Mental Retardation

Mental Retardation

A broad neurodevelopmental illness known as intellectual disability (ID), sometimes known as intellectual developmental disability (IDD), general learning impairment, or mental retardation (MR), is characterized by markedly reduced intellectual and adaptive functioning. It is identified by an IQ below 70 and deficiencies in two or more adaptive behaviors that are important for day-to-day, daily existence. The definition, which used to be almost entirely cognition-focused, has since added elements relating to mental functioning and environment-specific functional skills.Because of this emphasis on the individual's practical skills, a person with an abnormally low IQ could not be seen as intellectually impaired. Intellectual disability can be further divided into non-syndromic intellectual disability and syndromic intellectual disability, which refers to intellectual deficits that don't coexist with other abnormalities such as behavioral or medical signs and symptoms. Syndromic intellectual disabilities include those caused by Down syndrome and fragile X syndrome.

Causes

• Genetic conditions.
• Sometimes disability is caused by abnormal genes inherited from parents, errors when genes combine, or other reasons. The most prevalent genetic conditions include Down syndrome, Klinefelter's syndrome, Fragile X syndrome (common among boys), neurofibromatosis, congenital hypothyroidism, Williams syndrome, phenylketonuria (PKU), and Prader-Willi syndrome.
• Problems during pregnancy.
• Intellectual disability can result when the fetus does not develop properly. For example, there may be a problem with the way the fetus' cells divide as it grows. A pregnant person who drinks alcohol (see fetal alcohol spectrum disorder) or gets an infection like rubella during pregnancy may also have a baby with an intellectual disability.
• Problems at birth. If a baby has problems during labor and birth, such as not getting enough oxygen, he or she may have a developmental disability due to brain damage.
• Exposure to certain types of disease or toxins. Diseases like a whooping cough, measles, or meningitis can cause intellectual disability if medical care is delayed or inadequate. Exposure to poisons like lead or mercury may also affect mental ability.
• Iodine deficiency, affecting approximately 2 billion people worldwide, is the leading preventable cause of intellectual disability in areas of the developing world where iodine deficiency is endemic. Iodine deficiency also causes goiter, an enlargement of the thyroid gland.
• Malnutrition is a common cause of reduced intelligence in parts of the world affected by famine, such as Ethiopia.
• Absence of the arcuate fasciculus.

Sign and Symptoms

• Delays in oral language development.
• Deficits in memory skills.
• Difficulty learning social rules.
• Difficulty with problem-solving skills.
• Delays in the development of adaptive behaviors such as self-help or self-care skills.
• Lack of social inhibitors.
• Sit up, crawl or walk later than other children.
• Inability to meet educational demand of school.
• An intelligence quotient (IQ) score below 70 on a standardized IQ test.

Degrees of Mental Retardation

• Mild mental retardation: IQ level of (50-69).
• Moderate mental retardation: IQ level of (35-49).
• Severe mental retardation: IQ level of (20-34).
• Profound mental retardation: IQ level of below 20.

Symptoms According to Level

• Failure to meet intellectual standards.
• Sitting, crawling, or walking later than other children.
• Problems learning to talk or trouble speaking clearly.
• Memory problems.
• Inability to understand the consequences of actions.
• Inability to think logically.
• Childish behavior inconsistent with the child’s age.
• Lack of curiosity.
• Learning difficulties.
• IQ below 70.
• Inability to lead a normal life due to challenges communicating, taking care of themselves, or interacting with others.

Mild Intellectual Disability

• Taking longer to learn to talk, but communicating well once they know how.
• Being fully independent in self-care when they get older.
• Having problems with reading and writing.
• Social immaturity.
• Inability to deal with the responsibilities of marriage or parenting.
• Benefiting from specialized education plans.
• Having an IQ range of 50 to 69.

Moderate Intellectual

• Are slow in understanding and using language.
• May have some difficulties with communication.
• Can learn basic reading, writing, and counting skills.
• Are generally unable to live alone.
• Can often get around on their own to familiar places.
• Can take part in various types of social activities.
• Generally, have an IQ range of 35 to 49.

Symptoms of Severe ID Include:

• Noticeable motor impairment.
• Severe damage to, or abnormal development of, their central nervous system.
• Generally, have an IQ range of 20 to 34.
• Profound intellectual disability.

Symptoms of Profound ID Include:

• Inability to understand or comply with requests or instructions.
• Possible immobility.
• Incontinence.
• Very basic nonverbal communication.
• Inability to care for their own needs independently.
• The need of constant help and supervision.
• Having an IQ of less than 20.

Diagnosis

• History taking,
• Physical examination and medical history including neurological ones,
• Level of intelligence and ability learn test,

IQ= mental age (MA) / chronological age (CA) x 100

• Mental status examination.
• Urine test.
• Blood tests.
• Radiological investigation.
• EEG.

Nursing Management

• Provide a safe and comfortable position.
• Difficult child behavior management.
• Limit excessive activity.
• Ambulate with assistance; give special bathroom.
• Help children identify personal strengths.
• Give knowledge to people nearby, about mental retardation.
• Encourage children to participate in activities with friends and other families.
• Encourage the children to maintain contact with friends.
• Give positive reinforcement on the results achieved by children.
• Assess understanding family about the child's illness and treatment plan.
• Emphasize and explain other health team, about the child's condition, procedures and therapies are recommended.
• Use every opportunity to improve understanding of the disease and its treatment family
• Repeat as often as possible information.
• Identification of the need for personal hygiene and provide assistance as needed.
• Identification of difficulties in self-care, such as lack of physical movement, cognitive decline.
• Encourage children to do their own maintenance.
• Education for parents:
• For each stage of child development ages.
• Support the involvement of parents in child care.
• Anticipatory guidance and management face a difficult child behavior.
• Inform the existing educational facilities and groups, etc.