Intellectual Disability (Formerly: Mental Retardation) 

Treatments

Integrative treatment     

Treatment Summary: Integrative treatment is a multidimensional approach used to treat people with intellectual disability. The treatment incorporates different dimensions that include: psychological, biological, behavioral and social. The first step is to assess the patient’s levels on each of the dimensions to understand the mechanisms of the disorder and the patient’s needs; this step needs to be done with cooperation of social workers, psychiatrist, psychologists, pedagogues and family members. Once the people who are directly involved in the patient’s care and who are close to him/her work for an integrative diagnosis the information is used to plan the methods of treatment. The methods can include interacting with the patient at his/her level of emotional development, educating and informing the people in the patients environment in order to secure optimal adaptation, providing psychotherapy and training to help the patient activate their capacity to solve problems and to help them adapt to different circumstances they may encounter at their environment, and lastly administering psychotropic medication.Applying therapeutic methods through the different dimensions is considered important; because people who suffer mental retardation can benefit more from a comprehensive approach that does not focus only on treating the symptoms, but also focuses towards restoring the mental well being 

• Reference: Dosen, A. (2007). Integrative treatment in persons with intellectual disability and mental health problems. Journal of Intellectual Disability Research, 51(1), 66-74. doi:10.1111/j.1365-2788.2006868.x. 

• Submitter: N/A 

Positive Practice Overcorrection 

Treatment Summary: After identifying the behavior that needs to be modified the individual will practice the correct forms of the behavior with help first and eventually through verbal cues. If an individual were “finger flicking” then you would place their fingers and hands in a stationary position and hold it there for a period of three minutes every time they exhibited the behavior for several weeks. Then you could decrease the amount of time to a two minute period then eventually to one minute. Over time, you would start to shadow them instead of physically placing their hands in the position and ultimately using verbal cues whenever the behavior was exhibited. 

• Reference: Luicelli, J., Evans, T., (1987). Assessing pharmacological and contingency management interventions with mentally retarded adolescents in a residential treatment program. Behavioral Residential Treatment, 3(3), 139-152. 

• Submitter: Melva Terpstra 

Behavioral Modification 

Treatment Summary: Behavioral modification can be applied to encourage positive behavioral through exaggerated praises and positive reinforcement. Individuals are given a 1 step task with a lot of visual Q’s each time the individual has completed one tasks, exaggerated praise is used before adding another task. Increase steps bigger and more complex. Behavioral modification is used to shape individual’s behavior to be more independent and build skills for adulthood. 

• Reference: Dombeck, M., & Reynolds, T.(2006). Mental Retardation and Applied Behavioral Analysis: Mental Retardation (Intellectual Disabilities) 

• Submitted by: Vanessa Carter 

Reducing Tongue Protrusion and Head Tilting 

Treatment Summary: Socially inappropriate behavior can have negative social engagement effects on persons with severe profound intellectual disabilities. To curb repetitive tongue protrusion and excessive head tilting, an automatic prompting and social approval system was developed. Each participant was given a Walkman which sounded an encouraging prompt to a) keep the tongue in the mouth, or b)to keep the head upright. These prompts occurred automatically every 30 – 60 seconds. A person would also provide praise for the participant every 60 – 120 seconds if the inappropriate behavior was not present. If behavior was present, praise was delayed until 10 seconds had elapsed without the behavior occurring. It is unknown if both components of the strategy (the Walkman prompts and personal praise) would be needed long-term to continue the high level of performance. This strategy is very practical using affordable and simple technology. The positive results of this study was statistically significant at the p < .01 level for both participants. 

• Reference: Lancioni, G.E., Singh, N.N., O’Reilly, M.F., Sigafoos, J., Didden, R., & Pichierri, S. (2010). Automatic prompting and positive attention to reduce tongue protrusion and head tilting by two adults with severe to profound intellectual disabilities. Behavior Modification, 34(4), 299-309. doi: 10.1177/0145445510372751 

• Submitted by: Tracey Eddy 

Video prompting for cooking tasks completion 

Summary of Treatment: In the study referenced below, the effectiveness of a technique to teach a cooking task to young adults with moderate intellectual disabilities was studied. The technique utilized a video recording shown on a portable DVD player and used the system of least prompts (SLP) to coach the clients to competency levels that were maintained over time. 

The client is assessed as to their ability to perform the needed individual cooking tasks such as opening bags, setting a timer, setting a burner or microwave control button, etc. The client is first trained in using a portable DVD player with three function buttons: Play, Pause, and Skip (repeat).  With minimal prompting from and adult observer (i.e., “make a grilled cheese sandwich”), the client pushes the play button on the DVD player which provides visual and audio instruction for the first step. The video then prompts the client to pause the video so that the client may perform the task. After the first step is completed, the client pushes play for the second step, and so on until all steps are completed. If the client is not able to grasp the step from one viewing, they may push the skip button to view it again. 

Video prompting with a portable DVD player provides step by step instruction for the client with intellectual disabilities, while affording a sense of autonomy and mastery. This DVD system is an affordable teaching and prompting tool that may be used for other domestic tasks or simple socializing. 

• Reference: Mechling, L. C., Gast, D. L., & Fields, E. A. (2008). Evaluation of a portable DVD player and system of least prompts to self-prompt cooking task completion by young adults with moderate intellectual disabilities. The Journal Of Special Education, 42(3), 179-190. doi:10.1177/0022466907313348 

• Submitted by: Kelly Leaming 

Counseling and Psychotherapy  

Summary of treatment: Clients diagnosed with mental retardation were given successful treatment of group counseling and psychotherapy. Counseling and psychotherapy techniques taught the clients problem solving skills, which in turn reduced the display of maladaptive behaviors and increased functionality within daily living and work. Counseling and psychotherapy, also allowed the clients to express themselves more appropriately during social interactions with other individuals that they could possibly encounter on a day-to-day basis. Overall, the therapeutic process of counseling and psychotherapy allowed the client, to feel increased social support from the therapist and other participant group members along with increased recognition as an important being in today’s society. 

• Reference: Oliver-Brannon, G. (1999). Counseling and psychotherapy in group treatment with the dually diagnosed (mental retardation and mental illness-MR/MI). The Union Institute). ProQuest Dissertations and Theses, 92 p. Retrieved from http://search.proquest.com/docview/304569442?accountid=7078 

• Submitted by: Michelle Walker