Exceptional support needs of the children with mental retardation and autism

Abstract

According to the contemporary model of mental retardation (MR), the assessment of intellectual functioning using standardized intelligence tests is essential to making diagnosis of mental retardation, rather than to classify the persons with intellectual disability. American Association for Mental Retardation (2002) has adopted socio-ecological perspective in a domain of disability, which means that classification process of the persons with MR should be based upon their level of needed support. Utilization of the Support Intensity Scale (AAMR, 2004) revealed that support needs considerably increase if children have severe health problems and (or) behavioral disorders, regardless of the scores obtained at the Scale. This research has been carried out in order to determine the frequency of the exceptional medical and behavioral support needs in children with mental retardation and autism. The sample consisted of 105 participants, of both sexes, aged from 3 to 16. Whole sample was divided into four subsets. The first three groups include children which have been traditionally classified according to the level of intellectual functioning (34 participants with mild MR, 33 participants with moderate MR and 15 participants with severe MR). The fourth sub/sample consisted of 23 children with autism and moderate or severe MR. The research has been carried out using the 3rd part of the Support Intensity Scale (AAMR, 2004) entitled "Exceptional medical and behavioral support needs". This subscale consists of 15 medical conditions and 13 types of behavioral disorders. Exceptional medical and behavioral support needs have been determined in children with autism, moderate MR, severe MR and mild MR (26%, 18.18%, 13.33% and 11.76%, respectively). All of these children fit into category of pervasive support needs, regardless of their support needs in other life domains. Having in mind that even those children that do not have any specific medical or behavioral problems sometimes have extensive or pervasive support needs, it is essential to create a new organizational system of support providers in order to meet these needs.

Prema savremenom modelu mentalne retardacije (MR) procena intelektualnih sposobnosti standardizovanim testovima inteligencije koristi se u svrhu dijagnostikovanja intelektualne ometenosti, ali ne i u svrhu klasifikacije osoba s MR. Američka asocijacija za mentalnu retardaciju (2002) promoviše socio-ekološki model ometenosti prema kome se osobe s MR klasifikuju u odnosu na stepen potrebe za podrškom. Primena Skale za procenu intenziteta potrebe za podrškom (AAMR, 2004) pokazala je da se, bez obzira na ostvarene skorove potrebe za podrškom značajno uvećavaju u slučaju da dete ima ozbiljne zdravstvene probleme i (ili) bihejvioralne poremećaje. Ovo istraživanje je sprovedeno sa ciljem da se utvrdi učestalost specifičnih medicinskih i bihejvioralnih potreba za podrškom kod dece s mentalnom retardacijom i autizmom. Uzorkom je obuhvaćeno 105 ispitanika, oba pola, starosti od 3 do 16 godina. Celokupan uzorak podeljen je u četiri poduzorka. Prve tri grupe ispitanika čine deca koja su prema tradicionalnom sistemu klasifikacije razvrstana u različite kategorije prema stepenu intelektualne ometenosti (34 ispitanika s lakom MR, 33 ispitanika s umerenom MR i 15 ispitanika sa teškom MR). Četvrti poduzorak čine 23 ispitanika sa autističnim poremećajem koji je kombinovan sa umerenom ili teškom MR. U istraživanju je korišćen treći deo Skale za procenu intenziteta podrške (AAMR, 2004) pod nazivom "Izuzetne medicinske i bihejvioralne potrebe za podrškom". Ovom podskalom obuhvaćeno je 15 medicinskih stanja i 13 oblika problematičnog ponašanja. Izuzetne medicinske i bihejvioralne potrebe za podrškom utvrđene su kod 26% ispitanika sa autizmom, 18,18% ispitanika s umerenom MR, 13,33% dece s teškom MR i 11,76% ispitanika s lakom MR. Ova deca spadaju u kategoriju ispitanika sa pervazivnim potrebama za podrškom, bez obzira na nivo potrebe za podrškom u drugim oblastima života. Ako imamo u vidu da se i kod dece bez specifičnih zdravstvenih ili bihejvioralnih problema mogu detektovati ekstenzivne, a u nekim slučajevima i pervazivne potrebe za podrškom, jasno je da zadovoljavanje takvih potreba zahteva novu organizaciju sistema pružanja podrške.