Management of mental retardation (mr)

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Management of mental retardation (mr)

  1. 1. MANAGEMENT OF MENTALRETARDATION (MR)PRESENTED BYDR. MAYANK SHARMA
  2. 2. INVESTIGATION THREE CRITERIA ARE USED TO DETERMINE MENTAL RETARDATION. 1 INTELLIGENCE QUOTIENT(IQ). 2 SIGNIFICANT LIMITATIONS IN 2 OR MORE AREAS OF ADAPTIVE BEHAVIORS. 3 THESE LIMITATIONS BECOME APPARENT IN CHILDHOOD.
  3. 3. INTELLIGENCE QOUTIENTCLASS IQPROFOUND MR LESS THEN 20SEVERE MR 20-34MODERATE MR 35-49MILD MR 50-69BORDERLINE INTELLECTUAL 70-84FUNCTIONINGIQ LESS THEN 70 IS CONSIDERED AS MR.
  4. 4. OTHER INVESTIGATIONS EEG. DEVELOPMENT AND FAMILY HISTORY. THYROID FUNCTION TEST: T4, TSH. CHROMOSOMAL STUDY FOR DOWN SYNDROME, TURNER’S SYNDROME, FRAGILE X SYNDROME ETC. URINE TESTS FOR
  5. 5. OTHER INVESTIGATIONS BIOPSY(BONE MARROW,LIVER,RECTUM,BRAIN,S KIN) TO CONFIRM STORAGE DISORDERS. X-RAY SKULL, CSF EXAMINATION. CT AND MRI SCAN MAY DEFINE HYDROCEPHALUS,ABSENCE OF CORPUS CALLOSUM,TUBEROUS SCLEROSIS,CORTICAL ATROPHY.
  6. 6. SCREENING TEST PRENATAL SCREENING TEST:-- AMNIOCENTESIS. CHORIONIC VILLOUS SAMPELING. ULTRASONOGRAPHY.
  7. 7. PREVENTION GENETIC COUNSELLING: CONSANGUINEOUS MARRIAGES. MOTHERS OLDER THAN 35YRS SHOULD BE SCREENED FOR DOWN SYNDROME. DURING PREGNANCY,GOOD ANTENATAL CARE AND AVOIDANCE OF TERATOGENS, HORMONES,IODIDE S, AND ANTITHYROID DRUGS IS GIVEN.
  8. 8.  DURING LABOR, GOOD OBSTETRICS AND POSTNATAL SUPERVISION IS ESSENTIAL TO PREVENT BIRTH ASPHYXIA,INJURIES,JAUNDICE AND SEPSIS. NEONATAL AND NEUROLOGICAL INFECTIONS SHOULD BE DIAGNOSED AND TREATED PROMPTLYY.
  9. 9.  CRETINISM AND GALACTOSEMIA SHOULD BE TREATED EARLY IN INFANCY. SCREENING OF ALL THE NEWBORN INFANTS FOR METABOLIC DISORDERS SUCH AS PKU AND HOMOCYSTINURIA.
  10. 10. DRUG THERAPY NO SPESIFIC DRUGS AVAILABLE.. NEUROLEPTIC DRUGS TO REDUCE AGGRESSIVE AND ANTISOCIAL BEHAVIOR. EG PHENOTHIAZINES. ANTIPSYCHOTIC DRUGS. ANTIDEPRESSANT DRUGS.
  11. 11. TREATMENT TREATMMENT REQUIRES PATIENCE, GOOD WILL, UNLIMITED TIME. MINIMAL CRETICISM AND HIGH APPRECIATION. ASSOCIATED VISION, HEARING, MUSCULOSKEL ETAL,AND LOCOMOTION DYSFUNCTION SHOULD BE APPROPRIATELY MANAGED. MAINSTREAMING.
  12. 12. MAINSTREAMING IT MEANS TO BRING THE MR CHILDREN WITH THE NORMAL CHILDREN. CAN BE ACHIEVED BY PLACING THE MR CHILDREN IN ‘REGULAR’ CLASSROOMS TO NORMALISE THEIR BEHAVIOR. DAY CAREER CENTERS, INTEGRATED SCHOOLS, VOCATIONAL TRAINING CENTERS ARE USEFUL.
  13. 13. TREATMENT STRATEGYMILDER MR SEVERE MR1 BEHAVIOR INTRUCTIONS 1 BEHAVIOR INTRUCTIONS2 EARLY INTERVENTION 2 DRUGS TO CONTROLPROGRAMS. AGGRESSION AND SELF INJURIOUS BEHAVIOR.3 SPECIAL EDUCATION 3 EITHER HOME CARE OR INSTITUTIONALIZATION4 MAINSTREAMING
  14. 14. THANK YOU

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