Whats in a Name?
Idiot
Moron
Feeble
Minded
Mentally Retarded
Intellectual Disability
AAMR
American Assn on Intellectual and Developmental
Disabilities (AAIDD)
Learning Objectives
retardation.
5) Define behavioral phenotypes for 5 common
mental retardation syndromes.
Definition
Deficits
Impairments
in Adaptive Functioning
Degrees of Severity
Mild
Mental Retardation
Moderate
Mental Retardation
Severe
Mental Retardation
Profound
Mental Retardation
referred to as educable
Largest segment of those with MR (85%)
Typically develop social/communication skills
during preschool years, minimal impairment in
sensorimotor areas, often indistinguishable from
typicals until later age
By late teens acquire skills up to approximately
the 6th grade level
referred to as trainable
About 10% of those with MR
Most acquire communication skills during early
childhood years
Generally benefit from social/vocational training and with
moderate supervision can attend to personal care
Difficulties recognizing social conventions which
interferes with peer relations in adolescence
Unlikely to progress beyond the 2nd grade academically
Often adapt well to life in the community in supervised
settings (performing unskilled or semiskilled work)
4% of those with MR
Acquire little or no communicative speech in
childhood; may learn to talk by school age and be
trained in elementary self-care skills
Can master sight reading survival words
Able to perform simple tasks as adults in closely
supervised settings
Most adapt well to life in the community, living in
group homes or with families
2% of those with MR
Most have an identifiable neurological
condition that accounts for their MR
Considerable impairments in sensorimotor
functioning
Optimal development may occur in a highly
structured environment with constant aid
Prevalence
1%
(1 3% in developed countries)
The prevalence of MR due to biological factors is
similar among children of all SES; however,
certain etiological factors are linked to lower SES
(e.g., lead poisoning & premature birth)
More common among males (1.5:1)
In cases without a specifically identified biological
cause, the MR is usually milder; and individuals
from lower SES are over-represented
Psychiatric Features
No
Disorders
Pervasive Developmental Disorders
Stereotypic Movement Disorders
Mental Disorders due to a GMC
Predisposing Factors
No
(5% of cases)
Tay-Sachs, PKU)
Single-gene abnormalities with Mendelian inheritance
and variable expression (e.g., tuberous sclerosis)
Chromosomal aberrations (e.g., Fragile X)
Early Alterations
of cases)
Chromosomal changes (e.g., Downs)
Prenatal damage due to toxins (e.g., maternal EtOH
consumption, infections)
stimulation
Mental
Disorders
Pregnancy
infections, trauma
General
Disability
Low
Etiology
Downs Syndrome
Most
Relative
weaknesses:
Generally
Downs Syndrome
Fragile X Syndrome
Relative weaknesses:
ST memory, VM integration, sequential processing, math & attn
Fragile X Syndrome
Fragile X Syndrome
Prader-Willi Syndrome
Deletion
Relative
weaknesses:
Prader-Willi Syndrome
Prader-Willi Syndrome
Angelman Syndrome
Severe
Angelman Syndrome
Williams Syndrome
MR,
Relative
weaknesses:
Williams Syndrome
Psychotropic Medications
No
More
Stimulants
ADHD
Antidepressants: Sertraline/Zoloft
No
Antidepressants: Fluoxetine/Prozac
Among
Antidepressants: Fluvoxamine/Luvox
One
Antidepressants: Paroextine/Paxil
Davanzo
Antidepressants: Citalopram/Celexa
Verhoeven
Antipsychotics in the
Treatment of MR
The
Antipsychotic: Clozapine/Clozaril
Found
Antipsychotic:
Risperidone/Risperdal
Efficacious
Antipsychotic: Olanzapine/Zyprexa
McDonough
Antipsychotic: Quetiapine/Seroquel
Hardan
Antipsychotic: Ziprasidone/Geodone
A case
Antipsychotic: Aripiprazole/Abilify
Stigler
Alpha-2 Agonists:
Guanfacine/Tenex &
Clonidine/Catapres
Frankhauser