AMERICAN ACADEMY OF DEVELOPMENTAL MEDICINE & DENTISTRY
BY H. BARRY WALDMAN DDS, MPH, PHD, STEVEN P. PERLMAN DDS, MSCD, DHL (HON), AND MISHA GAREY, DDS
“Your age doesn’t define your maturity, your grades don’t define your intellect, and rumors don’t define who you are.” 1
“I hate it when people say, ‘you’re smart for your age.’” 2
“Age is an issue of mind over matter. If you don’t mind, it doesn’t matter.” 3
(Mark Twain)
The three of us (authors of this article) are dentists, but we are quite different from each other. We range in age from 35 years to 69 years to 80 years. We are of different genders and quite dissimilar in many other characteristics; just like individuals with intellectual disabilities; we have differing abilities and ages.
INTELLECTUAL DISABILITY
“A disability characterized by significant limitations in both intellectual functioning and in adaptive behavior, which covers many everyday social and practical skills. This disability originates before the age of 18.”4
• “ Based only on IQ test scores, about 3% of the total population is considered to have intellectual disability (ID). However, if classification is based on the need for support, only about 1% of people are classified as having significant mental (cognitive) limitation.” 5
• “Common causes occur from genetic conditions (Down syndrome and Fragile X syndrome are examples), problems during pregnancy (a pregnancy of the mother who drinks alcohol while pregnant can result in Fetal Alcohol Spectrum Disorder), problems at the time of birth, health problems such as whooping cough, measles or meningitis and exposure to environmental toxins like lead or mercury.
• Children may take longer to learn to speak, walk and take care of their personal needs, such as dressing or eating. It may take longer to learn in school.
• As adults, some people are able to lead independent lives in the community without paid supports. A small percentage will have serious, lifelong limitations in functioning. However, with early intervention, an appropriate education and supports as an adult, all can lead satisfying lives in the community.”6 (please see Table 1)
AGE-RELATED MILESTONE
Pediatricians (and parents) maintain watchful concern regarding the developmental milestones during the early months and years of the youngsters in their charge (particularly the development of premature infants). These milestones do not occur on certain days, but rather over an average period of time when most youngsters accomplish particular steps toward an increasing physical, intellectual and inter-personal ability; whether it is turning over in their crib, standing, first words, toileting, etc. that introduces them to the next stages in their development. Age-specific milestones may differ for youngsters with varying levels of intellectual disabilities. The emphasis on milestones should be tailored to the particular needs of the youngster with intellectual disabilities rather than to some standardized age formula.
ASSISTIVE TECHNOLOGY
Assistive technology is any tool that helps students with disabilities do things more quickly, easily or independently. It can be elaborate and expensive or simple and low-cost. 7
• “A student who can comprehend history at the 6th grade level, but can read only at the 3rd grade level, might read a textbook with the help of a computer that scans and reads text.
• For students with disabilities that interfere with their communication, learning, social relationships or active participation, assistive technology supports their participation in learning experiences in the least restrictive environment.
• A non-verbal student can be the ‘caller’ for a game of “Red Light/Green Light” by using a talking switch. ”7
WE’VE COME A LONG WAY, BUT…
“It is better for all the world, if instead of waiting to execute degenerate offsprings for crime or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind… Three generations of imbeciles are enough.” 8
– Oliver Wendell Holmes (1927)
Buck v. Bell, 274 U.S. 200 (1927), was a decision of the United States Supreme Court, written by Justice Oliver Wendell Holmes, Jr., in which the Court ruled that a state statute permitting compulsory sterilization of the unfit, including the intellectually disabled, “for the protection and health of the state” did not violate the Due Process clause of the Fourteenth Amendment to the United States Constitution. The Supreme Court has never expressly overturned Buck v. Bell. 9
“Current scholarship shows that Carrie Buck’s sterilization relied on a false diagnosis premised on the now discredited science of eugenics. (The science of improving a human population by controlled breeding to increase the occurrence of desirable heritable characteristics.) It is likely that Carrie’s mother, Emma Buck, was committed to a state institution because she was considered sexually promiscuous, that the same diagnosis was made about Carrie when she became an unwed mother at the age of 17 due to being raped, and that her daughter Vivian was diagnosed as “not quite normal” at the age of six months largely in support of the legal effort to sterilize Carrie.”
CHANGE BY UNDERSTANDING
To this point, we considered some past history and emphasized the need for an understanding of youngsters with intellectual disabilities in terms of an individual’s abilities beyond their specific age and milestones. The need is also to consider specifically the dramatic progress since the past long-term institutionalization of individuals with ID or committing these family members in the proverbial “back rooms” of family residences. The current mainstreaming of these youngsters in community schools and in movies, shopping centers and employment settings (essentially in “our” world) has offered the opportunity to experience first hand the vast potential of so many youngsters with intellectual (and other) disabilities.
“Life is like a sandwich! Birth as one slice, and death as the other. What you put in-between the slices are up to you. Is your sandwich tasty or sour? ” 10 (Allan Rufus)
“We can complain because rose bushes have thorns, or rejoice because thorn bushes have roses.” 10 (Abraham Lincoln)
“Brains are like snow flakes – no two are alike.” 11 (Rebecca Reitman) •
ABOUT THE AUTHORS:
H. Barry Waldman, DDS, MPH, PhD – Distinguished Teaching Professor, Department of General Dentistry at Stony Brook University, NY; E-mail: h.waldman@stonybrook.edu
Steven P. Perlman, DDS, MScD, DHL (Hon) – Global Clinical Director, Special Olympics, Special Smiles and Clinical Professor of Pediatric Dentistry, The Boston University Goldman School of Dental Medicine, Private pediatric dentistry practice – Lynn MA.
Misha Garey, DDS is Director of Dental Services at the Orange Grove Center.
References
1. Learning. Web site: https://twitter.com/factsguide/status/472233485768613888 Accessed September 22, 2015
2. Learning. Web site: http://www.experienceproject.com/groups/Believe-Age-Doesnt-Define-Maturity/522387. September 22, 2015.
3. Brainy Quote. Web site: http://www.brainyquote.com/quotes/topics/topic_age.html Accessed September 22, 2015.
4. American Association on Intellectual and Developmental Disabilities. Definition of Intellectual Disability. Web site: http://aaidd.org/intellectual-disability/definition#.VgGIgtJVikp Accessed September 22, 2015.
5. Merck Manual Intellectual disability. Web site: http://www.merckmanuals.com/home/children-shealth-issues/learning-and-developmental-disorders/intellectual-disability Accessed September 25, 2015.
6. The ARC. Intellectual disability. Web site: http://www.thearc.org/learn-about/intellectual-disability. Accessed September 25, 2015.
7. South Carolina Access through AT. What is assistive technology and how is it used in schools? Web site: http://www.sc.edu/scatp/cdrom/atused.html Accessed September 25, 2015.
8. Eugenics in Virginia: Buck v. Bell and Forced Sterilization. Web site:http://exhibits.hsl.virginia.edu/eugenics Accessed September 30, 2015.
9. Buck v Bell Wikipedia. Web site: https://en.wikipedia.org/wiki/Buck_v._Bell Accessed September 30, 2015.
10. Quotes about positive thinking. Web site: http://www.goodreads.com/quotes/tag/positivethinking?page=34 Accessed September 28, 2015.
11. Reitman H, Reitman R, Fizzano P. Aspertools: The practical guide for understanding Asperger’s syndrome, Autism Spectrum Disorders, and neurodiversity. Deerfield Beach, FL: HCI Books, 2015
