The Mental retardation is a generalized neurodevelopmental disorder characterized by a significant impairment of intellectual and adaptive functioning. It is defined by an IQ score lower than 70, in addition to deficits in two or more adaptive behaviors that affect daily life.
Mental retardation is subdivided into syndromic, in which there are intellectual deficits associated with other medical signs and symptoms, and non-syndromic, in which intellectual deficits appear without other abnormalities. Down syndrome and fragile X syndrome are examples of syndromic intellectual disabilities.
The terms mental disability and mental retardation were invented in the mid-20th century to replace the earlier set of terms, which were considered offensive. The term intellectual disability is now preferred by most advocates and researchers.
People with intellectual disabilities can learn new skills, but they do so more slowly. To measure a child's adaptive behaviors, a specialist will observe the child's abilities and compare them with other children of the same age.
General mental skills that are tested for the diagnosis of mental retardation include: reasoning, problem solving, planning, abstract thinking, judgment, learning from experience, and understanding. These skills are measured using individually administered intelligence tests that are given by a trained professional..
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The DSM-IV-TR, Diagnostic and Statistical Manual of Mental Disorders, speaks of Mental retardation and includes it within the disorders of onset in infancy, childhood or adolescence.
The definition of this developmental condition is addressed by the DSM based on a series of clinical criteria that must be present in a person for it to be diagnosed: significantly lower than average intellectual capacity and deficits or alterations of occurrence in adaptive activity current.
TO. Significantly below average intellectual ability: an IQ of approximately 70 or below on an individually administered IQ test (for young children, a clinical judgment of significantly below average intellectual ability).
B. Deficit or alterations of occurrence in the current adaptive activity (effectiveness of the person to satisfy the demands made for their age and their cultural group), in at least two of the following areas: personal communication, domestic life, social / interpersonal skills, utilization of community resources, self-control, functional academic skills, work, leisure, health and safety.
C. The beginning is before the age of 18.
If these three criteria are met in a child or adolescent, he or she may be diagnosed with an intellectual development disorder (formerly, mental retardation)..
I use this version of the DSM because, although it is old, it is the one used in the majority due to its pragmatism and the dissatisfaction among professionals of the fifth version of said diagnostic manual.
I speak in the plural because the causes that can trigger the alteration of intellectual development are very diverse. Some of them are:
According to data from the National Institute of Statistics, 24,700 people in Spain are affected by mild intellectual deficiency (15,000 men and 9,800 women), 52,800 moderate intellectual deficiency (34,300 men and 18,400 women) and 47,000 profound and severe intellectual deficiency (24,100 men). and 23,000 women).
If we segment these data according to age, it is observed that the vast majority of affected people belong to the group of 6 to 64 years (23,300, 48,700 and 418,000 respectively), data that indirectly informs about the life expectancy of these collective.
There are various ways in which a health professional might suspect or consider the presence of an intellectual development disorder.
In this case, the doctor will focus on ruling out physical causes that may explain the abnormality, such as deafness in the aforementioned case. If in addition to the physical causes, possible neurological disorders are also ruled out, it will be checked whether the person meets the criteria mentioned above for disorders of intellectual development.
In order to diagnose an intellectual development disorder, the evaluation of the aforementioned criteria must be done globally. That is, interviews with parents, observation of behavior and adaptation will be included, as well as intelligence tests..
If only one of the criteria or one of the evaluation pathways is positive, the diagnosis will be ruled out.
If and only if the three criteria of the DSM are corroborated through the triple evaluation, the diagnosis of intellectual development disorder will be established.
Thus, in the clinic, a fusion is made between the descriptive precision of the DSM-IV criteria and the globalizing approach of the DSM-V in terms of evaluation.
Although making a list of observable signs is, in this case, excessively general, I will present some of the most frequent:
As a general rule, these signs will be more noticeable and easier to identify at an earlier age if the intellectual development disorder is more serious..
In any case, given that there is a very high variability in the picture presented by these children, although the cause of their developmental abnormality is the same, we cannot speak of common signs.
If we review the possible causes we see that, in most cases, intellectual development disorders can be prevented.
The cause of intellectual development disorder associated with a higher success rate in prevention programs is fetal alcohol syndrome, caused by the mother's alcohol consumption during pregnancy. Currently, the consumption habits of pregnant women are continuously monitored.
Other highly widespread prevention measures are the consumption of vitamins during pregnancy or the vaccination of the mother against infectious diseases highly related to abnormal intellectual development syndromes..
Although it is not yet as widespread as the previous prevention tools, there are currently sophisticated genetic analyzes to determine the probability of hereditary diseases that occur with intellectual disabilities or other disorders..
In any case, many of the genetic abnormalities are due to “de novo” mutations: mutations that are not inherited by either parent but occur at the time of conception or at different stages of fetal development (failures in the replication of DNA).
The “mass sequencing” approach is the currently scientifically committed tool to detect any possible spectrum disorder in time. However, currently, only 60% of cases are identifiable using this sophisticated technology..
Why?
Despite the initial enthusiasm for genetic testing, it has been seen that the same syndrome of intellectual development can be activated through the same genes. In addition, the same genetic modification can translate into different syndromes or different degrees of involvement of the same syndrome.
Acceptable treatment for intellectual developmental disorders is multidisciplinary in approach. And what is that? Address the pathology with interventions by different health and social professionals at the same time:
As stated in the multinational study of attitudes towards individuals with intellectual disabilities of 2003, the general public does not understand the capacities of people with intellectual disabilities.
The observed reality reflects that people with mental health problems are subject to discrimination, even in health care settings, which has a negative impact on their self-esteem and degree of participation in society.
Several studies conclude that the best way to combat discrimination and stigma is through direct personal contact and social outreach campaigns..
The World Report on Disability states that students with severe intellectual disabilities who were taught in general education classes had better social outcomes.
If this is so for the most serious cases, why segregate even the mildest cases?
Intellectual development is not just a matter of how much you know or how many things you learn, it is also related to social inclusion. One of the greatest sources of learning and development is the social group. What I defend is not something new, Bandura already said in 1977 (vicarious learning).
In addition, it is not a question of me saying it or being defended by experts in the area, what we must not forget is the opinion and word of those affected:
“I am a student, like my other classmates I have difficulties learning and I learn according to the rhythm of the group… so why do you label me? as a child with a disability or special ?; Is my difficulty in learning out of the ordinary ?; And if it is the opposite, why you Ignorance keeps labeling me? ”- Yadiar Julián.
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