MENTALLY DISABLED CHILDREN

MENTALLY DISABLED CHILDREN

MENTAL RETARDATION IS A LEVEL OF INTELLIGENCE BELOW AVERAGE WITH LIMITED FUNCTIONALITY, COMBINED WITH DISORDERS IN ADAPTIVE BEHAVIOR THAT OCCURS DURING THE DEVELOPMENT PERIOD.

• With below-average intellectual function; Two or more impairments in communication, self-care, home life, social skills and social usefulness, self-direction, health maintenance, academic functioning and work are predicted.

• Before age 18 It should be observed during the developmental period.

Frequency

• Studies have reported that the prevalence of mental retardation is1%.

• It is observed twice more frequently in boys than in girls.

• In 58-78% of individuals with mild mental retardation and in 23-43% of individuals with severe mental retardation, no cause can be shown with current diagnostic investigations.

Prenatal Causes

• Genetic causes

• Mother-fetus infections

• Developmental cerebellar anomalies

• Radiation

• Hypothyroidism

• Maternal causes

Congenital Causes

• Birth Trauma

• Acquired metabolic disorders(hypoglycemia, hyperbilirubinemia)

• Infections

• Intraventricular hemorrhage

• Multiple congenital deformities

• Neonatal Convulsions

Postnatal Causes

• Infectious and inflammatory diseases

• Head Traumas

• Intoxications

• Environmental causes

• Congenital metabolic diseases

• Neuromuscular diseases

• Brain tumors

• Asphyxia

Assessment of Mental Retardation

Evaluate Mental Retardation Its processing is multidisciplinary. Psychologists conduct cognitive assessments. Pediatricians and clinical geneticists perform physical diagnostic evaluations. Psychiatrists and behavioral therapist psychologists; Evaluates the individual in terms of mental disorders and behavioral functions. Methods used for prenatal diagnosis of factors causing mental retardation are as follows:

• Ultrasonography

• Amniocentesis

• Fetoscopy

• Chorionic villus samples

Co-existing Disabilities and Psychiatric Disorders

If a person with mental retardation also exhibits one or more physical or mental disorders, it is called “multiple disabilities.” It is called. Multiple disabilities have significant effects on educational, social and work adaptation.

1-Physical disabilities

a. Visual impairments p>

b. Hearing loss

c. Speech and language problems

d. Epilepsy

e. Cerebral palsy

2-Psychological Disabilities

Psychotic Disorders (Schizophrenia)

Neurotic Disorders (Conversion)

Personality Disorders (Homocidal and sexual crimes)

Serious Mental Disorders of Childhood (Autism)

Intelligence Levels

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Genius 130 and above

Brilliant intelligence 120-129

Superior intelligence 110-119

Normal intelligence 90-110

Dull normal intelligence 80-89

Borderline mental retardation 70-79

MENTAL RETARDATION 69 and below

Mild mental retardation 52-69

Moderate mental retardation 36-51

Severe mental retardation 20-35

Profound mental retardation less than 20

Monitoring and Treatment of Mental Retardation

• External Aggressive behavior towards the bee or oneself can create clinical problems that are difficult to manage. The most necessary situation for the use of psychotropic medication in individuals with MR is destructive behavior.

The three most commonly observed types of destructive behavior are:

one. Self-destructive behaviors

2.Stereotypical (repetitive) behaviors

3.Aggression (aggression)

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The basis of treatment in patients with MR is changing behavior and normalizing activities in daily life.

There is no specific pharmacological treatment for aggression and self-mutilating behaviors in mental retardation. There is no treatment. The pharmacological treatment to be applied should be symptomatic, aiming to control abnormal behavior and support behavior change programs.

Psychotherapy in Mental Retardation

Mentally retarded people are prone to many emotional disorders because they do not have sufficient ego resources to cope with the stresses of daily life. Although treatment needs in this regard are increasing, psychotherapy practices with mentally retarded people are few. The reasons for this can be listed as follows:

- Those with MR are less aware of the difficulties and are not motivated enough to ask for help.

- Low intelligence level prevents them from understanding that behavior needs to be changed.

- People with MR have weak impulse control and ego strength to develop self-confidence. A lot of effort is required to achieve a certain result in these patients.

- Psychotherapists are insufficient to understand those with mental retardation. Conflicts of meaning arise between the therapist and the patient.

Behavioral Treatment

Mild and moderate mental retardation constitute 96% of those with mental retardation. Behavioral interventions in groups are extremely effective. The purpose of behavioral therapy applied to those with mental retardation is not to treat the mental disorder, but to facilitate adaptation in areas where skill deficiencies exist, such as self-control, social skills and educational problems. Self-control problems prevent the correction of aroused behaviors and the lack of positive behaviors. It is treated with techniques that aim to educate people and reduce stereotypes.

Punishment, which effectively reduces undesirable behaviors, is the last resort.

With behavioral treatment, significant improvements are made in social skills, especially communication and daily living skills. is provided. In general, reinforcement techniques give positive results in the development of expression language, understanding and following instructions, and the acquisition of basic personal and domestic life skills. An increase in academic performance is also observed with the implementation of behavioral interventions.

Drug Treatment

Drugs and vitamin supplements that accelerate brain blood flow and intracellular metabolism and increase attention can be given. Behavioral controls. and treatment for depression can be arranged. Early treatment is important.

Communication in Patients with Mild Mental Retardation

• Minimize distraction

• Use short explanations

• Use simple language

• Spend more time getting information

• Avoid explanation of causes

• Focus on the effects of the deficiency you are addressing

• Activities rather than concepts teach

• Encourage compliance

• Use positive reinforcement

• Verbal Use compliments

Communicating with Patients with Severe Mental Retardation

• Use short, easy explanations

• Repeat the training more

• Use the positive contribution more

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