Mental Retardation

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Mental Retardation

• Chapter 8

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• Mental retardation (MR) (IDEA 1997) is
  characterized by significantly sub-average
  general intellectual functioning, existing
  concurrently with deficits in adaptive behavior
  and manifested during the developmental period
  that adversely affects a childs educational
  performance.

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• AAMR (92) Mental retardation (MR) refers to
  substantial limitations in present functioning.
  It is characterized by significantly subaverage
  intellectual functioning, existing concurrently
  with related limitations in two or more of the
  following applicable adaptive skill areas
• 1. Communication 2. Self-Care3. Home Living4.
  Social Skills 5. Community Use 6.
  Self-Direction7. Health And Safety 8.
  Functional Academics9. Leisure And Work
• Mental retardation manifests before age 18.

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• Two areas of deficits, intellectual functioning
  and adaptive skills,
• Intellectual skills, the ability to solve
  problems related to academics usually estimated
  by an IQ test
• Adaptive skills, skills needed to adapt to ones
  living environments usually estimated by an
  adaptive behavior survey

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• 70-75
• (Approximately two standard deviations below
  average)
• 5 point spread addresses or variability of
  testing instruments
• Limitation in memory generalization, and
  motivation, also, adaptive behaviors

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• Supports Based (AAMR suggested)
• Page 227 figure 8-2 gives description definition
  and examples of intensities of support
• Intermittent
• Limited
• Extensive
• Pervasive

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• Classification (traditional and APA suggested)
• Mild (55 - 70)Moderate (40 - 55)Severe (25 -
  40)Profound (below 25)
• Figure 8-6 page 237

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• Intelligence
• Conceptual Intelligence (traditional view of
  intelligence ---IQ)
• Practical intelligence (refers to ability to act
  independently and manage daily living activities)
• Social intelligence ( ability to interpret the
  social behavior of others and to interact in a
  socially appropriate manner)
• Causes of Mental Retardation

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Causes by time.

• Prenatal (12) occurs during fetal development
• Perinatal (6) causes at birth
• postnatal (4) occurring after birth, can be
  biological or psychosocial
• 78 unknown

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Causes by type

• Biomedical - biological processes
• Prenatal
• Maternal malnutrition
• Metabolic disorders
• Chromosomal disorders

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• Chromosomal 23 pair one extra or one lacking
• 30 of those requiring extensive or pervasive
  support
• Down syndrome extra 21st chromosome (Trisomy 21)
  not linked to heredity
• (MR, slanted eyes, single palm crease, hypotonia,
  shortness, obesity tendency)
• Fragile X Syndrome (bottom of 23rd is pinched
  off, can cause MR, more often males, thought to
  be most common hereditary cause of MR)

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• Tay-Sachs Disease - a heritable metabolic
  disorder which leads to mental retardation,
  paralysis, dementia, or blindness. Both parents
  must be carriers.
• Williams syndrome (deletion of materials in 7th
  often cause mild to mod. MR heart defects, elfin
  facial, features, often display strengths in
  spoken language and very social deficits in
  special skills, reading, math, writing

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• Prader-Willi syndrome from fathers side lack of
  material in 15th pair degree of MR varies, most
  mild MR, obesity,
• metabolism
• Phenylketonuria (PKU)
• Spina bifida
• Microcephalus, hydrocephalus, fetal alcohol
  syndrome, rubella,

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Prenatal Screening

• Amniocentesis (fluid)
• Chorionic villus sampling (CVS) (tissue)
• Sonography (visual)
• Maternal serum screening (MSS) (blood)

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• Perinatal
• anoxia,
• low birth weight,
• syphilis,
• herpes simplex
• Head trauma at birth
• Meningitis at birth
• prematurity

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• Postnatal
• TBI
• Meningitis
• Herpes simplex
• Encephalitis
• Lead intoxication
• Child abuse and neglect

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• Social social and family interactions,(stimulatio
  n response)
• Behavioral injuries and maternal substance abuse
• Educational availability of educational supports
  that promote mental development of adaptive
  skills
• Social, behavioral, and educational often overlap
  these are sometimes referred to as
  cultural-familial mental retardation

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• Exposed to lead have a decrease of 2-6 IQ points
• Head injuries from accidents, falls or child
  abuse 50 of all postnatal causes
• Younger mothers with 12 years of education or
  less more likely to have children with MR

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Prevention

• Primary intervention before it occurs(vaccines
  for rubella)
• Secondary intervention soon after detection
  (lead screening, PKY screening)
• Tertiary intervention to reduce long term effects
  (early education intervention)

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Prevalence

• Reported 1 to 3 according to source
• Accepted statistics is 1 to 2 below 70
• .96 reported by the 23rd annual report to
  congress
• African Americans still disproportional in their
  classification

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Assessment

• Assess intellectual and adaptive skills
• Intellectual
• Professional administered IQ tests
• Stanford-Binet
• Wechsler Intelligence Scale for Children
  (WISC-III)
• Kaufman Assessment Battery for Children (K-ABC)
• Includes observation, screening, and
  nondiscriminatory evaluation

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• Determining nature and extent of services needed
• Frequency
• Daily support time
• Type of support

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• Figure 8-7 page 237 (2001)
• 14 spend less than 21 of their time outside of
  regular class
• 29 spend 21 to 60 of their time outside of
  regular class
• 51 spend greater than 60 of their time outside
  of regular class
• 0.5 separate facility
• 0.5 residential facility
• 0.5 home/hospital

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• Students with MR achieve high academic gains
  where they are more fully included in general
  classrooms
• Students with MR who were in general classroom
  full time were more socially competent and
  accepted than were students who were included in
  general classrooms only part time

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• Academic gains are more positive when there is a
  greater degree of inclusion
• Age/grade of students appear to have more
  influence than extent of retardation in
  accounting for favorable inclusion outcomes.
  (Older experience more negative consequences from
  partial inclusion)

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• Metacognition
• A persons awareness for what strategies are
  necessary to perform a task and ability to use
  self-regulation strategies

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• Self-determination
• The ability to make personal choices, to regulate
  ones life, and to be a self-advocate.

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• Universal Design
• Page 241 figure 8-8
• Emphasize readiness skills for younger, and
  functional skills, community adjustment, and
  vocational training for older students

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• MR community stress need for strong transitional
  plan
• Job coach
• Community living