MENTAL RETARDATION

Francisco, Dominque Hadjirul, Eliona Pineda, Marjorie

Definition of Mental Retardation

Past

Strictly a measurement of cognitive abilities

Present

Combination of cognitive abilities

AAMR Definition
1. Significantly subaverage intellectual functioning 2. Limitations in 2 or more of 10 separate indicators of adaptive skills
AAMR- American Association of Mental Retardation

How We Should See Mental Retardation

- Something that you have like blue eyes or a heart defect - Something that you are like short or thin - Neither a medical disorder or a mental one - A particular state of functioning that begins in childhood and is characterized by limitations in both intelligence and adaptive skills

 Developmental Disabilities
- Includes mental retardation AND other conditions of mental and physical impairment likely to need lifelong help from a variety of health, social, and educational agencies

1. Intelligence
Traditionally determined by

performance on intelligence tests Results of IQ tests: Children with MR are markedly slower than their agemates in:
- Associating and classifying information

- Reasoning - Making sound judgments

education

Alfred Binet - Developed an intelligence test for the purpose of finding children who were not capable of responding to the traditional education

 David Wechsler - Developed individual tests of intelligence - Provide for 10 subtests and scale scores that allow psychologists to develop a profile of the skills of the individual tested and allow teachers to distinguish between verbal IQ scores and performance IQ scores

Category
Communication

Skills
Skills involving the ability to comprehend and express information through symbolic behaviors (e.g. Spoken word, written word/ sign language or nonsymbolic behaviors (e.g. Facial expression) Skills involved in toileting, eating, dressing, hygiene, and grooming Skills related to functioning within a home, which include clothing care, housekeeping, food preparation, and home safety

Self-Care Home Living

Social

Skills related to social exchanges with other individuals, including initiating interaction and terminating interaction with others; responding to pertinent situation cues; recognizing feelings Skills related to the appropriate use of community resources, including travelling in the community; shopping at the stores and markets; purchasing or obtaining services (e.g. Gas stations, doctor s and dentist s offices); using public transportation and facilities Skills related to making choices; following a schedule; initiating activities appropriate to the setting

Community Use

Self-Direction

Health and Safety

Skills related to maintenance of one s health in terms of eating; illness, treatment, and prevention; basic first aid; sexuality; basic safety considerations (e.g. Following rules and laws) Cognitive abilities and skills related to learning at school that also have direct application in one s life (e.g. Writing, reading, using basic practical math , awareness of the physical environment and one s health and sexuality The development of a variety of leisure and recreational interests (e.g. Self-entertainment and interaction) that reflect personal preferences and choices

Functional Academics

Leisure

Work

Skills related to holding part- or fulltime job or jobs in the community in terms of specific job skills (E.g. Completion of tasks, awareness of schedules, ability to take criticism and improve skills

A child or an adult must be significantly deficient in at least two of these ten categories of adaptive behavior

2. Adaptive Skills Emphasis on environment and context of the child Key in special education programs

 It is possible to have a low IQ score AND STILL: Possess usable adaptive skills Be self-sufficient in the community Be able to interact reasonably with citizens Maintain a part-time or full-time job

 Levels of Mental Retardation:

- Past Categories Used:
Idiot Imbecile Moron Educable Trainable Dependent

- Current Categories Used:

1. 2. 3. 4.

Mild Moderate Severe Profound

1. Mild
- Development between 1/2 and 3/4 of the normal rate

2. Moderate
- Development at about 1/2 of the normal rate 3. Severe - Development at slightly more than 1/4 of the normal cognitive growth 4. Profound - Development less than 1/4 of a normal cognitive growth

 Formal definition of MR
- Places the issue within the child

Another way of viewing the child with MR:

- Defining the level or intensity of support necessary to allow the child or individual to operate effectively

 Intensity of Support
1.

Intermittent
- Support as needed but not necessarily

present at all times

2. Limited
- Support provided on a regular basis for

a short period of time

3. Extensive
- Ongoing and regular involvement/ support

4. Pervasive
- Constant high-intensity help provided

across environments and involving more staff members than other categories

Examples of Support Areas for Individuals with MR

Human development activities Providing social and emotional developmental activities to foster trust, autonomy, and initiative Learning and using functional academics (reading, signing, counting change, etc.) Participating in leisure activities within the home Interacting with co-workers Avoiding health and safety hazards Making and keeping friends Controlling anger and aggression

Teaching and education activities Home living activities Employment activities Health and safety activities Social activities Behavioral activities

Cognitive Abilities

Adaptive Behaviors

Supports

Adapting The Curriculum

 Important question in adapting a curriculum for children with MR:

WHAT ARE THE GOALS?

 Example goals reasonable for a child with moderate MR:

- Learn to read at least to the "survival words" level (stop, poison, restroom, etc.) - Do basic arithmetic skills, such as the ability to work cooperatively with others - Have some leisure-time skills - Communicate with persons such as storekeeper and community helpers - Learn some work skills to be partially or fully self-supporting in adulthood, if possible

 Differentiated Instruction
- Each teacher adjusts the level of difficulty

of tasks to fit the level of development of the child with MR

Example: If the rest of the class is doing complex multiplication or division problems, the child with MR may be given addition or division problems.

 Differentiated instruction takes place in 4 major areas:

- Readiness & academic skills - Communication & language development - Socialization - Prevocations & work study skills

Basic Academic Skills

Task analysis for primary-grade children
Benefits 1) Subtasks are the source from which academic skills will develop. 2) Mastery of the subtasks gives the child with MR an opportunity to succeed and gain selfconfidence.

 Additional help with their memory and attention Cognitive strategies to be specifically taught
- Rehearsal strategies (shadowing or vocalized thinking or thinking aloud) - Use of verbatim notes with the student copying text, such as spelling words in written form)

 Language and Communication (for children with moderate MR)

- Language to communicate feelings - Development in speech and the understanding and use of verbal concepts - Communication skills such as the ability to listen to stories, discuss pictures, and tell about experiences stressed

 Socialization
- Social skills are critical, but instruction should be informal - Difficulty transferring or applying ideas from one setting to another - Needed social skills to be taught directly - Some type of counselling and roleplaying of situations with the opposite sex often part of the curriculum

 Activities that enhance social contact and learning devised to meet socialization goal of inclusion Example activities:
- Peer-buddy systems - Peer support networks - Circles of friends

 Prevocations and Work-Study Skills

- Development of work skills
5 areas to be mastered: 1. Consumer economics 2. Occupational knowledge 3. Health 4. Community resources 5. Government and law

 Vocational training
Focuses on dimensions beyond the job

itself Examples: banking and using money, grooming, caring for a car and obtaining insurance, interviewing for jobs, and using leisure time

Transition: School to Work

After graduation in high school

About half graduated from high school; the rest either dropped out or aged at school
Dropping out because of behaviorrelated performances 28% of those who dropped out had serious discipline problems

Social Relationships
1 out of every 4 was a social isolate in school Percentage of students with MR who regularly saw their friends was no lower than the percentage of those who were visually impaired, speech impaired, or learning disabled Less likely than other students with disabilities to be members of organized groups

 Family and Lifespan Issues

 Family Support o Respite care
- the provision of child-care services so the parents are freed, for a few days, of their constant care responsibilities o Understanding and empathy - Reflect the feelings of the parent

oHelp establish a sustainable daily routine

- Develop a daily routine that meets the needs of each family member in some optimal way

oImportance of father - Direct counselling and support