Mental retardation or MR is the most common disability in Bangladesh. In Bangladesh, 3.8 per cent children are mentally retarded. We can find these types of patients beside us. They may be our close relatives or neighbours or we can see them on the way. A few days ago I read news about a boy whose name is Rafiq (pseudo name). He is a mentally retarded boy of 18 years of age. His father died and his mother works in a garment factory. Rafiq is the only child of his mother. When his mother goes to work in the morning, she locks up Rafiq at home. Because, Rafiq disturbs all people and their neighbours complain about Rafiq when his mother comes home after work. All the time Rafiq stays alone inside the home. In our country there are many Rafiqs whose news we know not. So, now it’s the time of raising awareness among people about this issue. If we know the real problem and rehabilitate them, then they can lead a normal life.
Mental retardation (MR) is a developmental disability that first appears in children under the age of 18. It is defined as a level of intellectual functioning (as measured by standard intelligence tests) that is well below average and results in significant limitations in the person’s daily living skills (adaptive functioning).
There are many causes of MR. Among them the following are most common:
e Acquired condition (toxic attack, trauma, infection, prematurity)
e Chromosomal problem
e Multiple congenital anomalies or syndrome
e CNS malformation
e Metabolic and endocrine disorders
e Neurocutaneous syndrome
Signs and symptoms may include
e Lack of or slow development of motor skills, language skills, and self-help skills, especially when compared to peers
e Failure to grow intellectually or continued infant-like behaviour
e Lack of curiosity
e Problems keeping up in school
e Failure to adapt (adjust to new situations)
e Difficulty in understanding and following social rules
According to The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR ), mental retardation classifies four different degrees : mild, moderate, severe and profound . These categories are based on the person’s level of functioning.
Mild mental retardation
Approximately 85 per cent of the mentally retarded population is in the mildly retarded category. Their IQ score ranges from 50–70, and they can often acquire academic skills up to about the sixth-grade level. They can become fairly self-sufficient and in some cases live independently, with community and social support.
Moderate mental retardation
About 10 per cent of the mentally retarded population is considered moderately retarded. Moderately retarded persons have IQ scores ranging from 35–55. They can carry out work and self-care tasks with moderate supervision. They typically acquire communication skills in childhood and are able to live and function successfully within the community in such supervised environments as group homes.
Severe mental retardation
About 3–4 per cent of the mentally retarded population is severely retarded. Severely retarded persons have IQ scores of 20–40. They may master very basic self-care skills and some communication skills. Many severely retarded individuals are able to live in a group home.
Profound mental retardation
Only 1–2 per cent of the mentally retarded population is classified as profoundly retarded. Profoundly retarded individuals have IQ scores under 20–25. They may be able to develop basic self-care and communication skills with appropriate support and training. Their retardation is often caused by an accompanying neurological disorder. Profoundly retarded people need a high level of structure and supervision.
Treatment
Federal legislation entitles mentally retarded children to free testing and appropriate, individualised education and skills training within the school system from ages three to 21. For children under the age of three, many states have established early intervention programmes that assess children, make recommendations, and begin treatment programmes. Many day schools are available to help train retarded children in such basic skills as bathing and feeding themselves. Extracurricular activities and social programmes are also important in helping retarded children and adolescents gain self-esteem.
Training in independent living and job skills is often begun in early adulthood. The level of training depends on the degree of retardation. Mildly retarded people can often acquire the skills needed to live independently and hold an outside job. Moderate to profoundly retarded persons usually require supervised community living in a group home or other residential setting.
You can take advice from an Occupational Therapist who can identify the patient’s problem and provide appropriate therapeutic services to promote independent daily life and also help to find out appropriate vocational training.
Prognosis
People with mild to moderate mental retardation are frequently able to achieve some self-sufficiency and lead happy and fulfilling lives. To reach these goals, they need appropriate and consistent educational, community, social, family, and vocational supports. The outlook is less promising for those with severe to profound retardation. Studies have shown that these persons have a shortened life expectancy. The diseases that are usually associated with severe retardation may cause the shorter life span.
There are many rehabilitation centres that help to do vocational training and help the disable persons make their life independent. You can also take help from these centres. By taking vocational training mentally retarded people can lead wonderful life. So, please help them and integrate them into our society. We are all part of this society.
The writer is an Occupational Therapist at Proyash, Savar Cantonment, Savar, Dhaka. Email: rabeya1988@gmail.com
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