The Effectiveness of Individualized Interventions on Institutionalized Children with Borderline Intellectual Functioning

Background/Purpose:

A considerable number of children come to institutions with cognitive impairments caused by genetic or environmental factors. When such deficits are severe, children are diagnosed with intellectual disabilities and have access to specialized facilities and appropriate interventions; however, in the case of Borderline Intellectual Functioning (BIF), symptoms are often undetectable unless they are accompanied by other noticeable disabilities (such as Attention Deficit Hyperactivity Disorder), and thus children are unable to receive proper treatment or even diagnoses. Without early interventions, children with BIF may end up with exacerbated intellectual functioning to disability levels or experience adverse psychosocial problems that lead to difficulty in achieving autonomy. The current study investigated the effectiveness of individualized interventions for children with BIF as a way to alleviate their symptoms and help prepare become independent adults.

Methods:

Individual interventions were conducted by professionals trained by the Independent Support Group for Children, a public agency under the Ministry of Health and Welfare in South Korea. Intervention services were provided for a year (2016-2017; total of 50 visits) to 56 children living in group homes located at various regions in Korea. Specific programs included activities and worksheets that targeted cognitive and social skills enhancement. To measure pretest-posttest effects, the Wechsler IQ test, and caregiver reported Child Behavior Checklist (CBCL) and Korean Social Skills Rating System (K-SSRS) were used. Data analyses included paired samples t-test and ANOVA which were performed by SPSS.

Results:

First, paired samples t-test of IQ scores showed no significant difference between pretest- posttest scores. When scores were divided into “improved”, “no change”, “worsened” groups based on the changes in IQ scores, a significant difference was detected between pretest and posttest results; “improved” and “no change” groups scored significantly higher than “worsened” groups. Additionally, when analyzed by grade, the proportion of “worsened” group decreased for elementary students in grades one to three. Second, CBCL scores generally improved; in particular, significant decreases in behavioral and emotional problems were visible. Last, total K-SSRS scores indicated a significant positive change. Within the social skills domain, there were significant changes in cooperation, empathy and self-control, but not assertion. Additionally, there was no significant change in academic competence measured by the K-SSRS.

Conclusions/Implications:

The current study not only drew attention to BIF children, a social welfare blind spot, but also highlighted the importance of individualized approaches for children with such conditions. Findings suggest that while changes in cognitive functions and learning abilities were miniscule, the intervention may have been effective in preventing further decline in intellectual abilities, which is often observed among BIF children. Furthermore, individualized interventions were successful in obtaining significant improvements in social skills, and behavioral and emotional problems. These effects were most salient among younger children, which stresses the importance of early intervention for BIF. In conclusion, further development and widespread use of this program are implied as a solution for struggling children with BIF to become well-adjusted independent adults after their discharge from institutions.