ABOUT MENTAL RETARDATION

Mental retardation is a condition - not a disease, and refers to an individual's level of intellectual functioning. Those who are mildly, retarded are capable of learning numerous skills and living independent or semi-independent adult lives. The mentally retarded generally learn more slowly than non-retarded people and may exhibit social immaturity. Approximately 90 percent of those diagnosed as retarded are in fact mildly retarded. Individuals who are moderately retarded are generally able to learn to care for themselves with special training, and in adulthood can often work with supervision. Individuals who exhibit severe and profound retardation will most noticeably experience delays in speech and coordination skills. They frequently have physical handicaps in addition to mental retardation, and some need constant care, while others can learn to perform routine tasks on their own. Mental retardation is a term used to describe a person with certain limitations in mental functioning and social skills, with specific regard to communicating and taking care of themselves. Children diagnosed with mental retardation tend to experience slower development than a typical child and may take longer learning to speak, walk, and attend to their personal needs, such as dressing and eating. They are likely to have difficulty learning in school because they learn at much slower speeds and there may be some things they are unable to learn at all.

Mild Mental Retardation Characteristics
  • Mental age range: 5-8 years old.
  • IQ ranges: 50-70, affects 85 percent of population.
  • Language: functional with ability to effectively use a communication device
  • Self-help: good.
  • Social skills: capable of meaningful, yet immature relationships with peers and the opposite sex.
  • Academic skills: can achieve up to sixth-grade level by late teens, although average achievement is at third-grade level.
  • Vocational status: generally adequate for minimum self-support; some achieve semi- skilled or helper status; others are capable of unskilled employment on a competitive to marginally competitive basis
  • Adult status: most typically marry and become parents; can maintain an independent adjustment but may need assistance during periods of stress
Moderate Mental Retardation Characteristics:
  • Mental age range: 1-5 years old
  • IQ ranges: 35-50
  • Language: functional although intelligibility may be greatly impaired; limited ability to use a communication device
  • Self-help: partial to nearly complete
  • Social skills: diminished ability to form relationships; may distinguish own needs and wants but disregard the needs of others
  • Academic skills: unlikely to progress beyond second-grade level
  • Vocational status: capable of some degree of productive unskilled or semi-skilled labor performed under close supervision, or in sheltered workshops with ability to travel alone in familiar surroundings
  • Adult status: seldom marry, but capable of self-management required for independent living; adapts well to life in a community living environment as well as supervised group homes
Severe Mental Retardation Characteristics:
  • Mental age range: 2 months 1 year
  • IQ ranges: 20-35
  • Language: slight communicative speech, often speaking in phrases
  • Self-help: partial with assistance
  • Social skills: capable of forming bonds with peers and adults
  • Academic skills: can become familiar with alphabet, counting, learn sight-reading of common survival words
  • Vocational status: can benefit from activity center programs
  • Adult status: dependent requiring constant need for supervision; can often live with family or in a community group home in community.
Profound Mental Retardation Characteristics:
  • IQ ranges: below 20, affects 1-2percent of population
  • Mental age: 0-6 months
  • Language: no commutative speech, except to say a few words often not appropriate for situation; unable to understand simple phrases
  • Self-help: little to partial assistance
  • Social skills: often enjoys individualized attention
  • Academic skills: none
  • Vocational status: benefits from activity center programs with basic stimulation activities
  • Adult status: needs constant supervision; often resides in ICF-DD facility or community group homes

The most commonly known associated conditions which also fall under the category of developmental disabilities are: cerebral palsy, epilepsy, and autism. These disabilities are caused by physical and mental impairments, which are chronic to severe and have occurred during the growth and developmental stages of life.

Cerebral Palsy
Cerebral palsy is not a single disorder but a term describing a group of conditions characterized by difficulty in muscular control and coordination. Sometimes cerebral palsy shows itself only by a slight awkwardness of gait, more often there has been a severe loss of muscular control in several areas of the body. Some people with cerebral palsy can do only simple tasks related to work and self-care, while others have attained professional careers and lead independent lives. Although some people with cerebral palsy are also mentally retarded, most have normal intelligence.

Epilepsy
The term epilepsy applies to a number of disorders of the nervous system centered in the brain. It is characterized by sudden seizures or muscle convulsions, and partial to total loss of consciousness, mental confusion, disturbances of bodily functions, such as: spots before the eyes, ringing in the ears and dizziness. The frequency of epileptic symptoms varies widely from person to person, and can strike with or without warning.

Autism
Autism is a disorder of communication and behavior. People with this condition have difficulty socializing and processing information. A person with autism has some or all of the following characteristics: rarely mixes with other individuals, acts deaf, resists learning, has no fear or real dangers, resists change in routine, gestures rather than talks, laughs and giggles inappropriately, shows marked physical over-activity, resists eye contact, shows inappropriate attachment to objects, has prolonged or odd body movements, is fascinated by spinning objects, and exhibits standoffish mannerisms. These individuals are capable of learning if given the proper education and learning environment to develop their skills. Those who suffer from severe and/or multiple disabilities have traditionally been labeled as having severe to profound mental retardation. They require ongoing, extensive support in more than one major life-activity in order to participate in an integrated community setting. They are seldom able to enjoy the same quality of life available to those with fewer or no disabilities. They frequently have additional disabilities, including movement difficulties, sensory losses, and behavior problems. Those with severe or multiple disabilities may exhibit a wide range of characteristics, depending on the combination and severity of disabilities and age. There are however, some shared traits which include:

Severe Multiple Disability Characteristics:

  • Limited speech or communication
  • Difficulty in basic physical mobility
  • Tendency to forget skills through disuse
  • Trouble generalizing skills from one situation to another
  • Support in major life activities (domestic, leisure, community, and vocational)

Medical Implications
A variety of medical problems may accompany severe disabilities. Some examples are: seizures, sensory loss, hydrocephaluswater of the brain, and scoliosis. These conditions should be taken into consideration when establishing school services. A multi-disciplinary team consisting of the student's parents, educational specialists, and medical specialists in the areas the individual demonstrates problems should work together to coordinate necessary services.

Educational Implications
In the past, students with severe and/or multiple disabilities were routinely excluded from public schools. Since the implementation of Public Law 94-142, the Education of the Handicapped Act, now called the Individuals with Disabilities Education Act (IDEA), public schools now serve large numbers of students with severe and/or multiple disabilities. Educational programming is likely to begin as early as infancy, where the primary focus is to increase the child's independence.

In order to be effective, educational programs need to incorporate a variety of components to meet the extensive needs of individuals with severe and/or multiple disabilities. Programs should assess needs in four major areas to be most effective: domestic, leisure and recreation, community, and vocation.

These assessments help identify functional objectives those which will result in the students increased skill and independence to effectively deal with the routine activities of life. Instruction should include: expression of choice, communication, functional skill development, and age-appropriate social-skills training.
Various other related services are of great importance, and the multi-disciplinary approach is crucial. Speech and language therapists, physical and occupational therapists, and medical specialists need to work closely with classroom teachers and parents. Because of problems with skill generalization, related services are best offered during the natural routine in school and community rather than removing a student from class for isolated therapy.

Frequently, classroom arrangements must take the students need into consideration for medications, special diets, and equipment. Adaptive aids and equipment enable these students to increase their range of functioning. For example, in recent years computers have become effective communication devices. Although, there are numerous other aids such as: wheelchairs, typewriters, headsticks-head gear, clamps, modified handles on cups and silverware, and communication boards. Computerized communication equipment and specially built vocational equipment also play important roles in adapting working environments for people with serious movement limitations.

Integration with non-disabled peers is another important component of the educational setting. Attending the same school and participating in the same activities as their non-disabled peers is crucial in the development of social skills and friendships for people with severe disabilities.

Integration can also benefit non-disabled peers and professionals and result in a greater awareness and understanding. Beginning as early as the elementary school years, community-based instruction plays an important role in educational programming. In order to increase the student's ability to generalize or transfer these skills to appropriate situations, this type of instruction is provided in the actual setting where the skills will be used.

As students grow older, more time is spent in the community-high school students may spend as much as 90 percent of their day there. Programs should draw on existing adult services in the community, including group homes, vocational programs, and recreational settings.

According to the U.S. Department of Education, in the 1999-2000 school years, 112,993 students with multiple disabilities were provided state services. In light of the current Vocational Rehabilitation Act, and the practice of supported employment, schools are now using school-to-work transition planning and working towards job placement in integrated, competitive settings rather than sheltered employment and day-activity centers.

REFERENCES: The Regional Center of Developmental Disabilities Fact Sheet. Association of Retarded Citizens (ARC), Website: www.thearc.org. National Dissemination Center for Children with Disabilities (NICHCY), Website: http://www.nichcy.org/. U.S. Department of Education, Twenty-third Annual Report to Congress, 2001. Individuals with Disabilities Education Act (IDEA) amended 1997.