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About Intellectual Impairment
According to the American Association on Intellectual and Developmental Disabilities, an intellectual disability is a disability that involves significant limitations both in intellectual functioning and in adaptive behavior. Adaptive behaviors include many everyday social and practical skills such as interpersonal and communication skills, social problem solving and responsibility, the use of time and money, as well as daily personal care and safety. Limitations in individuals often coexist with strengths, and will vary from individual to individual.
This disability originates before the age of 18 and encompasses a wide range of conditions, types, and levels. Intellectual disability is caused by factors that can be physical, genetic, and/or social. According to the President's Committee for People with Intellectual Disabilities, an estimated seven to eight million Americans of all ages experience intellectual disability. Intellectual disabilities affect about one in ten families in the United States.
- JAN's Accommodation Solutions: Executive Functioning Deficits is a publication detailing accommodations for individuals with limitations related to executive functioning. These ideas may be helpful in determining accommodations.
- JAN's Effective Accommodation Practices (EAP) Series: Communication Tips for Working with Individuals with Intellectual Disabilities is a publication discussing strategies for communicating with individuals who process information more slowly.
Additional Helpful Terminology
Developmental disabilities that may also include an intellectual disability are briefly described below. Intellectual disabilities can also be caused by a head injury, stroke or illness. For some no cause is found. Intellectual disabilities will vary in degree and effect from person to person, just as individual capabilities vary considerably among people who do not have an intellectual disability. People should not make generalizations about the needs of persons with intellectual disabilities. In some instances an intellectual disability will not be obvious from a person's appearance, nor will it be accompanied by a physical disability. Persons with intellectual disabilities successfully perform a wide range of jobs, and can be dependable workers. (EEOC, 2011)
Autism: Individuals with disabilities on the autism spectrum may have complex developmental disabilities that typically appear during the first three years of life. These disabilities are the result of a neurological disorder that affects the normal functioning of the brain, impacting development in the areas of social interaction and communication skills. Both children and adults with disabilities on the autism spectrum typically show difficulties in verbal and non-verbal communication, social interactions, and play or leisure activities. http://www.autismsociety.org
Cerebral Palsy is a condition, sometimes thought of as a group of disorders, that can involve brain and nervous system functions such as movement, learning, hearing, seeing, and thinking. Cerebral palsy is caused by injuries or abnormalities of the brain. Most of these problems occur as the baby grows in the womb, but they can happen at any time during the first two years of life, while the baby's brain is still developing. http://www.ncbi.nlm.nih.gov/guide/
Down Syndrome is a genetic disorder that causes lifelong intellectual disabilities, developmental delays and other complications. Down syndrome varies in severity, so developmental problems range from moderate to serious. Down syndrome is the most common genetic cause of severe intellectual disabilities in children. Individuals with Down syndrome have a higher incidence of heart defects, leukemia, sleep apnea, and dementia later in life. http://www.TheArc.org
Fetal Alcohol Syndrome is a condition that results from prenatal alcohol exposure. It is a cluster of mental and physical birth defects that include intellectual disabilities, growth deficits, central nervous system dysfunction, craniofacial abnormalities and behavioral instabilities. Fetal Alcohol Effect is a less severe set of the same symptoms. It is the only form of intellectual disability that can be totally prevented and eradicated. http://www.nofas.org
Fragile X Syndrome is a hereditary condition that can cause learning problems ranging from subtle learning disabilities and a normal IQ, to severe intellectual disabilities and autism. Individuals with Fragile X Syndrome may also have physical and behavioral disorders, and speech and language delays. http://www.fragilex.org/
Prader-Willi Syndrome (PWS) is the most common known genetic cause of life-threatening obesity in children. PWS typically causes low muscle tone, short stature if not treated with growth hormone, and a chronic feeling of hunger that, coupled with a metabolism that utilizes drastically fewer calories than normal, can lead to excessive eating and life-threatening obesity. PWS is also characterized by motor development delays along with some behavior problems and unique medical issues. Intellectual deficits can be present to varying degrees, but even higher functioning individuals will have learning difficulties. http://www.pwsausa.org
Intellectual Impairment and the Americans with Disabilities Act
The ADA does not contain a definitive list of medical conditions that constitute disabilities. Instead, the ADA defines a person with a disability as someone who (1) has a physical or mental impairment that substantially limits one or more "major life activities," (2) has a record of such an impairment, or (3) is regarded as having such an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).
Accommodating Employees with Intellectual Impairment
People with intellectual or cognitive impairments may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with intellectual or cognitive impairments will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.
Questions to Consider:
- What limitations is the employee experiencing?
- How do these limitations affect the employee and the employee’s job performance?
- What specific job tasks are problematic as a result of these limitations?
- What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
- Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
- Do supervisory personnel and employees need training?
Situations and Solutions:
The following situations and solutions are real-life examples of accommodations that were made by JAN customers. Because accommodations are made on a case-by-case basis, these examples may not be effective for every workplace but give you an idea about the types of accommodations that are possible.
A production worker with an intellectual impairment and cerebral palsy had difficulty grasping a plastic bottle to accurately apply an adhesive label.
JAN suggested making a wooden jig, which secured the bottle, thus allowing the employee to use both hands when applying the label.
A gaming store clerk with Fragile-X did not know her ABCs and could not read movie titles.
She had difficulty stocking returned video games to the shelf. JAN suggested the employer make picture labels for the cases that matched shelf display boxes. This allowed the employee to match pictures, not words, when returning games to the shelf.
A grocery stocker with a cognitive impairment could not remember to wear all parts of his uniform.
JAN suggested taking a picture of the employee in full uniform and providing the picture to use as a reference when preparing for work.
A store clerk with an intellectual impairment had limited reading skills, making it difficult to return items to the shelf.
JAN suggested making picture labels for cases that matched shelf display boxes. This allowed the employee to match pictures, not words, when returning items to the shelf.
JAN Publications & Articles Regarding Intellectual Impairment
Consultants' Corner Articles
- A Support Person as an Accommodation
- Accommodation Scenarios for the Interviewing Process
- Accommodations Related to Commuting To and From Work
- Confidentiality of Medical Information under the ADA
- Disability Awareness Training
- Employment Testing and the ADA
- Interviewing Tips for Applicants with Autism Spectrum Disorders (ASD)
- Less Clutter, More Productivity
- Accommodations Beyond Job Performance = Compliance and Inclusion
- Cognitive Impairment and the Interactive Process
- Interview Tips for New Grads with Autism Spectrum Disorders (ASD)
- Job Coaches and Support People for Individuals with Intellectual Disabilities
- When Support Persons Hamper the Process They were Brought in to Facilitate