Mental retardation, or intellectual disability, tells about a person’s below-average intelligence compared to the average population.
However, using the term ‘retardation’ is derogatory, and it is essential to be aware of the common intellectual and developmental disabilities in today’s time. Only by being informed on these topics can we break the stigma and prejudice that surrounds people with Intellectual disability and make our community more inclusive.
Apart from this, we also need to be mindful of the preventable causes of mental disorders so that we can ensure the healthy and well-rounded development of the next generation.
1. What do we mean by an Intellectual Disability?
This can be described as a generalized Neurodevelopmental Disorder (ND). What was formerly called “mental retardation” is now defined with the term Intellectual Disability (intellectual developmental disorder).
This neurodevelopmental disorder involves significantly subaverage intellectual functioning and significant limitations in a person’s everyday adaptive behaviors.
1.1 Characteristics of Mental Retardation
- Approximately 1% to 3% of the global population is affected by mental retardation.
- Mental retardation is characterized by an Intelligence Quotient (IQ) of under 70, accompanied by insufficiencies in two or more everyday adaptive functioning.
- The onset of mental retardation is usually before the age of 18, in childhood or adolescence, and it prevails throughout adulthood.
- The signs and symptoms of mental retardation might be detected at the time of birth or in early childhood.
- According to the Diagnostic and Statistical Manual-IV (DSV IV), a diagnosis of mental retardation is made after a person is placed on an intellectual functioning level well below average for their age group.
One’s intellectual functioning level is calculated with standardized tests (for example, Weschlar Intelligence Scales). These standardized tests measure a person’s reasoning abilities in a ratio of mental age to chronological age (IQ). Low mental age to chronological age ratio for cognitive ability constitutes mental retardation.
- People with mental retardation struggle in daily life as they have minimal adaptive functioning.
Adaptive functioning means skills needed to live a productive everyday life. These skills include social skills, using community resources, language & communication, and functional academic skills.
- Children with mental retardation generally take a much longer time to achieve developmental milestones like walking, talking, etc., as compared to other kids in their age group.
- Children afflicted with neurological disorders such as encephalitis or meningitis also run a risk of exhibiting mental retardation-like symptoms in the form of cognitive impairment and adaptive difficulties.
2. What are the Categories of Intellectual Disability?
Based on the range of IQ scores within which an individual falls, mental retardation can be divided into four different levels or categories, ranging from mild to profound or severe mental retardation. Other categories can be made based on the level of support the individual needs.
2.1. Mild Mental Retardation
A diagnosis of mild mental retardation is made when a person’s cognitive ability falls in the IQ range of 50 to 69. Most cases of mental retardation (approximately 85%) are those of this category. Someone with mild mental retardation can acquire a level of academic skills equivalent to that of a sixth-grader.
People with mild mental retardation are capable of developing communication and social skills to help support themselves and be self-sufficient, even living and earning independently in some cases. But they might require assistance in times of unusual stress.
If adequate support, guidance, and training are provided to people with mild mental retardation, then they can lead fruitful lives in community settings. Around 80% of mildly retarded people are engaged in employment activities, though they are mainly semi-skilled or unskilled jobs.
2.2. Moderate Mental Retardation
Anyone with an IQ score falling within the range of 35 to 49 will be diagnosed with moderate mental retardation. Around 10% of the cases of mentally disabled people belong to this category. People with mild mental retardation are usually only able to acquire academic skills up to the level of an average second-grader.
Someone with moderate mental retardation can develop sufficient communication and language skills in childhood, though growth in this area might be slow-paced. Training for social and occupational skills proves beneficial in helping moderately mentally disabled people adjust better to their environment and lead productive lives.
Most people with moderate mental retardation can be employed for unskilled or semi-skilled work in a sheltered environment but would need proper supervision as well as guidance. These people can live well-functioning lives in supervised places like group homes. They can generally tend to their needs and might or might not need supervision.
2.3. Severe Mental Retardation
A person will be diagnosed with severe mental retardation if their IQ score is somewhere between the range of 20 to 34. An approximate 3% to 4% of the mentally retarded population is considered to fall into this category.
Learning to talk and communicate might be possible for people with severe mental retardation, but this is vastly hindered by their limited speech skills and narrow vocabulary. They also have inadequate motor coordination, which makes it hard to perform chores. People with severe mental retardation can manage to undertake basic and simple self-care tasks but require close supervision and guidance for it.
Most people with severe mental retardation reside in group home facilities or with their families who look after them. Because severe mental retardation poses a risk of other conditions like neurological problems, and cardiovascular issues, the person might also need specialized nursing or hospital care.
Children with severe mental retardation are also commonly known to exhibit self-injurious behavior. This might include scratching, head banging, biting, etc.
2.4. Profound Mental Retardation
Anyone with an IQ score of less than 20 will be said to have profound mental retardation. Cases of profound mental retardation constitute only about 1% to 2% of all mental retardation diagnoses and are very rare. Profound mental retardation is characterized by severe impairment of cognitive ability.
Mental retardation in these cases often occurs due to other accompanying neurological disorders (for example, cerebral palsy).
People with profound mental retardation might be able to gain basic self-care skills and the ability to communicate through proper support and training programs. They typically need a high level of supervision, care, and assistance.
3. What are the Signs and Symptoms of Mental Retardation?
The symptoms of mental retardation usually begin to become prominent in childhood itself. A contrasting deficit in the child’s cognitive abilities, adaptive functioning, and social skills as compared to other children of their age group is one of the first indicators of possible mental retardation. Apart from cognitive and social insufficiencies, there are no obvious physical symptoms of mild intellectual disability.
A few of the early signs and symptoms of mental retardation occur in the following areas:
3.1. Milestones of Motor-Skill Development
Children with mental retardation are slow in achieving developmental milestones according to their appropriate age level when it comes to motor skills. In advanced cases of mental retardation, they might even fail to achieve these milestones at all.
Milestones of motor-skill development for growing kids include sitting, crawling, walking, etc.
3.2. Communication and Language
Mentally disabled children are much slower in learning to talk as compared to their peers. Even after they start talking, it is difficult for them to acquire age-appropriate speech and language skills.
As mentioned earlier, people with mental retardation face communication barriers due to their limited lingo and narrow vocabulary knowledge. However, they can learn to communicate successfully and efficiently without proper training and guidance.
3.3. Intellectual Deficits
Children with mental retardation fail to achieve markers of intellectual development fitting for their age.
Mentally disabled people have diminished or below-average intellectual abilities. They typically have poor planning skills, face hardships in problem-solving, and exhibit a scarcity of curiosity and interest in other people and the world around them. They lack the capacity for logical thought and action.
Besides these, their ability to learn, remember, and recall things is also reduced.
3.4. Behavioral Problems
Kids with mental retardation might continue to demonstrate infantile behavior regardless of how old they are. They might speak in a childlike manner, throw temper tantrums, fail to understand the consequences of their actions, etc.
Other behavioral problems may include difficulty looking after themselves, maintaining their upkeep, and not having self-care skills.
Training for these tasks also goes a long way in helping mentally disabled people in being able to become self-dependent.
3.5. Social Aspect
The most common problem faced by school-age children with an intellectual disability is keeping up at school. It is tough for them to meet their grade level educational standards at school due to their inadequate academic skills.
Mentally disabled people usually do not understand and, hence why, fail to meet social rules and norms. Their inability to respond suitably to social cues invites harsh misinterpretation of their good intentions. They are also not good at accommodating and adapting themselves to new situations.
Of course, social skills training can provide people with mental retardation support to become well-adjusted in their social environments.
3.6. Why is it Important to Know the Symptoms of Mental Retardation?
Being aware of the signs and symptoms of mental retardation might help new parents and guardians in spotting them early on in their children. Following this, they can get a proper assessment and diagnosis of mental retardation, if present, for their kids. With early intervention, children with mental retardation will be able to gain the required assistance and training they need to become adjusted adults in the future.
4. What are the Causes of Mental Retardation?
About 30% to 50% of cases of intellectual disability in children are from unknown reasons. A 5% share of intellectual and developmental disabilities is related to inheritance from ancestors and parents.
While the causes discussed below can contribute to intellectual disabilities, many other cases are due to complex interactions between these factors.
Let us look at the many causes attributed to the occurrence of mental retardation in children and even adults:
4.1. Genetic Causes
Genetic causes of mental retardation can be either inherited from either or both parents or can arise due to mishaps or the development of mutations during genetic mutations.
The presence of a history of mental retardation in family members increases the chances of children inheriting abnormal genes for intellectual disability. Besides this, errors during the combing of genes during the time of fertilization can also lead to genetically caused mental retardation.
Examples of inherited causes of mental retardation where genetics are responsible can be single-gene disorders like phenylketonuria and hypothyroidism.
4.1.2. Mutations or Accidents
If genetically caused mental retardation is not inherited, then they are a result of errors or mutations in genes. Accidents may include cases of trisomy 18 (generation of an additional chromosome 18), Down Syndrome (growth of an extra chromosome 21), Fragile X syndrome, etc.
As for mutations, intellectual disability has also been attributed to the presence of de novo mutations in genes.
Alterations or modifications in the protein histones, essential in regulating genes, can hinder their proper functioning. If this, in turn, affects the genes related to the development of neurons in a person, it might result in intellectual and developmental disabilities.
4.2. Prenatal Environment
The prenatal environment includes everything from the mother’s health to her social environment and the nutrition she gets during pregnancy. Intellectual disability during pregnancy usually occurs when the development of the fetus is hindered or improper.
Maternal malnutrition or deficiencies like that of iodine can cause mental retardation in the developing fetus. Apart from this, the usage of substances like alcohol can lead to problems like fetal alcohol syndrome in the baby, which is another form of intellectual disability.
Suppose the mother is exposed to harmful substances like heavy metals, toxic pollutants, or dangerous radiation in her environment. In that case, there is a very high risk of resultant mental retardation in the growing fetus.
Apart from these, being affected by infections like rubella or syphilis or diseases like diabetes makes a mother’s growing baby very vulnerable to being born with an intellectual disability.
4.3. Causalities During Birth
Complications at the time of labor and the birth of a baby can also cause mental retardation in them. Not getting enough oxygen during birth leads to brain damage in the newborn (birth asphyxiation) and might result in developmental disabilities.
If a child is born very prematurely or has significantly low body weight at the time of birth, then their chances of being affected by mental retardation are high.
Exposure to some dangerous diseases at any time in an individual’s lifetime might cause mental retardation in them. During the neonatal period, diseases like hypoglycemia or septicemia can give rise to intellectual disabilities in the newborn baby.
Infants or children that happen to get afflicted with brain infections like encephalitis or meningitis stand exposed to the probability of getting mental retardation if timely medical treatment is not provided to them.
Not only diseases but also cases like exposure to poisonous substances like lead or mercury or even traumatic brain injury are well-known causes of mental retardation.
Prolonged malnutrition, especially during childhood years, can also lead to mental retardation in a person. This happens to be one of the most common reasons for the occurrence of intellectual disability in third-world countries where famines are frequent or continuous wars, and internal disputes hinder their agricultural production.
Another severe but highly preventable deficiency known to result in mental retardation is that of iodine. An Intellectual disability caused by iodine deficiency is called congenital iodine deficiency syndrome. A more benign and more common form of this is mild mental impairment.
5. Is there a Cure for Mental Retardation?
There is no well-defined “cure” for mental retardation since it is not a disease but rather a more or less permanent condition.
But instead of a cure, there are many ways, such as early intervention, personalized education plans, and support services, to help improve the state of the person with mental retardation and help them live their lives to the fullest potential. Let us take a look at them:
5.1. Treatment of Mental Retardation
Treatment for mental retardation comprises medications to treat the co-morbid conditions that occur alongside the impairment of cognitive ability in most cases of mental retardation. Such co-morbidities include behavioral problems like aggressive or self-injurious behavior, mood disorders, and physical symptoms like convulsions, etc. Some common types of medications prescribed for people with mental retardation are:
- Anti-anxiety meds
- Mood stabilizers
- Anti-epileptic meds
5.2. Management of Mental Retardation
Management of mental retardation is made up of various forms of therapies and training which focus on helping the mentally retarded person cope better with their intellectual disability and the demands of everyday life. The goal of this is to bring down the safety risks for the person with mental retardation and teach them valuable and essential life skills. Which type of therapy works for which person depends on many factors such as their age, their level of mental retardation, their specific needs and that of their family, etc.
Therapies and training that aid in the management of mental retardation may include:
- Early Interventions: Specialists help young children with an intellectual disability via various targeted activities. These activities are aimed at helping these kids keep up with their education and increase their chances of having a successful school life.
- Developmental Therapy: Guides children with an ID throughout childhood to ensure good overall development.
- Occupational Therapy: Focuses on equipping the mentally disabled person with life skills to enhance their adaptive functioning in environments like home, school, workplace, etc.
- Speech Therapy: Attempts to teach communication and verbal speech skills to people with mental retardation.
- Behavior Modification Therapy: This aims to help the person with mental retardation or their caretakers either eliminate undesired behaviors or initiate desirable behaviors.
- Special Education: Includes specially designed education programs suited to the needs and requirements of the mentally disabled person and meet their distinctive learning needs.
6. What Have We Learnt
Mental retardation, better known as intellectual disability, is a part of human diversity that presents unique challenges but does not define an individual’s entire identity.
We have discussed the various aspects of intellectual disability, emphasizing the need for compassionate, personalized care and support.
Knowledge and understanding are crucial to overcoming ignorance and stigma, and many forms of management and support are available to help individuals lead fulfilling lives.
Although there is no cure, societal efforts to accept differences and advocate for rights can significantly improve the quality of life for those with intellectual disabilities. There should be continued progress and commitment to creating inclusive communities where every person is valued and can thrive.