Mental Retardation (MR)

Prepared by
Group (7)

Under Supervision
Assist.Prof.Dr :- Mawahab Mahmoud Zaki
Assist. Prof. Dr: Fathia Said Sayed
Dr: Doha Abdel baser Mahmoud
Dr: Abeer Abdelaziz Afifi Mohamed

Faculty of Nursing

Frist Semester

)2023-2022(

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 Outlines :

Introduction -

Definition of mental retardation -

Etiology of mental retardation -

IQ formula -

Categories of mental retardation -

Sign and symptoms of mental retardation -

Diagnosis of mental retardation -

Complication of mental retardation -

Treatment of mental retardation -

Prevention of mental retardation -

Nursing care plan -

References -

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Introduction

Mental retardation, also known as intellectual disability, is a condition diagnosed

before a child attains 18 years. In some cases, it can be diagnosed before birth or
during infancy. The intelligence and adaptability of such child is significantly below
his/her peer's level. About 1% of every country’s population has mental retardation. It
has a lasting implication on the development of a child. It results in reduction in the
child's ability to cope independently and reduced ability to learn new skills and
understand new information. The child has impaired social functioning and
intelligence. The Individuals with Disability Education Act state that mental
retardation refers to significantly sub-average general intellectual functioning that
presents itself together with reduced adaptive behavior and manifests during a child’s
developmental period and has an adverse impact on the performance of the child in
education.

Definition

Mental retardation is now called “intellectual disability” refers to the lack of mental
ability or the skills to perform the day-to-day living. 

It is defined as an intellectual functioning level (as measured by standard tests for

intelligence quotient) well below average and significant limitations in daily living
skills (adaptive functioning).

Etiology of mental retardation

Prenatal
- Genetic Disorders: Down’s syndrome.
- Brain Malformations: Microcephaly, hydrocephalus.
- infection e.g., toxoplasmosis, cerebral palsy.
- Drugs, radiation, and alcohol can have harmful effect on CNS system of a
developing fetus.

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- errors of metabolism such as phenyl ketonuria or congenital hypothyroidism.

Perinatal

o Difficult delivery, severe prematurity, very low birth weight, birth asphyxia, birth
trauma.

Postnatal

o Septicemia, jaundice, hypoglycemia, neonatal convulsions.

Infancy and childhood

o Brain infections like tuberculosis, Head trauma, chronic lead exposure, severe and
prolonged malnutrition, gross under stimulation.

IQ calculation formula

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Categories of mental retardation

o Mild Mental Retardation

Mild retarded individuals IQ score ranges from 50 to 75 and they can acquire
academic skills up to the sixth-grade level. and, in some cases, live independently,
with community and social support.

o Moderate Mental Retardation

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.

o Severe Mental Retardation

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 conform to daily routines.

o Profound Mental Retardation

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. The profoundly retarded need a high level of structure and supervision.

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Sign and Symptoms of Mental Retardation

o Anxiety, Vision Problems, Hearing Problems

o Failure to meet intellectual developmental markers

o Failure to meet developmental milestones such as sitting, crawling, walking, or

talking, in a timely manner
o Lack of curiosity and difficulty solving problems
o Decreased learning ability and ability to think logically
o Trouble remembering things
o An inability to meet educational demands required by school

Diagnosis Of Mental Retardation

o Testing Of Intelligence

The intelligence is assessed using the IQ test. The score obtained in the test
determines the presence of intellectual disability.

o Observation Of Child

A child is checked for developmental delays. The failure to reach the milestone
within the specified timeframe indicates some problem.

o Interview With Parents

The specialists interview the parents to know the medical history of the child in
detail.

o Physical Abnormalities

 Blood Tests
 Imaging Tests (To detect the structural problem of the brain)
 EEG (Electroencephalogram)

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Complications of mental Retardation

o epilepsy and cerebral palsy.
o attention deficit hyperactivity disorder (ADHD)
o depression
o bipolar disorder
o anxiety disorder
o autism spectrum disorder
o stereotypical movement disorder

Mental Retardation Treatment

pharmacological treatment
The most frequently used drugs are stimulants, atypical antipsychotics, and selective
serotonin reuptake inhibitors (SSRI)

Psychological treatment

o Speech Therapy
Mental retardation can result in a delayed speech in children. The rate and extent of
the learning depend on the child’s degree of retardation. Therefore, speech therapy is
essential to overcome the communication problem. The speech pathologist can work
with the child for overcoming language difficulties.
o Special Assistive Devices Training

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children with mental retardation can train with devices like self-help aids to improve
their capabilities.
o Physical Therapy
The exercises can promote motor skills required to perform everyday activities. The
physical therapist can provide flexibility to the motion. It also stimulates learning
abilities.
o Family Therapy
 It can help the parents and close relatives deal with the varying emotions of guilt and
anger.
o Preventing injury
The care-giver is responsible for protecting the child.
The health care facility as well as the home must be made safe.

Prevention Of Mental Retardation

o Genetic Testing
If you have genetic disorders in your family
o Prenatal Care
Pregnant women need to take care of themselves well. So, good prenatal care can
prevent mental retardation to an extent.
o Immunization
Getting immunity against diseases like Hib and measles can avoid the illness.
o Newborn Screening
Newborn screening can detect diseases like hyperthyroidism
o Avoid Alcohol

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Nursing care plan for mental retardation

1- Altered Growth and Development related to abnormalities in cognitive

function.
Expected results
Children and families actively involved in infant stimulation program.
Families applying these concepts and continue the child care activities at home.
Children perform activities of daily living at optimal capacity
Nursing interventions:
o Monitor the patterns of growth (height, weight, head circumference and refer to a
dietitian to obtain nutritional intervention)
o Involve children and families in early infant stimulation program to help
maximize growth in children.

o Assess the progress of the child's development with regular intervals, for which
detailed records to distinguish subtle changes in function.
o Help families set goals for the child's reality to encourage the successful
achievement of goals and self-esteem.
o Provide positive reinforcement and specific tasks to the behavior of children.
o Promote age-appropriate games as well as other activities that enhance gross and
fine motor development, sensory development, and cognitive development, like
allowing the child to sort and arrange the different colors of balls.
o Encourage a child while he or she is involved in his or her activities

2- Altered family processes related to having a child with mental retardation.

Expected results:
Family expresses feelings and concerns about the birth of a child with mental
retardation and its implications.
o Family members indicate acceptance of the child.

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Nursing Interventions:
o  Provide information on the family as soon as possible during or after birth In
order for families able to receive the actual circumstances.
o  Encourage both parents to be present at the conference giving information In
order for parents to get lots of information about mental retardation.
o  Discuss with family members about the benefits of home care; give them a
chance to investigate all residential alternatives before making a decision.
o Encourage the family to meet with other families who have the same problem so
they can receive additional support.
o Be on the lookout for signs of approval-seeking behavior, whether verbal or
nonverbal.
o Acknowledge the family’s engagement in the patient’s care and accentuate their
strengths.
o Refer family members for counseling or psychotherapy if necessary.

3- Self-care deficit related to the physical and mental incompetence / lack of maturity
development.
Expected results:
o Perform self-care, appropriate age and developmental level of the child.
Nursing intervention:
o Identification of the need for personal hygiene and provide assistance as needed.
o Identification of difficulties in self-care, such as lack of physical movement,
cognitive decline.
o Encourage children to do their own maintenance.
o Give frequent encouragement and aid with dressing as needed.
o Aid patient in eliminating or changing unnecessary clothing.
o use energy-conservation techniques.
o Promote independence
Education for parents:

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o For each stage of child development ages.
o Support the involvement of parents in child care.
o Anticipatory guidance and management face a difficult child behavior.
o Inform the existing educational facilities and groups, etc.
o Inform family members to allow the patient perform self-care measures as much
as possible.

4- Impaired social interaction related to trouble speaking / social adaptation

difficulties
Expected results:
o Minimize disruption of social interaction.
Intervention:
o Help children identify personal strengths.
o Give knowledge to people nearby, about mental retardation.
o Encourage children to participate in activities with friends and other family.
o Encourage the children to maintain contact with friends.
o Give positive reinforcement on the results achieved by children.
o Motivate the patient to express feelings and perceptions of problems.
o Involve in Role Playing New Ways to Deal with Identified Behaviors or
Situations.
o Let the Patient List Behaviors that Cause them Discomfort.

5- Risk for Injury related to uncontrolled motor coordination.

Expected results:
o Indicates changes in behavior, lifestyle to reduce risk factors and to protect
themselves from injury.
Intervention:
o Provide a safe and comfortable position.

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 o Place the patient in a room near the nurses’ station.
o Difficult child behavior management.
o Limit excessive activity.
o Ambulate with assistance; give special bathroom.
o Provide medical identification bracelets for patients at risk for injury.
o Do not restrain the patient.

6- Impaired Verbal Communication related to delayed language skills of expression

and reception.
Expected results:
o Communication fulfilled in accordance stages of child development.
Interventions:
o Improve communication verbal and tactile stimulation.
o Give repetitive and simple instructions.
o Give enough time to communicate.
o Encourage continuous communication with the outside world, for example:
newspapers, television, radio, calendar, clock.
o Pay attention to nonverbal cues and gestures.
o Never speak loudly at a speech-impaired person unless they are hard of hearing.
o Maintain eye contact and allow the patient to see your mouth, do not turn away
when speaking. Give the patient plenty of time to respond.

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 References
o https://nursingcrib.com/nursing-notes-reviewer/maternal-child-health/mental-
retardation/
o https://www.slideshare.net/NavjyotSinghChoudhary/mental-retardation-27678159
o https://nandanursingdiagnoses.blogspot.com/2013/10/nursing-care-plan-for-
mental.html?m=1
o https://nurses-nanda.blogspot.com/2015/09/nursing-diagnosis-and-interventions-
for.html?m=1
o https://nursestudy.net/dysfunctional-family-processes-nursing-diagnosis/
o https://nurseslabs.com/self-care-deficit/
o https://nurseslabs.com/risk-for-injury/
o https://www.nursetogether.com/impaired-verbal-communication-nursing-
diagnosis-care-plan/

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