Mental Retardation

Mental Retardation

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Often referred to as Intellectual Disability or General Learning Disability, mental retardation is a neurodevelopment disorder involving significant underdevelopment of the brain. The functioning of an individual’s intellectual and adaptive capacities is severely affected in this condition. Apart from a low Intelligence Quotient (IQ), a person may also face adjustment problems, physical disability and impaired learning, speech and social interactions.

Intellectual disability may be mild, moderate, severe, profound and sometimes ‘unspecified’. While severe intellectual disability can be recognized at birth itself, mild retardation may take a few years to show. Most forms of intellectual disability are recognized by the age of 18.

Those affected by this condition face difficulty in communication, self-care, home living, social skills, community use, self-direction, health and safety, academics, leisure, and work.

Though the exact cause of this condition remains unknown for close to 50% of the cases, in some cases it may be inherited or caused by genetic mutations or genetic accidents such as development of an extra chromosome.

The most common forms of abnormal gene conditions are Down’s Syndrome, Klinefelter’s Syndrome, Fragile X Syndrome, Phenylketonuria and congenital hypothyroidism. In many cases, underdevelopment of the fetus or abnormal fetal cell division can result in such a condition. A baby not getting enough oxygen during birth may also suffer brain damage.

Exposure to diseases such as meningitis, measles etc and to toxins like lead and mercury can also damage the brain. Iodine deficiency and consequently malnutrition are the chief factors contributing towards brain damage, especially in the developing world.

A few other risk factors of mental retardation are:

  • Infections (either at birth or occurring after birth)
  • Metabolic (such as hyperbilirubinemia, very high bilirubin levels in babies)

An affected person may not meet standards of intellect, speech, memory, logic and learning as expected from an individual of a specified age. Learning is usually delayed - this includes learning to talk, walk and speak - and there is a general inability to understand actions and their consequences. This makes day to day chores difficult and persons with severe intellectual disability are mostly dependent on others for living. Physical growth may also be impaired and facial features may be distorted.

There is a general tendency towards aggressive, depressive and impulsive behavior, social isolation, attention-deficit, hurting one’s self and stubbornness.

Developmental aspects affected by mental retardation include:

  • Poor attention and concentration
  • Weak memory
  • Language ability
  • Gross and fine motor coordination
  • Learning, logical thinking and problem-solving ability
  • Social and self-care skills
  • Ability to control emotion and behavior

There may not be any cure for intellectual disability, but there are newer milestones being surpassed every day by way of providing support and inculcating learning. Intervention helps, the earlier the better. Encouraging the child to be curious, providing language-rich environment and teaching him to do basic jobs on his own can make quite a difference. Often, assistance by the family, agencies concerned and proper medical care can guarantee a good quality of life for those with intellectual disability. An important step is to collate a thorough patient and family history.

The Wechsler IQ tests are used for assessing IQ. According to the WHO, those affected by intellectual disability have an IQ equal to or less than 70.

There are special programmes being run that concentrate on training individuals in basic living skills. The main goal is to inculcate independence and in this case the learning process is long and gradual even for such a small thing as tying your shoe laces.

Education

Educational environment for such children should impart adaptive skills, social skills and vocational skills with focus on improving communication and social interaction.

Behavior therapy

This method helps condition and improve social behavior and reduce aggressive behavior.

Cognitive therapy

Those who can follow instructions can benefit from this therapy by practicing relaxation exercises.

Psychodynamic therapy

This therapy is used to decrease conflicts about expectations that cause anxiety, rage and depression. The patient and his family both benefit from this therapy.

Family Education

This involves educating the patient’s family in ways to increase competence and self-esteem all the while maintaining realistic expectations. Parents of children with mental retardation need therapy to vent their feelings of guilt, despair, anguish, denial and anger.

Stem Cell Therapy

Most patients reach a stage of stagnation with prolonged use of medication, rehabilitative and surgical therapies. Stem cell therapy scores because it stimulates the nervous system to repair damaged tissue.

Coupled with Rehabilitation Therapy, Stem Cell Therapy can work wonders for a person affected with Mental Retardation by triggering repair of the damaged nervous tissue. Stem cells derived from bone marrow are a shining ray of hope for management of mental retardation.

Stem cells bring about changes in the surrounding tissue that leads to repair of damaged cells. As is obvious, this improves brain function and networking that eventually decrease dependency in an individual suffering from mental retardation leading to a better quality of life.

This therapy called Autologous Stem Cell Therapy is safe and can be explored as an alternate treatment method.

Dr. Alok Sharma

Consultant Neurosurgeon

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