Management of mental retardation (mr)

1. MANAGEMENT OF MENTAL RETARDATION (MR) PRESENTED BY DR. MAYANK SHARMA

2. INVESTIGATION THREE CRITERIA ARE USED TO DETERMINE MENTAL RETARDATION. 1 INTELLIGENCE QUOTIENT (IQ). 2 SIGNIFICANT LIMITATIONS IN 2 OR MORE AREAS OF ADAPTIVE BEHAVIORS. 3 THESE LIMITATIONS BECOME APPARENT IN CHILDHOOD.

3. INTELLIGENCE QOUTIENT CLASS IQ PROFOUND MR LESS THEN 20 SEVERE MR 20-3 4 MODERATE MR 35-49 MILD MR 50-69 BORDERLINE INTELLECTUAL FUNCTIONING 70-84 IQ LESS THEN 70 IS CONSIDERED AS MR.

4. OTHER INVESTIGATIONS EEG. DEVELOPMENT AND FAMILY HISTORY. THYROID FUNCTION TEST: T4, TSH. CHROMOSOMAL STUDY FOR DOWN SYNDROME, TURNER’S SYNDROME, FRAGILE X SYNDROME ETC. URINE TESTS FOR GALACTOSEMIA, PKU,HOMOCYSTINURIA.

5. OTHER INVESTIGATIONS BIOPSY(BONE MARROW,LIVER,RECTUM,BRAIN,SKIN) TO CONFIRM STORAGE DISORDERS. X-RAY SKULL, CSF EXAMINATION. CT AND MRI SCAN MAY DEFINE HYDROCEPHALUS,ABSENCE OF CORPUS CALLOSUM,TUBEROUS SCLEROSIS,CORTICAL ATROPHY.

6. SCREENING TEST PRENATAL SCREENING TEST :-- AMNIOCENTESIS. CHORIONIC VILLOUS SAMPELING. ULTRASONOGRAPHY.

7. PREVENTION GENETIC COUNSELLING: CONSANGUINEOUS MARRIAGES. MOTHERS OLDER THAN 35YRS SHOULD BE SCREENED FOR DOWN SYNDROME. DURING PREGNANCY,GOOD ANTENATAL CARE AND AVOIDANCE OF TERATOGENS, HORMONES,IODIDES, AND ANTITHYROID DRUGS IS GIVEN.

8. DURING LABOR, GOOD OBSTETRICS AND POSTNATAL SUPERVISION IS ESSENTIAL TO PREVENT BIRTH ASPHYXIA,INJURIES,JAUNDICE AND SEPSIS. NEONATAL AND NEUROLOGICAL INFECTIONS SHOULD BE DIAGNOSED AND TREATED PROMPTLYY.

9. CRETINISM AND GALACTOSEMIA SHOULD BE TREATED EARLY IN INFANCY. SCREENING OF ALL THE NEWBORN INFANTS FOR METABOLIC DISORDERS SUCH AS PKU AND HOMOCYSTINURIA.

10. DRUG THERAPY NO SPESIFIC DRUGS AVAILABLE.. NEUROLEPTIC DRUGS TO REDUCE AGGRESSIVE AND ANTISOCIAL BEHAVIOR. EG PHENOTHIAZINES. ANTIPSYCHOTIC DRUGS. ANTIDEPRESSANT DRUGS.

11. TREATMENT TREATMMENT REQUIRES PATIENCE, GOOD WILL, UNLIMITED TIME. MINIMAL CRETICISM AND HIGH APPRECIATION. ASSOCIATED VISION, HEARING, MUSCULOSKELETAL,AND LOCOMOTION DYSFUNCTION SHOULD BE APPROPRIATELY MANAGED. MAINSTREAMING.

12. MAINSTREAMING IT MEANS TO BRING THE MR CHILDREN WITH THE NORMAL CHILDREN. CAN BE ACHIEVED BY PLACING THE MR CHILDREN IN ‘REGULAR’ CLASSROOMS TO NORMALISE THEIR BEHAVIOR. DAY CAREER CENTERS, INTEGRATED SCHOOLS, VOCATIONAL TRAINING CENTERS ARE USEFUL.

13. TREATMENT STRATEGY MILDER MR SEVERE MR 1 BEHAVIOR INTRUCTIONS 1 BEHAVIOR INTRUCTIONS 2 EARLY INTERVENTION PROGRAMS. 2 DRUGS TO CONTROL AGGRESSION AND SELF INJURIOUS BEHAVIOR. 3 SPECIAL EDUCATION 3 EITHER HOME CARE OR INSTITUTIONALIZATION 4 MAINSTREAMING

14. THANK YOU