This condition affects approximately 2-3% of the general population and has different levels of severity. Are currently specified 4 degrees which reflect the level of intellectual impairment: Mild (85% of patients), moderate (10%), severe (3-4%) and Profound (1-2%).
After diagnosis, made through the special assessment with standardized intelligence tests (always indicated if possible) and reliable evidence of significant deficits in adaptive functioning, the problem that arises concerns the nature strategies to be implemented on the psycho-social rehabilitation plan. In other words, what to do to improve the living conditions and the adaptability of people with the disorder?
The problem is not simple and any strategic approach to key rehabilitation that aims to be truly effective, it must necessarily include at least four aspects: (1) a comprehensive approach aimed at quality of life of person, (2) an accurate assessment basic (3) an individualized plan that contains specific rehabilitative interventions, (4) a method of work including procedures for verification on the results achieved.
try to explain these points briefly.
The approach must be directed to the quality of life
Any approach to education and rehabilitation can not, as higher-level view, not be aimed at improving the quality of life of the person subject of the approach. This means taking into account both subjective aspects - such as psychological well-being and personal satisfaction - that objective which support autonomy, the ability to be productive, the integration social and community.
The approach is not possible without an accurate baseline assessment
Mental retardation can result from multiple etiologies that lead squares between their very different individual. An accurate assessment requires a quantitative and a qualitative aspect.
The quantitative point of view necessarily expected from the assessment of the severity of the delay.
Patients with mild, with adequate guidance and assistance, can acquire social skills and employment for a sufficient minimum level of self-reliance. For these people, then the rehabilitation strategies must be able to point to a gradual acquisition of autonomy necessary social and community work.
A diagnosis of Mild delay does not affect all chance of a partial job placement if these people are offered the chance to work in protected environments, under proper supervision. Individuals with this level of functional impairment also typically require interventions directed to the increase autonomy in the care of its people and the improvement of interpersonal and social skills.
People with Severe and Profound Retardation are particularly in need of specific interventions by which they may be able to increase their autonomy and their ability. Most of them are well suited to the life of communities in protected environments, and benefits from adequate treatment conducted in specialized areas.
The quantitative assessment refers to the intellectual level is not sufficient to prepare an adequate rehabilitation process. People with the same IQ (IQ Intelligence score, which comes from the evaluation through appropriate standardized tests) may present very different problems and deficits.
It is very important then observed through targeted observations and / or right tools (there are specific rating scales) deficits in adaptive functioning refers to each individual, to achieve skills and clinical evaluations that highlight significant shortcomings in various areas .
The approach must provide educational and rehabilitative interventions specific
love, acceptance, inclusiveness are essential elements of any strategy aimed at rehabilitating people with intellectual disabilities, but not enough to produce significant functional improvements. If then isolated, they can slip into an attitude of compassion and attention to the fact that is likely to reinforce the general person in its most regressive.
In direct consequence of the above then you need to set specific technical assistance, targeted at deficit and highlighted with the aim of improving the conditions for departure, when it is deemed possible.
More widely, the specific interventions can be designed to pursue two directions: on one side tend to favor the development of new skills on the side of personal autonomy, communication, social skills, the other directed to reduce the frequency and intensity of dysfunctional behaviors (stereotypy, aggressive acting out toward others, self-injurious conduct, etc ...).
The validity of measures prepared (together with their precocity) is an essential aspect of an effective rehabilitation approach. An action may be said to be valid when it is proven effectiveness. Over the past four decades, numerous studies aimed at people with intellectual disabilities have demonstrated the effectiveness of behavioral and psychological techniques in the teaching of new skills essential to survival in the social-problem behaviors decrease.
The approach must use a method of working including procedures for verifying the results achieved
The use of proven interventions from the behavioral model expected to be preceded and followed by two distinct major steps.
(a) Before conducting the intervention is indicated to establish the objectives resulting in turn from the initial assessment carried out. The goals should be realistic and feasible, aiming at improving the conditions of departure when it is deemed possible. Moreover, the objectives will be expressed in a clear and empirically verifiable.
(b) The interventions will include monitoring the effectiveness of subsequent phases the same in relation to its objectives. In other words, we must determine whether the action taken or not they have produced the desired results. If not, storage operators will prepare the necessary corrections.
The path I have outlined the objectives of evaluation → → → action occurs, constitutes a working method that provides entry into the field of interventions of proven effectiveness through the appropriate procedures of the scientific method.
is to add also that the registration and documentation of procedures and outcomes that necessarily results from the application of such a approach, allows you to keep track of their performance and can support a virtuous cycle of communication potentially useful to the parties involved in the service provided (relatives of users, operators and educators, administrative staff).
Riferimenti Bibliografici:
American Psychiatric Association (1995), DSM-IV , Masson.
Martin G, Pear J. (2000), Strategies and techniques for change: the way behavioral , McGraw-Hill.
Foxx RM (1986), Techniques behavioral basis of the method, Erickson.
E. Caracciolo, F. Rovetto (Ed.) (1997), Mental Retardation : strategies and intervention techniques , FrancoAngeli.
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