Understanding Visual Impairment, Intellectual Disabilities, and Learning Disabilities

Posted on Feb 27, 2025 in Psychology and Sociology

Visual Impairment

Anatomic or functional disturbances in the sense of vision affecting visual acuity, field of vision, color perception, or binocular visual function. This refers to persons with visual acuity ranging from 20/70 to 20/200.

Definitions

Legally blind: 20/200 in best eye with corrected vision, or <20% visual field (norm is 140-160).

Causes

  • Diabetic retinopathy (#1 cause; 80% of juvenile-onset diabetes will experience diabetic retinopathy)
  • Glaucoma
  • Head trauma
  • Macular degeneration
  • Cataracts
  • Retinitis pigmentosa
  • Retinopathy of prematurity

Adjustment

It is easier to cope with Braille at a younger age. Adaptation is more difficult with some sight versus being totally blind due to embarrassment and fear of further sight loss.

Accommodations

  • Contacts
  • Glasses
  • Surgery (PRK, Lasik)
  • Prosthetic eye
  • Guide dogs
  • Canes
  • Assistive devices (audiocassettes, talking watches, video magnifiers, computer software)
  • Low vision aids
  • Enlarged texts
  • Magnifiers
  • Speech output for computers
  • Braille texts and forms

Intellectual Disabilities

DSM5: Neurodevelopmental disorder with onset during the developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains.

AAIDD: Community environment typical of peers and culture.

Must meet 3 criteria:

  • Deficits in intellectual functioning such as reasoning, problem-solving, and abstract thinking.
  • Deficits in adaptive functioning that result in failure to meet developmental and sociocultural standards for personal independence and social responsibility without ongoing support.
  • Onset of intellectual and adaptive deficits during the developmental period.

Etiologies

Genetic and environmental factors; 50% of causes cannot be determined. Examples include:

  • Fragile X syndrome or trisomy 21
  • Brain malformations and chromosomal abnormalities
  • Maternal exposure to infections
  • Maternal abuse
  • Maternal exposure to toxic chemicals
  • Maternal exposure to prescription drugs
  • Lack of oxygen supply in utero
  • Postnatal brain injury
  • Meningitis
  • Age
  • Number of children
  • Socioeconomic status

Severity

  • Mild (85%, IQ 52-69): Mostly self-sufficient.
  • Moderate (10%, IQ 36-51): Can mostly do self-care but might need extended instructions.
  • Severe (3-4%, IQ 20-35): Needs daily assistance.
  • Profound (1-2%, IQ 19 or Below): 24-hour support.

Supported Employment

Facilitated approach by a job developer, use of long-term 3rd party job coaching that is faded to minimal levels over the life, stable at 20% of scheduled work hours per month for 2 months, individual group or work activity program.

Predictors

  • Expectations from others regarding the person will affect the prospect for employment.
  • On-the-job training.
  • Ongoing coaching and employment support even after placement.
  • Individuals usually perform better in structured environments.
  • Individuals may need additional social skills training.

Chronic Pain

  • Average pain duration: 10.2 years
  • Requires 2 evaluations: physical therapy and behavioral pain evaluation
  • Pain affects emotionally/psychologically; emotions can affect chronic pain

Body Systems Implicated

Nervous and endocrine systems.

Risks

Female and middle-aged individuals.

Goals

Improve mood, improve ability to manage pain, improve quality of life, better social interaction.

Treatment

Short-term psychotherapy, breathing and meditation, self-hypnosis, biofeedback (muscle tension, thermal, cardio), physical therapy (yoga, self-care, body awareness, gentle swimming).

Learning Disabilities

  • Dyslexia: Difficulty processing language like reading, writing, and spelling.
  • Dyscalculia: Difficulty doing math.
  • Dysgraphia: Difficulty writing, spelling, and organizing ideas.
  • Dyspraxia: Sensory integration disorder.
  • Auditory processing disorder: Hearing differences between sounds.
  • Visual processing disorder: Difficulty interpreting visual information.
  • Nonverbal learning disability: Difficulty interpreting nonverbal cues.

Diagnosis

  • Average to above-average intellectual ability.
  • Severe processing deficits.
  • Severe aptitude-achievement discrepancies.
  • Measured achievement in an instructional setting.

Prevalence

  • 3 million kids (6-21) have learning disabilities and receive special education.
  • Learning disabilities form the largest category in special education.
  • 50% of special education kids have learning disabilities.
  • 3 males:1 female ratio.

Risks

Male, genetic predisposition.