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Mental Retardation

Definition Mental retardation is a developmental disability that first appears in children under the age of 18. It is defined as an intellectual functioning level (as measured by standard tests for intelligence quotient) that is well below average and significant limitations in daily living skills (adaptive functioning). Description Mental retardation occurs in 2.5-3% of the general population. About 6-7.5 million mentally retarded individuals live in the United States alone. Mental retardation begins in childhood or adolescence before the age of 18. In most cases, it persists throughout adulthood. A diagnosis of mental retardation is made if an individual has an intellectual functioning level well below average and significant limitations in two or more adaptive skill areas. Intellectual functioning level is defined by standardized tests that measure the ability to reason in terms of mental age (intelligence quotient or IQ). Mental retardation is defined as IQ score below 70-75. Adaptive skills are the skills needed for daily life. Such skills include the ability to produce and understand language (communication); homeliving skills; use of community resources; health, safety, leisure, self-care, and social skills; self-direction; functional academic skills (reading, writing, and arithmetic); and work skills. In general, mentally retarded children reach developmental milestones such as walking and talking much later than the general population. Symptoms of mental retardation may appear at birth or later in childhood. Time of onset depends on the suspected cause of the disability. Some cases of mild mental retardation are not diagnosed before the child enters preschool. These children typically have difficulties with social, communication, and functional academic skills. Children who have a neurological disorder or illness such as encephalitis or meningitis may suddenly show signs of cognitive impairment and adaptive difficulties. Mental retardation varies in severity. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) is the diagnostic standard for mental

healthcare professionals in the United States. The DSM-IV classifies four different degrees of mental retardation: mild, moderate, severe, and profound. These categories are based on the functioning level of the individual.

Mild mental retardation


Approximately 85% of the mentally retarded population is in the mildly retarded category. Their IQ score ranges from 50-75, and they can often acquire academic skills up to the 6th grade level. They can become fairly self-sufficient and in some cases live independently, with community and social support.

Moderate mental retardation


About 10% of the mentally retarded population is considered moderately retarded. Moderately retarded individuals 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 a supervised environment such as a group home.

Severe mental retardation


About 3-4% of the mentally retarded population is severely retarded. Severely retarded individuals have IQ scores of 20-40. They may master very basic selfcare skills and some communication skills. Many severely retarded individuals are able to live in a group home.

Profound mental retardation


Only 1-2% 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. The profoundly retarded need a high level of structure and supervision. The American Association on Mental Retardation (AAMR) has developed another widely accepted diagnostic classification system for mental retardation. The AAMR classification system focuses on the capabilities of the retarded individual

rather than on the limitations. The categories describe the level of support required. They are: intermittent support, limited support, extensive support, and pervasive support. To some extent, the AAMR classification mirrors the DSM-IV classification. Intermittent support, for example, is support needed only occasionally, perhaps during times of stress or crisis. It is the type of support typically required for most mildly retarded individuals. At the other end of the spectrum, pervasive support, or life-long, daily support for most adaptive areas, would be required for profoundly retarded individuals. Causes and symptoms Low IQ scores and limitations in adaptive skills are the hallmarks of mental retardation. Aggression, self-injury, and mood disorders are sometimes associated with the disability. The severity of the symptoms and the age at which they first appear depend on the cause. Children who are mentally retarded reach developmental milestones significantly later than expected, if at all. If retardation is caused by chromosomal or other genetic disorders, it is often apparent from infancy. If retardation is caused by childhood illnesses or injuries, learning and adaptive skills that were once easy may suddenly become difficult or impossible to master. In about 35% of cases, the cause of mental retardation cannot be found. Biological and environmental factors that can cause mental retardation include:

Genetics
About 5% of mental retardation is caused by hereditary factors. Mental retardation may be caused by an inherited abnormality of the genes, such as fragile X syndrome. Fragile X, a defect in the chromosome that determines sex, is the most common inherited cause of mental retardation. Single gene defects such as phenylketonuria (PKU) and other inborn errors of metabolism may also cause mental retardation if they are not found and treated early. An accident or mutation in genetic development may also cause retardation. Examples of such accidents are development of an extra chromosome 18 (trisomy 18) and Down syndrome. Down syndrome, also called mongolism or trisomy 21, is caused by an

abnormality in the development of chromosome 21. It is the most common genetic cause of mental retardation.

Prenatal illnesses and issues


Fetal alcohol syndrome affects one in 600 children in the United States. It is caused by excessive alcohol intake in the first twelve weeks (trimester) of pregnancy. Some studies have shown that even moderate alcohol use during pregnancy may cause learning disabilities in children. Drug abuse and cigarette smoking during pregnancy have also been linked to mental retardation. Maternal infections and illnesses such as glandular disorders, rubella, toxoplasmosis, and cytomegalovirus infection may cause mental retardation. When the mother has high blood pressure (hypertension) or blood poisoning (toxemia), the flow of oxygen to the fetus may be reduced, causing brain damage and mental retardation. Birth defects that cause physical deformities of the head, brain, and central nervous system frequently cause mental retardation. Neural tube defect, for example, is a birth defect in which the neural tube that forms the spinal cord does not close completely. This defect may cause children to develop an accumulation of cerebrospinal fluid on the brain (hydrocephalus). Hydrocephalus can cause learning impairment by putting pressure on the brain.

Childhood illnesses and injuries


Hyperthyroidism, whooping cough, chickenpox, measles, and Hib disease (a bacterial infection) may cause mental retardation if they are not treated adequately. An infection of the membrane covering the brain (meningitis) or an inflammation of the brain itself (encephalitis) cause swelling that in turn may cause brain damage and mental retardation. Traumatic brain injury caused by a blow or a violent shake to the head may also cause brain damage and mental retardation in children.

Environmental factors
Ignored or neglected infants who are not provided the mental and physical stimulation required for normal development may suffer irreversible learning

impairments. Children who live in poverty and suffer from malnutrition, unhealthy living conditions, and improper or inadequate medical care are at a higher risk. Exposure to lead can also cause mental retardation. Many children have developed lead poisoning by eating the flaking lead-based paint often found in older buildings. Diagnosis If mental retardation is suspected, a comprehensive physical examination and medical history should be done immediately to discover any organic cause of symptoms. Conditions such as hyperthyroidism and PKU are treatable. If these conditions are discovered early, the progression of retardation can be stopped and, in some cases, partially reversed. If a neurological cause such as brain injury is suspected, the child may be referred to a neurologist or neuropsychologist for testing. A complete medical, family, social, and educational history is compiled from existing medical and school records (if applicable) and from interviews with parents. Children are given intelligence tests to measure their learning abilities and intellectual functioning. Such tests include the Stanford-Binet Intelligence Scale, the Wechsler Intelligence Scales, the Wechsler Preschool and Primary Scale of Intelligence, and the Kaufmann Assessment Battery for Children. For infants, the Bayley Scales of Infant Development may be used to assess motor, language, and problem-solving skills. Interviews with parents or other caregivers are used to assess the child's daily living, muscle control, communication, and social skills. The Woodcock-Johnson Scales of Independent Behavior and the Vineland Adaptive Behavior Scale (VABS) are frequently used to test these skills. Treatment Federal legislation entitles mentally retarded children to free testing and appropriate, individualized education and skills training within the school system from ages 3-21. For children under the age of three, many states have established early intervention programs that assess, recommend, and begin treatment programs. Many day schools are available to help train retarded children in basic skills such as bathing and feeding themselves. Extracurricular

activities and social programs 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 individuals can often acquire the skills needed to live independently and hold an outside job. Moderate to profoundly retarded individuals usually require supervised community living. Family therapy can help relatives of the mentally retarded develop coping skills. It can also help parents deal with feelings of guilt or anger. A supportive, warm home environment is essential to help the mentally retarded reach their full potential. Prognosis Individuals with mild to moderate mental retardation are frequently able to achieve some self-sufficiency and to 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 individuals have a shortened life expectancy. The diseases that are usually associated with severe retardation may cause the shorter life span. People with Down syndrome will develop the brain changes that characterize Alzheimer's disease in later life and may develop the clinical symptoms of this disease as well. Prevention Immunization against diseases such as measles and Hib prevents many of the illnesses that can cause mental retardation. In addition, all children should undergo routine developmental screening as part of their pediatric care. Screening is particularly critical for those children who may be neglected or undernourished or may live in disease-producing conditions. Newborn screening and immediate treatment for PKU and hyperthyroidism can usually catch these disorders early enough to prevent retardation.

Good prenatal care can also help prevent retardation. Pregnant women should be educated about the risks of drinking and the need to maintain good nutrition during pregnancy. Tests such as amniocentesis and ultrasonography can determine whether a fetus is developing normally in the womb. Resources

Organizations
American Association on Mental Retardation (AAMR). 444 North Capitol St., NW, Suite 846, Washington, D.C. 20001-1512. (800) 424-3688. http://www.aamr.org. The Arc. 900 Varnum Street NE, Washington, D.C. 20017. (202) 636-2950. http://thearc.org.

Other Americans With Disabilities Act (ADA) Page.


http://www.usdoj.gov/crt/ada/adahom1.htm.

CHARACTERISTICS OF MENTAL RETARDATION


1.Mild Mental Retardation- master academic skills up to about the sixth- grade level and able to learn job skill well enough to support themselves independentlt to semi-independently. 2. Moderate Mental Retardation- show significant delays in development during their preschool years, as they grow older , discrepancies in overall, intellectual development , and adaptive functioning generally grow wider between these 3. Severe or Profound Mental Retardation- are almost identified at birth or shorly afterward. Most of these infants have significant central system damage , and many have additional disabilities and or health conditions.

EDUCABLE MENTALLY RETARDED. Means , is the one who because of slow mental development is unable to profit from the programs of the regular schools His limited potentialities for development include. 1. Minimum Educability in reading, writing, spelling, mathematics, and etc. 2. Capacity for social adjustment to a point where he can get along independently in the community. 3. Minimum occupational adequacy to support himself later to support himself partially . or totally at a marginal level. TRAINABLE RETARDED CHILD Defined as the child who is subnormal in intelligence unable to profit from the programs for the EMR but has potentialities in the three areas namely. 1, Self -care activities such as eating , dressing, toileting and sleeping. 2. learning to adjust in the home ot neighborhood. 3. learning economic usefulness in the home. TOTALLY DEPENDENT MENTALLY RETARDED CHILD. Refers to a child who is markedly abnormal intelligence , is unable to be trained in self care , socialization or mic usefulness , and who needs continuing assistance in attending to this personal needs. He is unable to survive without help and needs supervision throughout his life. ADAPTIVE BEHAVOIR - Self-care and daily living skills - Social development

- Behavioral excesses and challenging behavior . POSITIVE ATTRIBUTES Descriptions of the intellectual functioning and adaptive behavior of individuals with mental retardation forces on limitations and deficits and paint a picture of a monolithic group of people whose most important characteristics revolve around the absence of desirable traits. Reference: Exceptional Children 2007 version. By William Hewart EDUCATIONAL PROGRAM FOR STUDENTS WITH MENTAL RETARDATION. LAW Writer Ohio Laws and Rules Search OAC Ohio Revised Code Home Help Route: Ohio Administrative Code 3301 Department of Education - Administration and Director Chapter 3301-53 Special Education Programs for the Mentally Retarded 3301-53-01 Minimum standards for chartering county board of developmental disabilities special education programs. (A) Definitions. All terms used in this rule shall be considered as defined in rules 3301-35-01 and 3301-51-01 of the Administrative Code. Rule 3301-35-01 of the Administrative Code sets forth the definitions for the minimum standards for elementary and secondary schools and rule 3301-51-01 of the Administrative Code sets forth the definitions for the rules governing the education of children with disabilities. (B) Responsibilities of the county board of developmental disabilities. The county board of developmental disabilities (board) shall provide a special education program (program) for eligible students appropriately placed in such programs pursuant to rules 3301-51-01 to 3301-51-11 of the Administrative Code. (C) Eligible students. The board shall provide a program to serve:

(1) School-age children with cognitive disabilities and/or multiple disabilities who are determined to be eligible for a program under rule 3301-51-06 of the Administrative Code. (2) Preschool children who are determined to be eligible for a program under rule 3301-51-06 of the Administrative Code. (D) Educational program requirements (1) All programs shall comply with the following statutes and related rules: (a) Section 3313.48 of the Revised Code, minimum school year. (b) Section 3313.661 of the Revised Code, policy regarding suspension or expulsion, except that if the section is inconsistent with the Individuals with Disabilities Education Act, the Individuals with Disabilities Education Act shall control. (c) Section 3313.67 of the Revised Code, required immunizations. (d) Section 3313.712 of the Revised Code, emergency medical authorization. (e) Section 3313.72 of the Revised Code, contract with health district for services of physician, dentist, or nurse. (f) Section 3319.321 and Chapter 1347. of the Revised Code, safeguarding of student records. (g) Section 3321.04 of the Revised Code, student attendance. (h) Chapter 3323. of the Revised Code, education of handicapped children. (i) Section 3707.26 of the Revised Code, inspection of schools by the board of health. (j) Section 3737.73 of the Revised Code, drills and rapid dismissals. (k) Rule 3301-35-01 of the Administrative Code, the purpose and definitions rule for the operating standards for Ohios elementary and secondary schools. (l) Paragraph (I)(2)(c) of rule 3301-35-06 of the Administrative Code, services that identify student health and safety concerns and opportunities for access to appropriate related resources. (m) Paragraph (I)(2)(d) of rule 3301-35-06 of the Administrative Code, student attendance strategies in accordance with section 3321.04 of the Revised Code. (n) Chapter 3301-51 of the Administrative Code, operating standards for Ohios schools serving children with disabilities. (2) The program shall be guided by written policies of the board which are consistent with applicable statutory requirements contained in the Revised Code and rules adopted by the state board of education. Such policies shall include, but not be limited to: (a) Staff; (b) Cumulative records;

(c) Curriculum and instruction in alignment with Ohios academic content standards; (d) Health and safety; (e) Instructional materials and equipment; (f) Student activity programs; (g) Student admission; (h) Student attendance and conduct; (i) Selection of materials, textbooks, equipment, and instructional resources; and (j) Use of behavior management procedures. (3) A written philosophy of education and educational goals shall give direction to the educational program and shall provide a basis for daily operation. (4) Courses of study, methods of instruction, and other procedures shall effectively promote the needs, interests, and abilities of each school-age student with cognitive disabilities and student with multiple disabilities. The program shall be designed to raise the level of functioning in all areas of development. (5) Curriculum and instruction shall be characterized by systematic planning, articulation, implementation, and evaluation. (6) A current individualized educational program shall be on file for each child with a disability in the program and available to appropriate staff. (7) Student achievement shall be monitored according to the students individualized education program . Reports of student progress shall be made to parents at established intervals in accordance with the childs individualized education program. (8) The school day. (a) The school day for students in grades one through six shall include scheduled classes, supervised activities or approved educational options for at least five hours, excluding the lunch period. The school day for students in grades seven through twelve shall consist of scheduled classes, supervised activities (excluding interscholastic athletics), or approved educational options for at least five and one-half hours, excluding the lunch period. (b) Preschool children may attend programs that meet the requirements of rule 3301-37-03 of the Administrative Code, programs. (9) A county board of developmental disabilities may ask that an innovative pilot program be exempted from specific laws or rules pursuant to section 3302.07 of the Revised Code and rule 3301-46-01 of the Administrative Code. (E) Educational resources

(1) Staff shall be recruited, employed, assigned, and provided inservice education without discrimination on the basis of age, color, ancestry, national origin, race, sex, religion, disability, or veteran status. (a) Staff shall be assigned responsibilities in accordance with written position descriptions commensurate with their certification, licensure, and qualifications respectively. (b) A special class teacher for school-age students with cognitive disabilities and students with multiple disabilities shall hold a valid certificate or license as an intervention specialist in the appropriate area and shall meet any other applicable requirements . A preschool class teacher shall hold a valid certificate or license as an early childhood intervention specialist and shall meet any other applicable requirements. (c) Related services personnel defined by rule 3301-51-01 of the Administrative Code who provide related services for children with disabilities shall meet the certificate or licensure requirements that are applicable to a qualified provider of that particular service or therapy. (2) The program shall be provided clerical and custodial services. (3) Staff shall be supervised and evaluated according to a planned sequence of observations and evaluation conferences. (4) Staff shall have opportunities to participate in in-service education, which shall include: (a) Cooperative planning, implementation, and evaluation; (b) Job-related training in areas of need identified in personnel evaluations; and (c) Orientation activities for new employees. (5) Records shall be maintained on staff participation in in-service education and educational program development. (6) Instructional materials and equipment shall support attainment of objectives specified in courses of study. Such materials and equipment shall be current, selected according to adopted policies with the involvement of staff, and be available for teacher and student use. (7) Facilities shall accommodate the enrollment and the philosophy of education and educational goals of the program. (8) Student activity programs shall be operated in accordance with the philosophy of education and educational goals and shall safeguard the interests of the program, participants, and spectators. (F) Evaluation and chartering.

(1) The program shall be evaluated by the department of education to determine if such program is in compliance with this rule. Following the initial evaluation of the program, the program shall be monitored by the department of education as determined appropriate by the department. (2) The program shall be recommended to the state board of education for chartering if the program meets the requirements specified in this rule and those set forth in Chapter 3301-51 of the Administrative Code relating to the education of students with disabilities. Effective: 10/23/2010 R.C. 119.032 review dates: 08/06/2010 and 10/23/2015 Promulgated Under: 119.03 Statutory Authority: 3301.07, 3301.07(J) Rule Amplifies: 3301.07(J), 3323.02, 3323.09 Prior Effective Dates: 11-1-77, 6-10-88, 7-1-89, 9-23-2005 3301-53-03 Excess cost charges for county boards of developmental disabilities for special education programs. (A) As used in this rule, the following definitions apply: (1) Excess cost means the per-pupil educational cost for educating school-age children incurred by the educating county board of developmental disabilities that is in excess of the per-pupil amount received by the county board of developmental disabilities under Chapters 3306. and 3317. of the Revised Code. (2) Individualized education program means a written statement for a child with a disability that is developed and implemented in accordance with rule 3301-51-07 of the Administrative Code. (3) Certified excess cost means the cost calculated under this rule approved by the Ohio department of education which is the maximum amount of money a county board of developmental disabilities may charge a public school district responsible for tuition of a nonresident student enrolled in a county board of developmental disabilities program. (4) County board means a county board of developmental disabilities. (B) County boards may charge the school district responsible for tuition an amount of excess cost calculated under this rule when the following occurs: (1) The school district places or has placed a child with the county board for special education, but another district is responsible for tuition under Chapter 3313. of the Revised Code; and (2) The child is not a resident of the territory served by the county board. (C) Excess cost calculations shall be the actual cost per individual pupil for special education and related services that exceeds the amount received from

state sources and transfers for such pupils . The calculation of excess cost shall be completed by December first and shall include costs incurred for the fiscal year just completed. (D) Payment of excess cost by the public school district shall be made directly to the educating county board. (E) Excess cost calculations completed by a county board shall be based on the following and shall apply only to school-age programs: (1) Expenditures for direct services of the teachers and aides, ancillary services excluding food service costs, program supervision, building services and maintenance, administrative, and transportation costs; and (2) Funding reported on the payment report and transportation reimbursement shall be deducted by the Ohio department of education, and the certified excess cost shall be reported to the county board. Effective: 10/23/2010 R.C. 119.032 review dates: 08/06/2010 and 10/23/2015 Promulgated Under: 119.03 Statutory Authority: 3301.07, 3323.142 Rule Amplifies: 3323.142 Prior Effective Dates: 11-1-77; 6-10-88; 7-1-89; 9/24/2005 Go To: Prev | Next 3301-53-01 Minimum standards for chartering county board of developmental disabilities special education programs. 3301-53-03 Excess cost charges for county boards of developmental disabilities for special education programs.