_retardation （mr）精神发育迟滞（mr）课件

Mental Retardation (MR) Dr Shreedhar Paudel May, 2009 MR Mental retardation is a developmental disability marked by lower-than-normal intelligence and limited daily living skills Diminished learning capacity and does not adjust well socially Mental retardation is normally present at birth or develops early in life MR. Mental retardation is defined by two standards first standard is a persons level of intelligence usually measured by special tests called intelligence tests Intelligence tests provide a numerical ranking of a persons mental abilities called an intelligence quotient or, more commonly, an IQ MR. The second standard for mental retardation is adaptive skills means how well a person can deal with the tasks of everyday life the ability to speak and understand home-living skills use of community resources leisure, self-care, and social skills basic academic skills (reading, writing, and arithmetic); and work skills MR. Intelligence Quotient:- Mental age divided by chronological age multiplied by 100 Degrees of mental handicap Mild 51-70 Moderate 36-50 Severe 21-35 Profound 0-20 MR I.Q level 7190 borderline intelligence (not included in mental handicap) Mild and moderate are educable and trainable Severe and profound are custodian MR Mild Mental Retardation 85 percent of the mentally retarded population Individuals often live on their own with community support Moderate Mental Retardation 10 percent of the mentally retarded population Individuals often lead relatively normal lives provided they receive some level of supervision Often live in group homes with other mentally retarded people MR Severe Mental Retardation 3% to 4% of the mentally retarded population master the most basic skills of living, such as cleaning and dressing themselves often live in group homes Profound Mental Retardation 1 % to 2% of the mentally retarded population develop basic communication and self-care skills often have other mental disorders MR. Etiology:- Interplay of several biomedical, sociocultural and psychological factors Prenatal Metabolic galactosemia, mucopolysaccharidosis Chromosomal Downs synd., Klinefelter syndrome Maternal factor teratogenic drugs, infection during pregnancy Neuroectodermal tuberous sclerosis Iodine deficiency MR. Natal Birth injury Hypoxic ischemic encephalopathy Hemorrhage Post natal Infection Head injuries Hypoxia Thrombosis of cerebral vessels Kernicterus Malnutrition Child abuse MR Predisposing factors Low socioeconomic status Low Birth Weight (LBW) Advance maternal age Consanguinity MR. Symptoms Continued infantile behavior Decreased learning ability Failure to meet intellectual developmental markers Inability to meet educational demands at school Lack of curiosity Etiological presentation MR Changes to normal behaviors depend on the severity of the condition Mild retardation may be associated with a lack of curiosity and quiet behavior Severe mental retardation is associated with infantile behavior throughout life MR Investigations:- Urine tests :- for metabolic diseases TFT :- T3, T4, TSH Genetic studies :- chromosomal studies Serology for TORCH LP :- any CNS infections CT and MRI :- hydrocephalus, absence of corpus callosum, tuberous sclerosis MR Exams and Tests Abnormal Denver developmental screening test Adaptive behavior score below average Development below that of peers Intelligence quotient (IQ) score below 70 on a standardized IQ test MR Other Scales Wechsler preschool and primary scale of intelligence(WPPSI) Wechsler intelligence scale for children (WISC) Stanford Biner Test (SBT) Denver ii development screening test MR Treatment The primary goal of treatment is to develop the persons potential to the fullest Special education and training may begin as early as infancy This includes social skills to help the person function as normally as possible MR Treatment It is important for a specialist to evaluate the person for other affective disorders and treat those disorders Behavioral approaches are important for people with mental retardation Parents sh