Mental Retardation

Chapter 5 Highlights

AAMR Definition

Significant limitations in both intellectual functioning and adaptive behavior

Onset before age 18 With appropriate supports over

sustained period, life functioning will improve.

Adaptive behavior

AAMR defines adaptive behavior as the collection of conceptual, social and practical skills that people have learned so that they can function in their everyday lives.– See table 5.1 on page 136 for examples

Prevalence and Classification

Around 1% of population identified– Lower than theoretical model on curve

• 2 % to fall below IQ of 70 Why could prevalence rates be lower than expected?

Classification– Mild MR 50-70– Moderate MR 35-50– Severe 20-35– Profound 20 and below

Causes of MR

More than 50% of causes are unknown Prenatal- before birth

– Chromosomal- Down Syndrome, Trisomy, Williams Syndrome, fragile x, Prader-Willi Syndrome

– Metabolic errors- PKU– Brain formation – microcephalus, hydrocephalus – Environmental influences – FAS (fetal alcohol syndrome),

Rubella

Discussion – what genetic screening procedures are available?

Causes of MR – continued

Perinatal- at birth– Deprivation of oxygen, low birth weight, syphilis

and herpes

Postnatal – after birth– TBI, meningitis, encephalitis, poor

environmental circumstances

Assessment

Intelligence tests– WISC-IV– Not the absolute determinant when it comes to

assessing a person’s ability to function in society

Adaptive Behavior Skills – questionnaires– Two parts

• Independence and daily living• Maladaptive behavior – social interaction,

trustworthiness, and self-abusive behavior

Psychological and Behavioral Characteristics Major areas include: attention, memory,

language development, self-regulation, social development and motivation.

Learned helplessness- feeling that no matter how hard he or she tries, failure will result.

Behavioral phenotypes vary – See table 5.3 on page 149

Discussion/Debate– Should the psychological and behavioral characteristics of persons with mental retardation exempt them from capital punishment?

Educational Considerations

Curriculum that promotes practical, age-appropriate skills – functional academics

Self-determination – ability to make personal choices, to regulate one’s life, and to be a self-advocate.

Systematic instruction – teaching technique that involves instructional prompts (verbal, gestural, and physical), consequences for performance, and transfer away from prompts.

Functional skill instruction should be in real-life settings with real materials.

Educational Considerations cont.

Inappropriate behavior often cause for self-contained placements– FBA and PBS recommended

Service delivery models– Range from general education to residential

facilities– More and more are being placed in inclusive

settings See the Responsive Instruction boxes on

pg.156-157

Early Intervention

EC programs designed for prevention– For at-risk population– Perry Preschool Project, 1960s

EC programs designed to enhance development of those already identified– Emphasis on language and conceptual

development– Connection to other professionals

• PT, speech therapists, vision, hearing, etc.

Transition to Adulthood

Planning should begin as early as elementary school

See table 5.4 on page 159 Community adjustment

– Majority of adults live with their families– Others:

• Community residential facility (group home)

• Supported living

Employment

High rates of unemployment With appropriate training and support,

adults with MR can be successfully employed– Sheltered workshops– Supported competitive employment– Job coach

Resources

The Arc – www.thearc.org American Association on Mental

Retardation – www.aamr.org Association for Down Syndrome –

www.nads.org TASH (advocates for full inclusion) –

www.tash.org