When adaptive functioning suffers a significant deficit or impairment and manifests during the developmental period (before the age of 18), this condition is known as mental retardation.
There are 1 to 3% of the general population who are mentally retarded, but the term “mental retardation” is avoided in some countries (such as the UK) because of its negative connotations.
Symptoms
Depending on the degree of the child’s disability, mental retardation symptoms may range from:
Missing intellectual benchmarks.
Taking longer than other kids to sit up, crawl, or walk.
Difficulties speaking loudly or learning to speak.
· Memory problems
A lack of understanding of how one’s actions will affect others
· Inability to think logically
Immature behavior out of character for the child’s age.
· Lack of curiosity.
· Learning difficulties.
· IQ below 70
Inability to live a fully independent life as a result of problems with communication, self-care, or social interaction.
Some of the following behavioral problems may occur in a child who is mentally retarded:
· Aggression
· Dependency
· Withdrawal from social activities
· Attention-seeking behavior
Depression that occurs in teens and young adults
· Lack of impulse control
· Passivity
· Tendency toward self-injury
· Stubbornness
· Low self-esteem
· Low tolerance of frustration
· Psychotic disorders
· Difficulty paying problems
Certain physical traits, such as short stature or facial anomalies, can also be present in some individuals with mental retardation.
CLASSIFICATION
According to the child’s IQ and level of social adjustment, mental retardation is divided into four levels.
MILD MENTAL RETARDATION
Since the diagnosis is typically made later than with other types of mental retardation, this type of mental retardation makes up 85–90% of all cases.
These children typically progress up to the sixth grade in school and can achieve vocational and social self-sufficiency with a little support. Supervised care may only be necessary under stressful circumstances or in the presence of an associated disease. In the preschool years, before the age of 5, these children frequently develop like other normal children, with very little deficit.
Mild mental retardation can exhibit a variety of symptoms, such as:
Though it takes longer for them to learn to speak, once they do, they communicate well.
Having complete autonomy over their own care as they age.
Possessing difficulties with reading and writing
· Social immaturity
A harder time juggling marriage or parenting obligations
Achieving success with specialized education programs
An IQ between 50 and 70
MODERATE MENTAL RETARDATION
They can be taught to support themselves by performing semi-skilled or unskilled work under supervision. A mild stress may destabilize them from their adaptation; therefore, they work best in supervised occupational settings. About 10% of all individuals with mental retardation have an IQ between 35 and 50. In the early years despite a poor social awareness, these children can learn to speak. Often, they drop out of school after the second class (grade).
Mild mental retardation can exhibit a variety of symptoms, such as:
Language comprehension and use is slow
Experience some communication issues
Develop fundamental counting, reading, and writing abilities.
Inability to live alone in general
Frequently navigate on their own in comfortable settings
Participate in different social activities.
Typically fall within the 35–50 IQ range.
SEVERE MENTAL RETARDATION
Mental retardation that is severe has the following symptoms:
· Noticeable motor impairment
Serious harm to, or abnormal growth in, their central nervous system
Usually falling within the 20–35 IQ range
PROFOUND MENTAL RETARDATION
Deep mental retardation presents with the following symptoms:
Failure to comprehend or follow directions or requests
· Possible immobility
· Incontinence
· Very basic nonverbal communication
Lack of capacity to meet their own needs on their own
The requirement for ongoing assistance and oversight
Possessing a IQ of 20 or less
OTHER MENTAL RETARDATION
The doctor may not be able to perform screening tests on the child because people in this category frequently have physical disabilities, hearing loss, are nonverbal, or are physically impaired.
UNSPECIFIED MENTAL RETARDATION
Symptoms of mental retardation will be present in a child with an unspecified mental retardation, but the doctor will not be able to determine the severity of the condition from the information available to him or her.
Causes
In more than one-third of cases, there is no known cause for the condition of mental retardation, which can also be brought on by psychological as well as biological factors.
Following are a few of the frequent contributors to mental retardation:
Genetic: Probably in 5 % of cases
Chromosomal disorders like Down’s syndrome, Fragile X syndrome, Turner’s syndrome, and Klinefelter’s syndrome.
Inborn errors of metabolism include phenylketonuria, homocystinuria, Hartnup’s disease, lipid diseases like Tay-Sachs, Gaucher, and Niemann-Pick, carbohydrate diseases like galactosaemia, and purine disorders like Lesch-Nyhan syndrome. Mucopolysaccharide disorders include Hurler’s disease, Hunter’s disease, and Sanfillipo’s disease.
Tuberous sclerosis, neurofibromatosis, and dystrophia myotonica are examples of single-gene disorders.
Anomalies of the skull, like microcephaly.
Perinatal causes: Probably in 10% of cases
Infections, including cytomegalo-inclusion body disease, toxoplasmosis, syphilis, and rubella.
· Prematurity
· Birth trauma
· Hypoxia
· Intrauterine growth retardation ( IUGR )
· Kernicterus
· Placental abnormalities
· Drugs during first trimester
Acquired physical disorders in childhood2 to 5% of cases, most likely.
· Infections, especially encephalopathies
· Cretinism
· Trauma
· Lead poisoning
· Cerebral palsy
Sociocultural causes: Probably in 15% of cases.
· Deprivation of sociocultural stimulation
Psychiatric disordersProbably 1–2% of the time
developmental disorders that are pervasive, like infantile autism
· Childhood onset schizophrenia
DIAGNOSIS
Following are the procedures used to make the diagnosis:
History.
General physical examination.
Detailed neurological examination.
Examining the mental state allows doctors to determine the level of intelligence and determine whether any psychiatric disorders are present.
Investigations.
· Routine investigations
Urine tests, such as those for phenylketonuria and the disease caused by drinking maple syrup,
EEG, particularly when seizures are present
Blood tests to check for metabolic disorders that are inherited
Chromosomal analyses, such as those of Down’s syndrome, can be performed both prenatally (by amniocentesis or chorionic villus biopsy) and postnatally.
A CT or MRI of the brain, such as in cases of toxoplasmosis, focal seizures, unexplained neurological syndromes, abnormalities in the shape of the skull, or tuberous sclerosis
Thyroid function examinations, especially if cretinism is suspected
Liver function examinations, such as those for mucopolysaccharidosis
Psychiatric evaluations: The following psychological evaluations are frequently used to assess intelligence:
· Seguin form board test
Binet-Simon, Binet-Kamath, or Stanford-Binet tests
For children aged 6 1/2 to 16, the Wechsler Intelligence Scale for Children (WISC).
Performance evaluations of batteries by Bhatia
Advance, Standard, and Colored Raven’s Progressive Matrix
The following tests are used to gauge an individual’s level of adaptability:
Scale of Vineland Social Maturity (VSMS)
Test for Denver’s Developmental Status (DDST)
· Gessell’s Development Scale
HOMOEOPATHIC REMEDIES
There are many effective medicines available in homoeopathy for treating mental retardation, but the choice depends on the patient’s individuality, taking into account their mental and physical health. Homoeopathy is currently a rapidly expanding system that is practiced throughout the world. Its strength lies in its evident effectiveness as it takes a holistic approach towards the sick individual through promotion of inner balance at mental, emotional, spiritual, and physical levels.
AETHUSA CYNAPIUM:Irritability, awkwardness, attention deficit, confusion, inability to retain what has been taught, and the belief that it is pointless to try further study even though they are working to prepare for an exam are all symptoms of idiosyncratic children who cannot assimilate due to mental repletion.
AGARICUS MUSCARIUS:Slowly developing mind; children who have trouble remembering their mistakes and who learn at a slow pace; stupid and sluggish; unable to learn anything new; incapable of performing routine tasks; sings and talks incoherently; fails to respond.
BARYTA CARBONICA :Baryta carbonicum is a great treatment for mental retardation in children. The child forgets her task or the word she was about to say. She has memory loss, mental weakness, loss of confidence, and confusion. The child is timid and cowardly, hiding behind the furniture and peering through her fingers. The child also has dullness of the mind and has trouble concentrating.
BARYTA MURIATICUM:Children who have an idiotic appearance and speak through their noses while walking and talking.
CALCAREA CARBONICUMFair and flabby children. Apprehensive, worse in the evening, fears loss of reason, misfortune. Forgetful, confused, and slow-witted. Misplaces words and expresses himself incorrectly. Craving for eggs and indigestible things like dirt, chalk, coal, pencils, etc. Susceptible to cold. Profuse sweat, especially on the head.
CANNABIS SATIVA :The child is very forgetful and cannot finish a sentence. There is a disappearance of thoughts and a lack of words. The child stares in front of him and appears to be lost in higher thoughts, but he is unaware of them. The child has difficulty remembering what he has just done.
HELLEBORUS NIGER :Inability to recall recent events and a slow response time are signs of a child with poor memory.
KALI BROMATUM :When writing, the child frequently adds or deletes letters, substitutes opposite words (such as hot for cold), suffers from memory loss, and must be instructed in a word before he can say it aloud.
LYCOPODIUM CLAVATUM :Children with poor memory and unclear thoughts. Children who spell or write incorrect words and syllables. Children who are unable to read what they write. Children who struggle to learn new languages and frequently make mistakes. Children who suffer from brain fog following an illness. Children who dislike trying new things. Children who struggle to pay attention during conversations. Children who have weak memories.
MERCURIUS SOLUBILIS :Child has low self-esteem, a poor memory, and forgets everything. They also have a loss of willpower, slow response times, and a lot of mouth salivation. They also have a profound reading disorder and a speech disorder.
NATRUM MURIATICUM :Children learn to speak slowly. The child complains of a buzzing and roaring noise in their ears and head. The child is awkward when speaking and has a tendency to drop things.
STRAMONIUM 200-Stramonium is used to treat mental retardation, in which a person uses the incorrect names for things.
SUMBUL :Children with poor mathematical abilities frequently make mistakes when writing and performing basic math operations, particularly when adding numbers.
TUBERCULINUM:This medication can be given in conjunction with other prescribed medications to begin treatment.
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