Overview of Mental Retardation

Mental retardation or intellectual disability, (MR/ID), exists in children whose brains do not
develop properly or function within the normal range. There are four levels of retardation:
mild, moderate, severe, and profound. Sometimes, MR/ID may be classified
as other or unspecified. Mental retardation involves both a low IQ and problems adjusting
to everyday life.
MR/ID can result in learning, speech, physical, and social disabilities. Severe cases are
diagnosed at birth. However, milder forms might not be noticed until a child fails to meet a
common developmental goal. Almost all cases of MR/ID are diagnosed by the time a child
reaches 18 years of age.

Levels of Mental Retardation

MR/ID is divided into four levels based on IQ and degree of social adjustment.

Mild Mental Retardation

At this level, a person:

takes longer to learn to talk, but can communicate well once he or she knows how

fully independent in self-care

has problems with reading and writing

is socially immature

is unable to deal with responsibilities of marriage or parenting

may benefit from specialized education plans

has an IQ range of 50 to 69

may have associated conditions, including autism, epilepsy, or physical disability

Moderate Mental Retardation

At this level, a person:

is slow in understanding and using language

has only a limited ability to communicate

can learn basic reading, writing, counting skills

is a slow learner

is unable to live alone

can get around on own

can take part in simple social activities

has an IQ range of 35 to 49

Severe Mental Retardation

At this level, a person:

has noticeable motor impairment

has severe damage to and/or abnormal development of central nervous system

has an IQ range of 20 to 34

Profound Mental Retardation

At this level, a person:

is unable to understand or comply with requests or instructions

is immobile

must wear adult diapers

uses very basic nonverbal communication

cannot care for own needs

requires constant help and supervision

has an IQ of less than 20

Other Mental Retardation

Children in this category are often blind, deaf, mute, and physically disabled. These factors
prevent physicians from conducting screening tests.

Unspecified Mental Retardation

Signs of MR/ID exist, but there is not enough information to assign the child to a level.

What Causes Mental Retardation?

According to Psychology Today, only 25 percent of MR/ID cases have a known cause
(Psychology Today, 2010).
When they are known, the cayses of mental retardation include:

trauma before or during birth, such as oxygen loss, alcohol exposure, or infection

genetic abnormalities, such as inherited abnormal genes, Down syndrome, fragile X syndrome, and PKU
(phenylketonuria)

lead or mercury poisoning

severe malnutrition or other dietary issues

early childhood sickness, such as whooping cough, measles, or meningitis

Symptoms of Mental Retardation

Symptoms of MR/ID will vary based on the level of the disability. They can include:

failure to meet intellectual standards

sitting, crawling, or walking later than other children

problems learning to talk or trouble speaking clearly

memory problems

inability to understand the consequences of actions

inability to think logically

childish behavior beyond a normal age

lack of curiosity

learning difficulties

IQ below 70

inability to lead a normal life because of the inability to communicate, take care of oneself, or interact with
others

Individuals who are intellectually disabled will often have some of the following behavioral
issues:

aggression

dependency

withdrawal from social activities

attention-seeking behavior

depression during adolescent and teen years

lack of impulse control

passivity

tendency toward self-injury

stubbornness

low self-esteem

low tolerance for frustration

psychotic disorders

attention difficulties

Physical signs of MR/ID include short stature and malformed facial features. However,
physical signs are not always present.

How Is Mental Retardation Diagnosed?

A diagnosis of MR/ID requires that both intellectual and adaptive skills be well below
average. There are three parts to the evaluation:

interviews with parents

observations of the child

standard tests

Your child will be given standard intelligence tests, such as the Stanford-Binet Intelligence
Test, to determine IQ. Other tests, such as the Vineland Adaptive Behavior Scales, will be
given to assess your childs daily living skills and social abilities compared with other
children in the same age group. It is important to remember that children from different
cultures and socio-economic statuses may perform differently on these tests. Results of
these tests will be combined with information obtained from interviews with parents and
observations of the child to assist in the diagnosis.
The screening process might include visits to many different professionals including the
following:

psychologist

speech pathologist

social worker

pediatric neurologist

developmental pediatrician

physical therapist

Laboratory and imaging tests may be performed as well to detect metabolic and genetic
disorders and structural problems with the brain. It is important to rule out such things as

hearing loss, learning disorders, neurological disorders, and emotional problems as the
cause for delayed development before making a diagnosis of MR/ID.
Once MR/ID has been diagnosed, the family, school, and primary care physician will use the
results of these tests and evaluations to develop a treatment and education plan.

Treatment Options for Mental Retardation

Ongoing counseling will often be needed to help the child cope with disabilities.
Parents with intellectually disabled infants and toddlers will get a family service plan that
describes their childs needs. The plan will also detail the services the child will need to help
him or her with normal development. Family needs are also addressed in the plan.
When the child is ready to attend school, a new plan, called the Individualized Education
Program (IEP), will be put in place to assist the child with his or her educational needs.
The main goal of treatment is to assist the child in reaching his or her full potential in terms
of education and social and life skills. Treatment may include behavior therapy,
occupational therapy, counseling, and in some cases, medication. All children with MR/ID
benefit from special education, and the federal Individuals with Disabilities Act (IDEA)
requires that public schools provide free and appropriate education to children with mental
retardation and other developmental disabilities.

What Is the Long-Term Outlook?

When MR/ID occurs with other serious physical problems, the life expectancy of the child
may be shortened. In general, the more severe the cognitive disability and the more
physical problems the child has, the shorter the life expectancy. However, a child with mild
to moderate MR/ID has a fairly normal life expectancy. As adults, these people can often be
successful at jobs that require basic intellectual skills, can live independently, and can
support themselves.