The importance of the socio‐ecological approach to conceptualizing intellectual disability

The conceptualization of intellectual disability by researchers has changed over time. One important feature of this change is the emphasis on the socio-ecological perspective of intellectual disability, based on the interaction of the individual with their environment. Based on this perspective, two new models of intellectual disability were developed: the World Health Organization’s (WHO) International Classification of Functioning, Disability and Health (ICF) and the American Association on Intellectual and Developmental Disabilities’ (AAIDD) conceptual framework of human functioning . Although these two models were created independently, both look at intellectual disability from an ecological point of view and the dimensions included in each framework are related. The ICF is a multidimensional framework, developed by the WHO, for organizing and documenting information on functioning and disability, and aims to provide a standard language and conceptual basis that allows professionals from different disciplines to share information in clear terms. This model takes into account three interacting domains of human functioning: body functions and structures, activities, and participation. Participation concerns the ecological aspect of the model, since it involves activities of the individual in real-life, social settings. The ecological perspective of the ICF places every person into a context, in other words, functioning and disability are the results of the interaction between the person’s health condition and their environment. The AAIDD created a multidimensional framework of human functioning based on a socio-ecological approach to disability that takes environmental considerations fully into account. This model includes a dynamic and reciprocal interaction between five functional dimensions: intellectual abilities, adaptative behaviour, health, participation, and context. Participation and context are important aspects of the AAIDD model, reflecting the ecological basis of the framework. Participation is the performance of a person’s activities in social life domains and is related to the functioning of the individual in society. Contextual factors represent the complete background of an individual’s life. Despite the relevance of these models, they are highly analytical constructs for use in professional or academic settings and do not reflect individuals’ experiences. The emergence of the concept of quality of life (QoL) is important in addressing this issue. There are several definitions of QoL, but all share the following features: general feelings of well-being, feelings of positive social involvement, and opportunities to achieve personal potential. QoL also has an ecological influence as one of its core ideas, according to the international literature, is that individuals are best understood within the context of the environments that are important to them. These environments should be viewed as changeable, to accommodate the individual’s interests, needs, and values. In the study by Williams et al., the authors aimed to investigate the associations between functioning, participation, and QoL in children with intellectual disability. The authors conclude that more impaired functioning is associated with lower QoL scores. Another important conclusion from the study is that more frequent participation was associated with better QoL, and community participation in part mediated the relationship between some aspects of functioning and QoL. This finding highlights the importance of the ecological aspect of participation to enhance the QoL of children with intellectual disability. In terms of intervention and clinical practice, the shift in the conceptualization of intellectual disability was crucial. The findings by Williams et al. support the idea that interventions that include ecological aspects, such as community participation, are a way of improving QoL in children with intellectual disabilities.