MENTAL RETARDATION
Mental retardation refers to significantly subaverage general intellectual functioning resulting in or associated with concurrent impairment in adaptive behaviour and manifested during the developmental period. intellectual disability (ID) also known as a learning disability in the united kingdom and firmly mental retardation (MR) is a generalized neurodevelopmental disorder characterized by significantly impaired intellectual and adaptive functioning.
CAUSES:
- GENETIC FACTORS :
- Down syndrome
- Fragile X syndrome
2. Cranial malformation
- Hydrocephaly
3. Gross disease of the brain
- Epilepsy
CAUSES -PRENATAL FACTOR :
- INFECTION: TORCH
- ENDOCRINE DISORDER
- Hypothyroidism
- Hypoparathyroidism
- diabetes Mellitus
3. Physical damage and disorder
- Injury
- hypoxia
4. Placental dysfunction
- placenta previa
- cord prolapse
- nutrition growth retardation
5. perinatal factor
- Birth asphyxia
- Prolonged or difficult labor
- prematurity
6. Postnatal factor
–Infections
- Encephalitis
- Measles
- Meningitis
- Septicemia
–Accidents
Classification:
Mild Retardation (IQ 50-70):
This is the most typical type of mental retardation accounting for 85-90% of all cases. These individuals have minimum retardation in sensory-motor areas.
Moderate Retardation (IQ 35-50)
- About 10% of the mentally retarded come under this group.
Severe Retardation (IQ 20-35)
Severe mental retardation is often recognized early in life with poor motor development & absent or markedly delayed speech & communication skills.
Profound Retardation (IQ below 20)
This group accounts for 1-2% of all mentally retarded. The achievement of developmental milestones is markedly delayed. They require constant nursing care & supervision.
Sign and symptom
- Failure to achieve the developmental milestone
- difficulty in cognitive functioning such as the inability to follow commands and direction
- Failure to attain intellectual development markers
- Reduce ability to learn or to meet academic demands
- Expensive or receptive
- psychomotor skill deficits
- Difficult performing self-esteem
- Irritability when frustrated or upset
- Depression or labile mood
- Acting out behaviour
- persistent infantile behaviour
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DIAGNOSIS:
- History collection from parents & caretakers
- Physical examination
- Neurological examination
- Assessing milestones development
Investigations:
- Urine & blood examination for metabolic disorders
- Culture for cytogenic & biochemical studies
- Amniocentesis in infant chromosomal disorders
- chorionic villi sampling
- Hearing & speech evaluation
- EEG, especially if seizures are present
- CT scan or MRI brain, for example, in tuberous sclerosis
- Thyroid function tests when cretinism is suspected
Psychological tests like Stanford Binet Intelligence Scale & Wechsler Intelligence Scale for Children (WISC), for categorizing a child’s level of disability
TREATMENT MODALITIES:
- Environmental supervision
- Monitoring the child’s development needs & problems.
- Programs that maximize speech, language, cognitive, psychomotor, social, self-care, & occupation skills.
- Ongoing evaluation for overlapping psychiatric disorders, such as depression, bipolar disorder, and ADHD.
- Family therapy helps parents develop coping skills & deal with guilt or anger.
- Early intervention programs for children younger than 3 with mental retardation
- Behaviour management
- Provide day schools to train the child in basic skills, such as bathing
PROGNOSIS:
- The prognosis for children with mental retardation has improved & institutional care is no longer recommended.
- These children are mainstreamed whenever feasible & are taught survival skills.
- A multidimensional orientation is used when working with these children, considering their psychological, cognitive, social & emotional development