Please raise your hand if you have ever visited a place where you did not speak the language? Can you recall a time when you need something or wanted to ask a question but had no way to communicate your need? Imagine if every day you woke up and you were unable to process the world around you. Imagine if everywhere you went took you twice as long and every task was made difficult because you could not comprehend the directions you were being given. Welcome to the life of someone with MR.
IDEA- Mental retardation means significantly subaverage general intellectual functioning, existing concurrently with deficits in adaptive behavior and manifested during the developmental period, that adversely affects a child's educational performance. DSM- has significantly subaverage intellectual functioning, with an IQ of approximately 70 or below. Deficits or impairments in adaptive functioning. Onset before age 18 years. Individuals with mental retardation represent 1% to 3% of the general population. Mental retardation is approximately 1.5 times more common in boys than in girls. Mild mental retardation is much more common than severe mental retardation, accounting for 65 to 75% of all cases with mental retardation.
More than 250 biologic causes are known, most of which can be grouped under the general categories of chromosomal abnormalities, other genetic factors, prenatal and perinatal factors (eg, anoxia), acquired childhood disorders, environmental factors (eg, lead),3and sociocultural factors. Knowing the cause in a particular case can sometimes provide important clues for understanding an individual's presentation; however, only approximately 25% of cases of mental retardation have a known biologic cause; in the remaining 75% of cases, the cause is unknown or is traceable to nonbiologic (eg, psychosocial) factors.
Risk factors are related to the causes. Causes of mental retardation can be roughly broken down into several categories: Infections (present at birth or occurring after birth) Congenital CMV Congenital rubella Congenital toxoplasmosis Encephalitis HIV infection Listeriosis Meningitis Chromosomal abnormalities Chromosome deletions (cri du chat syndrome) Chromosomal translocations (a gene is located in an unusual spot on a chromosome, or located on a different chromosome than usual) Defects in the chromosome or chromosomal inheritance (for example, fragile X syndrome, Angelman syndrome, Prader-Willi syndrome) Errors of chromosome numbers (such as Down syndrome) Genetic abnormalities and inherited metabolic disorders Adrenoleukodystrophy Galactosemia Hunter syndrome Hurler syndrome Lesch-Nyhan syndrome Phenylketonuria Rett syndrome Sanfilippo syndrome Tay-Sachs disease Tuberous sclerosis Metabolic Congenital hypothyroid Hypoglycemia (poorly regulated diabetes mellitus) Reye syndrome Hyperbilirubinemia (very high bilirubin levels in babies) Nutritional Malnutrition Toxic Intrauterine exposure to alcohol, cocaine, amphetamines, and other drugs Lead poisoning Methylmercury poisoning Trauma (before and after birth) Intracranial hemorrhage before or after birth Lack of oxygen to the brain before, during, or after birth Severe head injury Unexplained (this largest category is for unexplained occurrences of mental retardation)
Social-Emotional Characteristics MR is a generalized disorder that can range from borderline to profound, based on their IQ level and cause. Because of this, their social-emotional and learning characteristics can manifest in the following ways: Difficulty in learning social rules and a lack of social inhibitors – Persons with MR have difficulty interpreting social interactions, for example, persons with MR have difficulty to strike up conversations with others. Furthermore, they have difficulty making and keeping friends by exhibiting behaviors that may put peers off such as disruptive behavior High propensity of Gullibility – persons with MR are vulnerable to being tricked into committing, but not limited to, crimes without realizing the ramifications Some may display low tolerance for frustration and may display impulsiveness, stubbornness and immaturity. For example, sometimes some may become aggressive towards others and may engage in self injurious behavior. However, some are passive and pleasant External Motivations – Due to having a long history of failure, persons with MR look for external motivations for support and reinforcement, such as positive praise from teachers and family and positive reinforcers like obtaining tokens to for prizes and/or rewards
Learning Characteristics Oral language development – Delays and limitations in language skills can be observed in their speech production, speech delay and language comprehension Problem solving skills – As seen in IQ results, persons with MR have difficulty in problem-solving and logical thought Memory – The most consistent finding in people with an intellectual disability have difficulty remembering information. Persons with MR have short attention spans and short term memory deficit, however, it seems that their long term memory is unaffected Learning methods – Despite these limitations, persons with MR are able to learn through lots of repetition. They respond well to hands on learning with real materials and real-life settings. Instructive learning such as finding months and dates on the calendar or physical and verbal prompts such as placing a book in the student’s hand and putting in the desk while simultaneously saying “Put your book in the desk” Nevertheless, virtually every child is able to learn, develop and become participating members of the community Transition to First person account Letter with MR
Mental Retardation (Intellectual Disabilities
Mental Retardation (Intellectual Disabilities) Andy Harris Raul Jimenez Stephanie Kirby Alex Manning
What is Mental Retardation? <ul><li>Also know as M.R. or Intellectual Disabilities </li></ul><ul><li>IQ below 70 </li></ul><ul><li>Onset before 18 years </li></ul><ul><li>Affects 1-3% of the population </li></ul><ul><li>11% of all students with disabilities in U.S. schools </li></ul>
Causes of M.R. <ul><li>250 biological causes are known </li></ul><ul><ul><li>Chromosomal abnormalities </li></ul></ul><ul><ul><li>Other genetic factors </li></ul></ul><ul><ul><li>Prenatal and perinatal factors (anoxia, trauma during birth) </li></ul></ul><ul><ul><li>Childhood disorders </li></ul></ul><ul><ul><li>Environmental factors (lead, mercury) </li></ul></ul><ul><ul><li>Socio-cultural factors </li></ul></ul>
Risk Factors of M.R. <ul><li>Infections </li></ul><ul><li>Chromosomal abnormalities </li></ul><ul><li>Genetic abnormalities and inherited metabolic disorders </li></ul><ul><li>Metabolic </li></ul><ul><li>Nutritional </li></ul><ul><li>Toxic </li></ul><ul><li>Trauma </li></ul>
M.R. in Education <ul><li>Classification </li></ul><ul><ul><li>Intellectual Functioning </li></ul></ul><ul><ul><ul><li>Adaptive Behavior </li></ul></ul></ul><ul><ul><ul><li>Levels of Functioning </li></ul></ul></ul><ul><li>Assessment </li></ul><ul><ul><li>Ongoing Assessment </li></ul></ul><ul><ul><li>Alternative Assessment </li></ul></ul>
Social-Emotional Characteristics <ul><li>Learning Social Rules </li></ul><ul><li>Gullibility </li></ul><ul><li>Low Tolerance for Frustration </li></ul><ul><li>External Motivations </li></ul>
Learning Characteristics <ul><li>Oral language development </li></ul><ul><li>Problem solving skills </li></ul><ul><li>Memory </li></ul><ul><li>Learning methods </li></ul><ul><li>First person account Letter </li></ul>
Terminology <ul><li>Idiot (profound) </li></ul><ul><li>Imbecile (moderate) </li></ul><ul><li>Moron (mild) </li></ul><ul><li>Educable (mild, students who can progress to a late elementary level) </li></ul><ul><li>Trainable (capable of learning personal hygiene and other living skills) </li></ul>
Statistics in Terminology <ul><li>27 states use the term mental retardation in their written educational guidelines. </li></ul><ul><li>2 still use mental handicap . </li></ul><ul><li>All others are using some form of cognitive/intellectual disability . </li></ul>
IQ cut-offs vs. Adaptive Behavior Assessment <ul><li>35 states require a cut-off score in classifying students with MR (usually between 70 and 75) </li></ul><ul><li>many states leave the IQ cut-off decision to the individual school districts. </li></ul><ul><li>All states note that they require assessment in adaptive behavior, but how is AB measured? Most states only offer a loose definition. </li></ul>
Things are looking good <ul><li>American Association on Intellectual and Developmental Disabilities (AAIDD) </li></ul><ul><li>Federal Language </li></ul><ul><li>“ We can not ignore the consumer’s aversion to the label of mental retardation. The right of minority groups to select the name by which they wish to be called is respected in our society” </li></ul><ul><li>(Snell and Voorhees, 2006, p. 74) </li></ul>
References <ul><li>American Association on Intellectual and Developmental Disabilities (AAIDD). (2009). Definition of Intellectual Disability. Available: http://www.aamr.org/content_100.cfm?navID=21 </li></ul><ul><li>Davis, M., Galler, J. L., & Hunt, B. (2006). Within-state availability of transition-to adulthood services for youths with serious mental heath conditions. Psychiatric Services , 57 (11), 1594-1599. </li></ul><ul><li>Hawkins-Shepard, C. (1994). Mental Retardation. ERIC Digest, E (528) . Retrieved June 19, 2009, from ERICDigests.org. </li></ul><ul><li>Lewis, Rachel A.. (2007, November 11). Mental Retardation. The New York Times. Retrieved from http://www.nytimes.com </li></ul><ul><li>Pearson (2009). Vineland Adaptive Behavior Scales, Second Edition . Retrieved June 20, 2009, from http://www.pearsonassessments.com/vinelandadapt.aspx . </li></ul><ul><li>Polloway, E.A., Patton, J.R., Smith, J.D., Lubin, J., & Antoine, K. (2009). State guidelines for mental retardation and intellectual disabilities: A re-visitation of previous analysis in light of changes in the field. Education and Training in Developmental Disabilities , 44 (1), 14-24. </li></ul><ul><li>Silka, Van R. & Hauser, Mark J. (March 1997). Psychiatric Assessment of the Person With Mental Retardation. Psychiatric Annals 27:3 .Retrieved June 20, 2008, from http://www.psychiatry.com/mr/assessment.html . </li></ul><ul><li>Tammi Reynolds, BA & Mark Dombeck, Ph.D. (August 23, 2006). Mental Retardation Associated Traits. Retrieved from, http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=10324&cn=208 </li></ul>