Intelligence in Nursing
Comprehensive Study Notes for Nursing Students
Learning Objectives
- Define intelligence and its key characteristics
- Analyze heredity vs. environment effects on intelligence
- Classify different types of intelligence
- Understand intelligence measurement tools
- Identify mental deficiencies and nursing implications
- Apply intelligence concepts in nursing practice
1. Meaning of Intelligence
Definition and Core Concepts
Intelligence is a multifaceted cognitive ability that encompasses the capacity to learn, understand, reason, solve problems, adapt to new situations, and apply knowledge effectively. In nursing practice, understanding intelligence is crucial for patient assessment, education planning, and providing individualized care.
Cognitive Components
- Abstract thinking: Conceptual reasoning
- Problem-solving: Finding solutions
- Learning capacity: Acquiring new information
- Memory: Storing and retrieving information
- Processing speed: Mental efficiency
Behavioral Manifestations
- Adaptability: Adjusting to new situations
- Creativity: Novel idea generation
- Critical thinking: Analytical evaluation
- Communication: Expressing ideas clearly
- Goal achievement: Purposeful behavior
Memory Aid: SMART Intelligence
Historical Perspectives
Developed first practical intelligence test to identify children needing special education
Introduced Stanford-Binet test and concept of Intelligence Quotient (IQ)
Proposed Theory of Multiple Intelligences, revolutionizing intelligence understanding
2. Effects of Heredity and Environment on Intelligence
The Nature vs. Nurture Debate
Intelligence results from complex interactions between genetic predispositions (nature) and environmental influences (nurture). Research suggests both factors contribute significantly, with estimates indicating genetic factors account for 50-80% of intelligence variance, while environmental factors contribute 20-50%.
Hereditary Factors (Nature)
- Genetic makeup: Inherited genes affecting brain structure
- Twin studies: Identical twins show similar IQ scores
- Family resemblance: Intelligence correlates within families
- Neurological factors: Brain size, neural efficiency
- Heritability: 50-80% genetic contribution
Key Research Findings:
Adoption studies show adopted children’s IQ correlates more with biological parents than adoptive parents, supporting genetic influence.
Environmental Factors (Nurture)
- Education: Quality schooling and learning opportunities
- Nutrition: Proper nutrition during development
- Socioeconomic status: Access to resources and stimulation
- Cultural factors: Values, expectations, opportunities
- Early experiences: Critical period development
Key Research Findings:
Enrichment programs like Head Start show environmental interventions can improve cognitive outcomes in disadvantaged children.
Intelligence Development Flowchart
Nursing Implications: Heredity vs. Environment
Assessment Considerations
- • Family history of intellectual disabilities
- • Genetic counseling referrals when appropriate
- • Environmental risk factor identification
- • Developmental milestone monitoring
Intervention Strategies
- • Patient/family education on modifiable factors
- • Advocacy for educational resources
- • Nutritional counseling and support
- • Community resource connections
3. Classification of Intelligence
Gardner’s Theory of Multiple Intelligences
Howard Gardner’s groundbreaking theory identifies eight distinct types of intelligence, each representing different ways individuals process information and solve problems. This theory has revolutionized educational approaches and patient care strategies in nursing.
Linguistic
Words & Language
- • Reading comprehension
- • Verbal communication
- • Writing skills
- • Storytelling ability
Mathematical
Numbers & Logic
- • Problem-solving
- • Pattern recognition
- • Logical reasoning
- • Mathematical operations
Spatial
Visual & Space
- • Visual processing
- • Spatial relationships
- • Mental imagery
- • Navigation skills
Musical
Rhythm & Sound
- • Rhythm recognition
- • Pitch sensitivity
- • Musical patterns
- • Sound discrimination
Bodily-Kinesthetic
Body & Movement
- • Motor coordination
- • Physical dexterity
- • Body awareness
- • Hands-on learning
Interpersonal
Social Skills
- • Empathy
- • Communication
- • Leadership
- • Social awareness
Intrapersonal
Self-Knowledge
- • Self-reflection
- • Emotional awareness
- • Personal insight
- • Self-motivation
Naturalistic
Nature & Environment
- • Pattern recognition
- • Classification skills
- • Environmental awareness
- • Natural phenomena
Other Classification Systems
Cattell’s Fluid vs. Crystallized Intelligence
Processing speed, pattern recognition, logical reasoning – peaks in early adulthood
Accumulated knowledge, vocabulary, learned skills – increases with age and experience
Emotional Intelligence (EQ)
Memory Aid: “My Brain Speaks Music Naturally, I Perform”
Mathematical
Bodily-Kinesthetic
Spatial
Musical
Naturalistic
Intrapersonal
Interpersonal
Linguistic
4. Introduction to Measurement of Intelligence Tests
Intelligence Testing Fundamentals
Intelligence testing provides standardized methods to assess cognitive abilities and compare individual performance to population norms. These assessments are crucial in healthcare settings for diagnosis, treatment planning, and educational recommendations.
Standardization
Uniform administration and scoring procedures
Reliability
Consistent results across time and testers
Validity
Measures what it claims to measure
Major Intelligence Tests
Wechsler Adult Intelligence Scale (WAIS-IV)
Age Range: 16-90 years
Administration: Individual, 60-90 minutes
Purpose: Comprehensive adult intelligence assessment
Four Index Scores:
- • Verbal Comprehension Index (VCI)
- • Perceptual Reasoning Index (PRI)
- • Working Memory Index (WMI)
- • Processing Speed Index (PSI)
Stanford-Binet Intelligence Scales (SB5)
Age Range: 2-85+ years
Administration: Individual, 45-75 minutes
Historical: First major intelligence test
Five Factors:
- • Fluid Reasoning
- • Knowledge
- • Quantitative Reasoning
- • Visual-Spatial Processing
- • Working Memory
Wechsler Intelligence Scale for Children (WISC-V)
Age Range: 6-16 years
Administration: Individual, 45-65 minutes
Purpose: Children’s cognitive assessment
Primary Indices:
- • Verbal Comprehension
- • Visual Spatial
- • Fluid Reasoning
- • Working Memory
- • Processing Speed
IQ Score Interpretation
IQ Score Classifications
Testing Considerations
- Cultural bias: Tests may favor certain cultural backgrounds
- Test anxiety: Performance can be affected by stress
- Language barriers: Non-native speakers may be disadvantaged
- Health factors: Illness, medication, fatigue can impact scores
- Educational background: Limited schooling affects performance
5. Mental Deficiencies
Important Note on Terminology
The term “mental deficiency” is outdated and considered offensive. Current professional terminology uses:
- Intellectual Disability (ID) – Preferred clinical term
- Developmental Disability – Broader category including ID
- Cognitive Impairment – General descriptive term
Intellectual Disability (ID) Overview
Intellectual Disability is characterized by significant limitations in both intellectual functioning and adaptive behavior, originating before age 18. It affects approximately 1-3% of the population and requires comprehensive, individualized support approaches.
Intellectual Functioning
- • IQ typically below 70-75
- • Learning difficulties
- • Problem-solving challenges
- • Abstract thinking limitations
Adaptive Behavior
- • Daily living skills
- • Social communication
- • Community participation
- • Self-care abilities
Developmental Onset
- • Before age 18
- • Early childhood identification
- • Developmental delays
- • Educational support needs
Classification by Support Needs
Current classification focuses on support intensity rather than IQ levels
Intermittent Support
Support “as needed” – not continuous
- • Can live independently with minimal help
- • May need assistance during transitions
- • Can maintain employment with support
- • Social relationships with guidance
Limited Support
Consistent but time-limited support
- • Regular assistance with specific tasks
- • Can work in supportive environments
- • May live semi-independently
- • Benefits from structured routines
Extensive Support
Daily support in multiple areas
- • Regular daily assistance required
- • Supervised living arrangements
- • Structured work environments
- • Ongoing health monitoring
Pervasive Support
Constant, high-intensity support
- • 24-hour care and supervision
- • Assistance with all daily activities
- • Complex medical needs
- • Limited communication abilities
Common Causes of Intellectual Disability
Genetic Causes (25-40%)
Trisomy 21 – most common genetic cause
X-linked disorder affecting boys more severely
Metabolic disorder – preventable with diet
Prenatal/Perinatal Causes
Maternal alcohol use during pregnancy
Oxygen deprivation, trauma, prematurity
Rubella, cytomegalovirus, toxoplasmosis
Comprehensive Nursing Care for Intellectual Disability
Assessment Priorities
- Functional abilities: ADLs, communication, mobility
- Health screening: Co-occurring medical conditions
- Social support: Family dynamics, community resources
- Educational needs: Learning style, adaptive equipment
- Safety concerns: Risk assessment, protective factors
Intervention Strategies
- Communication: Simple language, visual aids, patience
- Time allowance: Extra time for processing and responses
- Routine establishment: Consistent schedules and procedures
- Family education: Support strategies, resources
- Interdisciplinary care: Collaboration with specialists
Person-Centered Care Principles
Nursing Applications & Clinical Implications
Intelligence Assessment in Healthcare Settings
Clinical Assessment Tools
- Mini-Mental State Exam (MMSE): Cognitive screening tool
- Montreal Cognitive Assessment (MoCA): Mild cognitive impairment detection
- Functional Assessment: ADL and IADL evaluation
- Behavioral observations: Problem-solving, communication patterns
Red Flags for Referral
- Developmental delays: Missed milestones in children
- Learning difficulties: Academic or workplace struggles
- Cognitive decline: Changes from baseline functioning
- Adaptive behavior concerns: Self-care, social skills deficits
Patient Education Strategies by Intelligence Level
Higher Intelligence (IQ 110+)
- • Complex written materials
- • Detailed explanations
- • Interactive discussions
- • Research-based information
- • Multiple options presented
- • Encourage questions
- • Detailed return demonstrations
- • Problem-solving scenarios
- • Self-monitoring tools
Average Intelligence (IQ 90-109)
- • Clear, straightforward language
- • Visual aids and demonstrations
- • Step-by-step instructions
- • Essential information focus
- • Practical applications
- • Repetition for reinforcement
- • Simple return demonstrations
- • Check understanding frequently
- • Written reminders
Below Average Intelligence (IQ <90)
- • Simple, concrete language
- • Multiple sensory approaches
- • Hands-on practice
- • Break into small steps
- • Use familiar examples
- • Frequent reinforcement
- • Observe actual performance
- • Include family/caregivers
- • Environmental modifications
Special Populations & Nursing Considerations
Pediatric Patients with ID
- • Developmental rather than chronological age focus
- • Family-centered care approach
- • Educational team collaboration
- • Transition planning for adulthood
- • Use age-appropriate communication
- • Assess for co-occurring conditions
- • Support family coping strategies
- • Advocate for inclusive environments
Adults with ID in Healthcare
- • Communication barriers
- • Consent and decision-making issues
- • Higher rates of health conditions
- • Medication compliance concerns
- • Extended appointment times
- • Caregiver involvement when appropriate
- • Simple, clear instructions
- • Regular follow-up and monitoring
Key Takeaways for Nursing Practice
Essential Concepts
- Intelligence is multifaceted – encompasses various cognitive abilities and adaptive behaviors
- Both nature and nurture matter – genetic and environmental factors interact to influence intelligence
- Multiple intelligences exist – individuals may excel in different cognitive domains
- Assessment has limitations – cultural, linguistic, and contextual factors affect test performance
Clinical Applications
- Individualized care – tailor interventions to cognitive abilities and learning styles
- Communication adaptation – modify language and teaching methods based on intelligence level
- Family involvement – include caregivers in care planning and education
- Support systems – connect patients with appropriate resources and services