From intelligence reduction are statistically affected about three percent of the population. Different degrees of severity are distinguished from the so-called “borderline intelligence” to “most severe intelligence reduction”. This is an impairment of mental abilities.
What is intelligence reduction?
Defined intelligence reduction is an incomplete or stagnant development of mental abilities that affect the level of intelligence (language, cognition, social and motor skills). Depending on the intelligence quotient, different levels are distinguished: An IQ of 70 to 84 is referred to as “borderline intelligence.” Affected persons learn more slowly and have difficulties absorbing school material. Mild intelligence impairment is characterized by an IQ between 50 and 69, which corresponds to the age of a nine- to twelve-year-old child. Affected individuals can usually be accommodated in special schools for the learning disabled and are capable of attending school. Moderate intelligence reduction denotes an IQ between 35 and 49, which corresponds to the intelligence level of six- to nine-year-olds. If the age of intelligence is three to under six (which corresponds to an IQ of 20 to 34), experts call it severe giftedness. If the IQ is below 20, the diagnosis is severe intelligence impairment, which entails severe limitations in speech, continence and mobility. Depending on the severity, those affected require more or less care and a protected setting.
Causes
The causes of intelligence impairment are often impossible to pinpoint. However, there are some risk factors that significantly increase the likelihood of later reduced intelligence. Often a reduction in intelligence is genetic-chromosomal (for example in the case of trisomy 21, also called Down syndrome), metabolic disorders are also conceivable. A reduced intelligence can also be the result of a brain-organic developmental defect, such as occurs in epilepsy, or it can be hormonal. It is also possible that the mother contracted viral or bacterial infections during pregnancy (e.g. rubella) or consumed drugs (nicotine, heroin), medication or alcohol, or was malnourished or undernourished. Premature birth or birth trauma can also result in permanent damage and be causes. In some cases, however, the reduction in intelligence also occurs postnatally. It can be the concomitant of an infection, such as meningitis, which is transmitted by tick bites. It has also been noted that vaccine damage or low vitamin D blood levels may play a role, as the latter are unfavorable for brain performance.
Symptoms, complaints, and signs
There are numerous symptoms, complaints, and signs that indicate intelligence impairment. However, it is important to distinguish it from other mental illnesses and from dementia. This is the task of careful diagnosis. In general, the following signs often appear in cases of reduced intelligence: For example, those affected often exhibit marked passivity and psychological dependence, as well as a low frustration tolerance. For this reason, they are very often dependent on care and a protected environment. Impaired impulse control, self-injury and aggressiveness can also be indications of a reduction in intelligence. Furthermore, people with reduced intelligence have a reduced ability to adapt to the demands of everyday life and are very often impaired in verbal and non-verbal communication, which can make living together with the environment difficult, as they often have difficulty making themselves understood and in turn have massive comprehension difficulties. Even simple tasks can present insurmountable problems, which can inhibit the affected person’s social development. Social adjustment disorders, behavioral problems and possibly physical symptoms are further signs of underachievement.
Diagnosis and course of the disease
Two main tools are available to make the correct diagnosis: These are, first, the clinical impression resulting from observation and, second, the measurement of the intelligence quotient by intelligence tests. The latter provide reliable information about the severity of the underachievement.If a reduction in intelligence is present, it can no longer be reversed, but only its effects can be slightly alleviated. Those affected are dependent on good living and working conditions and often on intensive care, otherwise there is a risk of social withdrawal, loneliness and isolation, as the environment usually shows little understanding.
Complications
The effects and complaints of intelligence reduction depend very much on the severity of this disease. As a rule, the patient’s everyday life is made considerably more difficult by the intelligence reduction. Also the parents and relatives suffer thereby very often from psychological complaints or from depressions. Most patients are limited in their thinking and acting by this reduction. Furthermore, severe mood swings or thinking disorders may occur. In the worst case, the affected persons are aggressive and may also show self-injurious behavior. It is not uncommon for a reduction in intelligence to lead to social problems, so that children in particular are excluded from groups at school or kindergarten. Furthermore, bullying or teasing may occur. Learning is also significantly impeded by the intelligence reduction, so that in most cases the patient will also suffer from this disease in adulthood. Treatment for this disorder is through various therapies and supports. In some cases, patients need special protection, as they may not properly assess dangers and could injure themselves. Likewise, in some cases, treatment in a closed clinic is necessary. However, it cannot be universally predicted whether treatment for intelligence impairment will lead to a positive course of the disease.
When should you see a doctor?
It is not always necessary to see a doctor for a check-up visit when there is a reduction in intelligence. If normal daily tasks can be performed, no doctor is needed. In some cases, the affected person needs more time in performing upcoming tasks because of the lowered intelligence. If severely reduced intelligence is present, the affected person often needs help and support in coping with everyday life. In order to be able to assess exactly how the mental performance capability is, an IQ test should be carried out as soon as children or adolescents show clear differences compared to their peers. If the affected person seems quickly overwhelmed or finds it difficult to learn new things, an assessment of the existing intelligence is recommended. If there are delays in development, severe forgetfulness or a premature intellectual developmental stop, a doctor should be consulted. If the individual appears absent frequently, if there are significant learning delays, or if new skills can only be acquired very slowly and with great effort, a visit to the doctor should be made. In order to promote the existing intelligence, a doctor can give important advice for training or regularly applicable exercise units. If there are disturbances in the ability to remember, if there are clear losses in existing mental performance or if there is an unnatural mental decline in the course of life, it is advisable to consult a doctor.
Treatment and therapy
Treatment of the cause of intelligence reduction is mostly no longer possible, since it is usually irreversible due to brain-organic causes. All the more importance is attached to prevention and precaution. However, it is possible to support those affected at a very early stage of their development and in this way strengthen existing resources and mitigate weaknesses. Good integration in families or in special institutions is also necessary in cases of need for care. Affected persons often need special protection because their psychosocial constitution makes them more likely to be neglected or abused. Depending on the degree of severity, special schools for the learning disabled may also be suitable if there is an ability to attend school. The less gifted generally need optimal living and working conditions in order to be able to develop to the best of their abilities. Whereas in past times they were mainly accommodated in homes, other forms of living are now being promoted. For example, assisted living or various integrative therapy programs exist to improve social integration and prevent hospitalization. In this way, those affected are enabled to participate in social life.If behavioral disorders are present in addition to the intelligence impairment, drug therapy can also make sense in order to reduce the suffering for the affected person and for the environment. However, there is no drug therapy for the intelligence impairment itself. This can only be slightly mitigated, but not canceled.
Outlook and prognosis
Intelligence impairment has an unfavorable prognosis. The brain disorders are irreparable, so a cure cannot occur. Improvements in cognitive performance can be achieved with targeted training and education tailored to the individual needs of the affected person. These lead to an increase in general mental abilities as well as stability of acquired knowledge. An intelligence in the normal range is not achieved despite all efforts. The goal of therapy is to improve existing skills as much as possible so that everyday tasks can be partially or almost completely taken over by the affected person. Verbal and non-verbal communication is also trained so that interpersonal interactions are improved. This leads to an improved sense of well-being and an increase in the general quality of life. If chronic illnesses are present, there is no prospect of stabilizing cognitive skills. The prognosis is particularly unfavorable in these patients. Due to the underlying disease, there is a continuous decline in mental performance that cannot be interrupted by conventional medical means. Treatment attempts to influence the progress of the disease. This is intended to delay the degradation processes and maintain an existing level for as long as possible. Reconstruction of mental performance is not possible in these cases.
Prevention
To prevent a reduction in intelligence, preventive measures should first be taken during pregnancy. Many maldevelopments can be detected and stopped prenatally. Expectant mothers should also pay attention to a lifestyle that is as healthy as possible and avoid drugs and alcohol in any form. In childhood, parents should take measures for the early detection of possible diseases in order to be able to intervene in time. Ultimately, prevention is the best alternative in the case of underachievement, as it can only be slightly improved later on, but cannot be reversed.
Aftercare
Aftercare proves to be relatively difficult in most cases of intelligence reduction, so that this disease can also not always be completely cured. In some cases, this reduction can also be alleviated, although the further course is also very much dependent on the underlying disease and also on the time of diagnosis. However, it is not possible for the disease to cure itself. Most of the affected persons are dependent on the support of their own family and friends in their everyday life in the context of an intelligence reduction. They are often unable to cope with everyday life on their own and therefore require intensive care. In this context, loving conversations with one’s own family are also very important, as this may also prevent depression or other psychological upsets. Likewise, contact with other affected persons with the same disease can be very useful, as it leads to an exchange of information. Often the affected persons have to be placed in a special institution. If the intelligence reduction occurs due to a genetic disease, genetic testing and counseling should be performed if the patient wishes to have children. This may prevent the recurrence of the reduction.
What you can do yourself
The affected person usually cannot take measures that have a causal effect, since the disorder is usually brain-based and irreversible. Moreover, the patient often cannot help himself anyway because of his mental retardation. Instead, it is the relatives and the social environment that are called upon. Parents who observe developmental disorders in their child should act promptly. Cognitive impairments in children are usually manifested by the fact that both their motor and social skills do not develop in an age-appropriate manner. Many affected children also show severely delayed language development.The vocabulary and the ability to form complex sentence structures are far behind those of peers. In such cases, parents should immediately consult a doctor to have the causes clarified. If there is indeed a reduction in intelligence, it is important that the child receives optimal support as early as possible. Psychological and educational measures cannot always compensate for existing deficits, but they can usually reduce them. Children with a reduction in intelligence can also only rarely attend a normal school. Since suitable special school places are often scarce, it is important that the families of those affected look for a suitable place at least twelve to 18 months before the child reaches school age. To the extent that it becomes apparent that the individual will be dependent on a sheltered environment for the rest of his or her life, parents should obtain information about all available care alternatives in a timely manner to ensure the best possible care for their child.
