Mental Retardation: Causes, Symptoms and What to Do

Mental Retardation: Causes, Symptoms and What to Do

When there is a developmental disability detected in children below the age of 18, it is called intellectual disability or mental retardation. When the intellectual functioning is well below average as measured by standard intelligence tests and it also causes limitations in the daily life of the person or adaptive functioning.

What Are the Possible Causes for Mental Retardation?
Although there are various causes of mental retardation, the specific cause can be determined in only 25% cases. Some of the causes are given below:

• Infection which might be present at the time of birth or after birth


• Abnormalities in the chromosomes e.g. Down’s syndrome


• Environmental causes


• Metabolic e.g. hyperbilirubinemia in babies


• Malnutrition


• Toxic e.g. exposure to alcohol, cocaine, amphetamines to the fetus


• Trauma i.e. injury before or after birth


• Unexplained, when the cause cannot be determined

You may watch the video below for a more specific explanation of the possible causes of mental retardation:

What Symptoms Will Mental Retardation Present?
Mental retardation can be categorized depending on the level of IQ of the person and how well they adjust in the society. There are basically 4 types of mental retardation and they are given below:

Levels	Description
Mild Mental Retardation	Here the person has an IQ in the range of 50-69. They have problems in reading and writing, learn to talk late, but once they learn, they can communicate well. They can manage self-care independently, but are socially immature and cannot handle the responsibility of marriage or of being parents. Special schools, education can be helpful for them. They can suffer from Autism, Epilepsy or some form of physical disability.
Moderate Mental Retardation	These individuals have an IQ in the range of 35 to 49. They are slow learners and would find it difficult to live by themselves. It is difficult for them to understand and use languages and hence have limited ability to communicate. They are able to learn basic reading, writing and counting, get around on their own and also take part in simple social events.
Severe Mental Retardation	They have IQ in the range of 20 to 34 and there is severe damage or abnormal development of the central nervous system in these individuals. They have noticeable motor impairment.
Profound Mental Retardation	With an IQ of less than 20, they require constant care and supervision. They do not understand requests or instructions and hence cannot comply with them. They are generally immobile and are required to wear adult diapers. They mostly can communicate using only basic nonverbal cues.

What About Mental Retardation in Children?

Depending on the severity of the mental retardation, the sign and symptoms of the child may be noticeable during infancy or sometimes after the child begins school. The symptoms can be varied in children; however, some of the most commonly seen signs and symptoms are given below:

• Reaching the milestones late – rolling over, crawling, sitting up and walking


• Late start in talking or difficulty in talking


• Late in getting potty trained, doing activities like dressing or feeding independently


• Difficulty in remembering things or associating actions with corresponding consequences


• Throwing tantrums and other behavioral problems


• Difficulty in logical thinking or problem solving

What to Do If Your Child Is Mentally Retarded

• Learn and read as much as possible regarding mental retardation so that that you can be the best advocate for your child.


• Let the child explore and learn things by themselves. Support and guidance should be provided when needed and ensure that you give positive feedback when they achieve something or master something new. Make the child independent.


• Make the child participate in group activities like art class, scouts, etc. so that they develop social skills.


• Keep yourself involved in the activities of your child, discuss the progress at school with teachers and help in reinforcing the learning by practicing at home.


• Get to know parents of other mental retarded children. You can talk to them for advice and emotional support.

How Will Mental Retardation Be Evaluated?
There are various techniques available for evaluating mental retardation. Some of them are given below:

• Head circumference: Mental retardation can occur due to microcephaly and macrocephaly which can cause changes in the head circumference. They are associated with cognitive defects, autism at different stages in children.


• Height: Height is associated with certain disorders like fetal alcohol syndrome, hypoThyroidism and genetic disorder for short stature. Tall stature could be due to fragile X syndrome, Soto syndrome or some other overgrowth syndrome associated with mental retardation.


• Neurological: In this examination the head circumference, height, muscle tone, strength, coordination, ataxia, deep tendon reflexes, persistent primitive reflexes and other abnormal movements like dystonia or Athetosis are evaluated.


• Sensory: This is done to determine if there are any visual impairments or hearing defects, as they are more commonly seen in children with mental retardation.


• Skin: Skin examination is done to find hyper or hypo-pigmented macules or ash-leaf spots, fibromas and irregular pigmentation patterns.


• Extremities: Of all the cases with mental retardation, only 5-10% cases have congenital anomalies and major malformations. These could involve 3-4 minor anomalies in the face and digits.

Available Treatments and Services for Mental Retardation

• In the United States, children in the age group of 3 – 21 years with mental retardation are entitled to free testing, individual education, skill training in special schools.


• Special schools also provide early intervention programs which teach children under age of 3 years basic skills like bathing and feeding.


• Depending on the level of mental retardation, they are trained in independent living and job skills during adulthood. This enables them to live independently and hold jobs for mild mental retardation. For individuals with moderate or profound retardation, supervised community living is recommended.


• The family should undergo therapy to cope and deal with various situations, feeling of anger and guilt. A warm and supportive atmosphere at home helps the individual to reach his full potential.

Mental Retardation

Mental Retardation






Mental retardation also known as intellectual disability or cognitive deficits occurs due to impaired intellectual function. It can be diagnosed in early childhood when the child shows limited ability to learn and memorize things. If the child’s intellectual ability is below 70 then he/she has cognitive deficits. Often such children cannot meet the daily demands of routine life and have impairment in education and learning skills. Mental retardation can cause serious effect on family relationship and can cause personality disorder.

Often children with MR will show aggressive behavior, impulsive reaction and stubbornness. They will cause self injury without knowing the consequences of their action. Most of them will have mood disorders, psychotic disorders and personality disorders. Some children with Down’s syndrome and Autism will have distinctive structure (short) and other physical features marked for MR but others may have normal physical features with intellectual disability.

According to American Psychiatric Association, DSM – IV category divides the individuals according to the range of intellectual disability in varying degrees of severity. They are usually classified as mild, moderate, severe and profound mental retardation. Roughly 5% of the total population has intellectual disability and most of them are categorized in mild range. One should not classify children with learning disability or verbal disorder or attention deficit disorder under cognitive deficit since they have normal intelligence. Psychometric tests are to be administered for checking the intellectual quotient of a child.

Symptoms :

The first symptom of mental retardation begins at the age of 3-5. There will be persistent infantile behavior, aggressiveness, learning disability, poor concentration, lack of curiosity and reduced socialization skills. It will start in the form of developmental delay for many children like delayed walking, delayed talking etc. Some parents will notice this delay only when the younger sibling meets up the development like regular children. If the impairment of cognitive deficit is less it will show in the form of difficulty in school when the child becomes incapable to read or remember math tables.

Causes :

For many cases, there will not be any apparent cause for mental retardation. Reports state that only in 25% of the cases specific cause can be found and in most of the cases there is no clear evidence. The major cause for intellectual disability is yet to be found. Other common causes are chromosomal abnormalities, prenatal trauma like deprivation of oxygen to the brain, metabolic disorders, and congenital infection. Congenital infections like CMV, rubella, HIV and encephalitis and chromosomal abnormalities like deletions, translocations, defective chromosome and error in number of chromosomes can also cause mental retardation.

Deprivation from the home and lacking nutritional food can also contribute for this disorder. Genetic problems like galactosemia, Hunter syndrome, Lesch Nyhan Syndrome, Tay Sachs disorder and metabolic disorders like Reye syndrome and hypoglycemia and toxic problems like lead poisoning and substance abuse during pregnancy can also cause this problem.

Tests :

A series of assessment tests are available for testing the cognitive development. It includes IQ test, Stanford Binet intelligence scale, Bayley scale, and Wechsler intelligence scale. Most of them include questions that test the language development, mathematic reasoning, spatial ability and problem solving skills of the child. Based on the results the child will be categorized as mild, moderate or severely impaired with intelligence.

Treatment :

No treatment is available for mental retardation since it is inherited by birth and is not an acquired disease. Treatment/therapy is available for developing appropriate behaviors and for improving cognitive development of the child. Therapy is given to uncover the child’s potential in full. Special education is given for such children. Nutritional deficiency can be corrected by taking healthy diet plan by the child. Medications are given for treating psychiatric problems, personality disorder and behavior problems.

Specific disability like cardiac problem, endocrine or orthopedic disorders can be repaired through surgery. Behavior therapy with medications is recommended for children with attention deficit disorder, and autism. The treatment should be oriented in developing their overall social skills.

Medications prescribed for correcting attention deficit include methylphenidate or detroamphetamine. For managing aggressive nature and irritability clonidine and antipsychotics like risperidone are given. For controlling anxiety related problems drugs like wellbutrin and fluoxetine are prescribed. Therapies like physiotherapy, speech therapy, recreation therapy and behavioral counseling is provided to the affected child. Special education is needed for such children and they also need help from various training groups for acquiring skills.

Mental Retardation

Mental Retardation

What is Mental Retardation?

Mental retardation is a cognitive disability that is termed as sub average intelligence and impaired mental and adaptive functioning. This intellectual disability may start to arise and progress to those aged below 18 years. This neurodevelopmental disability is common to pediatric patients. As regarding with the term mental retardation, social stigma has been quite the problem of those affected and of the parents, close relatives of the mentally challenged individual. The term “mentally retarded” is placed to avoiding of its use as for intellectually disabled is a much more suitable terminology of the mental condition.

According to studies, mental retardation is manifested among 3% of children and an approximately 10% of children has some learning impairment, but shouldn’t be compared with MR/ID. In order to diagnose such condition, the use f the DSM – IV is essential in the process. It has been noted that one can be diagnosed of such condition if the child has an intelligence deficit of at least 2 standard deviations below the mean IQ. A mean score of 100 of an IQ test is the standard average of an individual. In case of mental retardation, an intelligence quotient score of 70-75 and below is mentally retarded. The functional skills of a person affected of intellectually disabled are skills of communication, self-care, home living and daily living, social and interpersonal skills, use of community resources, self-directions, academic skills, work, leisure, health and safety. In general, the domains affected of mental retardation are conceptual skills, social skills and practical skills. In terms of epidemiological reports, the frequency of MR of all degrees ranges from 1.6 to 3% of all population in the US. A particular race is not associated with this mental disability, as well in gender.

Mental retardation does not necessarily present death to the affected, however cases of severe and profound mental retardation has provided a decreased life expectancy to the affected for complications may arise such as neurologic disorders. Respiratory complications are also presented in some cases of profound ID. Some psychiatric conditions are associated with this condition and these include ADHD (attention deficit/hyperactivity disorder), self-injury and mood disorders.

Mental Retardation Types

The types of mental retardation are basically the same with the levels of mental retardation. The condition is classified according to these:

• Mild – The person is educable.


• Moderate – The person can be trained but cannot learn academic subjects at school.


• Severe – Confinement may be necessary.

Mental Retardation Causes

The causes of this condition would generally conclude to genetics. There is some alteration in the DNA structure of the affected. Here are the following prenatal conditions associated with mental retardation:

Genetic irregularities
Trisomy 21 or Down syndrome

Those who are accounted to have Down syndrome have mental retardation. An approximate 1 per 800 live births have Down syndrome. About 25 to 50% of all cases have severe mental retardation. The condition is referred as trisomy 21 for the chromosome 21 of the affected is increased in fashion.

Fragile X syndrome

The prevalence of this disorder is approximately 1 in 3500 males. According to studies, mental retardation from fragile X patients is accounted about 5.9% of cases in males while only 0.3% in females.

Contagious gene deletion syndromes

This is a less common cause of mental retardation.

Birth problems
Premature birth may be a cause of this condition as the brain is not well developed at this time.

Environmental factors

• Fetal Alcohol Syndrome and fetal alcohol effect – Alcohol has a great influence in teratogenic effects. Mental retardation is one of the common adverse effects of alcohol abuse while a woman is pregnant.


• Congenital Hypothyroidism – This neurologic syndrome can result to severe thyroid hormone deficiency during the fetal period. As the infant is growing; he or she may have a compromised speech resulting to mutism-deaf, moderate to severe MR, spasticity and Strabismus.


• Congenital rubella – Pregnant mothers who have contracted rubella may compromise the health of the child.


• Meningitis, neurodegenerative disorders and shaken baby syndrome are said to be possible causes of mental retardation.

Mental Retardation Characteristics

The presenting characteristic of mental retardation truly depends on the type and level of intellectual incapacity. A person’s developmental progress truly depends on the etiology of the condition and its level. Here are the following characteristic presentations of mental retardation:

Language

Language delay is one of the first signs of MR/ID. Speech as in expression is altered and the receptive language or the response of a mentally retarded patient is altered. Understanding is not entirely attained as to taking response to a communication.

Fine motor

There is delay in the motor adaptation. Significant delay is noted as to areas of self-care activities. These include self-feeding, toileting and dressing.

Cognition

Cognitive delay is noted as there is difficulty in memory, problem-solving and logical reasoning.

Social

Communication delay is noted. Social interaction is found ineffective for the affected may present lack of interest in age-appropriate activities and play.
Gross motor

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Motor development is said to be altered. The child or person may have difficulty in their fine motor and adaptive skills. Clumsiness is noted among patients with MR.

Behavior

Behavioral disturbances are noted as they have difficulty in controlling oneself. There is deviance from the normal temperament of behavior. Aggression, self-injury, inattention and hyperactivity are commonly the behaviors observed to patients.

Neurologic

In some cases, neurologic abnormalities are associated with MR. This would include seizure problems, microcephaly, macrocephaly, prematurity and congenital anomalies.

Levels of Mental Retardation

MR/ID is categorized according to the disability:

Mild retardation

An IQ mean score of 50-55 to 70 would indicate for a mild retarded case. The education level that a person is capable of attaining is only about the 6th grade. Mild retardation is also referred as educable.

Moderate retardation

An IQ mean score of 35-40 to 50-55 is moderately retarded. The person affected is capable of attaining 2nd grade level of education. While the person needs supervision. It is also referred as imbecile.

Severe retardation

An IQ mean of 20-35 to 35-40 is categorized as severe. The person affected may learn words, and can adapt to elementary self-care skills and activities. There is need of close supervision in this case of retardation. This level of mental retardation is referred as moron.

Profound

An IQ mean of <20 – 25 is profound mental retardation. The child or person has little self-care skills that one needs constant aid and supervision. This condition affects about a small population of MR/ID cases. Profound mental retardation is also referred as “idiot”. This has the greatest degree of intellectual disability.

Severe Mental Retardation

This level of mental retardation needs intensive support and supervision for the rest of his or her life. The child may still be capable of learning activities of daily living but still needs assistance in most times. It is recommended that the person with severe mental retardation has an attendant to avoid self-destructiveness, and injury infliction to oneself.

Mild Mental Retardation

Mild mental retardation is termed to have a cognitive age of about eight to twelve years. Those with mild retardation has a learning disability but is only limited. But the person affected can learn self-care activities and practical skills. They are even capable of living and reaching adulthood and even gain employment.

Mental Retardation in Children

Mental retardation begins in childhood or before the age of 18. In most cases, this condition would persist in the adult life. Mental retardation in childhood does not mean that they cannot attain the developmental milestones of life. Normally, they attain the important milestones in life such as walking and talking. But as the symptoms of mental retardation presents and starts to appear, the child can be diagnosed with the difficulties of social, communication and academic skills.

Mental Retardation Facts

Social stigma should not be placed on people with mental retardation. This has been prevalent but is tried to be lessened by social groups who support those people with intellectual disabilities. A person who is mentally retarded needs love, care and support that one has to offer. One should always put in mind that this condition is not a disease but a Mental Illness.

Those affected of mental retardation needs more time to adjust compared with people who are intellectually gifted. They may have a slower grasp of ideas in life, and has trouble in adjusting cognitively. Assistance is a must and we need to approach them in a manner that is acceptable to the society.

We need not to pressure those with ID for this can only make them wary of things. Assistance and understanding is a must when one is interacting with a mentally retarded person.

Treatment

The primary treatment for a person with mental retardation is to develop his or her potential in life. Assist the client in attaining his greatest potential. Providing special education and training should start in an early age. Evaluation of the child’s condition is a must before anything else so that he or she shall receive the recommended assistance that he needs. There is no specific medication for this condition. A health care provider should always have a standing goal of assisting the person with ID to attain his fullest capability.