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Mental retardation 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 and deficits in adaptive functioning. People with mental retardation may be described as having Developmental Disabilities , global Developmental Delay , or Learning Difficulties . ALTERNATIVE TERMS The term "Mental retardation" has acquired pejorative and shameful connotations over the last few decades and is now used almost exclusively in technical or scientific contexts.
The American Association On Mental Retardation continued to use the term ''mental retardation'' until 2006.1 In June 2006 its members voted to change the name of the organisation to the "American Association on Intellectual and Developmental Disabilities," rejecting the options to become the AAID or AADD. Part of the rationale for the double name was that many of the members worked with people with Autism and Asperger Syndrome , also known as Pervasive Developmental Disorder s, not all of whom were also mentally retarded. In the UK, "mental handicap" had become the common medical term, replacing "mental subnormality" in Scotland and "mental deficiency" in England and Wales, until Stephen Dorrell , Secretary of State for Health in England and Wales from 1995-7, changed the National Health Service 's designation to "learning disability." The new term is not yet widely understood, and is often taken to refer to problems affecting schoolwork (the American usage): which are known in the UK as "learning difficulties." British social workers may use "learning difficulty" to refer to both people with MR and those with conditions such as dyslexia. In England and Wales the Mental Health Act 1983 defines "mental impairment" and "severe mental impairment" as "a state of arrested or incomplete development of mind which includes significant/severe impairment of intelligence and social functioning and is associated with abnormally aggressive or seriously irresponsible conduct on the part of the person concerned."2 As behavior is involved, these are not necessarily permanent conditions: they are defined for the purpose of authorising detention in hospital or guardianship. However, English statute law uses "mental impairment" elsewhere in a less well-defined manner—''e.g.'' to allow exemption from taxes—implying that mental retardation without any behavioural problems is what is meant. Mental Impairment is scheduled to be removed from the Act when it is amended in 2008. SIGNS 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
In early childhood mild disability (IQ 60–70) may not be obvious, and may not be diagnosed until children 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. 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, virtually every child is able to learn, develop, and grow to some extent. DIAGNOSIS According to the latest edition of 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 below 70 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, Cultural Differences , 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: Significant limitations in two or more areas of adaptive behavior 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 structured interviews, with which they systematically elicit information about the person's functioning in the community from someone who 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:
Evidence that the limitations became apparent in childhood 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. CAUSES 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:
TREATMENT AND ASSISTANCE By most definitions mental retardation is more accurately considered a ''disability'' rather than a ''disease''. MR can be distinguished in many ways from Mental Illness , such as Schizophrenia or Depression . Currently, 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. The Burton Blatt Institute at Syracuse University works to advance the civic, economic, and social participation of people with disabilities. 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. TRADITIONAL TERMS Several traditional terms denoting varying degrees of mental deficiency long predate Psychiatry , but have since been subject to the Euphemism Treadmill . In common usage they are simple forms of abuse. Their now-obsolete use as psychiatric technical definitions is of purely historical interest. They are often encountered in old documents such as books, academic papers, and Census forms (for example, the British census of 1901 has a column heading including the terms ''imbecile'' and ''feeble-minded''). |
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