Mental retardation: a review of the past 10 years. Part I.
ABSTRACT To review the literature over the past decade on mental retardation, particularly as regards its definition, prevalence, major causes, and associated mental disorders.
A computerized search was performed for articles published in the past decade, and selected papers were highlighted.
The study of mental retardation has benefited considerably by advances in medicine generally and by developments in molecular neurobiology in particular. Increasing awareness of psychiatric comorbidity in the context of intellectual disability highlights the need for studies of the phenomenology and treatment of mental disorders in this population.
Although the study of developmental disorders has advanced significantly over the past decade, considerable work remains. Mental retardation is a model for the utility of the biopsychosocial approach in medicine.
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ABSTRACT: Intellectual disability (ID) is a condition of limited intellectual and adaptive functioning that occurs before the age of 18 years. For varied reasons, ID is the most forgotten of public health programs. Exact prevalence is unknown, due to the absence of epidemiological research in children and adolescents, which is essential to know the needs of this population. Detection involves identifying children at risk for any type of atypical development with emphasis on language probes and dysmorphic searching, optimally combined with developmental screening tools with proven psychometric properties; training psychologists and health providers such as general practitioners or pediatricians in the first level of attention is needed. The goal of second-level intervention is to diagnose ID with an emphasis on accurate measurement of intellectural coeficcient (IC) and adaptive level, including expanded genetic medical evaluation and assessment of the personal, familiar, and community resources of children with suspected ID. We also recommend the use of existing classifications, employing the World Health Organization (WHO) International Classification of Functioning, Disability and Health, to identify individual and environmental barriers and facilitators and the application of appropriate tests. The overall treatment includes specific medical, psychological and educative & social interventions. Medical intervention also includes pharmacological treatments, especially psychotropic medication, including risperidone, methylphenidate and melatonin. Developing evidence for the use of this medication is provided for challenging behaviors such as aggression, hyperactivity, sleep problems and depression. Psychological help includes psychoeducation and techniques evidence based, such as those derived from applied behavior analysis and cognitive behavior. Its chronic use is discouraged and medication is recommended to be combined with proper behavior management. Early and appropriate education for ID is lacking; which also requires improving access to health services, limiting social exclusion. Enhancing advocacy and promoting the human rights for this population is also needed.Salud Mental 10/2011; 34(5):443-449. · 0.42 Impact Factor
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ABSTRACT: Currently Intellectual disability (ID) is classified as a Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) Intelligence Quotient (IQ) below 70 and an impairment in adaptive skills during the developmental period. We argue that because so many children/adults with ID have language based deficits, mental age comparison or matching of individuals from different ID groups or to a typically developing (TD) group should be according to their overall performance on a non-verbally based measure, such as the Raven's Coloured Progressive Matrices (RCPM). We suggest that the RCPM should replace the commonly used WISC-IV measure of intelligence, as a means of matching groups of ID and TD group on mental age as it is a better measure of reasoning ability in children with ID who invariably have verbally based deficits. In addition, we present evidence that RCPM mental aged matched children with low functioning Autism Spectrum Disorder (ASD), Down Syndrome (DS), idiopathic ID use different problem solving strategies than TD children, to achieve the same overall performance on the RCPM. This is presumably due to group difference in brain impairments as evidenced by brain imaging studies. We also present evidence from the literature that working memory is a major component of successful performance on an IQ test and impairment in working memory in ID could also affect problem solving abilities on the RCPM. The theoretical and educational implications of the discrepancy between similar overall performance level on an intelligence test, but different use of strategy are also explored.