Mental Retardation
Mental retardation is defined as:
IQ below 70
Impairment across a wide range of functions
And onset in childhood
The assessment of a child with suspected mental retardation encompasses:
Making the diagnosis
Evaluating concurrent psychiatric problems
Management is aimed at maximizing potential and quality of life, and treating concurrent psychiatric problems.
Mental Retardation
Mental Retardation is not equivalent to mental illness.
Mental Retardation are of 4 categories;
Mild (IQ = 50 – 69)
Moderate (IQ = 35 – 49)
Severe (IQ = 20 – 34)
Profound (IQ = less than 20)
Note: Children with MR can avail disability benefits
Mental Retardation
Marked delay in development (includingsitting, standing, walking, speaking etc.)
Inability to carry out age appropriateactivities for personal living including eating,drinking, bathing, dressing etc
Inability to understand and learn at home orin school
Inability to recognize colour, shape, size,direction, weight or any such concepts
Inability to recognize, count, and operatemoney
Inability to travel independently and makepurchases
Inability to judge right or wrong
Inability to behave age appropriately in socialsituations
Behavioral problems
Non-Organic Enuresis (Bedwetting)
Majority of children become dry by about 5 years
Enuresis is characterized by involuntary voiding of urine by day or night
It is not caused by neurological or other organic factors
School refusal is not a psychiatric disorder, but it is a common cause of consultation and is frequently caused by emotional disorder (social phobia, specific phobia, separation anxiety disorder) or possible child abuse.
Assessment of suspected school refusal:
Why is the child absent from school?
What does the school refusal reflect?
What are the other factors affecting the presentation?
Management:
Should aim at a rapid return to school before avoidance is too ingrained. Always involve parents & teachers
Beh Therapy in form of a graded re-exposure is useful
Need to address any specific fears of stress, and treat any associated psychiatric disorder
Poor School Performance (PSP)
Evaluate by ruling out sequentially the following causes of PSP:
Sensory impairments (blindness, deafness)
Intellectual Disability/MR
Learning Disorders/SLD (Dyslexia)
Behavioural Disorders (ADHD)
Emotional Disorders (Anxiety disorders)
Disorders of adolescence
Are classified in terms of:
Residual childhood problems (e.g. conduct disorder)
Problems of adolescent transition (adjustment disorder, eating disorder, Para suicide/DSH,drug abuse)
Early adult disorders (e.g. Schizophrenia, bipolar disorder, OCD)
