Assessment of Mental Retardation

Assessment of Mental Retardation

American Association on Mental Retardation’s Classification of Mental Retardation

The American Association on Mental Retardation has pub-lished in 2002 a new edition of its manual Mental Retardation: Defi nition, Classifi cation and Systems of Supports. Several di-mensions of mental retardation are described, which might also serve as an outline for its assessment

Dimension I:         Intellectual abilities

Dimension II:       Adaptive behavior (Conceptual, social and practical skills)

Dimension III:      Participation, interactions and social roles.

Dimension IV:      Health (physical health, mental health, etiologi-cal factors).

Dimension V:       Context (environments and culture).

This is a comprehensive description of the person’s cur-rent environment: its nature, strengths, and weaknesses, supports for person’s development and well-being (including factors such as poverty, family and its attitudes, availability of education and other services).

In all aspects of the assessment, attention should be paid both to the strengths as well as to the weaknesses and the impairments.

Biomedical Etiological Assessment of Mental Retardation

Mental retardation associated with syndromes and disorders with obvious phenotypical features is usually recognized earliest, such as in the case of Down syndrome. The diagnosis is then confirmed by chromosomal or other appropriate laboratory studies. If there was a suspicion of a family’s risk for a genetic disorder before the birth (such as through prior genetic counseling), appropri-ate studies are performed in the neonatal period. Some cases of congenital mental retardation (e.g., PKU) are discovered in the course of routine neonatal screening. Newborns with perinatal risk factors like prematurity and asphyxia should be followed up closely for later manifestations of developmental delay. Other children might come to medical attention because of a delay in achieving developmental milestones or regression in a previously normal developmental pattern. Finally, many children with men-tal retardation will be referred for diagnostic assessment when they reach school age because of failure in academic learning.

Elements of Biomedical Assessment

The scheme for assessing the etiology of mental retardation is summarized in Figure 24.2. This work-up has been used by Finn-ish physicians for 20 years (Wilska and Kaski, 1999).