Case Study: Supporting Independence with Mild Intellectual Disability

This report presents a case study of John, an individual with mild intellectual disability, and explores strategies for supporting his independence and social interactions, particularly in the context of a developing relationship with Ann, who also has a mild intellectual disability. The report emphasizes the importance of a caregiver's role in implementing coping strategies, addressing communication challenges, and promoting sexual health through education and support. It discusses various measures, including active, emotion-focused, and problem-focused coping, culturally sensitive approaches, and fostering a community environment. The report highlights potential obstacles such as cultural and religious taboos surrounding sexuality, communication barriers, and behavioral challenges, while also offering solutions to facilitate informed choices and consensual relationships. The importance of providing sex education and addressing social stigmas are also discussed, along with the need for collaborative partnerships involving parents and professionals to ensure John and Ann's autonomy and sexual rights are respected.

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Intellectual disability includes the challenges with the mental abilities which impact the
functioning in the areas of adaptive functioning and intellectual functioning. According to the
data reports, the intellectual disability tends to affect males than the female towards being
diagnosed with mild intellectual disability (Koslowski et al. 2016). The word "intellectual
disability" means a person having limitations in cognitive operations and skills, especially
communication, interpersonal and self-care abilities, are other disabilities (Hanlon et al. 2018).
Such limitations that result in a child developing and learning more slowly or differently than a
child in general. Intellectual disability is considered and identified by challenges in both the field
of adaptive and intellectual functioning. This study will discuss the case of John who has a mild
intellectual disability and will propose some of the recommended solutions from the view of a
health caregiver towards the support he requires for independence and also the probable
challenges he might face during the implementation of the process.
Measures to explore for supporting John for the development of his independence
concerning Ann.
In consideration of the situation where John met Ann, it is important for Jon to develop his
independence in the blooming relation. Since both John and Ann are being diagnosed with mild
intellectual disability, it is important for me, being the key worker to initiate some of the specific
categories of coping strategies. This is because these will help John to face the stressful social
interaction with Ann. The copying strategies will initiate a link with the psychological distress of
John, thereby enabling him to take the first step for the development of interventions for
improving his social habits and communication skills. According to Hosking et al. (2016),
challenges regarding communication are the major challenges that are faced by adult individuals

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having a mild intellectual disability. In light of the case study and linking with the data reports
regarding the challenges of mild intellectual disability, John has challenges in learning social
rules and delayed adaptive behavior. It is my role as the key worker to initiate measures like
active coping, emotion-focused coping and problem-focused coping strategies for enabling John
to develop independence in his blooming relation with Ann, whom he met recently. In the early
stages of the development and the enhancement of his self-independence (Emerson et al. 2016),
another measure that I can explore is the support seeking coping strategy. In the current situation,
I should encourage John to go forward and talk to Ann for working out their relation.
Understanding that this approach falls under the problem-focused coping strategy, this measure
will enable john to take the first step since both John and Ann are intellectually disabled at a mild
stage. Some of the other measures that I can initiate include a culturally appropriate and
collaborative family-centered approach. This will be well suited for John due to the complexities
of his health and developmental issues towards social interaction. It is important for John to
develop independence and confidence to initiate communicating with others and socialize with
others without my help.
While progressing towards the development of the relation with Ann, who is another patient of
mild intellectual disability, some of the other measures that can be adopted include the provision
of co-ordinated and professional services for capitalizing the strength of John. A strength-based
perspective can emphasize the development of trusting relationships with Ann within the natural
environment (Bishop-Fitzpatrick, Mazefsky and Eack 2018). John must develop his adaptability
skills and form functional communication for maximizing his self-sufficiency for interacting
with Ann. Fostering a community environment together with ensuring inclusion and respect will

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be some of the beneficial measures that I can explore for supporting John for the development of
independence within the relationship.
The most important aspect in supporting John and Anna in the development of their
relationship is to provide assistance and support in facilitating sex education. There is an inherent
stigma in the society that tends to consider persons with learning disabilities as asexual or
sexually uninhibited, and sex education for such people are often considered as harmful or
unnecessary. According to Rohleder and Swartz (2009), the common attitude among educators,
care providers and healthcare professional who provide support to people with intellectual and
learning disabilities do not necessarily oppose the idea of providing sexual education to such
people out of stigma; rather a majority of them fear that exposure to sexual knowledge will
eventually increase high-risk sexual behaviours. However, this taboo in reality has the potential
to put them at a greater risk of transmitting STIs such as HIV infections, as well as subject to
sexual abuse and unwanted pregnancy, due to their lack of knowledge and awareness regarding
sexuality and subsequent safety measures.
The primary importance of sex education, however, lies in maintenance of sexual health.
WHO defines sexual health not only as the absence of sexual disease or untoward sexual
exposure, but also a possibility to have a safe and pleasurable sexual experience. Furthermore,
the definition also stipulates that the sexual rights of all individuals, irrespective of their
cognitive and physical abilities are to be protected respected and thereby fulfilled (World Health
Organization 2011). Sexual liberty and rights are considered as an essential element of human
rights, extending the freedom of sexual experience, choice and sexual orientation to people with
disability as well. The fundamental right recognizes sexuality as a rudimentary means to express

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love and attachment between people. According to Elias and Murphy (2006), children and
adolescents with developmental disability should be introduced to sex education to avoid any
harmful or unwanted exposure to sexual activities. And at the same time, the parents of such
individuals are to be incorporated in the process to epitomize independence, social skill, self-care
as well as developmentally appropriate education regarding sexual education at home,
community and institutional settings.
The social stigma attached with sexuality among people with developmental disability
can also be a significant hindrance in the fostering confidence and self-appreciation among such
individuals themselves, as they may consider themselves as undesired or sexually unattractive.
This may lead them in engaging potentially dangerous sexual relationships out of the craving for
attention and affection. Moreover, such lack of self-worth and low self-esteem can also adversely
impact the budding relationship between individuals with developmental disability. Therefore,
engaging them in positive sexual education is all the more essential to support their interpersonal
and intimate relationship (Björnsdóttir, Stefánsdóttir and Stefánsdóttir 2017).
Supporting John and Anna in their intimate relationship therefore necessitates
recognizing them as sexual beings with the capability to make consensual and informed choices.
In this regard, an easy, undeterred access to be facilitated for them that would foster knowledge
and information regarding sexual health, pregnancy, safe sex practices, contraception, sexually
transmitted infections, and intimate touch. In this regard, a strong and reliable partnership with
the clients has to be established as the foundation of imparting sexual education. They are to
make aware of their autonomy and self-dependence in making informed choices regarding their
sexual relationship, including the comprehension of consent as well as deciding about safe sex

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procedures and pregnancy. In this regard, it is also effective to engage their parents in the
pedagogical approach to provide them undeterred autonomy as well as safe environment. Also,
this engagement is essential to promote a collaborative partnership to impart sexual education,
while upholding their sexual rights (McDaniels and Fleming 2016).
Some of the potential obstacles that could arise
The major obstacle that could arise in the context of imparting sex education and
facilitating sexual autonomy for John and Anna is the cultural and religious taboos regarding
sexuality. In most of the cultures, sexuality is in itself a stigmatized topic This conservative
attitude often reduces the issue to the sexual intercourse alone, which essentially deters the open
dialogues and imparting information regarding sexual health. For John and Anna, this cultural
taboo is all the more significant, as the attitude essentially subjugates the sexual autonomy of
people with intellectual disability. To this end, the inclusion of John and Anna’s parents in the
pedagogical process.
Another obstacle in the process may arise in the context of collaborating on making
informed choices together in the relationship and understanding the element of consent.
Challenges within communication are one of the major reason, as the varying levels of cognitive
ability may hamper their communication. It is to not that the communication style of people with
intellectual disabilities at a mild stage tends to vary. Hence the communication style of John and
Ann might differ. Since IQ is not at all and useful indicator of the communication capacity of a
person, there are high chances that IQ of both John and Ann might differ in terms of their
practical abilities and verbal fluency. The poor communication ability might also result from the
lack of self-confidence and independence which can result in a wide impact over John's ability to

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negotiate his relationship with Ann. Belonging to the community of people with mild intellectual
disability, John has a few handful numbers of friends and experiences social exclusion (Bowring
et al. 2017). Lack of necessary knowledge as well as skills correct attitude my one of the
potential obstacles that could arise while John intends to develop his independence in his
relationship with Ann. Furthermore, since Ann currently leaves with her parents and has also
been diagnosed with mild intellectual disability, it can be assumed that just like John, she also
has communication and social barriers. This might be a challenge for Jon even after exploring
support from me, as his key worker. The deficit in cognition together with adaptive function and
onset during the period of development among John might also contribute to language disorder
which might hinder his self-confidence towards initiating communication which Ann. Some of
the targeted behaviors that might affect both John and Ann while initiating in a relationship are
frequent aggression, hyperactivity, repetitive and self-injurious behavior in case any of both
characters misunderstand each other. Mood liability together with anxiety and depressive mood
are some of the probable and potential obstacles that might arise in the blooming relation
between two mile intellectually disabled people, John and Ann. Since both the characters have
been diagnosed with mild intellectual disability, the impulse signature among both of them might
not allow additional time for the exchange of information as well as the patience to understand
each other's language.it is to understand that communicating with people having a mild
intellectual disability is different than communicating with people with no disability. However,
in this case, both the adults, John and Ann diagnosed with mild intellectual disability have
chances towards the potential obstacle of the lack of understanding, problems due to delayed
response, absence of comprehension skills, the involvement of caregivers due to interpretation of
internal cues such as anxiety and urge to urinate. Choosing the appropriate language and

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listening together with understanding the body language can also be one of the potential barriers
while initiating communication with Ann. Some of the internal obstacles that Jon might face
include poor articulation skills, cognitive impairment, lack of the fear of expressing and
behavioral challenges in his relationship with Ann. However, some of the external potential
obstacles that might arise include ignorance, usage of jargon or complicated languages, the
tendency towards the prioritization of speech and finally the fragmentation of information while
initiating communication and bonding with Ann.

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