An intellectual disability (ID) is characterized by significant cognitive limitations and impaired skills, including communication, social and self-care skills. More specifically, cognitive limitations include the ability to reason, problem-solve, plan and understand complex ideas. Impaired skills include reading and writing, concepts surrounding money, time and numbers, following rules or laws, activities of daily living such as eating, dressing, and toileting, preparing meals, and others. The onset of ID typically occurs early in life, often before the age of 18. The exact cause of ID is often unknown, but many factors can contribute, such as biological or environmental. In many cases, improper chromosomal development leads to the onset of ID, such as Down Syndrome. Exposure to chemicals in the environment are also known to impact fetal development. ID is generally considered a lifelong disability. People with mild ID have a life expectancy similar to the general population. However, people with severe ID are less likely to reach old age. Many different occupational performance areas can be affected and to varying degrees depending on the cause and severity of ID. For example, some people with mild ID may be able to brush their teeth independently but are unable to complete activities involving more complex sequencing of steps such as cooking a meal. An occupational therapist's goal when working with a person diagnosed with ID is to promote participation in meaningful occupations. These occupations enhance wellbeing, health and quality of life. Treatment for people with ID is an ongoing process throughout their life and may change depending on the person's needs and desires. Intervention often requires education and coaching to help learn and perform occupations in a variety of contexts. Reference: Atchison, Ben, and Diane Dirette PhD. Conditions in Occupational Therapy: Effect on Occupational Performance. Wolters Kluwer/Lippincott Williams & Wilkins, 2012.