Mental Retardation

Mental Retardation

Mental handicap is more complex enterprise. Some children can go through life but others need help depending upon their disability. Institutionalization and special schooling are required for a number of mentally handicapped children.

Mental retardation has a new name “Intellectual disability” or “Intellectual Developmental Disorder or General Learning Disability”.

Meaning

Retarded is derived from Latin Word

“Retardare” = which means to make slow, keep back, or hinder.

Definition of Mental Retardation:

"Mental retardation is a generalized neuro developmental disorder characterized by significantly impaired intellectual and adaptive functioning” –American Association on mental deficiency (1983).

Causes for Mental Retardation

·  Genetic Causes: Abnormal genes form parents (chromosomal abnormalities)

·  Metabolic: Phenylketonuria, Wilson’s disease and Galactosomia

·  Cranial malformations: Microcephaly and hydrocephaly

·  Prenatal: Infection Eg. Rubella

·  Intranatal: Birth asphyxia

·  Postnatal: Infections, Accidents, Lead poisoning

·  Environmental And Socio – Cultural Causes: Low socio economic status, cultural deprivations.

Classification of Intellectual Disability

IQ Calculation (Interlligent Quotient)

IQ = Mental Age (MA)/ Chronological Age (CA) × 100

For example: If 8 year old child has 4 year of mental age , it would be considered as 4 years of mental age.

Calculate as follow: IQ =4/8 × 100=50

(Mental age is calculated by psychiatrist and chronological age is the actual age from birth)

Clinical Features

Mild Mental Retardation: (IQ 50 to 70)

·  Deficit in intellectual, and academic performance,

·  Motor or sensory deficits are slight.

·  Their mental retardation can not be detected until the start of schooling.

Moderate Mental Retardation: (IQ 35 to 50)

·  Trainable, unaware of the needs

·  Poor communication skills,

·  Partially dependence on others for this care,

·  Difficulty in social relationship

Severe Mental Retardation (IQ 20 to 35)

•      Poor verbal skills, Poor psychomotor development,

·  Only able to develop simple focus

Profound Mental Retardation: (IQ < 20)

·  No capacity for socialization skills,

·  Lack of both fine and gross motor skills,

·  Requires constant supervision,

·  May associated with other psychosocial disorders.

Signs and Symptoms

·  Failure to Milestones

·  Deficiencies in cognitive Function

·  Reduced ability

·  Expressive or accepting language problem

·  Psychomotor skill deficits

·  Neurologic impairments

·  Lack of curiosity

Dignosis

·  History: Family History, and abnormalities in pregnancy and delivery, Developmental milestone and Associated behavioural disorders.

·  Physical Examination: Height, weight, head circumference physical sign of specific disorders.

·  Detailed Neurological Examination: Especially vision, hearing of specific sign.

·  Mental Status Examination

·  Investigation: Blood, Urine, CT Brain, and chromosomal studies.

·  Intelligence test

·  EEG.

Management

Treatment Modalities

·  No satisfactory treatment is available till today. No drugs available to increase intelligence.

·  Behaviour and environmental supervision

·  Monitoring the child’s developmental needs and problems.

·  Programs that maximize speech, language, cognitive, psychomotor, social, self-care, and occupational skills.

·  Ongoing evaluation for overlapping psychiatric disorders

·  Family therapy and Early intervention programs for children

·  Provide day schools to train the child in basic skills, such as bathing, brushing and eating.

Prevention of Mental Retardation

·  Genetic counselling, avoid consanguinity marriages.

·  Good perinatal care and hospital deliveries

·  Avoiding marriages of mentally retarded

·  Early diagnosis and treatment.

Rehabilitation

Rehabilitation is aimed at

·  Physical (appliances for handicaps),

·  Social (social skills training) and

·  Occupational areas (e.g. by teaching and training the patients to make them self-sufficient).

·  Day care centres and schools, integrated schools, vocational training centres, sheltered forms and workshops are useful.

Tips for Parents of Mentally Challenged Children:

·  Mental retardation will not be caused by sin, god’s anger.

Do not consider them as a burden.

·  Home training will give good result.

·  Home is the best place to train the child.

·  Home training will lead to independent life

Social welfare schemes available for mentally retarded in India

·  Monthly maintenance charge of Rs.1000/-

·  Self-employment subsidy to persons through banks, and free travel concession with one escort, free special education, appointment of legal guardianship, homes and vocational training programme from non-governmental organizations are available.