mental retardation (mr)精神发育迟滞（mr）

Mental Retardation (MR),Dr Shreedhar PaudelMay, 2009,MR,Mental retardation is a developmental disability marked by lower-than-normal intelligence and limited daily living skillsDiminished learning capacity and does not adjust well sociallyMental retardation is normally present at birth or develops early in life,MR.,Mental retardation is defined by two standardsfirst standard is a persons level of intelligence usually measured by special tests called intelligence testsIntelligence 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 skillsmeans how well a person can deal with the tasks of everyday lifethe ability to speak and understandhome-living skillsuse of community resourcesleisure, self-care, and social skillsbasic academic skills (reading, writing, and arithmetic); andwork skills,MR.,Intelligence Quotient:-Mental age divided by chronological age multiplied by 100Degrees of mental handicapMild 51-70Moderate 36-50Severe 21-35Profound 0-20,MR,I.Q level 7190 borderline intelligence (not included in mental handicap)Mild and moderate are educable and trainableSevere and profound are custodian,MR,Mild Mental Retardation85 percent of the mentally retarded population Individuals often live on their own with community supportModerate Mental Retardation10 percent of the mentally retarded population Individuals often lead relatively normal lives provided they receive some level of supervisionOften live in group homes with other mentally retarded people,MR,Severe Mental Retardation3% to 4% of the mentally retarded population master the most basic skills of living, such as cleaning and dressing themselvesoften live in group homesProfound Mental Retardation1 % to 2% of the mentally retarded population develop basic communication and self-care skillsoften have other mental disorders,MR.,Etiology:-Interplay of several biomedical, sociocultural and psychological factorsPrenatalMetabolic galactosemia, mucopolysaccharidosisChromosomal Downs synd., Klinefelter syndromeMaternal factor teratogenic drugs, infection during pregnancyNeuroectodermal tuberous sclerosisIodine deficiency,MR.,NatalBirth injuryHypoxic ischemic encephalopathyHemorrhagePost natalInfectionHead injuriesHypoxiaThrombosis of cerebral vesselsKernicterusMalnutritionChild abuse,MR,Predisposing factorsLow socioeconomic statusLow Birth Weight (LBW)Advance maternal ageConsanguinity,MR.,SymptomsContinued 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 conditionMild retardation may be associated with a lack of curiosity and quiet behaviorSevere mental retardation is associated with infantile behavior throughout life,MR,Investigations:-Urine tests :- for metabolic diseasesTFT :- T3, T4, TSHGenetic studies :- chromosomal studiesSerology for TORCHLP :- any CNS infectionsCT 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 ScalesWechsler preschool and primary scale of intelligence(WPPSI)Wechsler intelligence scale for children (WISC)Stanford Biner Test (SBT)Denver ii development screening test,MR,TreatmentThe primary goal of treatment is to develop the persons potential to the fullestSpecial education and training may begin as early as infancyThis includes social skills to help the person function as normally as possible,MR,TreatmentIt is important for a specialist to evaluate the person for other affective disorders and treat those disordersBehavioral approaches are important for people with mental retardationParents shoul