Epidemiologia y manejo integral de la discapacidad intelectual

Type Journal Article - Salud mental
Title Epidemiologia y manejo integral de la discapacidad intelectual
Volume 34
Issue 5
Publication (Day/Month/Year) 2011
Page numbers 443-449
URL http://www.scielo.org.mx/scielo.php?pid=S0185-33252011000500008&script=sci_arttext&tlng=pt
Intellectual disability (ID) is a condition of limited intellectual and adaptive functioning that occurs before the age of 18 years. For varied reasons, ID is the most forgotten of public health programs.

Exact prevalence is unknown, due to the absence of epidemiological research in children and adolescents, which is essential to know the needs of this population.

Detection involves identifying children at risk for any type of atypical development with emphasis on language probes and dysmorphic searching, optimally combined with developmental screening tools with proven psychometric properties; training psychologists and health providers such as general practitioners or pediatricians in the first level of attention is needed. The goal of second–level intervention is to diagnose ID with an emphasis on accurate measurement of intellectural coeficcient (IC) and adaptive level, including expanded genetic medical evaluation and assessment of the personal, familiar, and community resources of children with suspected ID. We also recommend the use of existing classifications, employing the World Health Organization (WHO) International Classification of Functioning, Disability and Health, to identify individual and environmental barriers and facilitators and the application of appropriate tests.

The overall treatment includes specific medical, psychological and educative & social interventions. Medical intervention also includes pharmacological treatments, especially psychotropic medication, including risperidone, methylphenidate and melatonin. Developing evidence for the use of this medication is provided for challenging behaviors such as aggression, hyperactivity, sleep problems and depression. Psychological help includes psychoeducation and techniques evidence based, such as those derived from applied behavior analysis and cognitive behavior. Its chronic use is discouraged and medication is recommended to be combined with proper behavior management. Early and appropriate education for ID is lacking; which also requires improving access to health services, limiting social exclusion. Enhancing advocacy and promoting the human rights for this population is also needed.

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