SCHOOL OF LAW

MANIPAL UNIVERSITY JAIPUR

INDIAN TAXATION SYSTEM

BA.LL.B. (Hons.) SEMESTER-I

IN

ECONOMICS

UNDER SUPERVISION OF: SUBMITTED BY:

Ms. Minali Banerjee Kuldeep Singh Shekhawat

Assistant professor Reg no.191301015

Department of Economics
 INDEX

 Acknowledgment
 Introduction
 Description of mental retardation
 Categories of mental retardation
 Cause of mental retardation
 Diagnosis
 Conclusion
 SCHOOL OF LAW
MANIPAL UNIVERSITY JAIPUR

SESSION 2019-2020

CERTIFICATE

This is to certify that Mr. Aishwarya verdhan of b.a.ll.b (hons) 1st

semester school of law Manipal university jaipur has completed the
project work entitled “Mental retardation” under my supervision and
guidance. It is further certified that the candidate has made sincere
efforts for the completion of this project work.

SUPERVISOR’S NAME

Dr Jyotika Sharma
 ACKNOWLEDGEMENT

I express deep sense of gratitude and ineptness to our teacher Dr.

Jyotika Sharma under whose guidance, valuable suggestions,
constant encouragement and kind supervision, the present research
work was carried out .I am also grateful to college faculty of law for
their feedback and for keeping us on schedule. I also wish to
express my sincere thanks to my friend who helped directly or
indirectly by giving their valuable suggestions.

Aishwarya verdhan
 Introduction

Mental retardation is a disability that is characterized by significant limitations that

are both intellectual functioning and in adaptive behavior that are expressed in
conceptual, social and practical skills. This will mean that such a problem will be
from the age of about 18 years of age. This problem can occur to people from all
races; ethnic, educational and social background meaning this problem is not made
to a certain ethnic group but can occur to all in a country.

In a study that was done in America it showed that about 25% of American people
are mentally retarded in that they have different disabilities that make such a person
have hard time to work and do things that can lead to success. The causes of mental
retardation can be: problems that many occur during pregnancy in that a women
may face dangers leading to problems to the new born child, there is early childhood
diseases and accidents, there is exposure to toxins and other environmental health
hazards and genetic anomalies and disorders.

There are many effects that result from mental retardation this is because this
person will not be able to do work that can lead to success in life then it will mean
that this person will depend on others for survival this is a problem as this person will
be a burden to the rest in the family.

This person is in need of special care meaning that there will be need for people to
take time in taking care of this person who has many challenges in life. This will
imply that a person who is mentally disabled may end up been discriminated in work
place and in a family where he or she is born. This will lead to further problems
which will mean that such a person will be serious affected by this discrimination.
Most of children who are mentally retarded and adults are not given care and
attention that is required as they are seen as a problem and burden to people who
have to take care of them.

A child who is mentally disabled is in need of individual support so that they can work
and feel in the right place because it is a problem in most of the countries due to lack
 of income that can offer the services that are important for such children. Most of
children who are mentally retarded find it hard to have right concentration in school
this will mean that this child should get special attention so that they can learn and
change their lives.

But the problem is that most of people do not want to accept the fact that a child is
disabled and take the right action what they do is to discriminate and take these
children to be of no use in a family. This will mean that a child will grow up with any
check ups that can lead to better lives as they are not taken acre of as important
people in the country. Most countries do not like to invest in getting treatment and
attention to these people been that they require a lot of concern and income.

Description of Mental Retardation

According to the ‘Centre for Disease Control and Prevention’, in the 1990s, mental
retardation occured in 2.5 to 3 percent of the general population. Mental retardation
begins in childhood or adolescence before the age of 18. 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  school. These children typically have difficulties with social, communication,
and functional academic skills. Children who have a neurological disorder or illness
such as enceptalis or meningitis.may suddenly show signs of cognitive impairment
and adaptive difficulties.

Mental retardation varies in severity. There are four different degrees of mental
retardation: mild, moderate, severe, and profound. These categories are based on
the functioning level of the individual.

 It persists throughout adulthood. Intellectual functioning level is defined by

standardized tests (Weschsler-Intelligence Scales) that measure the ability to reason
in terms of mental age (intelligence quotient or IQ). 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. 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. 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.
 Mental retardation is defined as IQ score below 70 to 75. 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 percent of cases, the cause of
mental retardation cannot be found. Biological and environmental factors that can
cause mental retardation include genetics, prenatal illnesses and issues, childhood
illnesses and injuries, and environmental factors.
 Adaptive skills are the skills needed for daily life. Such skills include the ability to
produce and understand language (communication); home-living 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 pre-
school.
 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. 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.
 The symptoms of mental retardation are usually evident by a child's first or second
year. In the case of Down syndrome, which involves distinctive physical
characteristics, a diagnosis can usually be made shortly after birth. Mentally retarded
children lag behind their peers in developmental milestones such as smiling, sitting
up, walking, and talking. They often demonstrate lower than normal levels of interest
in their environment and responsiveness to others, and they are slower than other
children in reacting to visual or auditory stimulation. By the time a child reaches the
age of two or three, retardation can be determined using physical and psychological
tests . Testing is important at this age if a child shows signs of possible retardation
because alternate causes, such as impaired hearing, may be found and treated.

Categories of mental retardation

Mild Mental Retardation

Approximately 85 percent of the mentally retarded population is in the mildly retarded

category. Their IQ score ranges from 50 to 75 and they can often acquire academic
skills up to the sixth grade level. They can become fairly self-sufficient and in some
cases live independently, with community and social support.

Moderate Mental Retardation

About 10 percent of the mentally retarded population is considered moderately

retarded. Moderately retarded individuals have IQ scores ranging from 35 to 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 to 4 percent of the mentally retarded population is severely retarded.

Severely retarded individuals have IQ scores of 20 to 40. They may master very
basic self-care skills and some communication skills. Many severely retarded
individuals are able to live in a group home.

Profound Mental Retardation

Only 1 to 2 percent of the mentally retarded population is classified as profoundly

retarded. Profoundly retarded individuals have IQ scores under 20 to 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.
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.
Profoundly retarded people need a high level of structure and supervision.

Levels of mental retardation:

Mild M.R 50-55 IQ to less 70 IQ
Moderate M.R 35-40 IQ to 50-55 IQ
Severe M.R 20-25 IQ to 35-55 IQ
Profound M.R Below 20 or 25 IQ

Mental retardation is defined as, an individual with limitations in cognitive ability and
adaptive behaviors that interfere with learning. Individuals with mental retardation
learn at a slower pace, have low IQs, and may reach a level where learning stops.
There are no exact causes for mental retardation but some things are associated with
the disability. Prenatal development problems, childbirth difficulties, and a childhood
brain injury can all lead to mental retardation.

CAUSES OF MENTAL RETARDATION

ETIOLOGY Approximately 3% of the population has an intelligence quotient (IQ) of
less than 70, among whom a cause for the mental retardation can be established in
less than half of all cases (Flint et al., 1995). The Journal of Sport and Health
Research 2009, 1(2):112-122 J Sport Health Res ISSN: 1989-6239 115 prevalence
of severe mental retardation is about 3 per 1.000 population and 30 per 1.000 for
mild mental retardation (Harper, 1993). A number of environmental, genetic or
multiple factors can cause mental retardation. It is also believed that behavioural or
societal factors such as poverty, malnutrition, maternal drug and alcohol use, as well
as severe stimulus deprivation can contribute to MR (McLaren & Bryson, 1987).
Unfortunately, in approximately 30 to 50 percent of cases, the etiology is not
identified even after thorough diagnostic evaluation (Cury et al., 1997; Schaefer &
Bodensteiner, 1992). Some persons have a congenital malformation of the brain;
others had damage to the brain at a critical period in pre- or postnatal development.
Acquired causes of retardation include neardrowning, traumatic brain injury and
central nervous system malignancy. The most common cause of MR in industrialized
nations is fetal alcohol syndrome with an incidence rate of 1 in 100 births. The
second leading known cause of MR is Down syndrome, or trisomy 21, with an
incidence rate of 1 in 800-1.000 births (Campbell, Morgan & Jackson, 2004).

Genetics conditions

A number of single-gene disorders result in mental retardation. Many of these are

associated with atypical or dysmorphic physical characteristics (Sultana et al., 1995).
Such conditions include fragile X syndrome, neurofibromatosis, tuberous sclerosis,
Noonan's syndrome and Cornelia de Lange's syndrome (Baraitser & Winter, 1996;
Jones & Smith, 1997). As many as one fourth of persons with mental retardation
have a detectable chromosome abnormality. Children with Down syndrome (trisomy
21) usually have highly recognizable physical characteristics, but features associated
with other chromosomal abnormalities, such as Klinefelter's syndrome (47,XXY),
may not be as obvious to family members or the physician (Batshaw & Perret, 1992)
Other children may have a small deletion or duplication of a particular chromosome
that is rarely reported; thus, the phenotype is still undetermined. Some chromosomal
abnormalities are inherited from a parent but most occur de novo (McKusick, 1994).
Many previously described clinical syndromes have been found to have an
associated chromosomal abnormality (e.g., DiGeorge, Prader-Willi, Angelman and
Williams syndromes). Other genetic conditions include Phelan-McDermid syndrome
(22q13del), Mowat-Wilson syndrome, genetic ciliopathy (Badano et al., 2006). In the
rarest of cases, abnormalities with the X or Y chromosome may also cause disability.
48, XXXX and 49 syndrome affect a small number of girls worldwide, while boys may
be affected by 47, XYY, 49, XXXXY, or 49, XYYYY (Moser, 1995).

Prenatal problems

Mental disability can result when the fetus does not develop inside the mother
properly. Moreover, prenatal causes include congenital infections such as
cytomegalovirus, toxoplasmosis, herpes, syphilis, rubella and human
immunodeficiency virus; prolonged maternal fever in the first trimester; exposure to
anticonvulsants or alcohol; and untreated maternal phenylketonuria (PKU) (Strømme
& Hagberg, 2007). Complications of prematurity, especially in extremely low-birth-
weight infants, or postnatal exposure to lead can also cause mental retardation
(Piecuch et al., 1997).

Perinatal problems

Perinatal causes involve late pregnancy (complications of pregnancy, diseases in

mother such us heart and kidney disease and diabetes and placental dysfuction),
during delivery (labour) (severe prematurity, very low birth weight, birth asphyxia,
difficult and/or complicated delivery and birth trauma), neonatal (first 4 weeks of life)
(septicaemia, severe jaundice, hypoglycemia) (Kolevzon, Gross & Reichenberg,
2007).

Iodine deficiency

Iodine deficiency affecting approximately 2 billion people worldwide is the leading

preventable cause of mental disability in areas of the developing world where iodine
deficiency is endemic. Iodine deficiency also causes goiter, an enlargement of the
thyroid gland (Delange, 1994). Lack of adequate availability of iodine from the
mother restricts the growth of the brain of the foetus, and leads to a condition called
hypothyroidism. More common than fullfledged cretinism, as retardation caused by
severe iodine deficiency is called, is mild impairment of intelligence (Gaitan & Dunn,
1992). Certain areas of the world due to natural deficiency and governmental
inaction are severely affected. India is the most outstanding, with 500 million
suffering from deficiency, 54 million from goiter, and 2 million from cretinism. Among
other nations affected by iodine deficiency, China and Kazakhstan have begun
factors obtained from the history. The child should be examined closely for
dysmorphic features or minor abnormalities, such as unusual eyebrow pattern, eyes
that are widely or closely spaced, low-set ears or abnormal palmar crease patterns.
Minor abnormalities are defined as defects that have unusual morphologic features
without serious medical implications or untoward cosmetic appearance.8 Most minor
abnormalities involve the face, ears, hands or feet, and are readily recognized even
on cursory examination (Holmes & Hassanein, 1988) The presence of three or more
minor abnormalities in newborns is correlated with a 90 percent frequency of
coexistent major abnormalities (Marden, Smith & McDonald, 1964), suggesting close
association with morphogenesis in utero. taking action, whereas Russia has not
(McNeil, 2006).

DIAGNOSIS

The first and most important step in the diagnosis of mental retardation is to obtain a
comprehensive patient and family history. Previous gynecologic and obstetric history
may reveal infertility or fetal loss (Matson & Sevin, 1994). Assessment of maternal
health status during pregnancy with the involved child should include questions
regarding use of tobacco, alcohol and drugs (prescribed and illicit); lifestyle or other
risks for sexually transmitted diseases; weight gain or loss; signs of infection; serious
illness or injury; and surgery or hospitalization (Reiss, 1994; Szymanski, 1994). To
establish a knowledgeable baseline history of the child, the physician should obtain
information regarding length of pregnancy, premature onset of labor or rupture of the
membranes, duration and course of labor, type of delivery and any complications
(Kolevzon, Gross & Reichenberg, 2007). Apgar scores at one and (especially) five
minutes should be reviewed, and birth weight, length and head circumference
measurements obtained and plotted on appropriate growth charts. The parents
should be asked about any illnesses, feeding or sleeping difficulties in the newborn
period and problems with sucking or swallowing, as well as the baby's general
disposition (Leonard & Wen, 2002). Extremes in infant temperament are often the
first clue to an atypical course in child development (Kolevzon et al., 2007). The
systems review of the child should be complete, with special attention to growth
problems, history of seizures, lethargy and episodic vomiting. A developmental
screen should be used at all well-child visits to obtain information about the timing of
the child's developmental milestones, any concerns by parents or caregivers and
comparison of the child's developmental rate and pattern with those of siblings
(Palmer & Capute, 1994). Specific questions about the child's current developmental
abilities should be asked at each visit. The Revised Denver Prescreening
Developmental Questionnaire (Frankenburg et al., 1981) is a useful screening tool
that parents can readily complete to help determine the need for further evaluation
with the time-honored Denver Developmental Screening Test (Frankenburg &
Dodds, 1967; Frankenburg & Dodds, 1990). Another practical and reliable tool with
which to monitor development in infants is the Kansas Infant Development Screen
(Holmes & Hassanein, 1982). The findings can be recorded and plotted just as with
somatic growth charts and shared with parents. Other developmental screening tests
are also available. Delays in speech development are common and may become
more obvious when contrasted with the speech development of a sibling. Inquiry
should be made regarding concerns about hearing and vision (Van Naarden,
Decoufle & Caldwell, 1999). One cannot overemphasize the importance of
addressing concerns voiced by a parent about a child's development, behaviour and
learning; because these expressed concerns accurately target the majority of
children with developmental problems. Information should be obtained about the
family unit, parents' occupations and educational achievements, educational and
developmental status of siblings, role of the patient in the family, discipline of the
children and identity of the child's caregiver when the parents are not home (Daily,
Ardinger & Holmes, 2000). Family history of fetal loss, mental retardation, severe
learning problems, congenital abnormalities and unexplained childhood deaths, as
well as other serious illnesses in first- and second-degree family members, should
be elicited. A complete physical examination can begin with a review of growth
curves since birth, if these are available. The head circumference should continue to
be plotted. The examination should be thorough, with special attention to physical
findings that are compatible with any risk factors obtained from the history. factors
obtained from the history. The child should be examined closely for dysmorphic
features or minor abnormalities, such as unusual eyebrow pattern, eyes that are
widely or closely spaced, low-set ears or abnormal palmar crease patterns. Minor
abnormalities are defined as defects that have unusual morphologic features without
serious medical implications or untoward cosmetic appearance.8 Most minor
abnormalities involve the face, ears, hands or feet, and are readily recognized even
on cursory examination (Holmes & Hassanein, 1988) The presence of three or more
minor abnormalities in newborns is correlated with a 90 percent frequency of
coexistent major abnormalities (Marden, Smith & McDonald, 1964), suggesting close
association with morphogenesis in utero.
CONCLUSIONS

Mental retardation is a genetic disorder mainfested in significantly below average

overall intellectual functioning and deficits in adaptive behaviour. A number of
environmental, genetic or multiple factors can cause mental retardation. In at least
30 to 50 percent of cases, physicians are unable to determine etiology despite
thorough evaluation. The systems review of the child should be complete, with
special attention to growth problems, history of seizures, lethargy and episodic
vomiting. The systems review of the child should be complete, with special attention
to growth problems, history of seizures, lethargy and episodic vomiting. Mental
retardation is not a great problem in that a country can be bale to work out this
problem in the right manner and safe lives of many. This imply that what t they are
supposed to do is to know the problem at early stages and know the way to go
through it through offering assistances that are important to lead to changes in lives
of these people. Treatment for Mental Retardation is not designed to "cure" the
disorder. Rather, ther An extremely common problem in MR patients concerns their
self-injurious behavior.77 This behavior is expressed differently in distinct disorders,
such as in the fragile X syndrome, Lesch-Nyhan syndrome, Smith-Magenis
syndrome, Rett’s syndrome and Prader-Willi syndrome. A study revealed a
prevalence of 2 to 50% for self-injurious behavior in children with severe MR and
investigated its occurrence in relation to chronic pain.78 The authors concluded that
there are two forms of self-injurious behavior: one that is associated with pain and
directed towards the site of origin of the pain, and another one, which is more
frequent, that is not associated with pain and is directed towards the hands and
head. The management of this problem can include changes in behavior and
functional communication training, as well as drug therapy with selective serotonin
reuptake inhibitors, trazodone, or buspirone. A recent study has proposed the use of
melatonin in the happy goals include reducing safety risks (e.g., helping an individual
maintain safety at home or school) and teaching appropriate and relevant life skills.
Interventions should be based on the specific needs of individuals and their families,
with the primary goal of developing the person's potential to the fullest.