NU674 Unit 13 DQ 1: intellectual and communication disorders
Discuss intellectual disability and communication disorders in children and adolescents, and define how you would progress with a comprehensive assessment of a child suspected of having one of these disorders.
Editorial process
Last reviewed · August 14, 2026
Two diagnoses that present the same way and are not the same
Take the two categories separately before you put them together, because the post is graded on the distinction. Intellectual disability is a deficit in both intellectual functioning and adaptive functioning — conceptual, social and practical — with onset in the developmental period, and current criteria set the level of severity by adaptive functioning rather than by an IQ number. Communication disorders are a group: language disorder, speech sound disorder, childhood-onset fluency disorder and social pragmatic communication disorder, each defined by difficulty out of proportion to the child's other abilities. The clinical problem is that they overlap and imitate one another. A child with an unrecognised expressive language disorder tests poorly on verbally mediated tasks and looks intellectually disabled; a child with intellectual disability has delayed language as one feature of a global picture. Hearing loss, autism, neglect and a second language at home all produce the same surface, so the assessment exists to tell them apart.
For the assessment, describe a sequence rather than a list, and say what each step rules in or out. Start with history: pregnancy and birth, milestones with dates rather than the parent's summary, family history of delay, seizures, regression, languages spoken at home, and the school's own observations. Then audiology first, always, because uncorrected hearing loss explains a great deal and is cheap to exclude. Then a validated developmental screen — ASQ-3, or M-CHAT-R/F when autism is in the differential — followed by the physical and neurological exam, looking for dysmorphology, growth, head circumference and neurocutaneous findings. Then referral for the assessments you cannot do yourself: standardised cognitive and adaptive testing by psychology, and a speech-language evaluation of receptive and expressive language separately. Genetic testing and lead follow the findings. Close with the school pathway, because the diagnosis only helps if it becomes an IEP.
Likely learning objectives
Inferred from the brief — check these against your own rubric.
- 01State the diagnostic criteria for intellectual disability, including adaptive functioning.
- 02Name and distinguish the communication disorders of childhood.
- 03Explain why the two categories are confused in clinic and what separates them.
- 04Sequence a comprehensive assessment so each step rules something in or out.
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Review every instruction before using the planning guidance that follows.
Course-wide instructions that accompany this question
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Turn the brief into deliverables
- 01A description of intellectual disability in children and adolescents.
- 02A description of communication disorders and their subtypes.
- 03How the two are distinguished from each other and from autism and hearing loss.
- 04A comprehensive assessment pathway, in order.
- 05The referrals and standardised testing required, and who performs them.
- 06At least two scholarly articles cited in APA format.
From concern to comprehensive assessment
Intellectual disability, defined
Intellectual and adaptive deficits, developmental onset, severity by adaptive function.
Communication disorders, defined
Language, speech sound, fluency and social pragmatic disorders.
Why they are confused
Verbally mediated testing, overlapping presentation, autism and hearing loss.
History and observation
Perinatal history, dated milestones, regression, languages at home, school report.
Screening, examination and referral
Audiology, ASQ-3 or M-CHAT-R/F, physical exam, psychology and speech-language referral.
After the diagnosis
Early intervention, IEP, family support and follow-up interval.
Criteria, screening tools and referral pathways
Recommended databases
- StatPearls, NCBI Bookshelf
- PubMed Central
- CDC developmental milestones
- American Speech-Language-Hearing Association
Search sequence
- 1.Read the current criteria for intellectual disability, noting the adaptive-function severity anchor.
- 2.Read a review of childhood language disorders and their subtypes.
- 3.Find the recommended screening intervals and named instruments.
- 4.Check what the evidence says about differentiating language disorder from intellectual disability.
- 5.Select two scholarly articles you can cite for the assessment sequence.
Reference shortlist
These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.
Nothing here is cleared for citation until you have read it.
- 01
Intellectual Disability
StatPearls, NCBI Bookshelf · 2023
Diagnostic criteria, adaptive-function severity levels, and aetiology.
- 02
Developmental Delay
StatPearls, NCBI Bookshelf · 2023
The assessment sequence and the referrals that follow a failed screen.
- 03
Speech and Language Developmental Milestones
National Institute on Deafness and Other Communication Disorders · 2024
The milestone baseline a delay is judged against, and when to refer for evaluation.
- 04
Autism Spectrum Disorder
StatPearls, NCBI Bookshelf · 2023
The overlapping presentation that the assessment has to exclude.
Review before submission
Common mistakes
- Treating communication disorder as a single diagnosis rather than a group.
- Defining intellectual disability by IQ alone and omitting adaptive functioning.
- Leaving hearing testing out of the assessment.
- Listing assessments without saying what each one excludes.
- Ignoring bilingualism, which produces the same surface as a language disorder.
- Stopping at diagnosis with no school or early-intervention pathway.
Submission checklist
- Adaptive functioning appears in the definition of intellectual disability.
- At least three communication disorder subtypes are named.
- Audiology is placed early and justified.
- A named validated screening tool is used.
- Referrals for cognitive, adaptive and language testing are specified.
- Two or more scholarly sources are cited in APA format.
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