MENTAL RETARDATION

1
MENTAL RETARDATION

• Historical Perspectives
• 1. Antiquity Prior to 1700.
• 2.Emergence and Early Disillusionment of a
  Field1700-1890.
• 3.Facilities-based orientation1890-1960.
• 4.Services-based Orientataion1960-1985
• 5.Supports-Based Orientation1985-Present.
• Beirne-Smith.M,Ittenbach.R, Patton.J.R Mental
  Retardation(2002) sixth ed.

2
Degrees of Mental Retardation

• Beirne-Smith.M,Ittenbach.R, Patton.J.R Mental
  Retardation(2002) sixth ed.p60

3
Mental Retardation-Definition

• Mental retardation refers to significantly sub
  average general intellectual functioning existing
  concurrently with deficits in adaptive behavior,
  and manifested during the developmental period
  (Grossman, 1983)
• Mental retardation refers to substantial
  limitations in present functioning. It is
  characterized by significantly sub average
  intellectual functioning, existing concurrently
  with related limitations in two or more of the
  following applicable adaptive skill areas
  communication, self-care, home living, social
  skills, community use, self-direction, health and
  safety, functional academics, leisure and
  work.mental retardation manifests before age
  18.(Luckasson.R AAMR,1992,P1)
• Mental retardation is a disability characterized
  by significant limitations both in intellectual
  functioning and in adaptive behavior as expressed
  in conceptual, social, and practical adaptive
  skills. (AAIDD, Present)

4
AAMD/AAMR Systems of Classification

• Prior to 1992 four levels- mild, moderate,
  severe and profound.
• 1992- Present a) Intermittent- supports on an
  as needed basis. Characterized by episodic
  nature, person not always needing the supports,
  or short-term supports needed during life-span
  transitions( e.g., job loss or an acute medical
  crisis). Intermittent supports may be high or low
  intensity when provided.
• b) Limited- an intensity of supports
  characterized by consistency over time,
  time-limited but not of an intermittent nature,
  may require fewer staff members and less cost
  than more intense levels of support(e.g time-
  limited employment training or transitional
  supports during the school to adult provided
  period).
• c) Extensive- supports characterized by regular
  involvement (e.g., daily) in at least some
  environments (such as work or home) and not time-
  limited (e.g., long-term support and long-term
  home living support).
• d) Pervasive- supports characterized by their
  constancy, high intensity, provided across
  environments, potential life- sustaining nature.
  Pervasive supports typically involve more staff
  members and intrusiveness than do extensive or
  time-limited supports.
• Beirne-Smith.M,Ittenbach.R, Patton.J.R Mental
  Retardation(2002) sixth ed.p58

5
Causes

• Genetic conditions. Sometimes mental retardation
  is caused by abnormal genes inherited from
  parents, errors when genes combine, or other
  reasons. Examples of genetic conditions are Down
  syndrome, fragile X syndrome, and phenylketonuria
  (PKU).
• Problems during pregnancy. Mental retardation can
  result when the baby does not develop inside the
  mother properly. For example, there may be a
  problem with the way the baby's cells divide as
  it grows. A woman who drinks alcohol or gets an
  infection like rubella during pregnancy may also
  have a baby with mental retardation.
• Problems at birth. If a baby has problems during
  labor and birth, such as not getting enough
  oxygen, he or she may have mental retardation.
• Health problems. Diseases like whooping cough,
  the measles, or meningitis can cause mental
  retardation. Mental retardation can also be
  caused by extreme malnutrition (not eating
  right), not getting enough medical care, or by
  being exposed to poisons like lead or mercury.
• 
  
  http//www.nichcy.org
  /pubs/factshe/fs8txt.htm

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Characteristics

• sit up, crawl, or walk later than other children
  
• learn to talk later, or have trouble speaking,
• find it hard to remember things,
• not understand how to pay for things,
• have trouble understanding social rules,
• have trouble seeing the consequences of their
  actions,
• have trouble solving problems, and/or
• have trouble thinking logically.

7
Diagnosis

• Ability for a persons brain to think, learn,
  solve problems and make sense of the world.
• whether the person has the skills he or she needs
  to live independently (called adaptive behavior,
  or adaptive functioning).
• Intellectual functioning IQ Test
• Adaptive behavior daily living skills, such as
  getting dressed, going to the bathroom, and
  feeding one's self communication skills, such as
  understanding what is said and being able to
  answer social skills with peers, family members,
  adults, and others.

8
School and Education
An early intervention program provides services
to children up to 3 yrs old. An IFSP
individualized Family services plan is developed
cooperatively with the parents input and it
describes the unique needs and services to
address those needs, needs of the family to help
their child with mental retardation. This service
is provided by the schools. As the child grows
older, schools along with parents develop IEP
individualized education Plan .
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Educational needs

• IDEA entitles every child with mental
  retardation from age 3 through 21 to a free
  appropriate public education through an
  individualized education program (IEP
• Direct instruction
• Task variation and analysis- breaking down the
  tasks into small steps
• Computer-assisted instruction
• Cooperative learning
• Peer tutoring
• Lecture-pause
• Flexible and cooperative groupings
• Emphasize visual learning
• Hands-on learning
• Learning relevant to the real world
• Minimize fine-motor demands
• Facilitate short-long term memory
• Encourage appropriate behavior.
• Horstmeier,D Teaching math to people with Down
  Syndrome and other hands-on learners, 2004 p 19

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Skills to work on..
communicating with other people. taking care of
personal needs (dressing, bathing, going to the
bathroom) health and safety home living
(helping to set the table, cleaning the house, or
cooking dinner) social skills (manners, knowing
the rules of conversation, getting along in a
group, playing a game) reading, writing, and
basic math as they get older, skills that will
help them in the workplace. http//www.nichcy.org
/pubs/factshe/fs8txt.htm
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Activities in classroom- Math

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Math Activity.

• Activity 2 -- Estimation.Display a container
  full of popcorn kernels. (The size of the
  container might vary depending on the age -- and
  counting abilities -- of your students you might
  use a jar, a 2-liter soda bottle, or some other
  container.) Challenge students to estimate how
  many kernels are in the container. Have each
  student write his or her name and estimate on a
  slip of paper.
• Can also be used for place value and counting

13
Activities in classroom

• Reading activity- I incorporated some movements
  with reading instruction.
• Students stand in a line with letter cards/word
  cards- word families(e.g at, bat..). I call one
  student at a time, then he/she has to put the
  word in the roller and roll with their stomach.
  He/she will come to me by rolling and has to
  sound out and say the word to me(phonic based
  instruction), then write down in the journal and
  go back to the line by making different
  movements. Task analysis differentiation.

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The cost or economic impact associated with
mental retardation

• Many people with mental retardation need
  long-term services or care.
• The average lifetime cost for one person with
  mental retardation is estimated to be 1,014,000
  (in 2003 dollars).
• the lifetime costs for all people with mental
  retardation who were born in 2000 will total
  51.2 billion (in 2003 dollars). 
• These costs include both direct and indirect
  costs.-Direct medical costs, such as doctor
  visits, prescription drugs, and inpatient
  hospital stays, make up 14 of these costs.
  Direct nonmedical expenses, such as home
  modifications and special education, make up 10
  of the costs.
• Indirect costs, which include the value of lost
  wages when a person dies early, cannot work, or
  is limited in the amount or type of work he or
  she can do, make up 76 of the costs.
• These estimates do not include other expenses,
  such as hospital outpatient visits, emergency
  department visits, residential care, and family
  out-of-pocket expenses. The actual economic costs
  of mental retardation are, therefore, even higher
  than what is reported here.
• 
  
  http//www.cdc.gov/ncbddd/dd/mr4.htm

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How can kids learn about mental retardation?Kids
Quest on Disability and Health
"Difficulty Learning New Things" Quest If a Kid
has Difficulty Learning, Can He or She Get a Job
when He or She Grows Up?" Follow the 10 steps
below to pursue your Web Quest. Step 1 See what
you think about kids who have difficulty learning
new things. Click here for your Attitude
Checkup. Step 2 Think about questions to ask.
Let's see...   Step 3 Check out some quick
facts that would be fun to know. Step 4 Check
out some great websites to start our
search. Step 5 Now look at even more cool
sites. Step 6 Find out about people we can read
about to help with our Quest. Step 7 Learn
about videos/books that can give us information. 
Step 8 Check out your own environment to look
for barriers in your school and
neighborhood. Step 9 Just for fun...unscramble
the secret message Step 10 Now check and see if
your attitudes have changed.  Take the Attitude
Checkup again. Want to know more???????????????
Go to http//www.cdc.gov/ncbddd/kids/klalpage.htm
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Organizations
The Arc of the United States1010 Wayne Avenue,
Suite 650Silver Spring, MD 20910301.565.3842Info_at_t
hearc.org   E-mailwww.thearc.org
 Webwww.TheArcPub.com  Web (Publications) America
n Association on Intellectual and Developmental
Disabilities(formerly the American Association on
Mental Retardation, AAMR)444 North Capitol Street
NW, Suite 846Washington, DC 20001-1512202.387.1968
800.424.3688 (outside DC)www.aaidd.org/  Web
Division on Developmental Disabilities The
Council for Exceptional Children1110 North Glebe
Road, Suite 300Arlington, VA 22201-5704888.232.773
3 703.620.3660866.915.5000 TTYcec_at_cec.sped.org
 E-mailwww.dddcec.org  Web
http//www.nichcy.org/pubs/factshe/fs8txt.htm
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Organizations

• National Information Center on Children and Youth
  with Disabilities (NICHCY)NICHCY provides
  information on disabilities and
  disability-related issues for families, teachers,
  and other professionals. NICHCY has a fact sheet
  about mental retardation that includes general
  information on topics such as diagnosis and
  causes as well as tips for parents and teachers.
  NICHCY staff will also give information and
  referrals over the phone ( 800-695-0285 ) or by
  email (nichcy_at_aed.org). In English  General
  Information about Mental RetardationEn
  Español El Retraso Mental 
• MEDLINEplus Developmental DisabilitiesMEDLINEplu
  s is an online service of the National Library of
  Medicine. MEDLINEplus is designed to link you to
  information on specific health topics, including
  developmental disabilities. Information about
  mental retardation is included on the
  Developmental Disabilities page. MEDLINEplus
  brings together information from many sources and
  is updated every day. This page includes
  information on the latest news, general
  overviews, clinical trials, coping, diagnosis and
  symptoms, research, specific conditions, law and
  policy, organizations, children, seniors.  Some
  materials are in Spanish. In English
  MEDLINEplus Health Information Developmental
  DisabilitiesEn Español MEDLINEplus
  Información de Salud Discapacidad de Desarrollo
  
• National Center on Birth Defects and
  Developmental Disabilities (NCBDDD)
  PublicationsNCBDDD staff have written many
  scientific articles on mental retardation. These
  articles examine such topics as how common mental
  retardation is, and factors such as low birth
  weight or smoking during pregnancy that increase
  the risk that a child will have mental
  retardation. You can see a list of these papers
  (starting in 1990) by using the keyword search on
  the NCBDDD publications Web page. Choose "mental
  retardation" in the keyword box on the search
  page. You can choose whether you want the list to
  be sorted by author or by date. You can also
  choose to have the list appear with or without
  graphics. Click on the Submit button. You will
  see a list of papers that are about mental
  retardation. The list will include the complete
  reference for each paper and a link to an
  abstract of the paper or to the full text, when
  available. 
• 
  
  
  
  http//www.cdc.gov/ncbddd/dd/mr5.htm

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Video clip
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Resources

• American Association on Intellectual and
  Developmental Disabilities. (2002). Mental
  retardation Definition, classification, and
  systems of supports (10th ed.). Washington, DC
  Author. (www.aaidd.org)
• American Association on Intellectual and
  Developmental Disabilities. (2005). Definition of
  mental retardation. Washington, DC Author.
  (Available online at www.aamr.org/Policies/faq_me
  ntal_retardation.shtml)
• Baker, B., Brightman, A. (with Blacher, J.,
  Heifetz, L., Hinshaw, S., Murphy, D.). (2004).
  Steps to independence Teaching everyday skills
  to children with special needs (4th ed.).
  Baltimore, MD Paul H. Brookes. (Telephone
  800.638.3775 ).
• Web www.brookespublishing.com)
• Beirne-Smith.M,Ittenbach.R, Patton.J.R Mental
  Retardation(2002) sixth ed
• Centers for disease control and prevention
  http//www.cdc.gov/ncbddd/dd/mr4.htm
• Division on Developmental Disabilities Council
  for Exceptional Children (http//www.dddcec.org/)
  
• Horstmeier,D Teaching math to people with Down
  Syndrome and other hands-on learners, 2004 p 19
• Kaufman, S. (1999). Retarded isnt stupid, Mom!
  (Rev. ed.). Baltimore, MD Paul H. Brookes.
• National Center on Birth Defects and
  Developmental Disabilities (NCBDDD)
  http//www.cdc.gov/ncbddd/kids/klalpage.htm