17.2.2 What can you do when you suspect ID?
There is no cure for ID. But there are things that can be done to make sure that there are no treatable problems affecting intellectual development that are being missed.
Tessema, a 3-year-old toddler, appears withdrawn and unhappy. His parents tell you that he has grown well physically but has problems talking. They also tell you that when he was 3 months old, he had a fever and discharge coming from his ear. They are concerned that, because he has not been able to talk, he may have ID. How would you proceed?
ID is not just about a child having problems with language development. ID is more pervasive and affects a child’s physical and emotional development as well. Language is an important indicator of intellectual development but it is not the only indicator. The first thing to consider in the case of Tessema is whether a problem with his hearing has caused a delay in his talking. At 3 months he had what appears to be an ear infection, which may have caused the problems with language development. However, before concluding that Tessema’s problem is just to do with his hearing, confirm that there are no problems with his physical and emotional development (Table 17.1 and Figure 17.2). If you suspect hearing problems, or if you are unable to exclude this possibility, refer Tessema to the next healthcare facility for further assessment and advice.
As noted above, under-stimulation can also make a child appear developmentally slow. As Tessema is withdrawn, this is a possibility, although it is relatively uncommon. You should check how Tessema’s family interacts with him. If you find that there is very little interaction between him and the family, you can gently suggest ways in which the family might encourage stimulation. For example, you can ask the family to try and talk to Tessema regularly, to take him out of the house on a daily basis, and to allow him to play with other children.
Although ID cannot be cured, there are several other things that can be done. You can play a key role in educating the parents, other relevant family members and the child’s teachers about the child’s difficulties, and give them information on how to best support the child.