Page 1 of 1: mental retardation

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Mental Retardation Mental Retardation is below average general intellectual functioning originating during the development period and associated with Impairment in Adaptive Behaviour.

- Arrested or Incomplete Development of Mind
- Subnormal State of Intelligence
- It is not an illness, but a condition of poor development of brain

Age à before 18 years
- 1 to 2 % of General Population
- Growth & Development is Slow
- Associated Conditions like Fits, Hearing Problem, Visual
Problem or Physically Handicap or Behavioural Problems.
- When the Mental age lesser than the Physical Age, Such
child is considered Mentally Retarded.
Intelligence of a person is referred à Intelligence Quotient
Mental Age
IQ = X 100
Chronological Age

IQ = < 70 – Mental Retardation
Classification – On the Basis of IQ
1. Mild Mental Retardation 50 – 69
2. Moderate Mental Retardation 35 – 49
3. Severe Mental Retardation 20 – 34
4. Profound Mental Retardation Below 20
Based on Practical Classification
1. Educable Group
2. Trainable Group
3. Custodial Group
Recognition of Mental Retardation in Children
1. By talking to the parents, especially mother, in detail about the
growth of the Child.
2. By observing the child’s physical appearance and behaviour.
Important Mile Stones
3 Months - Holding Neck Erect
6 Months - Sitting with Support
9 Months - 1 Year - Walking
1 – 1½ Years - Speaking few words or phrases
1. Below 5 Years – History of Delayed Milestones
2. Above 5 Years – History of School Failures, Behaviour
Problems & Behaviour against society’s expectations.
Physical Appearance

- Small or Large Head
- Slanting Eyes
- Thick Protruding Tongue
- Microcephaly, Hydrocephalus
- Rough SKIN
- Stunted Growth
Causes of Mental Retardation
Genetic
Chromosome Abnormalities
Down’s Syndrome
Klinefelter’s Syndrome
Turner’s Syndrome
Metabolic Disorders Affecting
Amino Acids (Eg. Phenylketonuria, Homocystinuria, Hartnup Disease)
The Urea Cycle (Eg. Citrullinuria, Aminosuccinic Aciduria)
Lipids (Tay-Sach’s, Gaucher’s & Niemann-Pick Diseases)
Carbohydrate (Lesch-Nyhan Syndrome)
Mucopolysaccaharidoses (Hurler’s, Hunter’s, Sanfilippo’s )
Gross Disease of the brain
Tuberous Sclerosis
Neurofibromatosis
Cranial Malformations
Hydrocephalus
Microcephalus
Antenatal Damage
Infections (Rubella, Cytomegalo Virus, Syphilis)
Intoxications (Lead, Alcohol)
Physical Damage (Injury, Radiation)
Placental Dysfunction (Toxaemia, Nutritional Growth Retardation)
Endocrine Disorders (Hypothyroidism, Hypoparathyroidism)
Perinatal
Birth Asphyxia
Complications of Prematurity
Kernicterus
Intraventricular Haemorrhage Post-Natal Damage
Injury (Accidental, Child Abuse)
Lead Intoxication
Infection (Encephalitis, Meningitis)
Malnutrition
Common Causes of Mental Retardation in Our Country

1. Infection during Infant – Encephalities Meningitis
2. Infection during pregnancy – Rubella, Syphilis, AIDS
3. Nutritional Deficiency during Pregnancy and Childhood
4. Primary & Genetically related Causes
5. Chromosomal Abnormality – Downs Syndrome
6. Endocrine – Cretinism
7. Phenylketonuria
Rehabilitation & Nursing Care
Rehabilitation
Depends upon their disability
Assesses through IQ & Clinical Evaluation
Problem – Three Aspects
1. Impairment – brain Injury
2. Disability – Reading Arithmetic
3. Social Handicap – Occupation or Personal Relationship
Assessment
- Whether the condition is treatable and reversible
Education of Mentally Retarded Children
- Mild and Moderate Mentally Retarded
- Education Program in a Special School
- Specially trained Teachers
Training the Mentally Retarded
- Mild & Moderate Mental Retardation
- Special Training
- Sheltered Workshop – Gardening, Book Binding, Paper &
Cover Making
- Specially trained teachers with Occupational Therapists
Custodial Care
- Severe or profound mentally retarded
- Either at home or in the institutions like Special Center or
Hospital.
Indication for Institutional Care
1. Severe Mentally Retarded without any Social
Support
2. Severe Mentally Retarded with Behavioural
Problems
3. Severe Mental Retarded with Complications like
intractable epilepsy
4. Short Time stay for Family Members [like Function
Time]
Prevention of Mental Retardation Before Conceiving (for mothers)
Rubella Immunisation
Genetic Counselling
Health Education – Diet, Smoking & Alcohol abstinent.
Consanguinous Marriages
Prenatal
Identification of Risk /groups
Rubella Screening
Syphilis & Aids Screening
Ultrasound Scan
- Microcephalus
- Hydrocephalus
- Multiple Births
Prevention of Mental Retardation Natal
Improved obstetric & Natal Care
Postnatal
Neonatal Screening of treatment of Hypothyroidism
Immunisation – Encephalitis & Meningitis
Reduce Child abuse, Road Traffic Accident & Home
Accident
Health Education Mental Retardation cannot be cured, but can be improved
through proper care
Mental Retardation improved with training but slowly

Require Good Food, Love & Affection, Special Education &
Training, Good Social Support
Controlling systemic infections
Parent’s Counselling

_________________
DR.M.RAJARAM

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