THE Philippine Department of Health (DOH) has designated the first week of February as the National Mental Retardation Week.
Mental Retardation (MR) is defined as a sub-average intellectual ability present from birth or early infancy.
Likewise, literatures published by American Psychiatric Nurses Association define MR as the deficits in general intellectual and adaptive functioning. It further states that general functioning is measured in terms of individual’s intelligence quotient (IQ); whereas, adaptive functioning refers to the person’s ability to adapt to requirements of daily living and conforming to the expectations of one’s cultural group.
Generally speaking, the exact cause of MR remains unclear. However, the DSM-IV TR states that it could have biological or sociological triggers. In some instances, it adds, a combination of both.
First, there is heredity. As low as 5 percent it may be, but such conditions as inborn errors of metabolism (Tay-Sachs disease, phenylketonuria, and hyperglycinemia, to name a few); chromosomal disorders (Down syndrome and Klinefelter syndrome); and single-gene abnormalities (tuberous sclerosis and neurofibromatosis) are thought to cause MR in a child.
Second are the early pregnancy factors. These factors refer to the alterations in embryonic development during early pregnancy that accounts for about 30 percent of all MR cases. Specifically, pregnant women who consume excessive alcohol or very toxic medications during the earliest stages of pregnancy (first trimester) are more likely to give birth to a child who will have MR. The same hypothesis holds true for pregnant women in the first trimester who acquire viral diseases such as rubella or German measles and to those women who develop complicated pregnancies such as toxaemia or gestational diabetes.
Third are the maternal nutrition and perinatal factors. It is thought that pregnant women not receiving all the nutrients during the course of pregnancy will predispose the unborn baby to MR during childhood. Statistics shares that about 10 percent of all MR cases are due to this third factor. Included in here are the problems or complications that occur during the process of labor and delivery of the baby. Head injuries that occur to the baby in the birth process may precipitate MR to the child.
General Medical conditions acquired in infancy or childhood may cause MR for about 5 percent of all cases. These include such infections as meningitis, encephalitis, poisoning from certain medications, lead (from paint and pencils); and physical trauma such as asphyxiation and head injuries.
Lastly, environmental influences account for about 15 to 20 percent of MR cases. These environmental influences are highly psychological and sociological in nature: deprivation of nurturance, social relationships with other children, and intellectual stimulation.
Meanwhile, degrees of MR are classified as Mild (IQ 50 to 55); Moderate (IQ 34 to 40); Severe (IQ 20 to 25); and Profound (IQ less than 20).
Experts share that mild MR comprise of 85 percent of all cases of MR. Individuals with Mild MR are considered “educable” but may need assistance in times of psychological stress. They are also good candidates for vocational learning.
Moderate MR (10 percent of all cases) is “educable.” They require supervision when directed to do tasks.
Severe MR (3 to 4 percent of all MR) is ideally thought “survival skills.” They have poor verbal and coordination skills.
Lastly, profound MR (1 to 2 percent of cases) requires a highly structured environment with one-to-one consistent caregiver, whom they are highly dependent with.
Ideally, management for MR is multi-disciplinary in approach that includes a team of child psychiatrist, psychologist, occupational therapist, speech pathologist and special education teachers.
What is important is that no child should be left behind in terms of development in their respective paces. This also calls for the unconditional love and support on the part of the families of children diagnosed with mental retardation.
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(Sources: Diagnostic and Statistical Manual of Mental Disorders IV- Text Revise; Psychiatric Mental Health Nursing; The Merck Manual of Medical Information)