Caring for people with mental retardation has evolved over time. Since the 1500s, the way that society views such people has changed. They have the right to live normal lives. In addition, institutions for such people closed down, and awareness creation on how to care for them has spread to the society. The diagnosis, etiology, and treatment of mental retardation have improved over time. An intensive study on this area has identified the possible causes and treatment of mental retardation. This paper aims at identifying the history, causes, diagnosis, symptoms, treatment, and prevention of mental retardation. It will also focus on the skills required by the person with mental retardation, as well as, their parents or caregivers in order to improve their quality of life.
Mental retardation, also known as intellectual disability, is a condition diagnosed before a child attains 18 years. In some cases, it can be diagnosed before birth or during infancy. The intelligence and adaptability of such child is significantly below his/her peers level. About 1% of every country’s population has mental retardation. It has a lasting implication on the development of a child. It results in reduction in the childs ability to cope independently and reduced ability to learn new skills and understand new information. The child has impaired social functioning and intelligence. The Individuals with Disability Education Act state that mental retardation refers to significantly sub-average general intellectual functioning that presents itself together with reduced adaptive behavior and manifests during a child’s developmental period, and has an adverse impact on the performance of the child in education. The term mental retardation is a medical term. In the UK, the term mental handicap was in use, but the term learning disability has displaced it. The legal term is mental impairment and learning difficulties used in the education sector in the UK. The term used in Australia, USA, and Canada include developmental disabilities and intellectual disabilities.
According to Frances & Rush (2000), mental retardation refers to a considerable limitation in the personal capacity of an individual. The victim suffers from below average intellectual functioning, accompanied by disability in adaptive skills such as self-care, social skills, communication, health and safety, self-direction, and work among others. A person with mental retardation has an intellectual quotient (IQ) of 70 or below. This is the traditional measure for intellectual functioning. However, some individuals with an IQ below 70 can be exempted from the diagnosis of mental retardation. This happens when the person does not show any significant deficiency in adaptive behavior. Mental retardation can be mild, moderate, or severe.
History of Mental Retardation
Among the ancient Romans and Greeks, children born with mental retardation were left to die during infancy. Society felt that the birth of such children resulted from gods anger. However, among the Romans, the children born with mental retardation in wealthy homes lived healthy lives (Volkmar, 2006). Prior to the 18th century, societies differed on the manner in which they treated people with mental retardation. Those whose condition was mild received no special treatment, but those who suffered from severe mental retardation received care from family members and/or in monasteries. Some communities believed that the individuals suffering from severe mental retardation had the capability of receiving divine revelation (Beirne-Smith, Patton, & Kim, 2006).
In 1799, Jean-Marc Itard, a French medical doctor, developed a skill-based program for an uncontrollable children. Eduoard Seguin developed the program further to establish a program to educate the mental retardation patients at Saloetriere Hospital in Paris. Seguin went to the USA and published a book, Idiocy and its Treatments in Psychological Methods in 1866. In 1841, Johann Guggenbuhl established the first known People with Intellectual Disabilities residential facility in Switzerland (Beirne-Smith, Patton, & Kim, 2006). During the early and mid-1800s, Americans were optimistic about the rehabilitation, training, and reintegration of people with a disability into society. In 1848, Samuel Howe established the first public training facility for mental retardation patients in the USA (Beirne-Smith, Patton, & Kim, 2006). In the late 1800s, urbanization, and industrialization required intellectual ability for a person to get employment opportunities. The job market required more intellectual ability than physical. The society blamed intellectually disabled people for the illnesses, poverty and high crime rate that came with urbanization. As a result, they became segregated and institutionalized (Radford, 1991).
In 1869, Sir Francis Galton established the eugenics movement that nature determined the intellect and personality of an individual. This established the basis of the inheritability of mental retardation. The people who supported eugenics believed that medicine interfered with Darwin’s natural selection theory keeping the weak species alive (Bachrach, 2004). Development of psychological testing in early 1900s improved the identification of people suffering from mental retardation, but it also increased segregation and institutionalization. In 1928, research conducted showed that mental retardation resulted from multiple causes other than the genetic explanation given by the eugenics (Radford, 1991). Since the beginning of the 20th century, the rights, policies and laws protecting individuals with mental retardation began coming up. Since the early 1970s, the focus on early intervention and community-based rehabilitation has increased. Research has shown that institutionalization brings about dehumanization, and it deteriorates their quality of life and adaptive behavior. The institutionalization of mentally retarded people has reduced in the USA, Canada, Norway, and England (Beadle-Brown, 2007).
Diagnosis of Mental Retardation
The most appropriate method of establishing a comprehensive and specific mental retardation diagnosis uses a three step process.
The first step involves a standardized measurement of adaptive skills and intelligence. There are numerous instruments used to enhance accuracy. The impact of language, environmental and cultural factors should be considered when choosing the test. The impact of other associated physical disabilities, such as vision, hearing, and illness should also be considered among others. The measure of adaptive skills involves questionnaires completed by a parent or a caregiver. The second step involves the definition of the individual’s needs and strengths in intellectual ability, health, adaptive behavior, social roles and contextual considerations. The context of individuals’ communities should also be taken into account. This involves assessing how the child functions in everyday life, and it also checks on the support available or not available (Beirne-Smith, Patton, & Kim, 2006). Since the needs may change, reassessment is necessary.
Causes of Mental Retardation
Cultural-Familial Mental Retardation
The children who have mental retardation resulting from this cause can only be diagnosed after starting school. They face serious learning difficulties. These children come from unstable, poor, and often disrupted backgrounds. They lack intellectual stimulation, inferior interaction quality, as well as environmental deprivation (Volkmar, 2006). When the environment and background deprive a child the chance to get basic learning skills, they find it difficult to learn the complex schoolwork. Such children fall behind in schoolwork and intelligence test ratings. Most of the children reveal prematurity, little medical care, and insufficient diet in their history.
Mild retardation is caused by genes that bring variation in intelligence. Some mental retardation types, for example, Downs syndrome, result from family genes. Defects in the genes result in metabolic alterations that impact on the development of the brain. Mental retardation associated with defects in the genes and chromosomes range from moderate to severe.
Trauma and Premature Birth
Studies have shown that prematurely born children that weigh less than 1.5 kg at birth, have a high incidence of neurological disorders. Underweight children have 10 times more risk of getting mental retardation than normal infants (Volkmar, 2006). During delivery and after birth, physical injury can result to mental retardation. The infants brain can also be damaged as a result of labor difficulty because of fetus malposition. Anoxia and bleeding within the brain are the two common birth traumas that results in brain damage.
Radiation on the sex cells of either parent can result in gene mutation. This can be the cause of defect of the infant. This may also happen in a fertilized ovum. The radiation may come from high energy X-rays, radioactive materials, and nuclear weapons testing.
Biological Factors and Malnutrition
Protein deficiency and other vital nutrients may result in physical and mental disorder. The mothers and infants diet has an impact on the childs intelligence level. Biological agents such as brain tumors may also result in mental retardation. However, the causes of some profound and severe mental retardation types are not certain.
Mental Retardation Symptoms
Some of the symptoms of mental retardation include:
- lack of curiosity;
- lack of self-motivation;
- reduced ability to learn;
- failure to achieve intellectual growth indicators;
- persistent childish behavior
- below average memory and attention span;
- below normal physical fitness and motor ability;
- postural anomalies.
The severity of the condition determines the deviation in ordinary adaptive behavior.
Mental Retardation Types
People suffering from Downs syndrome have the trisomy of chromosome 21. Such people have slanted eyes, abnormally thick eyelids skin, flat and broad nose, face, and back of the head. They may also show frequently speckled iris and fissures. Metabolic factors influence the trisomy of chromosome 21.
This is a rare metabolic disorder. A child appears normal at birth but lacks an enzyme required in the breakdown of phenylalanine. When phenylalanine accumulates in the blood, it results in brain damage. This disorder manifests itself in 6 to 12 months after birth (Volkmar, 2006). Signs of mental retardation become evident. Patients skin, hair and eyes, appear very pale. When detected early, a child can lead a normal life. Both parents have to carry a PKU recessive gene for the baby to inherit it.
It results when thyroid has degenerated or has failed to develop properly, or has suffered an injury. When this happens, there is a deficiency in thyroid secretion in the childs body resulting in brain damage (Beirne-Smith, Patton, & Kim, 2006). When it happens early in life, the child has dwarf-like features. These are a thick head and abundant black, wiry hair, thick eyelids, and dry, thick and cold skin. In addition, they have large ears, broad, flat nose, and they do not mature sexually.
Mental retardation has also been associated with alteration in size and shape. Macrocephaly, microcephaly and hydrocephaly can result in mental retardation. When the head is very large or very small, the brain does not work properly resulting in mental retardation. When the cerebrospinal fluid accumulates in the head abnormally, it leads to hydrocephalus.
Early detection of the different types can assist greatly in the treatment and ensuring that the child leads a normal life. The treatment of individual types can be used as well as enhancement of adaptive behavior. Therapy aims at developing a persons potential to the maximum. Special education and treatment can be started early in life. Coexisting affective disorders should also be assessed and taken care of. Surgical treatment of hydrocephalus early in life can take place avoiding severe damage to the brain. Cretinism can be medicated early using thyroid gland extract. This will result in normal development of a childs intelligence. When phenylalanine gets treated early in life, the childs level of intellectual functioning can range between borderline and normal (Abramovitz, 2007).
There are four tactics applied in the prevention of mental retardation. They include genetics, social, toxins, and other infections. In order to reduce the risk of a child getting an inherited genetic disorder, prenatal genetic testing and counseling for families at risk should be provided. This will reduce the risk of the child getting mental retardation. Malnutrition can be alleviated using government programs, and this can reduce cases of mental retardation. It can also be reduced using environmental programs that reduce exposure to mercury, lead, as well as other toxins (Beirne-Smith, Patton, & Kim, 2006). Awareness increase on dangers of drug abuse during pregnancy is also important. Prevention of diseases that can result in mental retardation should be done to reduce the risk of its development among children.
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Suggestions on Overcoming Mental Retardation
Children suffering from different levels of mental retardation have difficulty focusing on an issue. When dealing with them, one should have patience and keep redirecting their attention. It should be refocused especially when they are dealing with difficult tasks such as homework (Abramovitz, 2007). One should ensure that they look at them directly when talking. When they do not face a person, they will tend to hear less. Since these children have difficulty expressing and understanding a conversation, one should make them feel comfortable and be patient with them. They should not be given complex details.
Parenting Skills to Help the Individual
The family should adjust in order to give the child a bright future. The parent or caregiver should learn about mental retardation, encourage the childs independence by letting eat by their own and give them chores around the house. The parent should also apply the skills that the child learns at school in home situations. For example, when making purchases, the parent can ask the child to assist him or her in counting the money (Abramovitz, 2007). The child should also be engaged in social activities in order to improve his/her social skills. The parent should communicate with other parents who have children with mental retardation for emotional support and practical advice. Finally, in collaboration with the childs school, the parent should develop a personalized educational plan to address the needs of the child.
Evidence-Based Therapy for Mental Retardation
Studies suggest that early intervention programs benefit children with mental retardation. Improvement of their developmental functioning and maladaptive behaviors is essential. From the research carried out, it is difficult to establish the most effective interventions for each level of mental retardation. A study conducted on 30 mental retardation patients revealed that some of the disorders can be treated using drugs. Some studies have shown that mGluR5-drugs can treat Fragile X syndrome. They have very minor side effects (Abramovitz, 2007).
In conclusion, it is clear that students with mental retardation face several challenges in their life. The parents, caregivers and special educators should have patience and provide mentorship to the children. Parental support plays a crucial role in the childs learning process. The government has made its contribution by enacting legislation catering for the educational need of children with disability. The solutions suggested should be applied to ensure that students with intellectual disability attain their full learning potential. Preventive measures should also be put in place in order to reduce the incidence of mental retardation cases.