only time medical evidence may be required is for short-term and long-term leave of absence from the workplace, just as with any other employee who gets injured or acquires a disability.
Should I pay the same rate of pay to someone with a disability?
Yes. Employees with disabilities should earn the same wage for the same work as their non-disabled counterparts.