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REAL COFFEE: PURCHASING, (HOME-)ROASTING, GRINDING, BREWING. LIBRARIANS FORUM 13 DECEMBER 2006. EARLY COFFEE HISTORY.

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mental retardation mr

Mental Retardation (MR)

Dr ShreedharPaudel

May, 2009

slide2
MR……
  • Mental retardation is a developmental disability marked by lower-than-normal intelligence and limited daily living skills
  • Diminished learning capacity and does not adjust well socially
  • Mental retardation is normally present at birth or develops early in life
slide3
MR….
  • Mental retardation is defined by two standards
    • first standard is a person's level of intelligence usually measured by special tests called intelligence tests
    • Intelligence tests provide a numerical ranking of a person's mental abilities called an intelligence quotient or, more commonly, an IQ
slide4
MR….
  • The second standard for mental retardation is adaptive skills
    • means how well a person can deal with the tasks of everyday life
      • the ability to speak and understand
      • home-living skills
      • use of community resources
      • leisure, self-care, and social skills
      • basic academic skills (reading, writing, and arithmetic); and
      • work skills
slide5
MR….
  • Intelligence Quotient:-
    • Mental age divided by chronological age multiplied by 100
    • Degrees of mental handicap
      • Mild→ 51--70
      • Moderate→ 36--50
      • Severe→ 21--35
      • Profound → 0--20
slide6
MR…
    • I.Q level 71—90 → borderline intelligence (not included in mental handicap)
  • Mild and moderate are educable and trainable
  • Severe and profound are custodian
slide7
MR…
  • Mild Mental Retardation
    • 85 percent of the mentally retarded population
    • Individuals often live on their own with community support
  • Moderate Mental Retardation
    • 10 percent of the mentally retarded population
    • Individuals often lead relatively normal lives provided they receive some level of supervision
    • Often live in group homes with other mentally retarded people
slide8
MR…
  • Severe Mental Retardation
    • 3% to 4% of the mentally retarded population
    • master the most basic skills of living, such as cleaning and dressing themselves
    • often live in group homes
  • Profound Mental Retardation
    • 1 % to 2% of the mentally retarded population
    • develop basic communication and self-care skills
    • often have other mental disorders
slide9
MR….
  • Etiology:-
    • Interplay of several biomedical, sociocultural and psychological factors
    • Prenatal
      • Metabolic –galactosemia, mucopolysaccharidosis
      • Chromosomal – Down’s synd., Klinefelter syndrome
      • Maternal factor – teratogenic drugs, infection during pregnancy
      • Neuroectodermal – tuberous sclerosis
      • Iodine deficiency
slide10
MR….
  • Natal
    • Birth injury
    • Hypoxic ischemic encephalopathy
    • Hemorrhage
  • Post natal
    • Infection
    • Head injuries
    • Hypoxia
    • Thrombosis of cerebral vessels
    • Kernicterus
    • Malnutrition
    • Child abuse
slide11
MR…
  • Predisposing factors
    • Low socioeconomic status
    • Low Birth Weight (LBW)
    • Advance maternal age
    • Consanguinity
slide12
MR….
  • Symptoms
    • Continued infantile behavior
    • Decreased learning ability
    • Failure to meet intellectual developmental markers
    • Inability to meet educational demands at school
    • Lack of curiosity
    • Etiological presentation
slide13
MR…
  • Changes to normal behaviors depend on the severity of the condition
  • Mild retardation may be associated with a lack of curiosity and quiet behavior
  • Severe mental retardation is associated with infantile behavior throughout life
slide14
MR…
  • Investigations:-
    • Urine tests :- for metabolic diseases
    • TFT :- T3, T4, TSH
    • Genetic studies :- chromosomal studies
    • Serology for TORCH
    • LP :- any CNS infections
    • CT and MRI :- hydrocephalus, absence of corpus callosum, tuberous sclerosis
slide15
MR…
  • Exams and Tests
    • Abnormal Denver developmental screening test
    • Adaptive behavior score below average
    • Development below that of peers
    • Intelligence quotient (IQ) score below 70 on a standardized IQ test
slide16
MR…
  • Other Scales
    • Wechsler preschool and primary scale of intelligence(WPPSI)
    • Wechsler intelligence scale for children (WISC)
    • Stanford Biner Test (SBT)
    • Denver ii development screening test
slide17
MR…
  • Treatment
    • The primary goal of treatment is to develop the person's potential to the fullest
    • Special education and training may begin as early as infancy
    • This includes social skills to help the person function as normally as possible
slide18
MR…
  • Treatment
    • It is important for a specialist to evaluate the person for other affective disorders and treat those disorders
    • Behavioral approaches are important for people with mental retardation
    • Parents should be counseled together
slide19
MR…..
  • Treatment
    • Anticonvulsive treatment is prescribed for seizures but phenobarbitone should be avoided
    • Hyperactivity treated with Amphetamine
    • Psychologically – warmth, love and appreciation