Mental Retardation: Mental Retardation PRESENTED BY: A.PRIYADHARSHINI M.Sc(N), IGMCRI, PUDHUCHERRY. Definition:: Definition: Mental retardation ( MR ) is a generalized disorder appearing before adulthood, characterized by significantly impaired cognitive functioning and deficits in two or more adaptive behaviors. It has historically been defined as an Intelligence Quotient score under 70 INCIDENCE:: INCIDENCE: Mental retardation affects about 2–3% of people. 75–90% of the affected people have mild retardation. Non-syndromic or idiopathic MR accounts for 30–50% of cases MR more common among males Intellectual functioning: Intellectual functioning IQ = Mental Age/Chronological Age * 100. The more severe the retardation the lower the ratio of MA/CA Causes: : Causes: Genetic conditions (Down syndrome, Klinefelter's syndrome ) Exposed to alcohol during pregnancy Infection like rubella during pregnancy Hypoxia during the birth Diseases like whooping cough, measles, or meningitis can cause mental disability if medical care is delayed or inadequate. General medical conditions acquired in infancy or childhood Lead poisoning, traumas, infections PowerPoint Presentation: CONTD…. Exposure to poisons like lead or mercury may also affect mental ability. Iodine deficiency Malnutrition CLASSIFICATION:: CLASSIFICATION: Class IQ Profound mental retardation Below 20 Severe mental retardation 20–34 Moderate mental retardation 35–49 Mild mental retardation 50–69 Borderline intellectual functioning 70–84 BORDERLINE INTELLECTUAL FUNCTIONING:: BORDERLINE INTELLECTUAL FUNCTIONING: IQ 70 to 84 NO impairment in adaptive skills MILD MENTAL RETARDATION:: MILD MENTAL RETARDATION: IQ: 50-69 Largest group of MR patients (about 85%) Used to be referred to as “educable” As a group, they often develop social, communication, and motor skills during the preschool years without concern. In late teens, can acquire academic skills commensurate with a 6 th grader. CONTD…: CONTD… As adults, can achieve social and vocational skills adequate for minimum self-support, but may need supervision, particularly when stressed. Can usually learn to live independently or in supervised settings. Moderate Mental Retardation: Moderate Mental Retardation IQ = 35 to 49 About 10% of the MR population Used to be called “trainable” Most acquire communication skills during early childhood. Can benefit from vocational training and with moderate supervision, attend to personal care. Unlikely to progress beyond 2 nd grade in academic subjects. Contd..: Contd.. May learn to travel independently in familiar places. Difficulties in social skills and recognizing social conventions can interfere with peer relationships in adolescence. As adults, most can perform unskilled or semiskilled work under supervision. Can live in the community, usually with supervision. SEVERE MENTAL RETARDATION:: SEVERE MENTAL RETARDATION: IQ 20-34 3-4% of the MR population During early childhood, acquire little or no communicative speech During school-age period, may learn to talk and be taught elementary self-care skills. Unlikely to progress beyond pre-academic skills (e.g., letter recognition, simple counting) but can master some “survival” sight words. CONTD…: CONTD… Most adapt well to life in the community in group homes or with their family members. PROFOUND MENTAL RETARDATION:: PROFOUND MENTAL RETARDATION: IQ below 20 About 1-2% of the MR population Most of these individuals have an identifiable neurological condition that accounts for their MR Considerable impairments in early childhood in sensorimotor functioning. Optimal development may occur in highly-structured environments. CONTD…: CONTD… Motor development, self-care, and communication skills may improve if appropriate training is provided. DIAGNOSTIC EVALUATION:: DIAGNOSTIC EVALUATION: No clear laboratory findings or physical exam findings in most cases. Severe to profound MR often is accompanied by other lab/physical findings Phenylketonuria Seizures Neuromuscular malformations Contd….:
Contd…. Developmental schedules Bayley infant scales Gassell's developmental schedules Verbal tests Binet Kamat test Malin's
for Indian children.
Contd…: Contd… Nonverbal and performances tests Developmental screening test Raven's progressive matrices Seguin form board test Gassel's drawing test Contd … MANAGEMENT:: MANAGEMENT: Motivation and training Special education Parental counselling Vocational training Job placement Self employment Sheltered workshop Behaviour modification PREVENTION:: PREVENTION: Genetic: Prenatal screening for genetic defects and genetic counseling for families at risk for known inherited disorders can decrease the risk of inherited mental retardation. Social: Government nutrition programs are available to poor children in the first and most critical years of life. CONTD…: CONTD… Toxic: Environmental programs to reduce exposure to lead, mercury, and other toxins will reduce toxin-associated retardation. Increased public awareness of the risks of alcohol and drugs during pregnancy can help reduce the incidence of retardation. PowerPoint Presentation: THANK YOU