Pathophysiology of Severe Mental Retardation

Legend
* - manifested by the client
- flow of disorder
- relevant factor
---- - signs and symptoms

Predisposing Factor Precipitating Factor

Genetic Conditions Pregnancy or Perinatal Problems such as:

Congenital Anatomical Tendencies
Mother’s Age -fetal malnutrition
Below 18 years old - infection
-hypoxia
-trauma

Mental Condition of Infancy

-chicken pox
-meningitis

Maternal and Diet lifestyle such as:

-alcohol drinking
*-cigarette smoking
-use of illicit drugs
-low protein and low iron diet
-lead poisoning
*-strenuous activity

Trauma during Birth

-physical trauma
-anoxia

Inadequate Blood Supply

Constriction in Blood Vessels

Shortage and Sluggish of Blood Circulation

Inadequate Oxygenation

Under develop of neurons

Malfunction of Axon
Terminal
 Malfunction of Nerve Impulses

Neurotransmitter binds to receptor in

Receiving Neuron’s membrane

Disrupted Level
Of Neurotransmitters

Insufficient Dopamine Increase in Gamma-aminobutyric Alteration in Serotonin

acid

*-*-loses
losesthe
theability
abilitytoto - -cause
causeanxiety
anxiety -- lack
lack of
of interest
interest in
in life
life
execute smooth
execute smooth and and **- -tingling
tinglingofofextremities -- sleep
sleep disturbances
disturbances
controlled
controlledmovements
movements - shortness of breath
extremities *-*-irritable
irritablemoods
moods
*-*-decline in memory,
decline in memory, - shortness of breath
attentionand
attention andproblem
problem
solving
solving

Alteration in transmitting neuron and

Receiving neuron function

Alteration in Brain

Damaged Damaged Atrophy of Dysfunction of

Cerebrum Cerebellum Hippocampus Amigdala

Alteration of Alteration of Alteration of long Alteration to

4 lobes behavior, term memory adaptive
movement and behaviors and
balance learning
* - difficulty in * - find hard to
judging * - difficulty in remember things * - temper
* - lack of following * - trouble tantrums
concentration instructions thinking logically * - difficult to
- repetitive * - decrease * - difficulty to adjust new
* - not seem to interest in solve problems environment
listen when learning * - learning
spoken * - answering disability
* - inattentive question * - unable to
- loss of smell inappropriately comprehend
and sensation *-hypersensitivity
* - loss of * - poor balance * - insensitive to
determining * - lack of focus stimuli
shapes, size and and attention * - difficulty
texture * - poor gross focusing
* - lack of motor skills * - delay language
concentration * - delayed fine skills
* - easily motor skills
distracted
* - easily
distracted
* - no eye contact

Delays in oral language development

Mental Retardation
Deficits in memory skills
Difficulty learning social rules
Difficulty with problem solving
skills
Delays in the development of
adaptive behaviors such as self-help
or self-care skills

Mild Mental Moderate Mental Severe Mental Profound Mental

Retardation Retardation Retardation Retardation

- IQ of 50 – 69 - IQ of 35 – 49 - IQ of 20 – 35 - IQ below 20
- delay in motor
development
- may respond
to training in
elementary
self-care
- impaired
judgment
in making
important
decisions

Delayed Language Skills

Delayed Motor Skills
Severe Mental Retardation Speech problems

With Interventions Without Interventions

Physical Assessment Client left alone without assistance

Diagnostic Test Reprimand client all the time
 - Newborn Screening Reprimand client all the time
- Bayley Scales of Infant Development Client is neglected by the family
- Standford-Binet Intelligence Scale Client isn’t corrected with his/her
- Wechsler Intelligence Scale for children doings
- Vineland Adaptive Behavior Scales Client does not taught how to care
Therapies about herself/himself
- Adaptive Physical Education
- Sensory Integration Program
*- Speech and Language Therapy
*- Occupational Therapy Poor Socialization
*- Special Education Class
*- Playhouse Experience
- Parental Counseling
Nursing Interventions Low Self- Esteem
- Provide Safety
- Stay always with the client
- Support the family by actively listening
to their feelings and concerns Dependent to Others
- Encouraging self-care goals and
emphasize needs of children, such as play
and social interaction
- Inform parents about stimulation, safety Worsen Complications
and motivation

Improved Level of Functioning

Improved activities of Daily Living

Self – Independent

GOOD PROGNOSIS BAD PROGNOSIS