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What is a cognitive impairment?

A cognitive impairment is a condition where your child has some problems with ability to think and learn. Children with a cognitive impairment often have trouble with such school subjects as math and reading. A cognitive impairment also affects how a person will functions in everyday life, e.g., getting dressed and feeding oneself. With the right support from family and professionals, children learn to do things like walk, talk and read but they will do it at a different, perhaps slower pace.

Doctors find out that a child has a cognitive impairment by testing. Q testing measures intelligence, putting a number to how well someone learns and thinks. It's not always a good way to measure someone's thinking, but it's the closest the doctors can get.

A cognitive impairment comes in different forms -- mild, moderate, severe and profound. These degrees of a cognitive impairment are measured by a child's IQ number. A child with a mild cognitive impairment has a higher IQ and can learn more quickly than a child with a severe cognitive impairment.

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What are some common signs of a cognitive impairment?

Some common signs that your child may show are:
  • Communicates with you in other ways than talking, such as signs or touching you.
  • Slower to do things than other children - learning to sit up, crawl and walk.
  • Problems with feeding and washing oneself.
  • Hard to remember things and solve problems.
  • Problems making friends or dealing with children one's own age.

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What can I do to help my child?

You have made an important first step by reading more information on your child's disability. Another step you can take is to talk to other parents of children who have a child with similar needs. They have gone through what you are going through now and may be able to help. You also can get great help from parent support and advocacy groups such as Parent to Parent of Miami. Research tells us that the earlier we begin to help children, the better the results for the child and family.

Below are some checklists to help your child. Remember, you are not alone.


Getting Started

 Get my child evaluated (tested):

If your child is between ages birth to 3 years old, your child can be evaluated by a team of experts through the Early Steps program for free. Your child may be eligible for free services. You can contact one of the centers closest to your home.

If your child is 3-5 years old and has problems with learning, speaking, playing, seeing, walking or hearing, he/she can still receive free screening through the Child Find/Florida Diagnostic and Learning Resources System (FDLRS/South)  program. That office also provides testing for special-education programs. (If already in the Miami-Dade Public School system, your child must be tested through the school.)

Contact Children's Medical Services (CMS): CMS provides local offices and will sometimes refer children to medical centers that work with CMS. Services are provided to help children with disabilities, special needs or major medical conditions, ranging from early intervention programs such as Early Steps to ones for a specific medical condition.

Contact the Agency for Persons with Disabilities : To register for services for my child. If your child is 3 or older and has an IQ of 69 or below, he/she can apply for services. Examples of some services for which your child may be eligible are:
  • Respite: A caregiver comes to your home so you can take a break for shopping, visiting friends and family or just to have a night out.
  • Behavioral services: Teaches your child ways to deal with day-to-day problems.
  • In-home supports: Personal care assistance, companions, homemaker services.
For more information on services and how to apply, please click here.

 Work with my child's service providers: A service provider is anyone who works with you and your child such as your pediatrician, a physical therapist, a teacher, a principal, a social worker or any professional. Remember that you know more about your child than anyone else and are the main influence in your child's life. Some tips for speaking with service providers:
  • Feel free to ask questions and make comments. Be specific about what you know about your child and what you want and need for your child. Be honest about what you expect, any worries you may have, or about anything you don't understand.

  • If you think your child needs something in particular (such as a speech evaluation or assistive technology), keep asking until you get it or until you learn why it is not needed.

  • Work with professionals in early intervention or in your school to write your child's IFSP or IEP to reflect your child's needs and abilities. Be sure it includes such services as speech-language pathology, physical therapy, and occupational therapy -- if your child needs these. Don't forget about assistive technology, too.
 Get more information: Visit more websites. Read a book. Watch a video that addresses your child's needs. Include your child and family. Talk with another parent. Parent to Parent of Miami can help you meet other parents and get services.

 Help my child work on adaptive skills: Children with a cognitive impairment will need to work on skills to help them live and work on their own. Teachers and other professionals can help with these skills, and you and your family can practice at home. Skills for which children may need help include:
  • Taking care of themselves: Feeding themselves, dressing themselves and toileting.
  • Reading and writing.
  • Social skills: Playing in groups, manners, getting along with others.
  • Communicating: Rules of conversations, talking with and understanding others.
  • Role at home: Setting the table, cleaning up after themselves.
  • Health and safety issues.

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What causes a cognitive impairment?

A cognitive impairment is caused when the brain is injured or there is something that keeps the brain from developing. This could happen when the baby is growing inside the mother or after the baby is born. Four main categories lead to a cognitive impairment:
  • Problems during pregnancy: When the baby does not develop properly inside the mother. A mother with some infections can affect the growth of the baby inside her. If a mother drinks alcohol or takes particular drugs, she may well be hurting her baby, and it can cause a cognitive impairment.

  • Problems at birth: If a baby does not get enough oxygen during birth, it can cause a cognitive impairment.

  • Something passed on from mother or father: Each of us has a map of whom we are within our bodies. This map is written in a code called DNA, which bundled together makes genes. Parents pass on traits such as skin color or height through genes. The genes of the mother and father can combine in a way that the child is born with a cognitive impairment.

  • Health problems/accidents: Diseases such as meningitis and the measles can lead to a cognitive impairment. Car crashes, near drowning and other brain injuries are even more common causes.

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How common are cognitive impairments?

Nearly 3 out of every 100 people in the U.S. have a cognitive impairment. Close to 613,000 children ages 6-21 have some level of a cognitive impairment and need special assistance in school.

The Arc, 2001, Twenty-fourth Annual Report to Congress, U.S. Department of Education, 2002

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What does this mean for my child’s intelligence and learning?

Children with a cognitive impairment can learn a great deal, but do so at their own pace. Many children with a cognitive impairment need help developing adaptive skills. These skills help them to work and play by themselves. They can learn adaptive skills through types of therapy as physical and occupational therapy.

A child with a cognitive impairment has the legal right to attend public school. The school is responsible for helping you and your child find the right program for learning. A child with a cognitive impairment may learn better in a special-education classroom. Many children with a cognitive impairment need special help from teachers. In special-education classrooms, teachers are trained in teaching children who learn differently from others.

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Who are some professionals my child may need to see?

Your child may need to see many different health care specialists. For example:

Pediatrician: A doctor who specializes in treating children. The word "pediatric" in front of a professional's title means he or she works with children.

Developmental pediatrician: A doctor with special training in your child's mental and physical growth can help you keep your child healthy and will have experience with children who have a cognitive impairment.

Pediatric psychologist: A professional who does IQ and other tests to find out if a child has a cognitive impairment. He or she also can help parents teach children to behave properly.

Speech therapist: A professional who helps your child develop sounds and speech and sometimes helps with feeding and swallowing issues. This professional will teach your child about communicating and help him or her talk to others properly.

Physical therapist: A professional who helps children with muscles and movement. Physical therapists help children learn to do daily activities on their own.

Occupational therapist: A professional who helps your child learn how to reach for and hold onto things. This therapist also will help your child with problem-solving using the five senses -- vision, touch, smell, movement and hearing.

Social worker and counselor: A professional who provides counseling and emotional support for the child and family, and may help coordinate services, too.

Care coordinator: An individual responsible for organizing the details across agency lines and serving as your contact to help you and your family get services and assistance.

Assistive technology specialist: A person who works with individuals with disabilities to provide assistive technology solutions to help with any problem areas. Assistive technology or assistive devices help a person with a disability with any daily living task, e.g., eating, speaking, getting around, working, playing. An assistive technology specialist is familiar with many options to help your child live life to the fullest. Some services and assistive devices may be covered under Medicaid.

Pediatric neurologist: A doctor who works with the brain, helping to find out why a child has a cognitive impairment. These doctors also take care of children with seizures.

Geneticist: A doctor or counselor who helps parents learn whether their child has a genetic condition causing a cognitive impairment. A geneticist or genetic counselor also helps families understand whether future babies in their family are likely to have a cognitive impairment.

Child psychiatrist: A doctor who can help when your child is depressed, anxious or angry. Psychiatrists can prescribe medications for children when they have trouble sitting still or controlling their impulses, or who are very aggressive or even out of control.

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What are some useful websites I can go to learn more about mental retardation?

American Association on Mental Retardation (AAMR) http://www.aamr.org/ An online resource offering rapid access to information about mental retardation and disabilities.

The Arc of the United States http://www.thearc.org/ Devoted to promoting and improving supports and services for people with cognitive impairments and their families.

Florida's Voice on Mental Retardation http://www.fvmr.org/ A statewide organization of families and friends of persons with cognitive impairments.

The President's Committee for People with Intellectual Disabilities http://www.acf.hhs.gov/programs/pcpid/index.html The President's Committee for People with Intellectual Disabilities, is a federal advisory committee advising the President about issues concerning intellectual disabilities.

National Institute of Health http://www.nih.gov/ Part of the U.S. Department of Health and Human Services, this is the primary federal agency for conducting and supporting medical research.

National Association for the Dually Diagnosed http://www.thenadd.org/ This not-for-profit membership association for professionals, care providers and families promotes understanding of and services for individuals with developmental disabilities and mental health needs.

Speaking for Ourselves http://www.speaking.org/ Teaches the public about the needs, wishes and potential of people with disabilities.

Division on Developmental Disabilities http://www.dddcec.org/ Focuses on individuals with cognitive disabilities/mental retardation, autism and related disabilities.

National Information Center for Children and Youth with Disabilities http://www.nichcy.org/pubs/factshe/fs8txt.htm Search the site for a quick reference and fact sheet on the condition.

Family Network on Disabilities of Florida, Inc http://www.fndfl.org A local resource offering full access to family-driven support, education, information, resources and advocacy.

Child Find/Florida Diagnostic and Learning Resources System (FDLRS/South) http://fdlrs-south.dade.k12.fl.us/ Provides diagnostic and instructional support services for district exceptional student education programs and families of students with exceptionalities.

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What are some special books I can read with my child?

Books for children:

Someone Special Just Like You by Tricia Brown. This book shows children with disabilities actively playing and learning. This book is for children who are -- or think and act like -- 3 or 4 years old.

Don't Call Me Special by Pat Thomas and Lesley Harker. This book shows kids how to deal with others with disabilities. It explores emotional issues behind disabilities and how they affect families. This book is appropriate for preschool children through kindergarten.

A Boy Called Hopeless by David Merton. This story about a brain-injured boy who isn't like everyone else helps siblings understand their brother's or sister's situation. Children become familiar with treatment and learn how the child with a disability feels.

What's Wrong with Timmy? By Maria Shriver. Kate knew something was wrong with Timmy because he didn't play or talk the same as anyone else. After Kate's mom introduced her to Timmy, a friendship began. This book teaches children about other children with disabilities and shows how a great friendship lived on between these two children. It will help children become more comfortable with the topic of disabilities. (Ages 4-10)

Books for parents:

Understanding Mental Retardation by Patricia Ainsworth and Pamela C. Baker. This book explores the challenges that people with mental retardation face in everyday life and shows ways to get around those challenges. It includes ways to help families with a child with mental retardation. This book also describes services and explains legal issues in a clear way. It includes causes and common forms of mental retardation along with a list of government resources for families.

The Mental Retardation and Developmental Disability Treatment Planner by Arthur E. Jongsma Jr., Kellye Slaggart, and David J. Berghuis. This book includes all of the planning necessary for a treatment for someone with mental retardation. The book talks about common problems, such as jealousy among siblings, parenting and other family conflicts. This book also includes possible health issues that could occur. For each degree of mental retardation, the book lays out short- and long-term goals and therapies to reach these goals.

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