1、Mental Retardation (MR),Dr Shreedhar Paudel May, 2009,MR,Mental retardation is a developmental disability marked by lower-than-normal intelligence and limited daily living skillsDiminished learning capacity and does not adjust well sociallyMental retardation is normally present at birth or develops
2、early in life,MR.,Mental retardation is defined by two standards first standard is a persons level of intelligence usually measured by special tests called intelligence testsIntelligence tests provide a numerical ranking of a persons mental abilities called an intelligence quotient or, more commonly
3、, an IQ,MR.,The second standard for mental retardation is adaptive skills means how well a person can deal with the tasks of everyday life the ability to speak and understand home-living skills use of community resources leisure, self-care, and social skills basic academic skills (reading, writing,
4、and arithmetic); and work skills,MR.,Intelligence Quotient:- Mental age divided by chronological age multiplied by 100Degrees of mental handicap Mild 51-70 Moderate 36-50 Severe 21-35 Profound 0-20,MR,I.Q level 7190 borderline intelligence (not included in mental handicap)Mild and moderate are educa
5、ble and trainableSevere and profound are custodian,MR,Mild Mental Retardation 85 percent of the mentally retarded population Individuals often live on their own with community supportModerate Mental Retardation 10 percent of the mentally retarded population Individuals often lead relatively normal l
6、ives provided they receive some level of supervision Often live in group homes with other mentally retarded people,MR,Severe Mental Retardation 3% to 4% of the mentally retarded population master the most basic skills of living, such as cleaning and dressing themselves often live in group homesProfo
7、und Mental Retardation 1 % to 2% of the mentally retarded population develop basic communication and self-care skills often have other mental disorders,MR.,Etiology:- Interplay of several biomedical, sociocultural and psychological factors Prenatal Metabolic galactosemia, mucopolysaccharidosis Chrom
8、osomal Downs synd., Klinefelter syndrome Maternal factor teratogenic drugs, infection during pregnancy Neuroectodermal tuberous sclerosis Iodine deficiency,MR.,Natal Birth injury Hypoxic ischemic encephalopathy HemorrhagePost natal Infection Head injuries Hypoxia Thrombosis of cerebral vessels Kerni
9、cterus Malnutrition Child abuse,MR,Predisposing factors Low socioeconomic statusLow Birth Weight (LBW)Advance maternal ageConsanguinity,MR.,Symptoms Continued infantile behavior Decreased learning ability Failure to meet intellectual developmental markers Inability to meet educational demands at sch
10、ool Lack of curiosity Etiological presentation,MR,Changes to normal behaviors depend on the severity of the conditionMild retardation may be associated with a lack of curiosity and quiet behaviorSevere mental retardation is associated with infantile behavior throughout life,MR,Investigations:- Urine
11、 tests :- for metabolic diseases TFT :- T3, T4, TSH Genetic studies :- chromosomal studies Serology for TORCH LP :- any CNS infections CT and MRI :- hydrocephalus, absence of corpus callosum, tuberous sclerosis,MR,Exams and Tests Abnormal Denver developmental screening test Adaptive behavior score b
12、elow average Development below that of peers Intelligence quotient (IQ) score below 70 on a standardized IQ test,MR,Other Scales Wechsler preschool and primary scale of intelligence(WPPSI)Wechsler intelligence scale for children (WISC)Stanford Biner Test (SBT)Denver ii development screening test,MR,
13、Treatment The primary goal of treatment is to develop the persons potential to the fullestSpecial education and training may begin as early as infancyThis includes social skills to help the person function as normally as possible,MR,Treatment It is important for a specialist to evaluate the person f
14、or other affective disorders and treat those disordersBehavioral approaches are important for people with mental retardationParents should be counseled together,MR,Treatment Anticonvulsive treatment is prescribed for seizures but phenobarbitone should be avoidedHyperactivity treated with AmphetaminePsychologically warmth, love and appreciation,
