MENTAL RETARDATION

MR can be defined as a state of arrested or incomplete development of mind, which includes subnormality of intelligence. Their mental age is much less than the chronological age. A fifteen years old child behaves and functions as if it is only a three years old child, if it is severely retarded. An individual is considered to have mental retardation based on the following three criteria: intellectual functioning level (IQ) is below 70-75; significant limitations exist in two or more adaptive skill areas; and the condition is present from childhood (defined as age 18 or less) (AAMR, 1992).

The symptoms of MR show up at birth itself. Insufficient oxygen supply to brain cells at birth or inadequate nutrition at crucial stages of brain development . There are degrees and levels of MR children: mild, moderate and severe. There are methods to find out the category to which a child belongs and this is necessary to determine the rehabilitation measures that have to be undertaken. For instance, a child with mild degree can be educated and trained to read,write and calculate and can be given occupation therapy;he can thus be trained to earn his living. Moderate degree implies that the child is trainable and vocational guidance can help; they can be trained in simple reading and writing. Severe degree means they can at best be trained to attain toilet control; it is difficult to impart any training to children of extreme retardation. Research done so far doesn't hold out any hope to cure them; there is no medicine. Fortunately, however, educational techniques have been developed over a period of time to facilitate the development of the already existing mental abilities of the child.

A person with limits in intellectual functioning who does not have limits in adaptive skill areas may not be diagnosed as having mental retardation. How many people are affected by mental retardation? The Arc reviewed a number of prevalence studies in the early 1980s and concluded that 2.5 to 3 percent of the general population have mental retardation (The Arc, 1982). Based on the 1990 census, an estimated 6.2 to 7.5 million people have mental retardation.
Mental retardation is 10 times more common than cerebral palsy and 28 times more prevalent than neural tube defects such as spina bifida. It affects 25 times as many people as blindness (Batshaw, 1997). Mental retardation cuts across the lines of racial, ethnic, educational, social and economic backgrounds. It can occur in any family. One out of ten American families is directly affected by mental retardation. How does mental retardation affect individuals? The effects of mental retardation vary considerably among people, just as the range of abilities varies considerably among people who do not have mental retardation. About 87 percent will be mildly affected and will be only a little slower than average in learning new information and skills. As children, their mental retardation is not readily apparent and may not be identified until they enter school.

As adults, many will be able to lead independent lives in the community and will no longer be viewed as having mental retardation. The remaining 13 percent of people with mental retardation, those with IQs under 50, will have serious limitations in functioning. However, with early intervention, a functional education and appropriate supports as an adult, all can lead satisfying lives in the community. How is mental retardation diagnosed? The AAMR process for diagnosing and classifying a person as having mental retardation contains three steps and describes the system of supports a person needs to overcome limits in adaptive skills. The first step in diagnosis is to have a qualified person give one or more standardized intelligence tests and a standardized adaptive skills test, on an individual basis. The second step is to describe the person's strengths and weaknesses across four dimensions.
The four dimensions are:
1. Intellectual and adaptive behavior skills
2. Psychological/emotional considerations
3. Physical/health/etiological considerations
4. Environmental considerations

Strengths and weaknesses may be determined by formal testing, observations, interviewing key people in the individual's life, interviewing the individual, interacting with the person in his or her daily life or a combination of these approaches. The third step requires an interdisciplinary team to determine needed supports across the four dimensions. Each support identified is assigned one of four levels of intensity - intermittent, limited, extensive, pervasive. Intermittent support refers to support on an "as needed basis." An example would be support that is needed in order for a person to find a new job in the event of a job loss. Intermittent support may be needed occasionally by an individual over the lifespan, but not on a continuous daily basis. Limited support may occur over a limited time span such as during transition from school to work or in time-limited job training. This type of support has a limit on the time that is needed to provide appropriate support for an individual. Extensive support in a life area is assistance that an individual needs on a daily basis that is not limited by time. This may involve support in the home and/or support in work. Intermittent, limited and extensive supports may not be needed in all life areas for an individual.

Pervasive support refers to constant support across environments and life areas and may include life-sustaining measures. A person requiring pervasive support will need assistance on a daily basis across all life areas. What does the term "mental age" mean when used to describe the person's functioning? The term mental age is used in intelligence testing. It means that the individual received the same number of correct responses on a standardized IQ test as the average person of that age in the sample population. Saying that an older person with mental retardation is like a person of a younger age or has the "mind" or "understanding" of a younger person is incorrect usage of the term. The mental age only refers to the intelligence test score. It does not describe the level and nature of the person's experience and functioning in aspects of community life. What are the causes of mental retardation?
Mental retardation can be caused by any condition which impairs development of the brain before birth, during birth or in the childhood years. Several hundred causes have been discovered, but in about one-third of the people affected, the cause remains unknown.
The three major known causes of mental retardation are
Down syndrome,
fetal alcohol syndrome and
fragile X.

The causes can be categorized as follows: ·

Genetic conditions - These result from abnormality of genes inherited from parents, errors when genes combine, or from other disorders of the genes caused during pregnancy by infections, overexposure to x-rays and other factors. More than 500 genetic diseases are associated with mental retardation. Some examples include PKU (phenylketonuria), a single gene disorder also referred to as an inborn error of metabolism because it is caused by a defective enzyme.

Down syndrome is an example of a chromosomal disorder. Chromosomal disorders happen sporadically and are caused by too many or too few chromosomes, or by a change in structure of a chromosome.

Fragile X syndrome is a single gene disorder located on the X chromosome and is the leading inherited cause of mental retardation. · Problems during pregnancy - Use of alcohol or drugs by the pregnant mother can cause mental retardation. Recent research has implicated smoking in increasing the risk of mental retardation. Other risks include malnutrition, certain environmental contaminants, and illnesses of the mother during pregnancy, such as toxoplasmosis, cytomegalovirus, rubella and syphillis. Pregnant women who are infected with HIV may pass the virus to their child, leading to future neurological damage. · Problems at birth - Although any birth condition of unusual stress may injure the infant's brain, prematurity and low birth weight predict serious problems more often than any other conditions. ·

Problems after birth - Childhood diseases such as whooping cough, chicken pox, measles, and Hib disease which may lead to meningitis and encephalitis can damage the brain, as can accidents such as a blow to the head or near drowning. Lead, mercury and other environmental toxins can cause irreparable damage to the brain and nervous system. · Poverty and cultural deprivation - Children in poor families may become mentally retarded because of malnutrition, disease-producing conditions, inadequate medical care and environmental health hazards. Also, children in disadvantaged areas may be deprived of many common cultural and day-to-day experiences provided to other youngsters. Research suggests that such under-stimulation can result in irreversible damage and can serve as a cause of mental retardation.
Children with mental retardation are usually slow in overall development, in learning to walk; speech is usually delayed and some may not be able to talk at all. A few may look normal physically but suffer from other physical anomalies like short stature, low set ears, high hunched palate, narrow forehead, small size of head ; some others have other kinds of retardation as well, that is, they may be deaf etc.Most mentally retarded children have other behavioural disorders like poor attention span, hyperactivity, stubbornness, temper tantrums, aggressive behaviour etc. Medicine is useful only to control hyperactivity and reduce aggression. The diagnosis is made after a careful developmental assessment and determining their IQ by psychological testing methods. Special schools are set up all over the country with training facilities and teachers apply special techniques to improve speech, coordination, memory, writing, reading skills etc.Some schools have vocational training centres for training the children to take up jobs.

Yoga techniques loosen the joints and relax the muscles and thus help the children in improving their physical skills and basic controls. Yoga brings control over breathing and that works in effectively increasing the body-mind coordination. Yoga is a conscious process of gaining control over the mind and hence both IQ and memory power are enhanced. By improved skills, coordination, etc. social behaviour also develops. The techniques included loosening exercises for joints, flexing the spine, breathing aids, abdominal breathing, abdominal movement, thoracic breathing, speech correction, hearing and eye sight development.