MENTAL

RETARDATION
COSTES – DOQUEZA – MENDIOLA – OCO - TAPAS
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MENTAL RETARDATION
- refers to substantial limitations in present functioning.
- It starts before age 18 and is characterized by significantly subaverage
intellectual functioning, existing concurrently with related limitations in
two or more of the adaptive skill areas
- is thought to affect about 1% of the population. Of those affected, 85%
have mild intellectual disability.

SOURCE: American Association on Mental Retardation

 THESE AREAS ARE:
 communication  self-direction
 self-care  health and safety
 home living  functional academics
 social skills  leisure
 community use  work

INTELLECTUAL ADAPTIVE
FUNCTIONING BEHAVIORS
IQ (INTELLIGENCE QUOTIENT)

 IQ (intelligence quotient) is
measured by an IQ test.
 Average IQ is 100
 IQ of less than 70 to 75
(Intellectually Disabled)
CLASSIFICATION OF MENTAL
RETARDATION
CLASSIFICATION IQ SCORE
MILD MR 50 – 70
MODERATE MR 35 – 49
SEVERE MR 20 – 34
PROFOUND MR BELOW 20
 CLASSIFICATION OF MENTAL
RETARDATION
CLASSIFICATION IQ SCORE
MILD MR 50 – 70
MODERATE MR 35 – 49
SEVERE MR 20 – 34
PROFOUND MR BELOW 20
1. Intellectual disability is a hereditary problem.
2. Intellectual disability is contagious.
3. Children with intellectual disability should not be made to cry
when being disciplined.
4. Adults with intellectual disability can pose sexual danger to others
because they have poor sexual control.
5. Bad deeds/karma of parents from a previous life can cause
intellectual disability.
6. Faith healers can cure intellectual disability.
 Description
• Sub average general intellectual functioning accompanied by
significant limitations in adaptive functioning in at least two
(2) of the following skills areas:

 Communication  Academic skills

 Self care  Work
 Social skills  Leisure
 Self direction  Health / safety
• Limitations are manifested before the age of 18
Source: American Association on Mental Retardation (AAMR)
Causes
1. Genetic disorders 3. Trauma during birth:
 Down syndrome  oxygen deprivation
 Phenylketonuria (PKU) 4. Severe cases of early
 Fragile X Syndrome (FXS) childhood illness:
 Fetal Alcohol Syndrome  Measles
(FAS)  Meningitis
2. Trauma before birth: 5. Central nervous system
 Infection damage
 Alcohol, drugs and other
toxins
 Manifestations
 IQ level below normal

 Failure to meet intellectual milestones

 Trouble in learning to talk or speaking

clearly

 Memory problems

 Inability to understand the consequences

of actions
 Manifestations
 Inability to think logically

 Behaviors inconsistent with age

 Learning difficulties

 Inability to lead a fully independent life

Classification of
Mental
Retardation
  IQ level of 50 to 70
 Takes longer time in learning how to
talk but can communicate well
MILD MR  Being fully independent in self care
when they get older
 Have problems with reading and writing
 IQ level of 35 to 49
 Slow in understanding and using language
MODERATE 

May have difficulties with communication
Can learn basic reading, writing and
MR counting skills
 Generally unable to live alone
  IQ level of 20 to 34
SEVERE  Noticeable motor impairment
MR  Severe damage /
development of their CNS
abnormal

 IQ level of below 20
 Inability to understand or comply with
PROFOUND instructions
 Possible immobility
MR  Inability to care for their own needs
independently
 Needs constant help and supervision
 Shows symptoms of MR but doesn’t
UNSPECIFIED have enough information to identify their
MR level of disability
Behavioral issues: Physical characteristics:

 Aggression
Short stature
 Dependency
Facial abnormalities
 Withdrawal from social activities

 Attention-seeking behavior

 Lack of impulse control

 Tendency toward self injury

 Stubbornness

 Difficulty paying attention

 Nursing
Interventions
 Therapeutic Communication
 Broad openings
 Encouraging expression
 Focusing
 Giving recognition
 Offering one self
 Suggesting collaboration
 Reflecting
 Formulating plan of action
 Treatment Modalities
 Behavior management

 Environmental supervision

 Monitoring the child’s development needs and

problems
 Treatment Modalities
 Programs that maximize speech, language, cognitive,
psychomotor, social, self-care

 Family therapy to help parents develop coping skills

and deal with guilt or anger

 Provide day schools to train the child in basic skills.

 Nursing Management
 Provide safety

 Prevent self injury

 Consider the child’s mental age not chromosomal age

 Listen to parents when assessing child

 Observe parents and child together

 Nursing Management
 Counsel and teach parents

 Simple step for habit forming

 Monitor the child’s development levels and initiate

supportive interventions

 Teach about natural and normal feelings and emotions

 Monitor the child for physical or emotional distress

 Nursing
Diagnoses
TOP 3 NURSING DIAGNOSES
 Risk for injury r/t aggressive behaviour or
uncontrolled motor coordination

 Altered Growth and development r/t damage to

cognitive function

 Impaired Verbal communication r/t Slow reception of

expression and language skill
Assessment Nursing Diagnosis Goal of Care Nursing Intervention Rationale
Objectives: Risk for injury r/t Long term Goal: • Provide safe and • To reduce stress
aggressive comfortable position. and strain on the
• Likelihoo behaviour / Indicates muscles, tendons
d of the uncontrolled
changes in and skeletal system
hazard motor
causing coordination behaviour, • Difficult child behaviour • To provide a
injury lifestyle to management. roadmap to calmer,
reduce risk more consistent
• Fractures factors and way to manage
protect problem behaviour.
• Sprains
themselves • Limit excessive activity. • To reduce stress
and
from injury and strain on the
strains
muscles, tendons
and skeletal system
• Ambulate with assistance; • To avoid tripping
give special bathroom. hazard that will
result injury

Assessment
Objective:
• Assessment of physical
• Assessment for growing up
• Family history assessment
• Medical history to obtain
evidence of trauma to
prenatal, perinatal,
postnatal or physical injury
• Prenatal maternal
infection (rubella),
alcoholism, drug
consumption.
• Infection, particularly
those involving the brain
(meningitis, encephalitis,
measles)
• Chromosome
abnormalities
Nursing
Goal of Care Nursing Intervention Rationale
Diagnosis
Altered Short term Goal: • Involve the child and • To help maximize growth in
Growth and family in early infant children
developmen Family applying stimulation program
t r/t damage these concepts • Assess the progress of • For the treatment plan can be
to cognitive and continue the the child’s development repaired as needed
function child care with regular intervals,
activities at for w/c detailed records
home to distinguish subtle
changes in function.
• Help the family set goals • To encourage the successful
for the child reality. achievement of goals and self
Long term Goal: esteem
• Provide positive • This can improve motivation
The children who reinforcement / specific and learning
has a MR task to the behaviour of
perform child
activities of daily • Give your child frequent • To build the child’s abilities.
living at optimal feedback. Praise your
capacity child when he/she does
well.
 Assessment Nursing Diagnosis Nursing Goal of Care Nursing Intervention Rationale Evaluation
Evalu
Assessment
Assessment Diagnosis Goal ofGoal
NursingDiagnosis Care of Care Nursing Intervention
Nursing Intervention RationaleRationale ation
Objectives: Risk for injury r/t Long term Goal: • Provide safe and • To reduce stress
Objective: aggressive Altered Short term Goal: • Involve• the
comfortable position. child and •
Give repetitive and Tostrain
and help•maximize
on the growth
To help in to follow
a child
Objective: Impaired Verbal Long term Goal:
• Likelihoo behaviour / Growth and
Indicates family in early infantinstructions.children
simple muscles, tendons commands effectively
• d of the communication
uncontrolled
Assessment of physical r/t Slow
developmen Family applying stimulation program
changes in and skeletal system
• hazard
Assessment motor
for growing t r/t damage these concepts • Assess the progress of • For the treatment plan can be
• Difficulty of reception of behaviour,
expression Communication • Difficult child •
behaviourInvolve the family
• To • a Enhances participation
provide
causing
up
coordination to cognitive and continue the the child’s development repaired as needed
forming words
injury and languagelifestyle
skill tochild fulfilled management.
in accordance members in planroadmap
of and commitment to the
to calmer,
• Family history assessment function care with regular intervals,
reduce risk activities at of child for w/c detailedcarerecords more consistent plan.
• or sentence
Medical history to obtain stages
• Fractures factors and home to distinguish subtle way to manage
evidence of trauma to
• Restricted protect development changes in function. problem behaviour.
prenatal, perinatal,
• Sprains Anticipate the The nurse/family
interest themselves from • • family
Help the set • child
To reduce • stress
andpostnatal or physical injury
Prenatal maternal injury • goals foractivity.
Limit excessive theneeds
child and pay and strain on the member should set
•• strains
Language delay
infection (rubella), reality. attention to non-muscles, tendons aside enough time to
alcoholism, drug Long term Goal: verbal cues • and Toskeletal
encourage the successful
attend
system all the details for
consumption. • Provide positive achievement of goals and self
child care.
• To avoid tripping
• Infection, particularly The children who reinforcement / specific esteem
hazard that will
those involving the brain has a MR task to the behaviour of
• Ambulate with• assistance;Improve •
result injury Quickest way to
(meningitis, encephalitis, perform child • This can improve motivation
activities of daily give
• special
Givebathroom.
communication verbal
your child frequent and learning
communicate
measles)
living at optimal feedback. Praisetactile stimulation.
your particularly when
• Chromosome
capacity child when he/she does • expressing
To build the child’s emotions.
abilities.
abnormalities
well.
THANKS!
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