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PubMed1996

Life expectancy of mentally retarded hemiplegics.

Sixty-four mentally retarded people with hemiplegia (35 females and 29 males), first recorded in 1963, were re-examined 30 years later for life expectancy. Detailed physical and mental states, lengths of hospital stays and other information were noted. Recent advances in diagnosis and prognosis of hemiplegics were included. The results of the study indicate that, with special provisions available, people with hemiplegia have the prospect of reaching pensionable age and beyond: the oldest female is 85 and the oldest male 76 years of age.

Adult↗
PubMedDate not supplied

Evaluation of BR-16 A (Mentat) in cognitive and behavioural dysfunction of mentally retarded children--a placebo-controlled study.

It is important to control abnormal behaviour and hyperactivity, and improve cognition in mentally retarded children (MRC), which would help in their education, training and subsequent rehabilitation. Recently it has become known that amongst other side-effects, protracted use of anti-convulsant medication induces cognitive and behavioural dysfunction, which is a major problem in mentally retarded epileptics. In a placebo-controlled study, we confirmed the efficacy of a herbal preparation, BR-16A (Mentat) in controlling such behavioural and cognitive deficits in 40 mentally retarded children. The efficacy of this remedy was further evaluated in 19 MRCs with epilepsy. Twelve patients had generalised seizure, 4 with partial and 3 with mixed seizure pattern was continued. Inspite of the usual antiepileptic treatment, the frequency of seizures ranged from 1 to 7 attacks in periods from 1 week to 1 year. With active drug Br-16A, it was possible to note a reduction in seizure frequency. Patients with higher frequency responded better. There was no further increase in the dosage of antiepileptic drugs. There was significant control of other abnormal behaviour as shown by reduction in rating score on the Children's Behavioural Inventory test. BR-16A was effective in controlling abnormal behaviour, especially hyperactivity and incongruous behaviour in mentally retarded children with and without epilepsy.

Adolescent↗
PubMedDate not supplied

A community genetics approach to population screening in India for mental retardation--a model for developing countries.

Some 0.55 million people living in semi-urban and slum populations were screened for mental retardation by trained primary health centre (PHC) doctors, nurses and community health volunteers (CHVs). The staff were provided with prior training on the detection, prevention and diagnosis of mental retardation, prenatal diagnosis, and reproductive responsibilities. Field visits were employed to confirm diagnosed developmental disabilities, and demographic data incorporating social maps of 14 PHCs were prepared. Cases with high-risk genetic factors detected by PHC staff were referred to the Centre for Research in Mental Retardation (CREMERE) for cytogenetic and metabolic investigations, thus linking the study population and the Referral Centre. A genetic team interacted with the patient and family members for genetic counselling. Mental retardation was confirmed in 511 of the 525 cases reported, reflecting the positive impact of training on the CHVs. Potentially preventable environmental factors, such as birth asphyxia, infections, and low birth weight were identified in 251 cases (49%), 137 (27%) of which had additional genetic factors. Genetic causes were found in 186 (36%) individuals, the most common being Down syndrome. The study illustrates the urgent need for the integration of genetic screening into the public health services in India.

Asphyxia Neonatorum↗
PubMed1986

Exhibiting mentally retarded people for amusement and profit, 1850-1940.

Historians in the field of mental retardation have neglected to document the exhibition of people for amusement and profit, commonly known as "freak shows." The exhibition of people we would now call "mentally retarded" during the period 1850 to 1940 in the United States was discussed. Biographical sketches were given to five famous persons who were exhibited in the 19th century. Information on other individuals who were exhibited was also provided. Patterns and trends in exhibitions and in the significance of "freak show" imagery for current attitudes toward those known as mentally retarded was discussed.

History, 19th Century↗
PubMed1994

Social acceptance by their peers of children with mental retardation.

Students' willingness to befriend a child with mental retardation was investigated using written vignettes of students said to be enrolling in the subjects' school. In the control condition, all stories described the incoming students as non-labeled peers. In the experimental condition, half of the descriptions of new classmates included the addition of the label mentally retarded. Subjects were asked to make a behavioral commitment to befriend an incoming student assuming that the child would be joining their class. Chi-squared analysis indicated that the addition of the label to a description of a child significantly reduced the frequency of that child's being selected by subjects, particularly boys. The data suggested that the label may inhibit students' willingness to accept labeled peers socially.

Attitude↗
PubMed2006

Amniotic membrane transplantation with cauterization for keratoconus complicated by persistent hydrops in mentally retarded patients.

PURPOSE: Vigorous eye rubbing is a cause of extensive hydrops in mentally retarded patients with keratoconus. We describe a new management approach for this condition. DESIGN: Prospective, noncomparative, consecutive case series. PARTICIPANTS: Ten eyes of 10 mentally retarded patients aged 18 to 37 years (8 with Down syndrome and 2 with oligophrenia not associated with Down syndrome). All patients had extensive and persistent hydrops in the course of keratoconus that was refractory to traditional therapy. INTERVENTION: The patients underwent multifocal cauterization of the cornea combined with amniotic membrane transplantation. MAIN OUTCOME MEASURES: Corneal protuberance, final corneal thickness, time to hydrops resolution, and postoperative complications were assessed. RESULTS: Hydrops was successfully resolved in all eyes. The mean initial corneal protuberance (7.6+/-4.2 mm) resolved after 21.4+/-9.5 days in all eyes. Mean final central corneal thickness was 0.47+/-0.11 mm. Extent of initial corneal protuberance, final corneal thickness, and time to resolution were positively correlated with each other. CONCLUSIONS: Amniotic membrane transplantation with cauterization in this series of mentally retarded patients was a highly effective treatment for persistent hydrops related to keratoconus.

Adolescent↗
PubMed2001

Sexual Abuse of the Mentally Retarded Patient: Medical and Legal Analysis for the Primary Care Physician.

The primary care physician has a vital role in documenting and preventing sexual abuse among the mentally retarded populations in our community. Since the current national trend is to integrate citizens with mental retardation into the community away from institutionalized care, it is essential that all physicians have a basic understanding of the unique medical and legal ramifications of their clinical diagnoses. As the legal arena is currently revising laws concerning rights of sexual consent among the mentally retarded, it is essential that determinations of mental competency follow national standards in order to delineate clearly any instance of sexual abuse. Clinical documentation of sexual abuse and sexually transmitted disease is an important part of a routine examination since many such individuals are indeed sexually active. Legal codes adjudicating sexual abuse cases of the mentally retarded often offer scant protection and vague terminology. Thus, medical documentation and physician competency rulings form a solid foundation for future work toward legal recourse for the abused.

Journal Article↗
PubMed1998

Rubella serology in mentally retarded adults.

BACKGROUND: Rubella and congenital rubella syndrome remain a problem in the United States; institutionalized individuals are at higher risk. We assessed demographic variables and rubella serology in a population of institutionalized adults with mental retardation. METHODS: Subjects were 181 institutionalized adults with mental retardation. We reviewed charts to determine patient's age, sex, race, and fertility status (if female), cause of mental retardation, and rubella history. Serologic testing to determine rubella immunity was done. RESULTS: We found that 26.4% of subjects were nonimmune. Sex, cause of mental retardation, and history of rubella vaccination were not related to serologic immunity status. Of the 29 fertile female subjects, 8 (27.6%) were nonimmune to rubella. CONCLUSION: Subjects with unknown immunization status had a similar serologic profile to those whose medical records indicated immunization. Neither history of infection nor immunization was predictive of serology status.

Adult↗
PubMedDate not supplied

Differences in job placements between men and women with mental retardation.

Thirty-three men and women with mental retardation living in the New York metropolitan area (USA), who entered a supported employment programme were followed during their first 9 months in competitive employment. Differences in placement outcomes were consistently associated with gender differences. The implications of these findings are discussed in terms of providing employment services to men and women with mental retardation and developmental disabilities.

Adult↗
PubMed1999

People with mental retardation as witnesses in court: a review.

Evidence concerning eyewitness testimony given by people with mental retardation in court was reviewed. Despite general perceptions that people with mental retardation make incompetent witnesses, available evidence suggests that they can provide accurate accounts of witnessed events. The accounts are usually less complete than those provided by the general population and are greatly influenced by the methods of questioning. The sparse available evidence suggests that cross-examination methods may lead to memory distortion. The use of closed, complex, and leading questions and the absence of aids to recall may have a particularly adverse effect on people with mental retardation. Resulting errors could lead to a false conviction or acquittal. Future policy and research in this much neglected area were discussed.

Criminal Law↗
PubMed1988

Clinical aspects of mental retardation. The chief complaint.

The charts of 101 mentally retarded children were studied to determine how their retardation first came to the attention of their pediatrician. It was found that Speech Delay, Developmental Delay, and School Failure were the three most common parental concerns. Speech Delay accounted for over 50 percent of all referrals of children age 2 to 6 years. A first step to improve accurate evaluation and treatment of mental retardation is to recognize how children ultimately diagnosed as retarded are initially brought to the attention of the pediatrician.

Child, Preschool↗
PubMed1985

Behavior disorders and mental retardation: associations with age, sex, and level of functioning in an outpatient clinic sample.

A survey of 130 mentally retarded children and adults referred to an outpatient mental health clinic is reported. Three categories of behavior problems accounted for a majority of the referrals: schizoid-unresponsive and psychotic disorders, conduct disorder, and anxious-depressed withdrawal disorder. The distribution of referrals among the three categories was examined as a function of level of intellectual functioning, age, and client sex. Comparisons are made with previous surveys of mentally retarded and of nonretarded clinic populations. The implications of the survey results for planning mental health services with mentally retarded individuals are discussed.

Adolescent↗
PubMed1975

Management problems of mentally retarded children and their families.

Pediatricians faced with the difficult task of providing management services to mentally retarded children and their families are confronted with a number of difficult problems. These range all the way from deciding how to inform parents that their child is retarded to dealing with grandparents who are a source of stress. Successful handling of these problems requires a recognition that management is central to the care of the mentally retarded child. The needs of mentally retarded children and their families will not be met by interacting with families only around issues of acute physical illness. Attention must be directed toward psychosocial as well as medical variables and the emphasis must be on the total family system.

Child↗
PubMed2005

Descriptive assessment of sleep patterns among community-living adults with mental retardation.

There is little information about the sleep patterns of adults who have mental retardation and are supported in the community. In the present study, direct-care staff recorded sleep behaviors of 59 adults residing in 16 suburban group homes. Based on direct observation and measurement procedures, the adults averaged 7.9 hours of sleep each evening and had low incidence of sleep problems. Sleep duration was not influenced by age, gender, degree of mental retardation, or psychiatric status. Adults taking antidepressant medication (SSRI) had fewer hours of sleep. We discuss implications of these findings and factors contributing to healthy sleep hygiene among community-living adults with mental retardation.

Adult↗
PubMed2001

[Maternal stress among mothers of children with Williams-Beuren syndrome, Down's syndrome and mental retardation of non-syndromal etiology in comparison to mothers of non-disabled children].

OBJECTIVES: This study assesses the quantity of stress in mothers of children with mental retardation of different etiologies (Williams Syndrome--WS, Down Syndrome--DS, mental retardation of different etiologies--MR) and in mothers of non-disabled children (MA). METHODS: 85 mothers were asked to complete the Parenting Stress Index (PSI) and the Child Behavior Checklist (CBCL). The groups were matched according to the children's age, sex, and verbal comprehension as assessed by the WISC-R. Data on the child's mental age (WISC-R) and the family's socio-economic level were collected. RESULTS: Significant differences were found in the Child Domain, but not in the Parent Domain of the PSI. According to the Child Domain, mothers of children with WS and DS scored significantly higher on the acceptance and demandingness scales, while mothers of children with MR scored higher on the acceptance scale than did mothers of children with MA. Moreover mothers of children with WS displayed the highest scores on the hyperactivity, mood and adaptability scales. Groups did not differ on the level of experienced reinforcement from their child. No significant differences were found in the Parent Domain according to the subscales attachment and social isolation. Mothers of children with DS scored higher than the other groups on the scales: depression, sense of competence and parent health. Mothers of children with MR scored lower on restriction of their role as a parent and relationship to their spouse. The degree of the children's mental retardation as well as conspicuous behavior correlated positively with maternal stress but not the familial socio-economic level or the age of the children. CONCLUSIONS: Generally, mothers of children with mental retardation, regardless of its etiology, find it more difficult to accept their child than do mothers of non-disabled children. Specific behavior problems associated with the behavioral phenotype of a syndrome also influence the level of maternal stress.

Adolescent↗
PubMed2006

Lujan-Fryns syndrome (mental retardation, X-linked, marfanoid habitus).

The Lujan-Fryns syndrome or X-linked mental retardation with marfanoid habitus syndrome is a syndromal X-linked form of mental retardation, affecting predominantly males. The prevalence is not known for the general population. The syndrome is associated with mild to moderate mental retardation, distinct facial dysmorphism (long narrow face, maxillary hypoplasia, small mandible and prominent forehead), tall marfanoid stature and long slender extremities, and behavioural problems. The genetic defect is not known. The diagnosis is based on the presence of the clinical manifestations. Genetic counselling is according to X-linked recessive inheritance. Prenatal testing is not possible. There is no specific treatment for this condition. Patients need special education and psychological follow-up, and attention should be given to diagnose early psychiatric disorders.

Adolescent↗
PubMed1996

Psychiatric disorders in children and adolescents with mental retardation and developmental disabilities.

Children and adolescents with mental retardation and developmental disabilities are thriving in their communities owing to special education programs that provide full inclusion in school and community life. Many youngsters, however, do not reach their full potential because of the limitations imposed by untreated psychiatric disorders. Although striking behavioral symptoms may be present, care providers often mistake them for typical aberrant behavior associated with developmental disabilities. When this occurs, these children do not receive proper psychiatric care and may suffer restrictive behavioral programming and exclusion from community living. On the other hand, children and adolescents with mental retardation and developmental disabilities frequently present with unusual symptoms associated with psychotic disorders, leading to misdiagnosis and inappropriate treatment with antipsychotic agents. The problems due to stress on these children and their families, long-terms costs in loss of educational and vocational opportunities, and the development of serious adult psychiatric disorders are enormous. By exploring the risk factors for psychiatric diagnosis in this population and presenting illustrative cases, awareness of the indicators for pediatric practice with this population is provided in this review.

Adolescent↗
PubMed1999

Breakthroughs in molecular and cellular mechanisms underlying X-linked mental retardation.

Although genetic causes of X-linked mental retardation (XLMR) are heterogeneous and complex, recent concerted actions between physicians and biologists have allowed some major difficulties to be overcome and led to the identification of an increasing number of genes involved in these conditions. Indeed, over the past 2 years significant progress has been made in understanding the molecular basis underlying not only XLMR, where there are distinguishing phenotypic or genetic markers (syndromal forms of XLMR), but also non-specific (or idiopathic) mental retardation (MRX). Recent breakthroughs have shown that genes responsible for these latter conditions encode for proteins involved in signalling pathways which regulate cytoskeleton organization, synaptic vesicle transport and, maybe, other cellular functions. Also, they suggest a provacative picture that conceptualizes MRX as disorders resulting from a dysfunctioning of genes required for processes such as the remodelling, establishment and stabilization of connections between neuronal cells. Such processes are crucial for the development of intellectual and cognitive functions. As these functions begin to evolve mainly in post-natal stages through contact with diverse stimuli and environments, a potential therapeutic approach would be the development of drugs that target cellular signalling pathways shown to be implicated in MRX.

Genetic Linkage↗