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by James C. Harris
Oxford University Press, 2010
Review by Benjamin J. Lovett, Ph.D. on Apr 12th 2011

Intellectual Disability

Many childhood psychological problems are the subject of wide media coverage, inspiring TV specials and articles in popular magazines. Autism spectrum disorders, child bipolar disorder, and ADHD are but three examples. In contrast, intellectual disability--previously known as mental retardation--is decidedly unglamorous. Although at least one of every 100 children born has some degree of intellectual disability, much confusion remains about the condition among both of the audiences named in this book’s subtitle: families and professionals.

The confusion is in part due to the definition of intellectual disability (ID). Like hypertension, obesity, and many other conditions, its definition is based on guidelines that have some degree of arbitrariness. As Harris notes in this book, there are several competing sets of diagnostic guidelines from professional associations, and additional sets of guidelines for legal purposes, often varying across different states. Therefore, it’s not unusual for an individual to meet some sets of guidelines and not others.

Despite these conceptual muddles, Harris deftly surveys the literature on ID, in a manner accessible to readers with varying amounts of background. He begins by considering the sad history of society’s treatment of those with ID, before turning to the methods of defining ID and assessing the abilities and needs of those with the condition. A chapter on the causes of ID follows, noting that ID is really a group of conditions, such as Fragile X syndrome and Down syndrome, each of which have distinct biological bases and characteristic symptoms.

The second half of the book turns to more practical matters, beginning with what families can expect when a child is evaluated for ID. Harris then includes a relatively lengthy chapter on associated psychiatric disorders which may accompany ID; this chapter may seem odd at first, but the issue of psychiatric comorbidity (multiple psychiatric conditions in the same person) is underappreciated, and both families and professionals may not be sufficiently attentive to additional psychiatric disorders in someone with ID, attributing all of the individual’s behavior problems to the ID. A chapter on treatments is next, consisting of brief descriptions of therapeutic approaches and definitions of common terms from that literature. The final chapter is an interesting discussion of ethical issues to be considered when an individual with ID is participating in research studies.

Overall, the book is an excellent non-technical introduction to ID for families, students, and professionals who do not specialize in the condition. It is clearly written and emphasizes useful themes of increasing the well-being and autonomy of individuals with ID. A reviewer can always complain about topics that would have been helpful to include, of course. I would have liked to see the author’s evaluation of the efficacy of various treatment approaches, rather than just descriptions of them. Similarly, given the varying guidelines for diagnosing ID, I was interested in finding out the author’s perspective on which are better than others. But I understand the virtue of steering clear of professional disagreements and presenting information in a neutral tone, emphasizing consensus rather than controversy. In sum, I would recommend the book to a variety of audiences, and I look forward to reading more of the author’s professional writings.

 

© 2011 Benjamin J. Lovett

 

Benjamin J. Lovett, Ph.D., is an assistant professor of psychology at Elmira College, where his research focuses on conceptual and psychometric issues in psychoeducational assessment and psychiatric diagnosis.