MR, Autism, LD & MI: An Overview

8/14/2019 MR, Autism, LD & MI: An Overview

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Mental Retardation& Mental Illness

- An

OverviewS. KarthikeyanClinical Psychologist

NIEPMD


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Mental Retardation

Mental retardation is a condition, characterized

by sub-average cognitive functioning and deficits

in two or more adaptive behaviors with onset

before the age of 18.


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Mental Retardation

Adaptive behavior, or adaptive functioning,refers to the skills needed to live

independently (or at the minimally acceptable

level for age).


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Mental Retardation

adaptive behavior, such as:

daily living skills, such as getting dressed,using the bathroom, and feeding oneself;

communication skills, such as understandingwhat is said and being able to answer;

social skills with peers, family members,spouses, adults, and others.
http://en.wikipedia.org/wiki/Daily_living_skillshttp://en.wikipedia.org/wiki/Communicationhttp://en.wikipedia.org/wiki/Social_skillshttp://en.wikipedia.org/wiki/Social_skillshttp://en.wikipedia.org/wiki/Communicationhttp://en.wikipedia.org/wiki/Daily_living_skills


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Mental Retardation

Delays in oral language development Deficits in memory skills Difficulty in learning social rules Difficulty with problem solving skills Delays in the development ofadaptive

behaviors such as self-help or self-care skills

Lack ofsocial inhibitions
http://en.wikipedia.org/wiki/Speech_communicationhttp://en.wikipedia.org/wiki/Memoryhttp://en.wikipedia.org/wiki/Social_constructionhttp://en.wikipedia.org/wiki/Problem_solvinghttp://en.wikipedia.org/wiki/Problem_solvinghttp://en.wikipedia.org/wiki/Social_constructionhttp://en.wikipedia.org/wiki/Memoryhttp://en.wikipedia.org/wiki/Speech_communication


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Causes for MR

Problems during pregnancy. Mental disabilitycan result when the fetus does not develop

properly.

For example, there may be a problem with

the way the fetus' cells divide as it grows. A

woman who drinks alcohol or gets an

infection like rubella during pregnancy mayalso have a baby with mental disability.
http://en.wikipedia.org/wiki/Pregnancyhttp://en.wikipedia.org/wiki/Fetushttp://en.wikipedia.org/wiki/Alcoholhttp://en.wikipedia.org/wiki/Rubellahttp://en.wikipedia.org/wiki/Rubellahttp://en.wikipedia.org/wiki/Alcoholhttp://en.wikipedia.org/wiki/Fetushttp://en.wikipedia.org/wiki/Pregnancy


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Causes for MR

Problems at birth. If a baby has problems

during labor and birth, such as not getting

enough oxygen, he or she may have

developmental disability due to braindamage.
http://en.wikipedia.org/wiki/Oxygenhttp://en.wikipedia.org/wiki/Oxygen


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Causes for MR

Exposure to certain types ofdisease ortoxins.

Diseases like measles, ormeningitis cancause mental disability if medical care is

delayed or inadequate.

Exposure to poisons like lead ormercury may

also affect mental ability.
http://en.wikipedia.org/wiki/Diseasehttp://en.wikipedia.org/wiki/Toxinshttp://en.wikipedia.org/wiki/Measleshttp://en.wikipedia.org/wiki/Meningitishttp://en.wikipedia.org/wiki/Leadhttp://en.wikipedia.org/wiki/Mercury_(element)http://en.wikipedia.org/wiki/Mercury_(element)http://en.wikipedia.org/wiki/Leadhttp://en.wikipedia.org/wiki/Meningitishttp://en.wikipedia.org/wiki/Measleshttp://en.wikipedia.org/wiki/Toxinshttp://en.wikipedia.org/wiki/Disease


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Causes for MR

Malnutrition is a common cause of reduced

intelligence

Iodine deficiency, affecting approximately 2

billion people worldwide, is the leading

preventable cause of mental disability
http://en.wikipedia.org/wiki/Malnutritionhttp://en.wikipedia.org/wiki/Iodine_deficiencyhttp://en.wikipedia.org/wiki/Iodine_deficiencyhttp://en.wikipedia.org/wiki/Malnutrition


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Diagnosis for MR

Three criteria must be met for a diagnosis ofmental retardation:

an IQbelow 70, significant limitations in two or more areas

ofadaptive behavior(as measured by anadaptive behavior rating scale, i.e.communication, self-help skills,interpersonal skills, and more), and

evidence that the limitations becameapparent before the age of 18.
http://en.wikipedia.org/wiki/IQhttp://en.wikipedia.org/wiki/Adaptive_behaviorhttp://en.wikipedia.org/wiki/Adaptive_behaviorhttp://en.wikipedia.org/wiki/IQ


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Diagnosis for MR

It is formally diagnosed by professional

assessment ofintelligence and adaptive

behavior.

The following ranges, based on Standard

Scores of intelligence tests, reflect the

categories of the Mental Retardation.


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Diagnosis for MR

Class IQ

Profound mental retardation Below 20

Severe mental retardation 2034

Moderate mental retardation 3549

Mild mental retardation 5069

Borderline intellectual functioning 7079


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Characteristics in MR

In early childhood mild mental retardation(IQ 5070) may not be obvious, and may

not be identified until children begin school.

As individuals with mild mental retardation

may reach adulthood, many learn to live

independently and maintain gainfulemployment.


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Characteristics in MR Moderate mental retardation (IQ 3549) is nearly

always apparent within the first years of life.

Children with moderate mental retardation will

require considerable supports in school, at home,

and in the community in order to participate fully.

As adults they may live with their parents, in a

supportive group home, or even semi-

independently with significant supportive services tohelp them


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Characteristics in MR

A person with severe and profound mental

retardation will need more intensive support

and supervision for his or her entire life.


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Treatment for MR

By most definitions mental retardation ismore accurately considered a disabilityratherthan a disease.

Currently, there is " no cure" for anestablished disability, though with appropriatesupport and teaching, most individuals can

learn to do many things.


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Treatment for MR

People with developmental disabilities learn

throughout their lives and can obtain many

new skills even late in life with the help of

their families, caregivers, clinicians and thepeople who coordinate the efforts of all of

these people


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AUTISMAUTISMSPECTRUMSPECTRUM

DISORDERSDISORDERS


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Autism A condition of uneven skill development primarily

affecting the communication and social abilities of aperson, marked by repetitive and ritualistic behavior

Children with autism spectrum disorders mostly have

a general appearance, leading to challenge in earlydiagnosis and in effective management during theirearly developmental period


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PREVELANCEPREVELANCE

10 in 10,000 births

Male Female Ratio is 4:1


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Autism Spectrum Disorders

Autism is part of a the broad group of disorders known as

pervasive developmental disorders

Retts Disordernormal development for 5 months to 4 years,followed by regression and mental retardation,

Childhood Disintegrative Disorder, normal development forat least 2 and to 10 years, followed by significant loss of skills


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Autism Spectrum Disorders

Aspergers Syndrome,or Aspergers Disorder

much like mild autism but usually without significant

delays in cognition and language.

Pervasive Developmental Disorder not

Otherwise Specified. Pervasive delays in

development that doesnot fit into any other

diagnostic categories


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Signs and symptoms

Language comprehension difficulties. Repetition of words (echolalia) Unable to react or express emotions

Self harming (hitting, biting, banging) Poor eye contact Delayed / limited speech Possession conflict (my toy) Seem to act like they are deaf even though

nothing is wrong with their hearing.


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CHARACTERISTICCHARACTERISTIC

FEATURESFEATURES

Language difficulties Unable to communicate verbally

Rarely use gestures

Rather than pointing they will get things for themselvesor take their mothers hand and put it on the desiredobject

Some children cry inconsolably until the parent hasguessed on trial and error what the child wants

Some children start to speak late they sing TV

commercials


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FEATURESFEATURES

Language difficulties Echolalia repeating the question

Use of you when they mean I

Some verbal children with autism do not know how

to participate in conversation, maintain topic, take

turns, look at their conversational partner etc

The tone of voice is different either high tone orsing-song or flat robot like, they speak in a

monotone or too softly


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FEATURESFEATURESThought difficulties Attachment to object rather than humans

Have difficulty in understanding other peoples thought

feelings and needs

Cant anticipate what one might think

For unexplained reasons, people with autism demand

consistency in their environment.


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FEATURESFEATURESSensory difficulties Hearing: every day sounds may be painful; unable

to filter out unwanted sounds

Sight: Difficulty in height, width and depthperception

Tactile: avoids being hugged; preference to certaintexture/garments; likes deep massages

Taste: is fussy about food


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Intervention for Autism

Applied Behavior analysis-ABA. Alternative Augmentative and Communication

system-AAC.

Calendar System.

Picture exchange communication system- PECS. Treatment and Education of Autistic and related

Communication Handicapped Children- TEACCH.

Sensory Diet program.

Sensory Integration techniques


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Persons with mental retardation /

developmental disabilities cannot becured but only be rehabilitated


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LearningDisability


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Learning disability

Also known as Dyslexia

Dyslexia occurs in individuals with normal visionand normal intelligence.

Such individuals usually have normal speech but

often have difficulty in interpreting spoken languageand writing.


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Learning disability

Individuals with dyslexia commonly haveproblems inProcessing and understanding what they hear.

They may have difficulty in comprehending

rapid instructions,

Following more than one command at a timeor


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Learning disability.

Remembering the sequence of things

Reversals of letters (b for d) and

Reversal of words (saw for was) are typicalamong individuals who have dyslexia.

Individuals with dyslexia may also try to

read from right to left,


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Learning disability

May fail to see (and occasionally to hear)

similarities and differences in letters and words,

May not recognize the spacing that organizesletters into separate words, and

May be unable to sound out the pronunciation

of an unfamiliar word.


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Academic failure in a normal intelligent child wouldindicate the existence of learning disability.

A child who functions two grades below his ageappropriate level with average intelligence can also be

considered to have specific learning disability.

Other areas of assessment may include perception,cognition, memory, attention, and language abilities.

Indications of L D

WHAT CAN TEACHERS


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WHAT CAN TEACHERSDO.

Try for a small class size that encourage all students toparticipate

Take a moment between classes to ask about students and

demonstrate you care

Allow students to participate in decision making regarding

class rules and management

Identify youngsters who demonstrate un- involvement or

detachment and refer them to the counselor.

Encourage students to participate in school related extra

curricular activities


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AVOID

Do not use methods or techniques that wereineffective previously

Do not focus on emotionally loaded situations

Do not create or maintain situations or conditionsthat cause embarrassment

Do not direct attention on what the student cannotdo


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Each student is unique. One differs from anotherintellectually, emotionally, socially & physically.

Special needs of the students must be met withadditional inputs from outside the regular classroom.


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Mental Illness


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Mental Illness

mental illness is a psychological or

behavioral pattern that disrupt a persons

thinking, feeling, behavior, ability to relate to

others and daily functioning.

mental illnesses is a condition that often

results in a diminished capacity for copingwith the ordinary demands of life


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Facts About Mental Illness Mental illnesses can affect persons of any

age, race, religion or income.

The World Health Organization estimates

that, by 2020, depression will be the leading

cause of disability in the world for women and

children.


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Facts About MentalIllness One in four adults has a diagnosable

psychiatric illness. One in ten children suffers

from a psychiatric illness.

Mental illnesses usually strike individuals in

the prime of their lives, often during

adolescence and young adulthood. All agesare susceptible, but the young and the old

are especially vulnerable.


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Causes - BiologicalFactors Genetics (heredity): Many mental illnesses run in

families, suggesting that people who have a family

member with a mental illness are more likely to

develop a mental illness.

Infections: Certain infections have been linked to

brain damage and the development of mental illness

or the worsening of its symptoms.Ex: pediatric autoimmune neuropsychiatric disorder

(PANDA)


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Brain defects or injury: Defects in or injury

to certain areas of the brain have also been

linked to some mental illnesses.

Prenatal damage: Some evidence suggests

that a disruption of early fetal brain

development or trauma that occurs at thetime of birth

Causes - BiologicalFactors


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Causes - BiologicalFactors Substance abuse: Long-term substance

abuse, in particular, has been linked to

anxiety, depression, and paranoia.

Other factors: Poor nutrition and exposure to

toxins, such as lead, may play a role in the

development of mental illnesses.


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Causes Psycho-SocialFactors Severe psychological trauma suffered as a

child, such as emotional, physical, or sexual

abuse

An important early loss, such as the loss of aparent

Death of a loved one

Neglect Poor ability to relate to others


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Causes Psycho-SocialFactors Divorce / Failure in affairs

A dysfunctional family life

Living in poverty

Feelings of inadequacy, low self-esteem,

anxiety, anger, or loneliness

Changing jobs or schools


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Mental Illness - Types The state of anxiety or fear can become disordered,

so that it is unusually intense or generalized over aprolonged period of time.

Commonly recognized categories of anxiety

disorders include Specific phobia Generalized anxiety disorder Social Anxiety Disorder

Panic Disorder Obsessive-Compulsive Disorder Post-traumatic stress disorder


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Mental Illness Types

Psychotic disorders centrally involving this

domain include Schizophrenia, and

Delusional disorder.

Schizoaffective disorderis a category used

for individuals showing aspects of both

schizophrenia and affective disorders.
http://en.wikipedia.org/wiki/Psychotic_disorderhttp://en.wikipedia.org/wiki/Schizophreniahttp://en.wikipedia.org/wiki/Delusional_disorderhttp://en.wikipedia.org/wiki/Schizoaffective_disorderhttp://en.wikipedia.org/wiki/Schizoaffective_disorderhttp://en.wikipedia.org/wiki/Delusional_disorderhttp://en.wikipedia.org/wiki/Schizophreniahttp://en.wikipedia.org/wiki/Psychotic_disorder


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Mental Illness Types

The fundamental characteristics of a personthat influence his or her cognitions,motivations, and behaviors across situationsand time - can be seen as disordered due to

being abnormally rigid and maladaptive.

Categorical schemes list a number ofdifferent personality disorders, such as those

classed as eccentric those described asdramatic or emotional
http://en.wikipedia.org/wiki/Personality_disorderhttp://en.wikipedia.org/wiki/Personality_disorder


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Symptoms

In adults

Confused thinking

Long-lasting sadness or irritability

Extreme highs and lows in mood

Excessive fear, worry, or anxiety

Social withdrawal

Dramatic changes in eating or sleeping habits

Strong feelings of anger


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S


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Symptoms

In older children and pre-teens

Abuse of drugs and/or alcohol

Inability to cope with daily problems and

activities

Changes in sleeping and/or eating habits

Excessive complaints of physical problems

Defying authority, skipping school, stealing, or

damaging property

S t


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Symptoms

Intense fear of gaining weight

Long-lasting negative mood, often along with

poor appetite and thoughts of death

Frequent outbursts of anger

S t


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Symptoms

In younger children Changes in school performance Poor grades despite strong efforts Excessive worry or anxiety

Hyperactivity Persistent nightmares Persistent disobedience and/or aggressive

behavior Frequent temper tantrums


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P h th


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Psychotherapy

Systemic therapy orfamily therapy is sometimes

used, addressing a network of significant others as

well as an individual. Some psychotherapies are

based on a humanistic approach.

Psycho-education may be used to provide people

with the information to understand and manage

their problems.
http://en.wikipedia.org/wiki/Systemic_therapyhttp://en.wikipedia.org/wiki/Family_therapyhttp://en.wikipedia.org/wiki/Psychoeducationhttp://en.wikipedia.org/wiki/Psychoeducationhttp://en.wikipedia.org/wiki/Family_therapyhttp://en.wikipedia.org/wiki/Systemic_therapy


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P h th


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Psychotherapy

Electroconvulsive therapy (ECT) is sometimes usedin severe cases when other interventions for severeintractable depression have failed.

Psychosurgery is considered experimental but isadvocated by certain neurologists in certain rarecases.

Many things have been found to help at least somepeople. A placebo effect may play a role in anyintervention.

A i t d C diti
http://en.wikipedia.org/wiki/Electroconvulsive_therapyhttp://en.wikipedia.org/wiki/Psychosurgeryhttp://en.wikipedia.org/wiki/Placebohttp://en.wikipedia.org/wiki/Placebohttp://en.wikipedia.org/wiki/Psychosurgeryhttp://en.wikipedia.org/wiki/Electroconvulsive_therapy


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Associated Conditions

ADHD

Emotional Disorders

Childhood Psychiatric Disorders


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when dealing with people, let us remember

that we are not dealing with creatures of

logic. We are dealing with creatures of

Emotions, creatures with Prejudices andmotivated by Pride and Vanity

- Dale Carnegie

MR, Autism, LD & MI: An Overview

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