Mental retardation short and sweet :) M.Sc. Nursing, Mental Health Nursing

1. MENTAL
RETARDATION
SUBMITTED BY:
MS. SNEHAL KAPADIYA
M.Sc NURSING
MENTAL HEALTH NURSING,

2. WHAT DO YOU MEAN
BY MENTALLY
RETARDED PERSON?

3. MENTAL RETARDATION
MEANS….
 Significantly sub-average intellectual
functioning existing with deficits in adaptive
behavior and manifested during the
developmental period or at the tie of birth.

4. Concept of challenged:
 According to WHO the sequence of the evnts leading to
the disability and handicapped or challenged conditiond
are as follows;

5. Concept of challenged:
conti…..
INJURY OR
DISEASE
CHALLENGED
OR
HANDICAPPED
DISABILITY
IMPAIRMENT

6. IMPAIREMENT
 It is defined as the loss of or
abnormality of psychological,
physiological or anatomical
structure or functions, eg., hearing
loss, loss of vision etc.

7. DISABILITY
 It develops as a consequences of the
impairments. Eg., loss of limbs results in
inability to walk. So it is the inability to
carry out certain activities which are
considered normal for age and sex.

8. HANDICAPPED OR
CHALLENGED
 Handicapped is defined as a disadvantage of a given
individual resulting from an impairment or a disability,
that limits and prevents the fulfillment of a role that is
normal for that individual depending on age, sex, social
and cultural factors.
 It means primary handicapped leads to secondary
handicapped condition.
 For eg., blindness leads to economical handicapped
situation.

9. HANDICAPPED/CHALLENGED
1) PHYSICALLY CHALLENGED
2) MENTALLY CHALLEGED
3) SOCIALLY CHALLENGED

10. MENTALLY CHALLENGED/
MENTALLY RETARDED
DEFINITION:
 “Mental retardation refers to significantly
sub average general intellectual functioning
resulting in or associated with concurrent
impairments in adaptive behavior and manifested
during the development period.”
 -American association on mental
deficiency, 1983

11. DEFICIT IN ADAPTIVE BEHAVIOR MAY BE
REFLECTED IN THE FOLLOWING AREAS:
DURNG INFANCY AND CHILDHOOD
I. -Sensory and motor skill development
II. -Communication skills (including speech and language)
III. -Self-help skills
IV. -Socialization
 DURING CHILDHOOD AND ADOLESCENT
I. Application of basic academic skill to daily life activities
II. Application of appropriate reasoning
III. Social skills

12. Continue…
 DURING LATE ADOLESCENT
I. Vocational and social responsibilities and
performance
Developmental period:
It is defined as the period of time
between conception and the 18th birth day of
life.

13. EPIDEMIOLOGY
 About 3 percent of the world population is estimated to be mentally
retarded.
 In India, 5 out of 1000 children are mentally retarded. ( a/c to the
Indian express)
 Mental retardation is more common in boys and girls.
 With severe and profound mental retardation mortality is high due
to associated physical diseases.
 For example: trauma, sepsis, Metabolic disease etc.

14. ETIOLOGY
Genetic factors
Chromosomal abnormalities
Fragile X syndrome
Trisomy X syndrome
Down’s syndrome
Turner’s syndrome
Cat-cry syndrome

15.  Metabolic disorders
Phenylketonuria
Wilson’s disease
Galactosemia
Cranial malformation
Hydrocephaly
Microcephaly
Gross disease of brain
Neurofibromatosis
Epilepsy

16.  PRENATAL FACTORS
 Infections
 Rubella
 Syphilis
 Herpes simplex
 Endocrine disorders
 Hypothyroidism
 Diabetes mellitus
 Physical damage and disorders
 Injury
 Hypoxia
 Hypertension
 emphysema

17.  Intoxication
 lead
 substance abuse
 certain drugs like Cocaine, ganja etc.
 placental dysfunction
 toxemia of pregnancy
 placenta previa
 cord prolapse

18. PERINATAL FACTORS
birth asphyxia
prolonged birth
prematurity
kernicterus
instrumental delivery (resulting in head injury,
intraventricular hemorrhage)
POSTNATAL FACTORS
infections
encephalitis
meningitis
septicemia
Accidents

19. ENVIRONMENTAL AND SOCIO-CULTURAL
FACTORS
low socio economic status
inadequate caretakers
child abuse

20. CLASSIFICATION
 Classification of mental retardation based on intelligent quotient:
MR= MA/CA
-Where, MR= mental retardation
-MA= Mental age ( it is determined by intelligent tests.)
-CA= Chronological age ( it is determined from the date of birth)
I) MILD: IQ 50-70
This is the commonest type of MR. these individuals have minimum
retardation in sensory motor areas.
II) MODERATE: IQ 35-50
About 10 percent of mentally retarded comes under this group.
III)SEVERE: IQ 20-35
It is often recognized early in life with poor motor development and
absent or markedly delayed speech and communication skills.
IV) PROFOUND REDARTATION: IQ below 20
This group accounts for 1-2% of all mentally retarded. They acquire
constant nursing care and supervision.

21. SIGNS AND SYMPTOMS
•Failure to achieve developmental milestones
•Deficiencies in cognitive functioning such as
Inability to follow commands or directions
•Reduced ability to learn
•Reduced ability to meet academic demands
•Expressive or receptive language problems
•Psychomotor skill deficits
•Difficulty performing self care

22. CONTINUE…
•Lack of curiosity
•Unable to conduct daily life activities
•Lack of affections
•Neurological impairments
•Medical problems such as seizure
•Low self-esteem
•Labile moods

23. DIAGNOSIS
•History collection from parents and caretakers
•Physical examination
•Neurological examination
•Assessing milestones and development
•Investigations
•Urine and blood examination for metabolic disorders
•Culture for cytogenic and biochemical studies
•Amniocentesis in infant chromosomal disorders
•Chorionic villi sampling
•Hearing and speech evaluation
•EEG
•CT scan or MRI (eg. Tubercle sclerosis)
•Thyroid function test (eg. Cretinism)
•Psychological test
•IQ tests
•Genetic testing
•Maternal serum alpha feto protein
•Maternal serum inhibin
•Maternal serum beta HCG

24. PROGNOSIS:
The prognosis for mental retardation has
improved and institutional care is no longer
recommended. These childrens are mainstreamed
whenever feasible and are taught survival skills. A
multidimensional orientation is used when
working with these children, considering their
physiological, cognitive, social and emotional
development.