Children's Hospital Colorado

Intellectual Disability

What is an intellectual disability?

Children with intellectual disability have unique personalities and learning styles. Most are happy and healthy. Children with intellectual disability learn and show developmental progress, although more slowly than others. They may take longer to learn to speak, walk, dress or eat by themselves. With ongoing support, a person with intellectual disability will function better and better over time. The term "intellectual disability" is used when a person’s intelligence and daily functioning are at a lower level than other people of the same age. The diagnosis also reflects how a child interacts with his or her environment and how much support is needed.

When a child is young, the term developmental delay is sometimes used to describe developmental skills that are lower than expected for a child’s age, such as language, motor, cognition or play. As a child becomes older, he or she may or may not "catch up" in all or some of these developmental skills. The term intellectual disability may then be used for some children, when it is felt that they will probably not totally catch up in their development. Other terms have been used in place of intellectual disability, such as cognitive disability. The term mental retardation previously was used.

What causes intellectual disability?

Intellectual disability has many different causes. Events that may be associated with the diagnosis can occur before, during or after birth.

The following factors can all cause or contribute to the occurrence of intellectual disability:

  • Genetic (inherited) conditions
  • Serious infections
  • Vascular (blood vessel) problems
  • Trauma (injury) to the brain
  • Metabolic (body chemistry) conditions
  • Exposure to toxins (such as lead or alcohol)

In some cases, it may be difficult or not possible to identify a specific cause.

What are the signs and symptoms of intellectual disability?

Children with intellectual disability may take longer to learn to walk, speak, dress or feed themselves than other children their age. Their play, problem solving and learning of pre-academic skills (such as knowledge of shapes, colors and letters) may also progress more slowly.

Overall, a child with an intellectual disability seems to function as a child younger than his or her age.

What tests are used to diagnose intellectual disability?

The diagnosis of intellectual disability is made based on the results of cognitive testing (like an IQ test) to measure intelligence, as well as evaluating how a child functions in everyday activities to measure their adaptive skills.

To test for intellectual disability, a qualified psychologist tests children using standardized testing tools. In addition, either the psychologist or developmental pediatrician does tests to evaluate a child's adaptive skill abilities. These tests are non-invasive and not painful to children. In fact, many of these tests seem like games.

Why choose Children's Hospital Colorado?

The Developmental Pediatrics Program at Children's Colorado has experienced physicians trained in developmental-behavioral pediatrics and neurodevelopmental disabilities. This means our experts have had additional training to evaluate children with a wide range of developmental problems.

We also have experienced licensed clinical psychologists, all of whom have doctoral degrees. Our psychologists have completed additional post-doctoral training in the area of children with intellectual and other developmental disabilities.

What to expect from cognitive testing

Cognitive tests evaluate a child's knowledge and problems solving skills and assess verbal and non-verbal skills. Different tests are used based on the child's age and level of functioning. Tests may often appear like play or may seem similar to school work. Evaluation of a young child may take 2 to 3 hours, while evaluation of an older child may take 4 or more hours.

How do providers at Children's Colorado make a diagnosis?

It is important to identify children who require additional assessment and to accurately test children who may have an intellectual disability. The results of diagnostic testing will guide recommendations for support and intervention at home, school and in the community. If you are concerned about your child's developmental progress, you should initially discuss your concerns with your child’s primary care provider.

At the Developmental Pediatrics Program, we offer coordinated psychological and medical evaluations to provide information about a child’s learning abilities and style, as well as areas of strength and vulnerabilities. Children generally undergo various tests that evaluate their functioning in a number of areas that affect learning. In addition, a medical assessment that includes a physical exam explores current health concerns, past medical history, family and social history. Results of information from the various assessments are combined to determine the diagnosis of intellectual or other developmental disabilities.  

What happens after the tests?

As a result of our findings, recommendations are made about the types of services that may benefit your child. Sometimes, those recommendations include additional medical testing to identify the cause of developmental issues or associated medical conditions.

Not all children require many tests. Some tests may affect the treatment of your child, while others may help identify a specific medical condition related to the diagnosis of intellectual disability. Additional referrals to other providers like, speech and language therapists, occupational therapists, geneticists and neurologists may also be recommended.

How is an intellectual disability treated?

Our services usually vary for each child, based on his or her particular cognitive, adaptive skill, physical and emotional needs, as well as available home and community resources. It is always important to identify and build on each child’s areas of strength. At Children's Colorado, our treatment focus for children with intellectual disability is to provide individualized therapies that meet your child's skill sets and functioning levels. In particular, we stress therapies to improve self-care skills and independence.

What should I expect for school?

Until age 3, services are provided through Early Intervention, a Federal program. At age 3, the school system begins to provide the needed school and therapy services. Ideally, children with intellectual disability are enrolled in regular classrooms with children of the same age, with special supports as needed. They may be included in a regular classroom for all or part of the school day. Children sometimes may also attend specialized classrooms or schools, based on their individual needs.

What other services and therapies are available?

In addition to services that may be provided by the school system, different types of services and therapies may be provided in the community, including:

  • Physical therapy to work on gross motor skills, particularly issues related to differences in muscle tone, strength, motor planning and coordination.
  • Occupational therapy to address issues related to fine motor, self-help, sensory processing, and/or feeding skills.
  • Speech and language therapy to address delays in speech sound production, understanding and production of language. Some children also may require special assistance in development of nonverbal communication skills. Therapy also may focus of feeding problems.
  • Behavioral therapies may be used to work on behaviors that interfere with learning, social interactions and day-to-day functioning, such as problems with attention, mood, aggression or self-injurious behaviors.

There is no medication to treat intellectual disability, as it is a disability and not a disease. However, in some instances medication may also be useful for helping associated problems, such as sleep, attention or mood.

Why choose Children's Colorado for your child's intellectual disability?

At Children's Colorado, our providers are experts in the assessment of children and adolescents with intellectual and developmental disabilities.

We evaluate children from birth through puberty. In addition to evaluations to diagnose intellectual disabilities, we also provide some treatment and interventions for children with developmental disabilities, including medication management to address behavioral issues, as well as treatments to address sleep, toileting, anxiety and behavioral problems. We also provide support for families to access community-based resources.

  • The ARC of Colorado is an advocacy group for people with intellectual disabilities.
  • Family Voices Colorado is a local support group for parents of children with medical needs including intellectual disability.

Related departments