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Mental Retardation

Definition of Mental Retardation:

AAMD (American Association for Mental Deficiency)

Mental Retardation refers to significantly sub-average general intellectual functioning existing concurrently with deficits in adaptive behavior, and manifested during the developmental period: (Grossman 1973)

In the above definition we can found that there is three components to call a person mentally retarded thy are.

1. significantly sub average general intellectual functioning

2. Deficits / impairment in adaptive behavior

3. manifested during developmental period.

significantly sub average general intellectual functioning

In this component it describes that the individual has an IQ score of less than 70 on one of the individually administered standard intelligence tests.

What is IQ ?

IQ=Intelligent quotient

Formula of IQ is MA/CA× 100

MA= Mental Age ( to find out the mental age of particular person is depended on that person where he brought up and the measuring equipment is specially designed by psychologists.)

CA= Chronological Age (Current Age).

Mental age / Chronological age is multiplied by 100 = IQ (Intelligent quotient)

Level of Retardation is as follows by deferent studies

Kirk, 1972, P. 164, and Hewett & Forness, 1974, pp.77-78

Hebber, 1961, pp.58-59 (Grossman, 1973, p. 18)

Dunn, 1973, p.71

National Association for Retarded Citizens

World Health Organization

American Psychiatric Association

Borderline or Slow learner (80-90)

Borderline (63-83)

Mild (55-65 to 70-80)

Marginally dependent (50-75)

Mild Subnormality (50-69)

Mild mentally deficient (70-85)

Educable (50-55 to 75-79)

Mild (52-67)

Moderate (30-40 to 55-65)

Semi dependent (25-50)

Moderate Subnormality (20-49)

Moderately Mentally deficient (50-70)

Trainable (30-35 to 50-55)

Moderate (36-51)

Severe 15-25 to 30-40)

Dependent (below 25)

Severe subnormality

(0-19)

Severely Mentally deficient (0-50)

Custodial or totally dependent or profound (25-30 and below)

Severe (20-35)

Profound below 15-25)

Profound (Under 20)

Second component: Deficits / impairment in adaptive behavior

Adaptive behavior is defined as the effectiveness with which a person meets the standards of personal independence and social responsibility expected of his age and cultural group. These reflect in the development of sensory motor skills, communication skills, self help skills, and socialization in early childhood; application of reasoning and judgment in mastery of environment, social skills in childhood, and adolescence; and vocational and social responsibilities in adult life. Any deficiency in these aspects will be considered as a deficit in adaptive behavior. For instance, if a three year old child with no physical defects does not walk or a 10 years child does not have toilet control or and 18 years old boy does not identify a five rupee coin or a two rupee coin, it is considered to be a deficit / and impairment in their adaptive behavior.

Manifested during developmental period

The third component of the definition focuses on the onset of the condition the developmental period which is considered to be below the age of 18 years. As the studies says that the developmental period starts from conception to the completion of 18 years and this period is marked as dangerous to get mental retardation with many causes.

Medical Classification of Mental Retardation

1. Infections and intoxications
2. Trauma or physical agents
3. Metabolism or nutrition
4. Gross brain disease ( post natal)
5. Unknown parental influences

6. Chromosomal abnormality

7. Gestational disorder

8. Psychiatric disorder

9. Environmental influence

10. Other influences

Normalization is the principle of educating handicapped persons in and for the “normal” environment of the non-handicapped, to the maximum feasible extent.

Mental Retardation

Causes

Mental retardation affects about 1 - 3% of the population. There are many causes of mental retardation, but doctors find a specific reason in only 25% of cases.

A family may suspect mental retardation if the child's motor skills, language skills, and self-help skills do not seem to be developing, or are developing at a far slower rate than the child's peers. Failure to adapt (adjust to new situations) normally and grow intellectually may become apparent early in a child's life. In the case of mild retardation, these failures may not become recognizable until school age or later.

An assessment of age-appropriate adaptive behaviors can be made using developmental screening tests. The failure to achieve developmental milestones suggests mental retardation.

The degree of impairment from mental retardation varies widely, from profoundly impaired to mild or borderline retardation. Less emphasis is now placed on the degree of retardation and more on the amount of intervention and care needed for daily life.

Risk factors are related to the causes. Causes of mental retardation can be roughly broken down into several categories:

Infections (present at birth or occurring after birth)

Chromosomal abnormalities

Chromosome deletions (cri du chat syndrome)
Chromosomal translocations (a gene is located in an unusual spot on a chromosome, or located on a different chromosome than usual)
Defects in the chromosome or chromosomal inheritance (for example, fragile X syndrome, Angelman syndrome, Prader-Willi syndrome)
Errors of chromosome numbers (such as Down syndrome)

Environmental

Deprivation syndrome

Genetic abnormalities and inherited metabolic disorders

Metabolic

Congenital hypothyroid
Hypoglycemia (poorly regulated diabetes mellitus)
Reye syndrome
Hyperbilirubinemia (very high bilirubin levels in babies)

Nutritional

Malnutrition

Toxic

Intrauterine exposure to alcohol, cocaine, amphetamines, and other drugs
Lead poisoning
Methylmercury poisoning

Trauma (before and after birth)

Intracranial hemorrhage before or after birth
Lack of oxygen to the brain before, during, or after birth
Severe head injury

Unexplained (this largest category is for unexplained occurrences of mental retardation)

Symptoms

Continued infantile behavior
Decreased learning ability
Failure to meet intellectual developmental markers
Inability to meet educational demands at school
Lack of curiosity

Note: Changes to normal behaviors depend on the severity of the condition. Mild retardation may be associated with a lack of curiosity and quiet behavior. Severe mental retardation is associated with infantile behavior throughout life.

Exams and Tests

Abnormal Denver developmental screening test
Adaptive behavior score below average
Development way below that of peers
Intelligence quotient (IQ) score below 70 on a standardized IQ test

Treatment

The primary goal of treatment is to develop the person's potential to the fullest. Special education and training may begin as early as infancy. This includes social skills to help the person function as normally as possible.

It is important for a specialist to evaluate the person for other affective disorders and treat those disorders. Behavioral approaches are important for people with mental retardation.

Outlook (Prognosis)

The outcome depends on:

Opportunities
Other conditions
Personal motivation
Treatment

Many people lead productive lives and function on their own; others need a structured environment to be most successful.

Possible Complications

Complications vary. They may include:

Inability to care for self
Inability to interact with others appropriately
Social isolation

When to Contact a Medical Professional

Call your health care provider if:

You have any concerns about your child's development
You notice that your child's motor or language skills are not developing normally
Your child has other disorders that need treatment

Prevention

Genetic: Prenatal screening for genetic defects and genetic counseling for families at risk for known heritable disorders can decrease the incidence of genetically caused mental retardation.

Social: Government programs to ensure adequate nutrition are available to the underprivileged in the first and most critical years of life. These programs can reduce retardation associated with malnutrition. Early intervention in situations involving abuse and deprivation will also help.

Toxic: Environmental programs to reduce exposure to lead, mercury, and other toxins will reduce toxin-associated retardation. However, the benefits may take years to become apparent. Increased public awareness of the risks of alcohol and drugs during pregnancy can help reduce the incidence of retardation.

Infectious:
The prevention of congenital rubella syndrome is probably one of the best examples of a successful program to prevent one form of mental retardation. Constant vigilance, such as limiting exposure to cat litter that can cause toxoplasmosis during pregnancy, helps reduce retardation that results from this infection.

Try this links to know more.....

Down syndrome

Autism

Pervasive Developmental Disorder

Learning disability

Mental disorder

Traumatic Brain Injury

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Adrenoleukodystrophy