Mental retardation{intellectual disability} is a condition of arrested or incomplete development of mind, which is specially characterized by impairment of skills manifested during the developmental period, which contribute to the overall level of intelligence, i.e cognitive, language, motor and social abilities. Prevalence of mental disorders is 4-5 times higher in person with intellectual disability CAUSES- GENETIC ENVIORNMENTAL/SOCIO-CULTURAL PRENATAL,PERINATAL AND POSTNATAL FACTOR COMBINED Behavior management Monitoring the child’s development needs & problems. Programs that maximize speech, language, cognitive, psychomotor, social, self-care, & occupational skills. Ongoing evaluation for overlapping psychiatric disorders, such as depression, bipolar disorder, & ADHD. Family therapy to help parents develop coping skills & deal with guilt or anger. Provide day schools to train the child in basic skills, such as bathing & feeding.

2. THE WORLD HEALTH ORGANIZATION
DRAWS ON A THREE–FOLD DISTINCTION
BETWEEN IMPAIRMENT, DISABILITY AND
HANDICAP: •
• Impairment is any loss or abnormality of psychological, physiological or anatomical
structure or function.
• Disability is any restriction or lack (resulting from an impairment) of ability to perform
an activity in the manner or within the range considered normal for a human being.
• Handicap is a disadvantage, for a given individual, resulting from impairment or a
disability, which prevents the fulfilment of a role that is considered normal (depending
on age, sex and social and cultural factors) for that individual.

3. TYPE OF DISABILITY
Physical Disability
Visual impairment
Locomotor
disability
hearing impairment
speech and
language
impairment
Intellectual
disability
Specific learning
disorder
Autism spectrum
disorder
Mental behavior
[mental illness]
Disability caused due to chronic neurological
condition

4. INTELLECTUAL DISABILITY(I.D)
• Mental retardation{intellectual disability} is a condition of arrested or incomplete
development of mind, which is specially characterized by impairment of skills
manifested during the developmental period, which contribute to the overall level of
intelligence, i.e cognitive, language, motor and social abilities.
• Retardation can occur with or without mental or physical disorder.

6. • Prevalence of mental disorders is 4-5 times higher in person with intellectual disability
• CAUSES-
• GENETIC
• ENVIORNMENTAL/SOCIO-CULTURAL
• PRENATAL,PERINATAL AND POSTNATAL FACTOR
• COMBINED

7. DIAGNOSTIC GUIDELINES
• Classification: ON THE BASIS OF IQ TEST
• Mild Retardation (IQ 50-70) This is commonest type of mental retardation accounting
for 85-90% of all cases. These individuals have minimum retardation in sensory-motor
areas.
• Moderate Retardation (IQ 35-50) About 10% of mentally retarded come under this
group.
• Severe Retardation (IQ 20-35) Severe mental retardation is often recognized early in life
with poor motor development & absent or markedly delayed speech & communication
skills.
• Profound Retardation (IQ below 20) This group accounts for 1- 2% of all mentally
retarded. The achievement of developmental milestones is markedly delayed. They require
constant nursing care & supervision.

8. PATIENT DETAILS
• X 7 YEAR OLD CHILD R/O MEERUT CAME TO OUT OPD FOR PSYCHIATRIC
EVALUATION AND CERTIFICATION FOR SUBNORMAL INTELLIGENCE
• INFORMATNT –MOTHER
• SHE GAVE H/O OF DELAYED CRYING AND MILESTONES, BOTH VERBAL AND MOTOR
• THERE IS NO H/O ANY OTHER PSYCHIATRIC ILLNESS
• CURRENTLY CHILD IS UNABLE TO SPEAK PROPERLY AND IS ANT ABLE TO TAKE CARE
OF MANY OF HIS BASIC NEEDS LIKE BRUSHING,BATHING WITGOUT INSTRUCTION
• CANNOT IDENTIFY COLOURS AND MONEY
• EATS WITH SPILLING

9. TREATMENT MODALITIES
• Behavior management
• Monitoring the child’s development needs & problems.
• Programs that maximize speech, language, cognitive, psychomotor, social, self-care, &
occupational skills.
• Ongoing evaluation for overlapping psychiatric disorders, such as depression, bipolar
disorder, & ADHD.
• Family therapy to help parents develop coping skills & deal with guilt or anger.
• Provide day schools to train the child in basic skills, such as bathing & feeding.

10. GOALS
1. The adaptive skill of a normal child was compared with the patient and the deficit
areas were shown to the parents.
2. After the base line evaluation the specific goal discussed with the mother.
3. The family members were concerned about the language of child, so this area was
decided to be taken first and gradually will shift to other areas.

13. THE MANUAL PORTAGE GUIDE TO
EARLY EDUCATION
• The portage guide is divided into 6 sections of which one is the infant stimulation section
five are developmental areas.
• The areas are:
1. Cognitive
2. Self help
3. Motor
4. Language
5. Socialization
• They are arranged in order of sequence in which they are learned by a normally developing
child
• They are divided into age groups.

14. .
BEHAVIOUR Feeds self but spills
Does not use spoon
2 Year
LANGUAGE Babbles ma, baba,
Communicates with pointing
Copies other’s sounds
6month
MOTOR Walks , climbs stairs stepwise,
can lock the door, plays with
toys
3 year
COGNITION Can’t arrange object in
sequence
6 month
SELF HELP Only undressing 2 year
SOCIALISATION Play with lower age group 2 year