(also called '''mental handicap''' and, as defined by the
UK Mental Health Act 1983 , '''mental impairment''' and '''severe mental impairment''') is a term for a pattern of persistently slow
Learning of basic motor and
Language skills ("
Milestones ") during
Childhood , and a significantly below-normal global
Intellectual Capacity as an
Adult . One common criterion for diagnosis of mental retardation is a tested
Intelligence Quotient (IQ) of 70 or below.
People with mental retardation are people who are usually described as having
Developmental Disabilities .
The term ''mental retardation'' has gradually acquired pejorative and shameful connotations over the last few decades and is now used almost exclusively in technical or scientific contexts where exactness is necessary.
- In North America the broad term ''developmental delay'' has become an increasingly preferred synonym by many parents and caregivers. Elsewhere, however, ''developmental delay'' is generally used to imply that appropriate intervention will improve or completely eliminate the condition, allowing for "catching up." Importantly, this term carries the emotionally powerful idea that the individual's current difficulties are likely to be temporary.
- ''Developmental disability'' is preferred by most physicians, but can also refer to any other physical or psychiatric delay, such as Delayed Puberty .
- Both the phrases ''intellectual disability'' and '' Learning Disability '' are increasingly being used as a synonym for people with significantly below-average IQ, primarily as a means of separating general intellectual limitations from specific, limited deficits as well as indicating that it is not an emotional or psychological disability. Intellectual disability is also used to describe the outcome of Traumatic Brain Injury or Lead Poisoning or Dementing conditions such as Alzheimer's Disease . It is not specific to congenital conditions like Down Syndrome .
The
American Association On Mental Retardation continues to use the term ''mental retardation''
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There are many signs. For example, children with developmental disabilities may learn to sit up, to crawl, or to walk later than other children, or they may learn to talk later. Both adults and children with intellectual disabilities may also:
- have trouble speaking,
- find it hard to remember things,
- not understand how to pay for things,
- have trouble understanding social rules,
- have trouble seeing the consequences of their actions,
- have trouble solving problems, and/or
- have trouble thinking Logic ally.
In early childhood mild disability (IQ 60–70) may not be obvious, and may not be diagnosed until they begin school. Even when poor academic performance is recognized, it may take expert assessment to distinguish mild mental disability from
Learning Disability or behavior problems. As they become adults, many people can live independently and may be considered by others in their community as "slow" rather than "retarded".
Moderate disability (IQ 50–60) is nearly always obvious within the first years of life. These people will encounter difficulty in school, at home, and in the community. In many cases they will need to join special, usually separate, classes in school, but they can still progress to become functioning members of society. As adults they may live with their parents, in a supportive group home, or even semi-independently with significant supportive services to help them, for example, manage their finances.
Among people with intellectual disabilities, only about one in eight will score below 50 on IQ tests. A person with a more severe disability will need more intensive support and supervision his or her entire life.
The limitations of cognitive function will cause a child to learn and develop more slowly than a typical child. Children may take longer to learn to speak, walk, and take care of their personal needs such as dressing or eating. They will have trouble learning in school. Learning will take them longer, require more repetition, and there may be some things they cannot learn. The extent of the limits of learning is a function of the severity of the disability.
Nevertheless, every child is able to learn, develop, and grow to some extent. The capacity to experience joy and human relationships is not IQ-dependent.
According to the below 70, significant limitations in two or more areas of
Adaptive Behavior (i.e., ability to function at age level in an ordinary environment), and evidence that the limitations became apparent in
Childhood .
It is formally diagnosed by professional assessment of ''intelligence'' and ''adaptive behavior''.
IQ tests were created as an attempt to measure a person's abilities in several areas, including
Language ,
Numeracy and
Problem-solving . The average score is 100. People with a score below 75 will often, but not always, have difficulties with daily living skills. Since factors other than mental ability (depression, anxiety, lack of adequate effort, etc.) can yield low IQ scores, it is important for the evaluator to rule them out prior to concluding that measured IQ is "significantly below average".
The following ranges, based on the
Wechsler Adult Intelligence Scale (WAIS), are in standard use today:
Adaptive behavior, or adaptive functioning, refers to the skills needed to live independently (or at the minimally acceptable level for age). To assess adaptive behavior, professionals compare the functional abilities of a child to those of other children of similar age. To measure adaptive behavior, professionals use instruments that are actually structured interviews, with which they systematically elicit information about the person's functioning in the community from someone that knows them well. There are many adaptive behavior scales, and accurate assessment of the quality of someone's adaptive behavior requires clinical judgment as well. Certain skills are important to adaptive behavior, such as:
This third condition is used to distinguish it from
Dementing conditions such as
Alzheimer's Disease or is due to traumatic injuries that damaged the brain.
Down Syndrome ,
Fetal Alcohol Syndrome and
Fragile X Syndrome are the three most common inborn causes. However, doctors have found many other causes. The most common are:
- Psycho-social disadvantage. Contributing factors are lack of reading material, use of language not common in that community, poor diet, poor health practices, and poor housing. This is the most common cause of mental retardation in the US.
- Genetic conditions. Sometimes disability is caused by abnormal genes inherited from parents, errors when genes combine, or other reasons. Examples of genetic conditions include Down Syndrome , Fragile X Syndrome , and Phenylketonuria (PKU).
- Problems during pregnancy. Mental disability can result when the Fetus does not develop inside the mother properly. For example, there may be a problem with the way the fetus's cells divide as it grows. A woman who drinks alcohol (see Fetal Alcohol Syndrome ) or gets an infection like Rubella during pregnancy may also have a baby with mental disability.
- Problems at birth. If a baby has problems during labor and birth, such as not getting enough oxygen, he or she may have developmental disability due to brain damage.
- Health problems. Diseases like Whooping Cough , Measles , or Meningitis can cause mental disability. It can also be caused by extreme Malnutrition , not getting enough medical care, or by being exposed to Poison s like Lead or Mercury .
- Iodine deficiency is the leading preventable cause of mental disability in areas of the developing world where iodine deficiency is endemic.
- The use of Forceps during birth can lead to mental retardation in an otherwise normal child. They can fracture the skull and cause brain damage.
- Institutionalisation at a young age can cause mental retardation in normal children.
- Sensory Deprivation in the form of severe environmental restrictions (such as being locked in a basement), prolonged isolation, or severe atypical parent-child interactions.
By most definitions it is more accurately considered a ''disability'' rather than a ''disease''. It can be distinguished in many ways from
Mental Illness , such as
Schizophrenia or
Depression . There is no "cure" for an established disability, though with appropriate support and teaching, most individuals can learn to do many things.
There are thousands of agencies in the United States that provide assistance for people with developmental disabilities. They include state-run, for-profit, and non-profit, privately run agencies. Within one agency there could be departments that include fully staffed residential homes, day habilitation programs that approximate schools, workshops wherein people with disabilities can obtain jobs, programs that assist people with developmental disabilities in obtaining jobs in the community, programs that provide support for people with developmental disabilities who have their own apartments, programs that assist them with raising their children, and many more. There are also many agencies and programs for parents of children with developmental disabilities.
Although there is no specific medication for "mental retardation", many people with developmental disabilities have further medical complications and may take several medications. Beyond that there are specific programs that people with developmental disabilities can take part in wherein they learn basic life skills. These "goals" may take a much longer amount of time for them to accomplish, but the ultimate goal is independence. This may be anything from independence in tooth brushing to an independent residence. People with developmental disabilities learn throughout their lives and can obtain many new skills even late in life with the help of their families, caregivers, clinicians and the people who coordinate the efforts of all of these people.
Several traditional terms denoting varying degrees of mental deficiency long predate
Psychiatry . In common usage they are simple forms of abuse. Their now-obsolete use as psychiatric technical definitions is of purely historical interest. There have been some efforts made among mental health professionals to discourage use of these terms, but as long as intelligence is seen to contribute to social and financial success, children will use any term they believe to mean "stupid" as an insult. In addition to the terms below, the abbreviation ''retard'' or ''tard'' is still used as a generic insult, especially among children and teens.
- is the oldest and probably comes from an old French word for Christian. The implication was that even people with significant intellectual or developmental disabilities were "still human" (or "still Christian") and deserved to be treated with basic human dignity. This term has not been used in any serious or scientific endeavor since the middle of the 20th century and is now always considered a term of abuse.
- indicated the greatest degree of mental deficiency, where the Mental Age is two years or less, and the person cannot guard himself or herself against common physical dangers. The term was gradually replaced by the term '''profound mental disability'''.
- indicated a mental disability less extreme than idiocy and not necessarily inherited. It is now usually subdivided into two categories, known as '''severe mental retardation''' and '''moderate mental retardation'''.
- was defined by the American Association for the Study of the Feeble-Minded in 1910 , following work by Henry H. Goddard , as the term for an Adult with a Mental Age between eight and twelve; '''mild mental retardation''' is now the term for this condition. Alternative definitions of these terms based on IQ were also used.
