Intellectual/Developmental Disabilities (I/DD)


Trillium serves approximately 2,450 adults and children annually who seek services for Intellectual and/or Developmental Disabilities (I/DD).   Individuals and families without Medicaid may be eligible for state-funded services. 

To ensure individuals and families receive the services they need in a timely manner, Trillium hires clinically trained staff to manage and authorize these services. 

What is Intellectual Disability?

A person with an intellectual disability has difficulty:

  • Learning and processing information as quickly as someone without an intellectual disability
  • Grasping abstract concepts such as money and time
  • Understanding interpersonal interactions
  • Using the ideas and concepts required for planning and organization

Intellectual disabilities can be mild, moderate or severe, and factors such as personality, coping strategies and the presence of other disabilities will affect a person's requirement for support with daily living. Intellectual disability is thought to affect about 1 - 3% of the population. Of those affected, the majority have mild intellectual disability.

Intellectual functioning: Also known as IQ (intelligence quotient). This refers to a person’s ability to learn reason, make decisions, and solve problems.  IQ is measured by an IQ test. The average IQ is 100. A person is considered to have an intellectual disability if he or she has an IQ of less than 70 to 75.

Adaptive behaviors: These are skills necessary for day-to-day life, such as being able to communicate effectively, interact with others, and take care of oneself.

Every person is unique, regardless of their IQ score. Everyone has their own personality and areas of ability and areas of difficulty.

Your child may have an intellectual disability if you notice any of the following:

  • Lack of or slow development of motor skills (physical movement), language skills, and self-help skills (like getting dressed), especially when compared to peers
  • Failure to grow intellectually or continued infant-like behavior
  • Lack of curiosity
  • Problems keeping up in school
  • Failure to adapt (adjust to new situations)
  • Difficulty understanding and following social rules

To measure a child’s adaptive behaviors, a specialist will observe the child’s skills and compare them to other children of the same age. Things that may be observed include how well the child can feed or dress himself or herself; how well the child is able to communicate with and understand others; and how the child interacts with family, friends, and other children of the same age.

What Causes Intellectual Disability?

There are many causes of intellectual disability, but doctors find a specific reason in only 25% of cases.  The most common syndromes associated with intellectual disabilities are Autism, Down Syndrome, Fragile X Syndrome, and Fetal Alcohol Spectrum Disorder (FASD).

Causes of Intellectual Disability Can Include:

  • Infections: present at birth or occurring after birth
  • Genetic Conditions: disease caused in whole or in part by a change in the DNA sequence
  • Environmental: external, toxic causes that can damage the brain
  • Metabolic: conditions that change how the body absorbs food which impacts energy generation and tissue growth
  • Nutritional: malnutrition (poor diet)  affects growth and development of the brain
  • Toxic: such intrauterine exposure to alcohol other drugs
  • Trauma: physical damage to the brain before, during  and after birth
  • Unexplained: unfortunately, this is the largest category as many times the exact causes of Intellectual Disability are not determined

What is a Developmental Disability?


"Developmental Disabilities" is an umbrella term that includes intellectual disability but also includes other disabilities that are apparent during childhood. About 15%, of children aged 3 through 17 years have one or more developmental disabilities.

Developmental disabilities are those that can be cognitive(reasoning and thinking), physical or both. These disabilities appear before the age of 22 and are likely to be lifelong. Some developmental disabilities are largely physical issues, such as Cerebral Palsy or Epilepsy. Some individuals may have a condition that includes a physical and intellectual disability.

Your child may have a developmental disability if you notice any of the following:

  • Delay in meeting fundamental milestones (such as walking and talking)
  • Issues with sight or hearing
  • Low birth weight or premature birth increase the risk for a developmental disability
  • Loses skills or stops doing things they could previously do
  • Does not respond emotionally when parent/caregiver leaves the room

Intellectual Developmental Disability (I/DD) Services Array Brochure: for more information on the services provided for individuals with Intellectual/Developmental Disabilities, click on the link.

This brochure includes details on:

  • Respite Services - are available to parents and caregivers to provide a temporary timeout from the stress of caring for an individual with a  disability. This service can be provided in your home, in the community, or even in the home of the respite provider. There are several kinds of respite services:
    • Traditional Hourly Respite
    • Overnight Respite
    • NC Start Facility Respite 
  • Community Navigators - This service provides direct assistance in identifying and linking individuals and families to services and supports— paid and community-based. It is available to both children and adults who receive Medicaid. It is a short-term service and will end when the person has developed some of the supports needed.
  • Developmental Therapy - This service is for children 3-21 years of age and is available whether or not they have insurance. There may be certain evaluations needed prior to service. This service is designed to support the child to learn skills that will strengthen self-help, language and cognitive development, and social abilities.
  • Personal Assistance - This service assists individuals with their activities of daily living such as personal hygiene and self-care.  It is available to children or adults and can be accessed for up to 10 hours per week whether or not they have insurance.
  • Supported Employment -
    • Supported Employment is available for persons 16 years of age or older with a developmental disability. An individual can also receive a similar service through Vocational Rehabilitation.
    • Long Term Supported Employment Follow-Up helps employed individuals maintain the job skills needed to keep their job. This might include visits to the job site, help with scheduling, etc.
  • Day Activity - This service provides structured activities during the day. People who participate in Developmental Therapy, Personal Assistance, or Adult Developmental & Vocational Programs (ADVP) are not eligible for this service.
  • Family Living - This service is sometimes called Alternative to Family Living or AFL. Individuals, couples or a family may live in a home environment with people trained to support individuals with I/DD.  This service is funded with an individual’s SSI check, County Special Assistance funds, or with additional services such as the Individual Supports mentioned above.
  • Individual Support - This service supports individuals in taking care of their own personal needs and living more independently. This could include teaching skills for bathing and grooming, self-feeding, meal preparation, medication management, grocery shopping, etc. It is available only for adults 18 years of age or older who have both an I/DD AND a mental health diagnosis, such as depression, PTSD, bipolar disorder, etc.
  • Supported Living - This service offers assistance and supports for people who live on their own. To help reinforce independence, a staff member might assist with money management, communication skills, household care, or accessing community services.
  • Group Homes - In a traditional group home for those with intellectual or developmental disabilities, four to six individuals live with 24-hour staff supervision. Staff provide assistance and guidance toward fuller independence for residents. Individuals may learn personal care skills, household maintenance, safety skills, and communication and relationship skills. Residents help make decisions during house meetings on issues from which community outings they would enjoy to what food is to be served.
  • Adult Developmental Vocational Program (ADVP) - This is a day activity service that teaches job skills in a group setting of adults. It is usually for 30 hours per week.
  • Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-IID) - is a group home or facility that offers residential care with a skilled nursing component and oversight by a doctor. Physical Therapy and Occupational Therapy are also available. An ICF-IID serves individuals who need more complex care than can be obtained in a group home. A physician’s order is required for admission into an ICF-IID.

Services are only authorized (approved) when medically necessary. Medical necessity is care that is appropriate for the prevention, diagnosis, or restorative treatment of a mental health illness, substance use disorder, or intellectual/developmental disability.

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