PSYCHIATRIC STUDY OF MENTALLY RETARDED CHILDREN OF PRESCHOOL AGE

Abstract

This is a preliminary report of a proposed 3-year project for the study and treatment of a group of 8 mentally retarded preschool children. It represents the combined efforts of a clinic team, consisting of psychiatrist, pediatrician, psychologist, social workers, and nursery school teachers. The aim is to determine whether psychogenic factors are responsible for all or part of the retardation and if they are, whether the child can be helped to function at a normal on a higher level. The children selected for this study have no demonstrable organic basis for the retardation, and are free from familial tendency toward mental deficiency. We have excluded from this project children ordinarily classified as "schizophrenic," yet most of our children reveal some schizoid features in varying intensity. Our preliminary findings would tend to corroborate the impressions of other workers in the field that many children who are labelled "mentally deficient" fit more correctly into a borderline psychotic group. Seven of the eight children in this study belong in this group although mental retardation was the main criterion for selection. After 1 year of preliminary study it is our impression that psychogenic factors exist in these cases. Progress reports will be published in the second and third years of study of this group with publication of a follow-up study of all of the children and their siblings. The topics to be covered in these reports will include details of case histories with emphasis on personality dynamics, and the special therapeutic techniques developed to meet the unique needs of these children. With the aid of a clinical team approach, those children in our group who attended regularly revealed changes of a positive nature, reflected in the attainment of skills more appropriate to their age bevel. We agree with Kanner that "Every person of a lower than average I. Q. has obtained a right to be studied with full attention to the genetic, physical, cultural, socio-economic, educational and emotional determinants...." If psychiatry can make a positive contribution to the understanding and treatment of mentally retarded children, it should be instituted at a very early age, as soon as there is any suspicion of retardation. In the hope that the problem will correct itself spontaneously, parents and physicians tend to postpone such study until the child has reached school age. In line with modern trends toward prevention, further and more intensive investigation of this problem at the preschool level might avoid problems later in life for the child and for the family. It is possible that such studies might reduce to a measurable degree the population of our institutions for the mentally defective child.