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Important Context for Counselling Persons With Developmental Disabilities

A developmental disability begins in childhood. It involves significant limitations in both intellectual capacity and the ability to carry out everyday activities.

The term developmental disability covers a variety of conditions. Synonyms include cognitive disability, intellectual disability, mental retardation, and mental handicap. However, mental retardation and mental handicap are no longer considered acceptable terms.

3 criteria determine a developmental disability:

  1. The person shows significantly below-average intellectual capacity. This is measured by below-average performance on an intelligence test.
  2. The disability began before age 18.
  3. The person shows limitations in 2 or more of the following adaptive skill areas:
    • Communication
    • Home living
    • Community use
    • Health and leisure
    • Self-care
    • Social skills
    • Self-direction
    • Functional academics
    • Work

Considering these different skill areas makes it possible to recognize a range of services that clients might need.

Types of developmental disorders

Persons with developmental disabilities often:

  • Have limited intellectual capacity.
  • Are slower to learn. They prefer reliability and consistency in processes and activities.
  • Have a simple, unsophisticated understanding of things. This can be seen as a gift rather than a gap when it results in common sense.
  • Benefit most from informal training or learning through real-life activities.
  • Have a co-existing condition or a dual diagnosis.

Autism spectrum disorders (ASDs)

Autism spectrum disorders (ASDs) are lifelong neurological disorders. They affect how the brain processes information.

Of the 5 ASDs, the 3 most common are:

  • Autistic disorder (also called autism, classic autism, and AD)
  • Pervasive developmental disorder–not otherwise specified (PDD-NOS)
  • Asperger disorder (also called Asperger’s syndrome or AS)

The term spectrum refers to a continuum of severity or developmental impairment. The conditions of children and adults with ASD cover a wide spectrum. They have differences in:

  • Number and kinds of symptoms
  • Severity of symptoms (mild to severe)
  • Age of onset
  • Levels of functioning
  • Challenges with social interactions

According to the Autism Society of Canada, “Individuals with ASD have varying degrees of difficulty in social interaction and communication and may show repetitive behaviours and have unusual attachments to objects or routines.”

Persons with ASD often have trouble with:

  • Communication
  • Social interaction
  • Learning
  • Behaviour
  • Perceptions
  • Interests
  • Activities

Asperger disorder is a high-functioning type of autism. It tends to be recognized and diagnosed later in life. Learning is not usually delayed.

Clients with high-functioning autism or Asperger disorder may be able to work in mainstream jobs. However, communication and social problems often cause trouble in many areas of life. Adults with ASD need encouragement and support in their struggle for independence.

Fetal alcohol spectrum disorder (FASD)

Fetal alcohol spectrum disorder (FASD) describes the range of physical and mental disabilities that can result from exposure to alcohol before birth. FASD is not a diagnosis. It is an umbrella term that covers multiple conditions:

  • Fetal alcohol syndrome (FAS)
  • Partial FAS (pFAS) or fetal alcohol effects (FAE)
  • Alcohol-related neurodevelopmental disorder (ARND)
  • Alcohol-related birth defects

Exposure to alcohol before birth can cause facial abnormalities, growth deficiencies, and damage to the central nervous system. This can result in:

  • Developmental delays
  • Intellectual deficits and learning disabilities
  • Hyperactivity
  • Attention or memory deficits
  • Inability to manage anger
  • Difficulties with problem solving
  • Skull and brain malformation
  • Neurological abnormalities

As these physical, cognitive, and behavioural deficits combine with adverse environmental factors, further problems can result. These problems are sometimes called secondary disabilities.

Examples of secondary disabilities are:

  • Mental health problems
  • Trouble at school, such as suspension, expulsion, or dropping out
  • Trouble with the law or with authorities
  • Alcohol or drug problems
  • Inappropriate sexual behaviour
  • Problems with employment, dependent living, and parenting

Attention deficit hyperactivity disorder (ADHD)

Attention deficit hyperactivity disorder (ADHD) is considered both a developmental disability and a neurological disability. For information on ADHD, see Important Context for Counselling Persons With Physical and Neurological Disabilities.

Inclusion of persons with developmental disabilities

Inclusion means helping everyone take part in everything. No one is left out. Community inclusion means offering supports to make choices possible. It also means actively including developmentally disabled individuals in the community, where they can contribute and be respected for their contribution.

Since school systems expanded their special education services in the 1970s, young persons with developmental disabilities have expected to work after graduation. Inclusion reinforces the fact that they can do so in an integrated setting.

Inclusion moves persons with developmental disabilities away from sheltered living and working environments and into the community. This includes education, employment, and community living arrangements. This movement is supported by government policies, funding, and resources.

Inclusion has been a part of Canadian society for many years. But older persons with developmental disabilities or those coming from outside of Canada may not have had life experiences that foster a belief in themselves. They may not picture a future that includes education, work, and recreation in the community. They may not expect or prepare to work and have a career. Likewise, employers and co-workers may still not be prepared for inclusion. They may need more knowledge and experience.

Persons with developmental disabilities now receive more support to overcome barriers to employment. Government policy takes more active measures to encourage them to work while receiving support such as health benefits.

Inclusion of persons with developmental disabilities in a diverse workforce makes sound economic sense. They bring unique skill sets and a valuable perspective to the workplace. They and their friends and relatives are a significant potential customer base for businesses that employ them.

You can help these clients enter the workplace in 2 ways. First, you can help them become aware of their assets and ways to use them. Second, you can help employers become aware of the great potential for employing them.

Social and life management skills

Experiences in inclusive settings allow clients to build social and life management skills. These skills are valuable in the competitive workforce. Inclusion in education helps clients build relationships with many community members. These people may then become allies in career building.

Barriers and challenges

A developmental disability can have many effects on a person’s major life activities. The following list identifies the extremes:

  • Self-care. Clients may have trouble with activities such as eating, preparing food, or maintaining hygiene. They may need help with personal care.
  • Receptive or expressive language. Clients may have limited or no use of their voice. They may be unable to express ideas or understand abstract ideas. They may need help with communication. This can include visual means of communication and adaptive technologies that use artificial intelligence and mobile devices.
  • Learning. Clients may be slower to learn or unable to do routine age-appropriate academic activities. They may need special programs and attention.
  • Mobility. Clients may have impaired fine or gross motor skills. They may need help from people or devices.
  • Self-direction. Clients may have trouble choosing among options. They may need help with decision making.
  • Capacity for independent living. Clients may have a limited ability to relate to community to satisfy personal, social, and health needs. They may also have trouble with travel to and from work or recreational outings. Clients may need in-home support, such as training on health and safety, hygiene, and daily living activities. They may also need help learning to use supports to manage independent travel.
  • Economic self-sufficiency. Clients may have trouble getting a job and staying above the poverty line. They may benefit from help learning to use supports, adaptations, and accommodations to hold positions in a traditional workplace.
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