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Intellectual Disability

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Intellectual disability (ID) is a neurodevelopmental condition characterized by deficits in intellectual and adaptive functioning that manifest during the developmental period. This condition encompasses challenges in reasoning, memory, problem-solving, and learning, accompanied by impairments in everyday life skills, such as communication, self-care, and social interactions. Intellectual disability affects approximately 1% of the population in the United States, impacting an estimated 5...

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Neurodiversity and Intellectual Disability: Opportunities and Challenges for Functioning and Participation Across the

Rudaina Banihani¹, Michael E Msall²

¹Newborn & Developmental Paediatrics, Sunnybrook Health Sciences Centre, Department of Paediatrics, Division of Developmental Paediatrics, University of Toronto, Toronto, Ontario, Canada.

Pediatric Annals

|July 6, 2026

Summary

This study advocates for understanding intellectual developmental disabilities through strengths and participation, using the F-Words framework. This approach shifts focus from prediction to enablement, improving quality of life for children and families.

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Area of Science:

Pediatric developmental disabilities
Rehabilitation and participation science

Background:

Intellectual developmental disabilities are increasingly understood through strengths and participation, not deficits.
The World Health Organization's International Classification of Functioning, Disability and Health (ICF) provides a framework for this understanding.
Existing approaches often focus on deficits and predictions, leading to uncertainty and stigma.

Purpose of the Study:

To introduce the "F-Words" framework (Function, Family, Fitness, Fun, Friends, Future) as a translation of the ICF for clinical and family use.
To demonstrate how early counseling and interdisciplinary support can shift care towards enablement and participation.
To propose principles for enablement counseling and collaboration to enhance quality of life.

Main Methods:

Review of three common pediatric scenarios: Down syndrome, fetal alcohol spectrum disorder, and prematurity.
Application of the "F-Words" framework to these scenarios.
Discussion of early counseling and interdisciplinary support strategies.

Main Results:

A function- and participation-focused approach supports clinically useful goal setting.
This approach reduces diagnostic overshadowing and stigma.
It improves alignment with family priorities and promotes belonging.

Conclusions:

Early enablement counseling and interdisciplinary collaboration are crucial for children with developmental delays.
Shifting from deficit-based to participation-focused care enhances quality of life across the life course.
The "F-Words" framework offers practical principles for this shift in health, education, and community systems.