MENTAL RETARDATION (MR)

A child is said to have mental retardation when he is of below average intelligence and has difficulty adjusting to his surroundings. However, just because a child is slow in learning certain skills does not always mean that he is mentally retarded. There is a normal variation in achieving the milestones of development. Some children are slow in picking up a particular skill, but are smart in all other respects. This could be normal. A child who is retarded is slow in almost all milestones of development.

Sometimes, lack of proper stimulus at the right age may also delay the process of development in an otherwise normal child. For example, some children who are brought up in institutions may be slow, but as soon as they are adopted, the loving stimulus provided by the adoptive parents helps them progress at an unbelievably rapid pace till they catch up with other children their age.

If you suspect that your child is slow in learning new skills, your doctor may like to see the child on a few occasions and then decide if he should be referred to a specialist for an expert opinion. The specialist does certain tests to assess the development of the child.

Your doctor may also find out if the child has any other handicaps like impaired hearing, visual defects, a specific learning disorder, attention deficit, cerebral palsy, etc. This is important to guide you in proper management of your child. 

In some cases, the diagnosis of mental retardation can be made at birth. A child with all the features of Down’s Syndrome may be diagnosed at birth. In certain cases, it may not be possible to suspect retardation at an early age. The handicap may be suspected later from observations by parents, grandparents, a caretaker or a schoolteacher.


Guidelines For Parents Of Children With Mental Retardation
Do not feel guilty: Most parents find it hard to believe and accept a diagnosis of mental retardation. Let guilt that you may have inadvertently caused the retardation not add to the burden of management. You may harm yourself, and your child may not get the care he deserves.


Say to yourself: ‘This child needed me and nobody else’. Accept that God gave you your child because he knew you would look after him like no one else. 

Be rational: Don’t fall  prey to misguided advice and the promise of quick cures. Be guided by your doctor.

Do not overprotect your child: Overprotection may unwittingly interfere with his growth and development.

Do not ignore your spouse and your other child(ren): Since your special child needs a lot of attention, your husband and other children may start feeling neglected. An understanding husband will respect your feelings and will support you, but you must not forget that he is also human and that your other children also need you.

Involve your other children in the care of the special child: No parent lives forever and your child may outlive you.

Education and training are vital: Let your child start getting help from experts in the field as soon as possible. Early intervention can make a lot of difference in the ultimate outcome. In some major cities, such expertise is available. If you can’t locate such a facility, go to the nearest medical college or teaching hospital for guidance.

A team of experts will first try to find the possible cause of the MR and then plan the management of your child. They will also discuss the ultimate prognosis and answer any queries that you have about the possibility of your future children getting affected.

Consider getting your child admitted to a school for normal children: Let the team of experts decide if your child should be admitted to a school for normal children.

Do attend to the general health of the child: Make sure your child gets a nourishing diet, proper exercise, enough sleep and a friendly environment. Avoid foods that will make him fat (see Obesity). Also make sure that he gets proper dental care. Some of these children may not chew their food well and extra sugar may cause caries of the teeth, as well as add to his weight.

Drugs are often not helpful: There is no ‘brain tonic’ that helps these children. However, the experts may prescribe some drug(s) for tackling certain specific problems.

Prefer home care to care in an institution: More and more people are coming to realise that special children are better looked after at home rather than in an institution. However, situations can arise when parents find it impossible to cope with a severely retarded child and institutionalised care may become necessary.


Fear Of Sexual Abuse
If you have a female child with MR, be extra careful about the possibility of the child being sexually abused. Avoid leaving the child alone with people who may take advantage of her handicap. Discuss the issues of contraception and menstruation with your doctor. 

Discuss with family members and the doctor about whether getting the child’s uterus removed is an option, to save her the problem of menstruation and to avoid the danger of an unwanted pregnancy. Take a well-considered decision. Your daughter may need the operation, but parents who feel capable of managing their daughter may decide against it.


Genetic Counselling
In some cases of MR, there is a possibility that the next child may have a similar condition. Discuss this with your doctor. Sometimes, the help of a genetic counsellor is needed in such cases.

11 February, 2013