Mental retardation
What is mental retardation?
It is defined as an intellectual functioning level (as measured by standard tests for intelligence quotient) well
below average and significant limitations in daily living skills (adaptive functioning).
Description of MR
According to the Centre for Disease Control and Prevention, in the 1990s, mental retardation
occured in 2.5 to 3 percent of the general population. Mental retardation begins in childhood or
adolescence before the age of 18.
It persists throughout adulthood. Intellectual functioning level is defined by standardized tests
(Weschsler-Intelligence Scales) that measure the ability to reason in terms of mental age (intelligence
quotient or IQ). Diagnosis of mental retardation is made if an individual has an intellectual functioning level
well below average and significant limitations in two or more adaptive skill areas.
Mental retardation is defined as IQ score below 70 to 75.
Adaptive skills are the skills needed for daily life. Such skills include the ability to produce and
understand language (communication); home-living skills; use of community resources; health, safety,
leisure, self-care, and social skills; self-direction; functional academic skills (reading, writing, and
arithmetic); and work skills.
In general, mentally retarded children reach developmental milestones such as walking and talking
much later than the general population.
Symptoms of mental retardation may appear at birth or later in childhood. Time of onset depends
on the suspected cause of the disability.
Some cases of mild mental retardation are not diagnosed before the child enters pre-school.
These children typically have difficulties with social, communication, and functional academic
skills.
Children who have a neurological disorder or illness such as encephalitis or meningitis may
suddenly show signs of cognitive impairment and adaptive difficulties.
Categories of mental retardation
Mild Mental Retardation
Approximately 85 percent of the mentally retarded population is in the mildly retarded category. Their IQ
score ranges from 50 to 75 and they can often acquire academic skills up to the sixth grade level. They can
become fairly self-sufficient and in some cases live independently, with community and social support.
Moderate Mental Retardation
About 10 percent of the mentally retarded population is considered moderately retarded. Moderately
retarded individuals have IQ scores ranging from 35 to 55. They can carry out work and self-care tasks with
moderate supervision. They typically acquire communication skills in childhood and are able to live and
function successfully within the community in a supervised environment such as a group home.
Severe Mental Retardation
About 3 to 4 percent of the mentally retarded population is severely retarded. Severely retarded individuals
have IQ scores of 20 to 40. They may master very basic self-care skills and some communication skills.
Many severely retarded individuals are able to live in a group home.
Profound Mental Retardation
Only 1 to 2 percent of the mentally retarded population is classified as profoundly retarded. Profoundly
retarded individuals have IQ scores under 20 to 25. They may be able to develop basic self-care and
communication skills with appropriate support and training. Their retardation is often caused by an
accompanying neurological disorder. The profoundly retarded need a high level of structure and
supervision
Causes of Mental Retardation
Prenatal causes (causes before birth)
Chromosomal Disorders: Downs syndrome, fragile X syndrome, prader wili syndrome,
klinfelters syndrome
Single Gene Disorders: Inborn errors of metabolism like galactosemia, phenyl ketonuria,
hypothyroidism, muco polysaccaridoses, tay sachs disease
Neuro Cutaneous Syndromes: Tuberous sclerosis, neurofibromatosis
Dysmorphic Syndromes: Laurence Moon Biedl syndrome
Brain Malformations: Microcephaly, hydrocephalus, myelo meningocele
Abnormal maternal environmental influences
Deficiencies: Iodine deficiency and folic acid deficiency, severe malnutrition
Substance use: Alcohol, nicotine, cocaine
Exposure to harmful chemicals: Pollutants, heavy metals, harmful drugs like thalidomide,
phenytoin, warfarin sodium etc.
Maternal infections: Rubella, toxoplasmosis, cytomegalovirus infection, syphilis, HIV
Exposure to: Radiation and Rh incompatibility
Complications of Pregnancy: Pregnancy induced hypertension, ante partum hemorrhage,
placental dysfunction
Maternal Disease: Diabetes, heart and kidney disease
During delivery
Difficult and /or complicated delivery, severe prematurity, very low birth weight, birth asphyxia, birth trauma
Neonatal period: Septicemia, jaundice, hypoglycemia, neonatal convulsions
Infancy and childhood: Brain infections like tuberculosis, Japanese encephalitis, bacterial
meningitis, Head trauma, chronic lead exposure, severe and prolonged malnutrition, gross under
stimulation
Symptoms of Mental Retardation
Failure to meet intellectual developmental markers
Failure to meet developmental milestones such as sitting, crawling, walking, or talking, in a timely
manner
Persistence of childlike behaviour, possibly demonstrated in speaking style, or by a failure to
understand social rules or consequences of behaviour
Lack of curiosity and difficulty solving problems
Decreased learning ability and ability to think logically
Trouble remembering things
An inability to meet educational demands required by school
Treatment
Treatment for Mental Retardation is not designed to "cure" the disorder. Rather, therapy goals
include reducing safety risks (e.g., helping an individual maintain safety at home or school) and teaching
appropriate and relevant life skills. Interventions should be based on the specific needs of individuals and
their families, with the primary goal of developing the person's potential to the fullest.
Medications are required to treat co morbidities like aggression, mood disorders, self injurious
behaviour, other behavioral problems and convulsions which occur in 40%to 70% of cases
