Mental Retardation and its Treatment

Mental Retardation is a condition diagnosed before the age of 18 that includes below average general intellectual function and a lack of the skills necessary for daily living. It is characterized by significantly impaired cognitive functioning and deficits in two or more adaptive behaviors”.

It can be defined as,

“Sub-average of Intellectual functioning that results from injury, disease or any Abnormality before the Age of 18 years”

It has historically being defined as “intellectual quotient” scores under 70. Mental Retardation is a sub type of “intellectual disability” although that term is now preferred by most advocates in most English countries.

PREVALENCE RATE OF MENTAL RETARDATION

The prevalence rate of mental retardation is 2% to 3% of population.

IQ CLASSIFICATION IN MENTAL RETARDATION

In mental retardation, the IQ (Intellectual Quotient) can be classified as the following.

Sr. No. CATEGORY OF MR IQ
1 Borderline 70 – 80
2 Mild Mental Retardation 55 – 70
3 Moderate Mental Retardation 40 – 55
4 Severe Mental Retardation 40 – 25
5 Profound Mental Retardation below 25

CATEGORIES / LEVELS OF MENTAL RETARDATION

There are four categories / levels of mental retardation to DSM – IV – TR as defined the following.

  1. Mild Mental Retardation
  2. Moderate Mental Retardation
  3. Severe Mental Retardation
  4. Profound Mental Retardation

MILD MENTAL RETARDATION

There are 75 to 85% cases of mild mental retardation. They are slow in all areas. They may have no unusual physical signs. They are educate-able. They have useful reading and math skills up to grade 3 to 6 level. They can acquire practical skills. They can conform socially. Their mental age is usually 8 years to 12 years.

MODERATE MENTAL RETARDATION

There are 10% to 25% cases of moderate mental retardation. They have notice-able delays, especially in speech. They may have some unusual physical signs. The self help can be developed through training. The reserved supervision is required for these persons. They can learn simple communication, health and safety habits. They also learn and modify their behavior through reward and punishment techniques. They have poor social awareness.

SEVERE MENTAL RETARDATION

There are 4% to 10% cases of severe mental retardation. They are marked obvious delays. They may walk late. They have little or no communication skills. They have some understanding of speech and show some response. They need direction and supervision and no vocational training. They may be trained in simple self-care. They follow routine frame work.

PROFOUND MENTAL RETARDATION

They are 1% to 2% cases of profound mental retardation. They are marked delays in all areas. They are needed close supervision. The congenital abnormalities often present in these children. These children have some motor development. They may response to regular physical activity and social stimulation.

TREATMENT / MANAGEMENT OF MENTAL RETARDATION

The management / treatment of mental retardation is done to eliminate or reduce the conditions that lead to development of the disorders associated with mental retardation. Some useful management plans of mental retardation are as defined the following.

  1. Primary Prevention
  2. Secondary & Tertiary Prevention
  3. Special Education for Child
  4. Different Therapies
  5. Family Counseling
  6. Community Services
  7. Individualized Education Plan (IEP)
  8. Individualized Therapy Plan (ITP)
  9. Play Therapy

PRIMARY PREVENTION

The primary prevention concerns actions taken to eliminate or reduce the conditions that lead to development of the disorders associated with mental retardation. Such manners include education to increase the general public’s knowledge and awareness of mental retardation, continuing efforts of health professional to ensure and upgrade public health policies, legislation to provide optimal maternal and child health care and eradication of the know disorders associated with central nervous system damage.

SECONDARY & TERTIARY PREVENTION

The disorder associated with mental retardation should be treated to shorten the cause of the illness (secondary prevention) and to minimize the consequent disabilities (tertiary prevention). Mentally retarded children frequently have emotional and behavioural difficulties requiring psychiatric treatment.

SPECIAL EDUCATION FOR CHILD

Special Educational settings for children who are mentally retarded should include a comprehensive program that addresses adaptive skills training, social skill training and vocational training.

DIFFERENT THERAPIES

There are different therapies that may be considered very effective for the management / treatment of mental retardation as defined the following.

  1. Group therapy
  2. Cognitive therapy
  3. Behavioural therapy
  4. Relaxation Exercise
  5. Play Therapy
  6. Psychodynamic Therapies
  7. Occupational Therapies

Group Therapy

The group therapy has often been a successful format, in which mentally retarded children can learn and practice hypothetical real life situations and receive supportive feedback.

Cognitive Therapy

The cognitive therapy is applied to the children who are mentally retarded. In this situation, the cognitive therapy dispels false beliefs of these mentally retarded children.

Behavioral Therapy

The behaviour therapy has been used for many years to shape and enhance social behaviours and to control and minimize aggressive and destructive behaviours. Positive reinforcement for desired behaviours and benign punishment for objectionable behaviours have been helpful.

Relaxation Exercise

The relaxation exercise with self instructions is recommended for mentally retarded persons who can follow the instructions.

Play Therapy

Special Olympics International is the largest recreational sports program geared for this population. The sports are assigned to these children to develop their physical fitness. Different types of toys, music and colors are selected in play therapy for these children.

Psycho-dynamic Therapies

The psychodynamic therapy has been used with patients and their families to decrease conflicts about expectations that result in persistent anxiety, rage and depression.

Occupational Therapies

The children with mental retardation are also assigned different types of occupational therapies to enhance their abilities of professions.

FAMILY COUNSELING

The family counseling is often addressed to the family of mentally retarded patient about ways to enhance competence and self esteem while maintaining realistic expectations for the patient.

COMMUNITY SERVICES

One of the most prevalent problems among persons who are mentally retarded is sense of social education and social skills deficits. Thus, improving the quantity and quality of social competence is a critical part of their care. Special Olympic also enhances social interactions, friendships and general self esteem.

INDIVIDUALIZED EDUCATION PLAN (IEPs)

The individualized education plan (IEP) is designed to educate the children with mental retardation.

INDIVIDUALIZED THERAPY PLAN (ITPs)

The individualized therapy plans (ITPs) are also designed for the management of the mentally retarded children.

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