Mental retardation occurs when a person cannot process and apply new information. In addition to a decrease in intelligence, social skills are also severely impaired. An intellectual disability can be congenital or acquired. An intellectual disability cannot be cured, however, depending on its severity, it can be treated to allow the affected person to lead a “normal” life.
What is an intellectual disability?
An intellectual disability is when the ability to understand or apply new or already known information is severely impaired. Furthermore, there is a reduction in the ability to learn new skills and apply them. Due to the reduced or impaired intelligence, it is seldom possible for those affected to lead a self-sufficient (independent) life. Due to the mental disability, social skills are also impaired. The term “mental disability” is also dependent on society and its norms. Mental retardation can begin before birth in the womb. According to the WHO (World Health Organization), the term “mental retardation” also includes the disease autism, since people suffering from this usually have cognitive impairments. Developmental disorders and psychological problems are also included, although it is disputed whether these should be classified as mental disabilities. In the case of dementia, previously learned abilities are lost, so that one speaks here of a mental disability. The distinction between mental and intellectual disability is fluid, so that a clear classification can often not be made. Some affected persons can lead an independent life with appropriate therapy. The more severe the mental disability, the more likely it is that affected persons will be dependent on help and care from third parties for the rest of their lives.
Causes
Intellectual disability can have many causes. A distinction is made between endogenous and exogenous factors. Endogenous factors include the hereditary component. Disorders caused by genetic defects, such as Down syndrome, are inherited from generation to generation. Exogenous factors include causes that have already occurred during pregnancy and have permanently damaged the embryo. In addition to alcohol and drug abuse, eating disorders can also disrupt cerebral development. Mental retardation can also result from chemotherapy and radiation therapy. If a pregnant woman is diagnosed with cancer, consideration should be given, together with all attending physicians, to what measures should be taken to protect the life of both mother and child. The human brain is very sensitive to oxygen deficiency. Particularly in high-risk pregnancies, a lack of oxygen can occur during birth, which can often result in a more or less pronounced mental disability.
Symptoms, complaints, and signs
Because intellectual disability is defined by a low intelligence quotient (IQ), many different symptoms typically occur. Mentally disabled children often think and act as if they are younger than they actually are. Depending on the severity of the intellectual disability, there may be several years between the actual age and the “mental age.” Such a discrepancy is also possible in adults. The reason for this apparent age shift lies in the cognitive and other mental abilities. These are less well developed in people with an intellectual disability than in most other people. As a result, difficulties in learning to read, count, or do arithmetic often occur. In young children, a possible early sign is inadequate or late language development – however, this symptom alone is not sufficient to speak of an intellectual disability. Intellectual disability can also affect emotional processing and coping. Mentally disabled people feel like any other person, but they are sometimes unable to control their emotions. As a result, they often seem impulsive and uninhibited. They may be more susceptible to emotional contagion, in which they pick up emotions from those around them and feel them themselves. Social skills may also be underdeveloped. The symptoms of mental retardation may also be compounded by motor impairments.
Diagnosis and course
Mental retardation is diagnosed by the neurologist and psychologist. Here, intelligence is measured with the help of intelligence tests. Mental retardation is classified as follows: mild mental retardation (IQ between 50 and 69), moderate mental retardation (IQ between 35 and 49), severe mental retardation (IQ between 20 and 34), most severe mental retardation (IQ below 20). Because there is often a physical disability in addition to intelligence, sometimes a traditional intelligence test is not possible. Therefore, other specific tests are performed to determine the extent to which the individual can care for him/herself independently, such as dressing, eating, or performing light tasks. The assessment of intellectual disability by means of an intelligence test is highly controversial. In the meantime, diagnostic methods have already been adapted to some extent, so that the individual patient is assessed with the help of a systemic person-environment relationship analysis. Other tests are performed to support the diagnosis. In addition to a chromosome analysis and a subtelomere analysis, a test for fragile X syndrome is also performed. The course of mental retardation is difficult to classify. Especially in the case of mild mental retardation, it is possible to lead a normal life with adequate therapy. As a rule, however, those affected are dependent on help from third parties for the rest of their lives. Depending on how pronounced the mental disability is, consideration should be given to facilities that can guarantee adequate care around the clock. In terms of life expectancy, there are no differences compared to healthy people. In some types of intellectual disabilities, which are mainly accompanied by physical impairments, life expectancy may be shortened.
Complications
An intellectual disability is a severe limitation in a person’s emotional or cognitive performance. This can be expressed in thinking disorders, intelligence reduction, and deficits in social interaction. Intellectual disabilities include Down syndrome, autism or meningitis, for example. In some cases, patients receive medication and other therapies such as occupational therapy, speech therapy, and remedial education and rehabilitation. However, complications can arise if a patient has an unforeseen flare-up of the disease. Also, if medications are not taken regularly or not taken at all, or are discontinued against medical advice, this can lead to incalculable problems. Complications also include the patient becoming a danger to himself or herself or to others. Therefore, it may be difficult to give the affected person responsible tasks at work or in the social sphere, as he or she may react differently than healthy people. In some cases, it is often advisable to employ people with intellectual disabilities in protected work areas or to allow them to participate in social life through inclusion projects. Likewise, the supervision ratio in social institutions or on the second labor market can be a factor in avoiding complications. However, the top priority should be to follow the advice of doctors, psychologists and educators.
When should you go to the doctor?
If relatives or close confidants notice abnormal behavior on the part of the affected person, a doctor should be consulted. If there are inappropriate reactions or if the affected person does not react at all to certain stimuli, this is unusual and should be examined by a doctor. Abnormalities in eye movements, head or body posture, and motor disturbances should be investigated and treated. Severe mental retardation, decreased intelligence, or learning disability should be presented to a physician. Developmental disorders and a lack of social skills indicate mental problems that require a doctor’s visit. Disturbances in attention, concentration, and orientation problems should be monitored medically. A delay in language formation or communication disorders are indications that need to be examined by a doctor. If the affected person is unable to manage an independent lifestyle, daily assistance is needed. If the sufferer is unable to care for himself or perform daily duties, a physician should be consulted.If there are problems with understanding or if the affected person does not adhere to simple agreements, the cause of the irregularities should be determined. If there is listlessness, apathy, disinterest in social activities or interpersonal exchanges, the observations should be discussed with a physician. If control of bodily excretions cannot be learned, a physician’s visit is required.
Treatment and therapy
Treatment of intellectual disability is difficult. Since mental retardation is usually present from birth, early intervention should be used to treat it. Early intervention includes various treatment concepts. With the help of occupational therapy, speech therapy, remedial education and individual drug therapy, both mental and physical abilities are specifically trained. If the mental disability occurs at a later stage of life, e.g. as a result of an accident, psychosocial and educational measures during rehabilitation can help to partially restore previously learned and mastered abilities and functions. Since only the basis for the treatment can be laid in the rehabilitation centers, it is necessary to continue the therapy in outpatient rehabilitation centers afterwards. For treatment to show success, it is necessary to carry out the various therapies throughout life.
Outlook and prognosis
The prognosis for mental retardation depends greatly on the severity of the disability itself. In no case is a cure from the condition of mental retardation to be expected. However, in some cases – such as those caused by degenerative diseases – the symptoms may worsen. People with mild mental retardation are usually able to lead a largely independent life. Although they are denied some knowledge and skills, they can – with a little support – build a life worth living. The situation is similar for people with a moderate mental disability. They can find their way in life, but, depending on the situation, they need outside help more often. At the same time, the quality of life of these mentally disabled people is strongly dependent on the support they receive. Mentally handicapped people who learn practical and social skills have a good chance of a largely fulfilling existence. However, severe and profound intellectual disabilities require lifelong support. Affected persons cannot find their own way in life and will never get out of this condition. Support measures are important, but they will not lead to an increase in intelligence. If mentally handicapped people do not experience any support measures and no care at all, they usually do not even reach the mental maturity of a three-year-old. Without support, they are not viable.
Prevention
Since mental retardation usually has many causes, various prophylactic measures can be taken. If mental retardation has already occurred in the family, genetic counseling is necessary, especially if there is a desire to have children. Pregnant women should be advised that alcohol, nicotine and drugs increase the risk of mental disabilities many times over. A healthy and balanced diet, the use of preventive examinations for pregnant women as well as a sufficient vaccination protection of the mother and later of the newborn are good measures to prevent a mental disability. Since a mental disability can also be the result of an accident, preventive measures to prevent accidents at home, kindergarten, school as well as with means of transportation such as bicycle, motorcycle and car are useful.
Aftercare
With an intellectual disability, care and aftercare can go a long way. Aftercare can include psychosocial and physical therapy, as well as any necessary follow-up on addiction or delinquency. The latter two are taboo topics. Unfortunately, there are so far only a few outpatient addiction counseling centers that are dedicated to this topic and include an aftercare group for mentally handicapped addiction patients. This topic also gains relevance in the penal system. Here, psychological aftercare is particularly important. Mentally disabled people need special care when they experience trauma and develop post-traumatic stress disorders.Depending on the age of the mentally handicapped person, a fuller participation in the life of others can be gained with speech and language support or the promotion of motor skills. In addition, if there are genetic causes, there may also be physical limitations such as short stature or club feet. These also require medical or orthopedic follow-up and monitoring. Aftercare for mentally retarded people includes comprehensive measures that vary according to the family situation and the degree of disability. Mentally disabled people need a special workplace. They need offers for assisted living. The fact that supportive care has made some people with Down syndrome into successful actors and fashion models speaks for itself. It proves that many people with intellectual disabilities can also lead independent lives.
What you can do yourself
Most intellectual disabilities are genetic or irreversibly caused by a disease. In the field of self-help in everyday life, it is therefore not about curing the mental impairment, but about ways to cope with it better. Accepting a mental handicap as such is especially difficult when one is suddenly confronted with it. In order to manage everyday life well, psychological support can therefore be useful. Depending on the exact form of the mental disability, a structured daily routine is also very important. This helps the person affected to cope better with everyday life. But also for the social environment a meaningful structuring can be important, in order to be able to master all pending tasks and to find nevertheless rest phases for itself. In order for this to succeed, all possibilities of support should also be used in everyday life. This includes on the one hand the offers that come from the environment itself, but on the other hand also all the possibilities of state or municipal support through financial assistance or concrete support in the care of people with mental disabilities. Many counseling centers provide those affected with an overview of all the offers to which they are entitled.
