Mental Retardation: Management and Prognosis

Abstract

1. Chris Plauche Johnson, MEd, MD* 2. William Otis Walker Jr, MD† 1. *Professor, Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Tex 2. †Director, Neurodevelopmental/Birth Defects Clinics, Children’s Hospital & Regional Medical Center. The University of Washington, Seattle, Wash After completing this article, readers should be able to: 1. List key components of the special education system that benefit children who have mental retardation (MR). 2. Describe associated conditions that commonly occur in children who have MR. 3. Recognize the importance of family supports, including support of siblings, in the management of children who have MR. 4. Discuss the most likely adult outcomes for persons who have various levels of MR. 5. Delineate the factors, in addition to cognitive skills, that help determine long-term outcomes of persons who have MR. 6. Know when it is appropriate to pursue guardianship proceedings for an adult who is mentally retarded. Management of mental retardation (MR) begins with breaking the news to parents of affected children sensitively, compassionately, and culturally appropriately. It is important to emphasize the child’s strengths in addition to describing the delays or deficits. It also is important to be realistic without taking away hope. If the child is younger than 6 years of age at the time of diagnosis, it may be more appropriate to use the term “global developmental delay” unless the delays are due to a recognizable syndrome known to be associated with MR. When the child enters elementary school and standardized testing provides more reliable and predictive results of adult cognitive impairment, the diagnosis may be revised to “mental retardation.” Parents should be informed that the child will continue to progress, albeit more slowly, than his or her peers. Families need additional patience and persistence when raising a child who has MR. Unlike typically developing children, who seem to learn skills simply by modeling their parents, siblings, and peers, children who have MR may need specific instruction to master a skill. If the global developmental delay or MR is due to a known syndrome, appropriate genetic counseling and up-to-date literature should be …