Bartholomew’s Case
Bartholomew’s case is an illustration of Intellectual Disability (ID) and Autism Spectrum Disorder (ASD). DSM-V code for ASD is 299.00 (F84.0) with three specifiers, such as severity, accompanied issues, and genetic or environmental nature (American Psychiatric Association, 2013, p. 50). ID’s code ranges from 319 (F70) to 319 (F73), where the qualifiers depend on the severity (American Psychiatric Association, 2013, p. 33). Intellectual disability can be determined by the fact it affects adaptive functioning, such as communication, social participation, academic or occupational functioning, and personal dependence (Reichenberg & Seligman, 2016). The given factors can be observed in this case, and ID is also supported by the criteria, which are onset during the developmental period, altered functioning, and clinical assessment or standardized testing (Reichenberg & Seligman, 2016). It is common that ID will exhibit comorbidity with other neurodevelopmental disorders, such as ASD.
Bartholomew expresses repetitive patterns of behavior and problems with social communication, which are the signs of ASD. The treatment methods should include psychoeducation, such as family training, and behavioral techniques, such as therapies, as well as communication training (Reichenberg & Seligman, 2016). Children and people who fall into the spectrum of autistic disorders, as a rule, are united by common features, that is, the presence of a characteristic triad. This involves difficulties in communicating with other people, difficulty in perceiving something new and determined by limited interests, and repetitive patterns of behavior.
Thus, autism is a general developmental disorder characterized by intolerance to normal human stress. Everything can be perceived strongly and vividly, especially the forms of close contact with another person, and the weakness of the ego-sense. Severe autism is rare, and mild and mosaic conditions are widespread. At the same time, children with such a diagnosis do not turn away from the world around them. They desire to communicate and be understood, and as a rule, they have even more than ordinary children. Not all of them have impaired speech, and many of them speak very well and have a preserved, and sometimes very high, intelligence.
The methods are based on the fact that adults should create a special environment for a child for comfortable personal development, removing all irritating factors from it. The whole day of a child brought up according to this system is subject to a strict schedule, which the child learns thanks to the help cards. All things are assigned a certain place, and the state of things in a room does not change. Correctional lessons include a long stage of adaptation of a child and establishing contact with a teacher, that is, pressure or inducement to action is unacceptable. In addition, a behavior modification technique is available that is suitable for the severe forms of autism. Each step is learned separately with a child, and then the actions are combined into a chain, forming a complex movement. An adult does not try to give the initiative to a child, but rather rigidly controls his activities. Correct actions are consolidated to the point of automatism, where wrong ones are strictly suppressed. A teacher builds a clear system of complication and gradual mastering of more and more new skills.
Jack’s Case
Jack’s case is also a demonstration of Intellectual Disability (ID) and Attention-Deficit/Hyperactivity Disorder (ADHD). As it was stated before, the DSM-V code for ID is 319 (F70-73) with qualifiers depending on the severity (American Psychiatric Association, 2013, p. 33). The codes for ADHD are 314.01 (F90.9) for unspecified ADHD, and 314.01 (F90.8) for other specified ADHD. In addition, 314.01 (F90.1) corresponds to predominantly hyperactive presentation, and 314.00 (F90.0) to predominantly inattentive presentation, and 314.01 (F90.2) for combined one (American Psychiatric Association, 2013, p. 59). Jack suffers from ID because he is low in adaptive functioning, which includes communication, social participation, academic functioning, and dependence (Reichenberg & Seligman, 2016). He exhibits all these types of difficulties, where he cannot properly express himself and was described to be “slow” at school.
Jack might also possess some form of ADHD because it is stated that he was “pushed through” the system. However, it is difficult to pinpoint a specific form of ADHD because more information is needed. Most of the evidence indicates that he clearly exhibits ID. A developmentally disabled child should be constantly monitored by one psychiatrist who knows his characteristics well, his family, and understands his capabilities. Parents should not rush from one specialist to another, travel to other cities and countries in search of a wonderful healer or medicine. As a rule, a competent psychiatrist, constantly observing a child, needs him much more than a one-time consultation of a celebrity. The psychiatrist periodically conducts a developmentally disabled child with courses of treatment that help improve his development, prevent concomitant neurotic reactions. Domestic specialists understand mental retardation as a persistent violation of the mental development of a certain qualitative structure. With mental retardation, there is a leading inadequacy of cognitive activity and, first of all, persistent, pronounced underdevelopment of abstract thinking, processes of generalization and abstraction, combined with the inertia of mental processes.
In the case of ID, there is an early, usually intrauterine, underdevelopment of the brain due to hereditary influences or various damaging environmental factors. They can act during the period of intrauterine development of the fetus, during childbirth, and during the first year of life. With ID, there is no increase in an intellectual defect. Features of the manifestation of intellectual disability are associated only with the age-related patterns of the child’s development.
One should also consider the clinical approach to the study of mental issues. The first clinical approach was associated with the task of mental retardation from the standpoint of the causes leading to intellectual underdevelopment. Diagnostics needs to be carried out, and a problem in the development of thinking should be revealed with the help of different methods. This was not an unambiguous position on the child’s illness or health. Currently, there is a departure from the medical paradigm, where mental retardation is characterized as a developmental disorder and not as a disease. Despite the similarity of external manifestations, a mental retardation is a heterogeneous group of intellectual development disorders of very different origins and various symptoms. It is defined as a state in which the psyche cannot achieve normal development.
In clinical definitions, mental retardation is considered as mental underdevelopment, organic in its origin. The clinical and psychological characteristics of this concept are the totality of mental underdevelopment and its hierarchy. Totality is characterized by a significant lack of formation of all mental processes and functions, including the structural organization of the mental sphere. First of all, the deficiency extends to the indicators of cognitive development. At the same time are also characterized by underdevelopment that does not correspond to the normative and the indicator of children’s learning ability.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). APA.
Reichenberg, L. W., & Seligman, L. (2016). Selecting effective treatments: A comprehensive, systematic guide to treating mental disorders (5th ed.). Wiley.