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Mental Retardation

Introduction (According to ICD - 10 - DCR) I Q - <70 – Mental retardation
  • 50 – 69 – Mild MR – Moron-Educable up to 6th class
  • 35 – 49 – Moderate MR –Imbecile- Trainable (study up to 2nd class)
  • 20 – 34 - Severe MR –Idiot- Specialized care
  • < 20 – Profound MR – chronic rehabilitation
  1. Mental retardation is condition of arrested or incomplete development of the mind.
  2. It especially characterized by impairment of skills, manifested during the development period, which contributes to the overall level of intelligence, i.e. cognitive, language, motor, and social abilities.
  3. Retardation can occur with or without any other mental or physical disorder .
  4. Mentally retarded individuals can experience the full range of mental disorder, and the prevalence of other mental disorders is at least there to four times greater in this population than in the general population.
  5. In addition, mentally retarded individuals, are at greats risk of exploitation and physical/sexual abuse.
  6. Adaptive behavior is always impaired, but in protected social environments where support is available this impairment may not be at all fourth character may be used to specific the extent of the behavioral impairment, if this is not due to an associated disorder.
  7. The presence of mental retardation does not rule out additional diagnosis coded elsewhere in this book However, communication difficulties are likely to make it necessary to rely more than usual for the diagnosis upon objectively observable symptoms such as in the case of a depressive episode.
  8. Psychomotor retardation. Loss of appetite and weight and sleep disturbances.
Treatment of MR Child (dividing it in primary, secondary & tertiary prevention will be better)
Key component of treatment include :
  1. Behavior management
  2. Environmental supervision
  3. Monitoring of the child ‘s development needs and problems
  4. Programs that maximize speech , language, cognitive , psychomotor , social, self care and occupational
  5. Ongoing evaluation for comorbid psychiatric disorders such as depression, bipolar disorder and ADHD.
  6. Family therapy to help parents develop coping skills deal with guilt or anger.
Activities of daily living can be taught to MR child by
  • Modelling
  • Contingency management
Feature Mild M. R. Moderate M.R. Severe M. R. Profound M. R.
IQ 50 – 70 35 – 50 20-35 <20
Other name Educable Trainable Dependent Need life support
Progress up to Class 6 Class 2 - -
Care needed - Only under stressful condition or in disease
- Other wise achieve vocational & social self sufficiency
Can be trained to support themselves by performing semi skilled or unskilled work under supervision Can perform simple tasks under close supervision Need nursing care or life support under care fully planned & structured environment like group home
Lack of speech development is seen in:      
  1. Mental retardation
  2. Deafness
  3. Perinatal CNS insult
  4. Cerebral palsy
Disorder of psychological development
These disorders have the following features in common
  1. Onset happening usually in infancy or childhood
  2. Impairment or delay in development of functions are strongly related biological maturation of central nervous system
  3. A steady course, usually not involvement remissions & relapses most commonly the areas affected are language visuo spatial skills and motor coordination.
Most common the areas affected are language visuo spatial and motor coordination . The impairment usually lession as the children grows older.
More common in boys and girls.
A strong family H/o is usually present , hence the presumption of rule of genetic factor. environment factors are not of paramount importance but do influence development functions.
  1.  Specific Development disorder of speech & language.
The normal pattern of language acquisition is disturbed . This is not direct lt related to neurological or speech mechanism abnormalities , sensory impairment menta retardation or environmental factors Has to be differentiated fro normal delay in language development.
In this there are multiple associated problems . Often associated with difficulties in reading & spelling in interpersonal relationship & behavior disorders.
  1. Specific speech articulation disorder
  2. Expressive language disorder
  3. Receptive language disorder
  4. Acquired aphasia with epilepsy ( landau – Kleffner syndrome)
  1. Specific Developmental disorder of scholastic skill (SDDSS)
Normal pattern of skill acquisition is disturbed again from early - stages of development. They are disorders because of abnormalities in cognitive processing that derive from some biological dysfunctions and not due to for e.g. lack of opportunity to learn or brain trauma or disease.
  1. Specific reading disorder
  2. Specific spelling disorder
  3. Specific disorder of arithmetic skills
  4. Mixed disorder of scholastic skills
Reading achievement is substantially below that expected of age. IQ and education, It interferes with academic achievement or activities of daily living that require reading skills. Usually in excess of sensory-deficits if present starts at 7 years of age.
Treatment includes Re - medial educational approach.
Specific spelling disorder
Writing skills are significantly below that expected (same as in reading disorder)
Specific disorder of arithmetic skills
Mathematical abilities are below that expected of age. IQ and education.
Specific Developmental disorder of Motor function
The main feature is serious impairment in the development of motor coordination not example by mental retardation, congenital or acquired neurological disorder.

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