Tuesday, April 2, 2019
Case study: Mental Retardation
Case study  psychic RetardationIntroductionWhen you go  let on from your ho physical exertion today, try to  mark the  tribe around our  environment, and we will found that  non everyone  stubs physically  lock  ilk us or at normal level. For instance,  at that place  be individual who blind, deaf  ar, and  overly who  atomic number 18 not  sufficient to  declare or move around. Generally, people refer them as physically disabled, so we will see this group of people having the   donationicular(a) privilege  such(prenominal)(prenominal) as in the shopping complexs parking space,  particular parking was  prompt with the label disable. On another hand, there are people who  bank  kindly  purpose at normal level like   intimately of us. They might have not able to control their body movement, their intelligence,  kindly interaction as  easy as langu days since the birth or  first childhood. In this case, we are referring them as  moral  ineptitude.The Ameri backside  railroad tie on Ment   al Retardation (2002) defined   psychological  unhurriedness as a particular state of  surgical procedure that begins in childhood and characterized by confinement in both intelligence and  adaptational skills. According to   state Information  middle(a) for children and  spring chicken with disabilities (2002), we label a  soul with  cordial retardation when he or she has specific limitation in  mental functioning and also in skills such as communicating, taking  negociate of him or her self as well as  hearty skills. All of this limitation will  salute the children in their  filming, such as slow in learning and development comparing to others typical child (National Information center for children and  offspring with disabilities, 2002). Mental retardation also reflects the fix between the capabilities of individuals and the  expression and expectation of their environment (The Ameri put up  draw on Mental Retardation, 2002). In specific example, children with mental retardation    may  postulate longer  epoch in learning to speak, walk, and  dispense care of their somebodyal  commands such as eating or dressing (National Information center for children and youth with disabilities, 2002). They are more likely to have problem learning in normal school (National Information center for children and youth with disabilities, 2002). They can learn,  save probably  ask a longer time or else there are something that they just  shift learn (National Information center for children and youth with disabilities, 2002). Mental retardation is sub-aver days  popular intellectual functioning that related with  concurrent impairments in adaptive behaviour and manifested during the developmental period (Southern  knowledge of institutional dentists, 2010). Mental retardation is an effectual theoretical intelligence, which is congenital or acquired early in life (Stefanovska, Nakova, Radojkova-nikolovska,  Ristoska, 2010). Children with mental retardation have the low  cast of     perceptiveness and limited do main(prenominal) of attention (Rezaiyan, Mohammadi  Fallah, 2007). The 34 Code of federal official Regulations 300.7(c)(6) of The United States Department of  tuition defined mental retardation as significantly sub-average general intellectual functioning, existing concurrently with deficits in adaptive behaviour and manifested during the developmental period, that adversely affects a childs educational  operation (Federal registration, 1999).The statistic showed that averagely, 3% of the general population will be suffered from mental retardation (Southern association of institutional dentists, 2010). Most people with mental retardation are  bring upd  in the  hotshot or during first years of school (Southern association of institutional dentists, 2010). The preponderance provided by statistical manual of mental  disobliges  fourth edition  school text revision DSM-IV-TR (2000) mentioned that mental retardation has been predictable at roughly 1%. In te   rm of gender, the ration for male to female is 1.5 to 1 (American psychiatric  connectedness DSM-IV-TR, 2000). This sh induce that mental retardation affect more male.The misconception about how people perceive what is mental retardation also   beingnessness pointing out. According to a case study from World Health Organisation (2006), a special education teacher who teaches the disable children is advised by the family and also neighbours to  throw overboard from her work when she is pregnant after 12 years of marriage. The reason  presumptuousness is that they want her to avoid contact with these types of children (means disable), concerning her un  natural(p) child will be like them. Acknowledged that this is superstitions, and with the  reserve from her husband, she continues to help the children at the  focus, and now her  impertinent born daughters intelligence is above average. Mental retardation is not something such as you having green eyes, bad heart, or you are born  scan   t(p) or thin, it is also not medical disorder, nor a mental disorder (The American  link on Mental Retardation, 2002).Criteria DefinitionReferring to the diagnostic and statistical manual of mental disorders fourth edition text revision (DSM-IV-TR),  published by American  psychiatrical  connection, there are  triple components of  ca drill of mental retardation, which all of the component must be present to diagnose a patient with mental retardation (American Psychiatric  experience DSM-IV-TR, 2000). The three diagnostic criteria for Mental Retardation are as below bar A. Significantly sub-average intellectual functioning an IQ of approximately 70 or below on an individually administered IQ  try (for infants, a clinical judgment of significantly sub-average intellectual functioning).Criterion B. Concurrent deficits or impairments in present adaptive functioning (i .e., the persons effectiveness in meeting the standards  evaluate for his or her age by his or her  cultural group) in    at least  twain of the following  subject fields   conversation, self-care, home living, social / inter individualised skills, use of community resources, self-direction, functional  schoolman skills, work, leisure, health, and safety.Criterion C. The onset is before age 18 years.In Criterion A, IQ or Intelligence quotient  adjudicate had  apply to administer the general intellectual functioning of an individual. Intelligence is the general mental capability. It  involved the ability in reasoning, problem  resolving power, abstract thinking, netherstanding complex ideas, quickly in learning, and also experience learning (American Association on Mental Retardation, 2002). The comm just IQ test such as the 3rd edition Wechsler Intelligence Scales for Children 4th Edition Stanford-Binet and also Kaufman  sagacity battery for children. All of this is an individually administered intelligence test. The cut-off score is IQ test scored 70 or sub-average intellectual functioning is IQ score    of about 70 or below, which are two standards deviation below the mean. However, in some cases, although the individuals IQ score is below 70, he or she should not be diagnosed as mental retardation if there is no  translucent disturbance in adaptive functioning. Adaptive functioning will be explained in Criterion B. The diagnostic and statistical manual of mental disorders fourth edition text revision (DSM-IV-TR) (2000), some others factor that may  top an individual score poorly should be taken into consideration. For example, some of the factors include the socio-cultural back groundwork of an individual the problem with native language as well as related communicative,  tug and sensory handicaps (American Psychiatric Association DSM-IV-TR, 2000). on that point is four degree of severity of mental retardation. The degree of severity is  headstrong by the IQ scores. The summary of the retardation and IQ level are as belowMild mental retardation IQ level 50-55 to approximately 70M   oderate retardation IQ level 35-40 to 50-55several(prenominal) mental retardation IQ level 20-25 to 35-40Profound mental retardation IQ level below 20 or 25(American Psychiatric Association DSM-IV-TR, 2000)About 85% of the mental retardation patient is  fall out under Mild Mental Retardation, which their IQ level through IQ test is about 50-55 to approximately 70 (American Psychiatric Association DSM-IV-TR, 2000). Normally, they cant be differentiating with normal children at the age of 0-5 years old. This is because the social and communication skills are developing at the age of pre-school (American Psychiatric Association DSM-IV-TR, 2000). At this stage, they have minimal disturbance in sensor motors areas (American Psychiatric Association DSM-IV-TR, 2000). The characteristic representing this category is the role of  woodwind in the movie Forest Gump. In the movie, Forest ever said that I been an idiot since I was born. My IQ is near 70, which qualifies me, so they say. (Smith,    2006). With the appropriate support, patient with mild mental retardation can live successfully. Forest, who always being classified as  developmentally challenged used chocolate to contrasting portrait of his struggle until he become a football star in the college, Vietnam war hero, and a successful business man (Smith, 2006).. On patients with moderate mental retardation, we  unremarkably refer them as trainable (American Psychiatric Association DSM-IV-TR, 2000). About 10% of the mental retarded patients fall under this category (American Psychiatric Association DSM-IV-TR, 2000). They learn communication skills at the early childhood, so that they can benefit from vocational training. With moderate supervision, patient with moderate mental retardation can  real fulfill personal care. They are able to travel by them self in a familiar setting however they cant  circulate beyond the 2nd grade level in the academic subject (American Psychiatric Association DSM-IV-TR, 2000). In a supe   rvised condition, patient can function well with the community around them.For patient with severe mental retardation, they are  rattling 3-4% of the mental retardation population (American Psychiatric Association DSM-IV-TR, 2000). During pre-school period, they might learn a little or no communication skills. During the school period, they learn talking at secondary level, they can be teaches in self-care. In a closely supervise condition, they can function well in life if they do not involve in  whatsoever handicap.Patient of mental retardation who falls under the  with child(p) mental retardation is 1-2% (American Psychiatric Association DSM-IV-TR, 2000). Most of the patient has a neurological condition that  emergence their mental retardation. Their motor development, self-care, and communication skills can be  amend if there is a proper education being given to them.If a mentally retarded patient who cant be categories within this four degree of severity, they will be put under    the category mental retardation, severity unspecified.In Criterion B, impairment in adaptive functioning is the  pore. Impairment functioning is the effectiveness of a person coping with  passing(a) life events and also how well a person  pass on the standard of self independence expected by their age group in a particular socio cultural back ground as well as community setting (American Psychiatric Association DSM-IV-TR, 2000). Yet, there are various factors that might influence the adaptive functioning of a person with mental retardation. Some of the factors are education, motivation, a persons characteristic, social and vocational opportunities and the mental disorder and general medical conditions (American Psychiatric Association DSM-IV-TR, 2000). The areas of adaptive functioning concerning is communication, self-care, home living, social social / interpersonal skills, use of community resources, self-direction, functional academic skills, work, leisure, health, and safety. A    person can  exclusively be diagnose with mental retardation if he meet any 2 of the area concerning in criterion B. For example, at the age of 16 years old, a person could not speak and poorly performance in academic.In criterion C, age is the focus. The onset must be before 18 years old.Intervention ProgrammeIntervention  program are to believe will help the children with mental retardation to  escape better in their daily life as well as future life. Intervention program for the mentally retarded children usually take part by the government, non-governmental organisation, school and also psychologist or expert in the field. Although it was take part by many organisations,  just now we have to  sensible that the   talk ofion program cost a large sum of  coin.  health check news today (2006) reported as in years 2000, money spend for patients with mental disorder is about 51 billion dollars. However, the  incumbrance program is still necessary to provide the patient another part of    life.One of the  interpolation programs for children with mental retarded is occupational therapy. In occupational therapy, thought about daily life functioning being discuss and share with the children (Kottorp, Hallgren, Bernspang,  Fisher, 2003). This therapy leads the children to perform the daily life task that the child would like to, or the task which is expected by the society or cultural back ground (Kottorp, Hallgren, Bernspang,  Fisher, 2003). The most important aims of occupational therapy are to lead the children to have meaningful and  resolute occupations through the  intervention (Kottorp, Hallgren, Bernspang,  Fisher, 2003). Occupational therapy also focuses to help the child with mental retardation to develop fine motor control (Reynolds  Dombeck, 2006).This fine motor skills is needed by the children with mental retardation to perform concentrated tasks (Reynolds  Dombeck, 2006). Some of the concentrated tasks are like theme or drawing. All of this basic concentr   ated task is important for self-help and academic skills in the later life of the children (Reynolds  Dombeck, 2006). Researcher found that occupational intervention program had a positive feedback (Kottorp, Hallgren, Bernspang,  Fisher, 2003). Patient can carry out activities of daily living in a safe and efficient manner. (Kottorp, Hallgren, Bernspang,  Fisher, 2003). In summary, Occupational therapy intervention program for children with mental retardation, aims to help the children to meaningful and purposeful activity. The activity include self-care, care for others, appreciate life and socially  lively in various situation. Mental retarded children who went through this therapy will able to use the skills learned in future.Another intervention program for children suggested by researcher is tooth-brushing intervention program. In a study done by Stefanovska, Nakova, Radojkova-nikolovska,  Ristoska (2010), they  intentional a 6 month intervention program that focus on the encou   ragement of independent manual skills looking after personal oral hygiene.100 school children at the age of 9-16 with low and moderate mental retardation in Skopje. Althought tooth brushing seems to be very easy for us,  barely it actually is a voluntary activity that requires motivation and physical ability. In term of motivation, the children with mental retardation are require to understand what is needed and also the reason or benefits of tooth brushing and also the desire to achieve the benefit ( reduction the plaque). Yet, they found that children with mentally retarded are not capable in understanding the oral hygiene procedures but they accept the  variegate (Stefanovska, Nakova, Radojkova-nikolovska,  Ristoska 2010). According to the researcher, patient of mental retardation normally suffered from periodontal disease. The result of their study showed that this six month program was effective in reducing the plaque and gingivitis scores and the long term success of the progr   am is to  wield the childrens motivation to brush their own teeth and make this part of their daily routine (Stefanovska, Nakova, Radojkova-nikolovska,  Ristoska 2010). Calculated the long term benefit, tooth brushing is actually cost effective ways of reducing plaque, reducing the needs to see  dental doctor and others. The mentally retarded children are able to brush their own tooth with proper encouragement and motivation.Besides that, Rezaiyan, Mohammadi  Fallah (2007) proposed that  ready reckoner game as an intervention instrument focusing on the attention capacity of the mentally retarded children. In their experiment, 60 male mentally retarded children were recruited from two 24 hours care centers in Tehra. All of them had an IQ level between 50 and 70 with no physical disability. The result of their study indicated that intervention of computer games increased the attention span of the mentally retarded children (Rezaiyan, Mohammadi  Fallah, 2007). Not only that, interventi   on of computer game also help in  change magnitude the internal motivation and activity if the children (Rezaiyan, Mohammadi  Fallah, 2007). The mentally retarded children was attracted by  trace of the computer games such as competition, laugh, curiosity and others, and all of this helped in  meliorate the ability to pay attention (Rezaiyan, Mohammadi  Fallah, 2007). The children also learned problem solving skills through the games Rezaiyan, Mohammadi  Fallah, 2007). In order to complete the game, the children need to practice and  living repeating the same process, this had help the children in self understanding skills,  slice paying attention to an object or location will improve the nervous system process (Rezaiyan, Mohammadi  Fallah, 2007). In summary, as we can see, the main function of the computer games is to help the children in understand and paying attention. The two benefits are actually interrelated to each others, to pay attention you need to understand, understandin   g help you in paying attention. The mentally retarded children need both of this skill. However, we should also consider the side effect of using computer. redundant education is another intervention program for the children with mental retardation. In Malaysia, a Non-governmental organisation, Lions Club of Kota Bharu operates a  downcast syndrome centre to give pre-school education to the  cut out syndrome children ages there to six years (Dahari, 2009). Down syndrome cause by the non-disjunction of chromosome 21and is the  starring(p) genetic cause of mental retardation (Ghosh, Sinha, Chatterjee  Nandagopal, 2009). After graduated from the canter, the Down syndrome children will be sending to the special classes in the government school. They  look at the Macquire Small step curriculum as teaching guide or you may called it as early intervention program. The term intervention is used to cover physiotherapy, occupational therapy, speech therapy and special education help. There ar   e several type of intervention provided such as home based, centre based, and nursery based. Parents with Down syndrome children might send their children to this centre for early education. mentally retarded children are educable (Demirel, 2010). Another intervention in term of education being done in Turkey, the curriculum for children with mental retardation was designed at primary school level, attending private class, focusing on improving the skills of understanding, showing positive social relations, adjusting to the social, technological and physical environment and surviving independently (Demirel, 2010). From two of this example, we can see that education actually help the mentally children to make their life better. As a psychologist, we should support all kind of effort in coming out with special education for the mentally retarded children. Education is one of the best intervention programs for the children.In conclusion, no one is this world choose to be born mentally    retarded mentally retarded is a give but not a choice. As a normal human, we should not  divert them yet give them the best of what we can do. Intervention program had being proven able to help the children with mental retardation to have a batter life. Every one of us should play our roles in  reinforcement all kind of intervention program. As a psychologist, we actually can do many things for them as there are within our area of study, we can contribute idea regarding their well fare, education and in others issues. They had born unlucky, why not we shown them another part of life?  
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