KAMPALA INTERNATIONAL UNIVERSITY WC

FACULTY: NURSING
NAME: KULUME SYLIVIA LOY
REG NUMBER: BNS/2262/153/DU
COURSE UNIT: MENTAL HEALTH 2
CLASS: 4.1D
LECTURERS NAME: MADAM PAMELA
TOPIC: MENTAL RETARDATION

OUTLINE
Definitions
Types/classification of mental retardation
Causes of mental retardation
Signs and symptoms of mental retardation

Mental retardation (intellectual disability) is refers to significantly sub average intellectual

functioning accompanied by impaired adaptive functioning.
Adaptive functioning refers to the person’s ability to adapt to the requirements of daily livingand
social responsibility expected of his age and cultural group.

Classification of mental retardation

Mental retardation is classified into the following levels based on the intelligent quotient of
individuals.
Intelligent quotient (IQ)
Mild (educable) 50-70
Moderate (trained) 35-50
Severe (dependent retardation) 20-35
Profound (life support) <20
Mild retardation (50-70)
 This is the commonest type of retardation accounting for 85-90%of all cases.
 This individuals often progress to p.6 and can achieve vocational skills with little support.
 They can develop social and communication skills but have poor cognitive function like
egocentric thinking.
Moderate mental retardation (IQ 35-50)
About 10%of the mental retardation Fall under this group.
 Communication skills develop slowly.
 They can be trained to support themselves by performing semiskilled or unskilled work
under supervision.
Severe mental retardation (IQ 20-35)
This type of retardation is often recognized in early life with poor motor development and
absence or markedly delayed speech and communication skills.
Through extensive training, they may be able to learn necessary life skills bout require to live in
sheltered home to avoid stressful situation.
Profound mental retardation
This is the most severe form of disability and also the rarest with only 1-2%of mentally
challenge children.
 They are severely handicapped and require extensive supervision
 Unable to profit from academic/vocational training.
 Adults with profound retardation cannot take care of themselves and need complete
support in daily living,
Cause of mental retardation
Mental retardation is a complex condition which is caused by the interaction of many factors
The exact cause is unknown.

Predisposing factors to mental retardation

Hereditary factors
Cause approximately 5% of the cases these include;
Inborn errors of metabolism like phenylketonuria and chromosomal disorders like Downs’s
syndrome.
Prenatal factors
Cause 30%of the cases they include
 Maternal illness during pregnancy for example rubella, toxoplasmosis result into mental
retardation.
 Drugs like cocaine and alcohol when taken during pregnancy may interfere with mental
development of the inborn child.
 Maternal malnutrition and exposure to retardation during pregnancy can also cause
mental retardation.
Perinatal factors
This cause approximately 10% of the cases of mental retardation. They include
 Birth asphyxia.
 Difficult birth
 prematurity
Postnatal factors
Conditions encountered in childhood accounts for approximately 5%.these conditions include,
 Infections like meningitis, encephalitis, and measles.
 Accidents like head trauma to the brain result in to mental retardation.
Environmental sociocultural factors
 Low socioeconomic status
 Inadequate caretakers
 Child abuse
Signs and symptoms
 Poor academic performance
 Learning speech at a slower rate
 Misplacing objects
 Having trouble remembering things
 Have trouble putting on clothes
 Aggression
 Depression
 Anxiety
 Tendency to cause injury on self
 Suicidal thoughts
 Poor interpersonal relationship
  Low attention

Diagnosis
History taking from parents and caretakers.
Physical examination
Neurological examination
Assessing milestones development
Investigations
Amniocentesis in infant chromosomal disorder
CT scan of the brain
Psychological tests like Stanford Binet intelligence scale and Wechsler intelligence scale for
Children (WISC) for categorizing the child’s disability.

Treatment
There is no medical cure for mental retardation,however there are ways in which you can enrich
theirlives and help them have apleasant childhood.

Prevention of mental retardation

Primary prevention
Preconception
 Genetic couseling to determine the risk of occurrence or recurrence of specific genetic
disorders.
 Immunization for maternal rubella
 Good maternal nutrition.
During gestation
 Adequate nutrition
 Fetal monitoring and protection from diseases
 Avoidance of teratogenic substances like exposure to retardation and consumption of
alcohol and drugs.
  Amniocentesis, fetoscopy, fetal biopsy and ultrasound.
At delivery
 Delivering should be conducted by the expert doctors and midwives.
 Close monitoring of the mother and the child.
 Injection of gamma globulin to prevent Rh-negative mothers from developing antibodies.
Childhood
Proper nutrition throughout the developmental period and particularly during the 6 month after
birth.
Avoidance of hazard like chemicals from the child’s environment.
Secondary prevention
 Early detection and treatment of preventable disorders like phenylketonuria.
 Early recognition of presence of mental retardation,
 Psychiatric treatment of emotional and behavioral difficulties.

Tertiary prevention.
This include rehabilitation in vocational, and social areas according to the level of
handcap.rehabilitation is aimed at reducing the disability and improving the optimum functioning
of the child with mental retardation.
 Early detection of handicap.
 Regular assessment of mentally retarded person’s disability.
 Advice and support to the families.
 Provision of education, training and work appropriate for each handicapped persons.
 Housing and social support to enable self-care.
 Medical, nursing care and other services for both outpatient and inpatient.
 Psychiatry and psychological services.

Nursing care plan of a patient with mental retardation

Nursing concerns
 Anxiety
 Risk for injury
 Self-care deficit
 Impaired verbal communication