Clinical Insights into Down Syndrome (Trisomy 21) and Intellectual Disability Disorder: A Clinical Case Study

Abstract

This study explored a single case about a 6-year-old girl with Down syndrome (Trisomy 21) and co-morbid with a moderate level of intellectual disability disorder. She was showing complaints of lack of social skills, poor speech, difficulty in fine motor skills, reduced sharing of emotions, poor self-help skills, lagging from her peers in academics, and having a history of delayed milestones. The informal and formal assessments consisted of clinical interviews with parents and teachers, behavior observation, identification of reinforcement survey, creating the baseline charts for problematic behaviors, comparison of the developmental milestones (Centers for Disease Control and Prevention, 2018),consulting the portage guide to early education (Sturmey & Crisp, 1986), the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) in 2022 criteria, and Raven-colored progressive matrices (Raven, 2000). The case was conceptualized by using the biopsychosocial model (Engel,1977). After analyzing the assessment, the child was diagnosed with an Intellectual Disability Disorder of moderate level (F 71) with Down syndrome. A management plan was devised and implemented. The Individualized Intervention Plan incorporated behavior therapy such as reinforcement, prompting, imitation, symbolic modeling, shaping, chaining, fading, floor time (DIR), and pivotal response treatment (PRT) were used to overcome problematic behaviors and encourage communication and social skills. The difference between pre-assessment and post-assessment clearly showed improvement in the client’s selected tasks like stubbornness and spitting hitting and nail biting by 80% after 16 sessions.