Diagnosis, treatment and prevention
Diagnosis, treatment and prevention
DIAGNOSIS
If mental retardation is suspected, a comprehensive physical examination and medical history should be done immediately to discover any organic cause of symptoms. Such conditions as hyperthyroidism and PKU are treatable. If these conditions are discovered early, the progression of retardation can be stopped and, in some cases, partially reversed. If a neurological or neurophychologist for testing.
A complete medical, family, social, and educational history is compiled from existing medical and school records (if applicable) and from interviews with parents. Children are given intelligence tests to measure their learning abilities and intellectual functioning. Such tests include theStanford-Binet Intelligence
Scale, the Wechsler Intelligence scales, the Wechsler Preschool and Primary scale of Intelligence, and theKaufman Assessment battery for Children.For infants, the Bayley Scales of Infant Development may be used to access motor, language, and problem-solving skills. Interviews with parents or other caregivers are used to access the child's daily living, muscle control, communication, and social skills. TheWoodcock-Johnson Scales of Independent Behavior and the Vineland Adaptive Behavior Scales (VABS) are frequently used to evaluate these skills.
TREATMENT
Federal legislation entitles mentally retarded children to free testing and appropriate, individualized education and skills training within the school system from ages three to 21. For children under age of three, many states have established earlyinterventionprograms that assess children, make recommendation, and begin treatment programs. Many day school are available to help train retarded children in such basic skills as bathing and feeding themselves.
Extracurricular activities and social programs are also important in helping retarded children and adolescents gain self-esteem.
Training n independent living and job skills is often begun in early adulthood.
The level of training depends on the degree of retardation. Mildly retarded people can often acquire the skills needed to live independently and hold an outside job. Moderate to profoundly retarded persons usually require supervised community living in a group home or other residential setting.
Family therapy can help relatives of the mentally retarded develop coping skills. It can also help parents deal with feeling of guilt or anger. A supportive, warm home environment is essential to help mentally retarded reach their full potential.
PROGNOSIS
People with meld to moderate mental retardation are frequently able to achieve some self-sufficiency and to lead happy and fulfilling lives. To reach these goals, they need appropriate and consistent educational, community, social, family and vocational supports. The outlook is less promising for those with severe to profound retardation. Studies have shown that these persons have a shortened life expectancy. The diseases that are usually associated with severe retardation may cause the shorter life span. People with Down syndrome will develop the brain changes that characterizeAlzheimer's disease in later life and may develop the clinical symptoms of this disease as well.
PREVENTION
Immunization against disease such as measles and Hib prevents many of the illness that can cause mental retardation. In addition, all children should undergo routine developmental screening as part of their pediatric care. Screening is particularly critical for those children who may be neglected or undernourished or may live in disease-producing condition. Newborn screening and immediate treatment for PKU and hyperthyroidism can usually catch these disorders early enough to prevent retardation.
Good prenatal care can also help prevent mental retardation. Pregnant women should be educated about the risks of alcohol consumption and the need to maintain good nutrition during pregnancy. Such tests as amniocentesis and Ultrasonography can determine whether a fetus is developing normally in the womb.
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