Shirah Vollmer MD

The Musings of Dr. Vollmer

Mental Retardation Leaves: Intellectual Disabilities Enter…From MR to ID….Freud Returns

Posted by Dr. Vollmer on June 15, 2013

Mental Retardation no longer exists. It has joined Asperger’s in the ‘remember when’ category. In comes intellectual disability, (ID), to remind us of Freud’s understanding of the id. A mere coincidence, I understand, but too close for my taste. In parenthesis the DSM 5 adds intellectual developmental disorder (IDD). So, the IQ test is no longer the defining feature of intellectual disability. One must consider functioning level. There are three domains of functioning: conceptual, social and practical. The conceptual domain includes skills in language, reading, writing, math, reasoning, knowledge and memory. The social domain refers to empathy, social judgment, interpersonal communication skills, the ability to make and retain friendships and similar capacities. The practical domain centers on self-management in areas such as personal care, job responsibilities, money management, recreation and organizing school and work tasks. So, what is my take? Much ado about nothing. A good assessment has always been a key feature in understanding disability. This assessment has always included understanding the impact of the disability on day-to-day life. Does the label change help parents? I do not think so. Does it help professionals approach the problem in a more comprehensive way? No. Was it important for my peers to spend countless hours debating this change to DSM 5? Maybe. They argue that this change brings the terminology in line with  the World Health Organization’s International Classification of Diseases and the American Association on Intellectual and Developmental Disabilities and the US Department of Education. The name does suggest a spectrum of children, who for a variety of reasons, have developmental challenges, requiring them to have much-needed services to maximize their developmental potential. In this way, creating this umbrella does make sense.

7 Responses to “Mental Retardation Leaves: Intellectual Disabilities Enter…From MR to ID….Freud Returns”

  1. Shelly said

    I think the revamp does more harm than good. Intellectal disabilities now does not sound different than dementia or senility, yet they are very different functional organic processes. Yet families still need help either way.Were the writers aware how damaging their new version would ma ke getting services for those affected by the changes, or th countries which closely followed the issuence of the new DSM? For now, what was previously considered a separate catagory of autistic spectrum disorder (Aspergers), where I live it is no linger considered a disability and our children are not entitled to disability benefits. Good job, DSM V!

    • I am going to talk about how they changed the names for dementia, as well. The issue of getting services is not clear to me, but I appreciate your comments. My understanding is that Asperger’s is now under the umbrella of autism spectrum disorders, and as such, should still help families get services. I understand that where you live services have been cut due to the changes in DSM 5. I think that is tragic, but I am not sure that DSM 5 is to blame for that. Thanks.

  2. Jon said

    Shirah, you use a Shakespearian title to correctly (in my mind at least) describe your take on change in the DSM 5, much ado about nothing. Another often quoted line also comes to mind, not a title but lines of Romeo and Juliet (Act II Scene II) “What’s in a name? that which we call a rose / By any other name would smell as sweet”

    That said, another line from Shakespeare comes to mind, this from Hamlet (Act III, scene II), but here the antithesis is true, “The lady doth protest too much, methinks.” That which you rant upon (albeit not a rant in this post), is protest; however, not too much, but wisely and well (not quite Othello Act V, scene II).

    And with these thought, I take my leave of this page for the nonce. Anon.

  3. Ashana M said

    It seems like it’s about time. Maybe we’ll start using the metric system next…

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