1. People With Mental Retardation
Chapter 9

2. Introduction

3. Definitions and Classification
The most widely accepted definition of mental retardation is that of the American Association on Mental Retardation (AAMR). The major components of the AAMR definition (1992) include the following characteristics:
Significant subaverage general intellectual functioning
Adaptive skill deficits
The age of onset refers
Significant subaverage general intellectual functioning which is defined as two standard deviations below the mean on an individual test of intelligence.
Adaptive skill deficits which are defined as significant limations on a person’s ability to exhibit self-care, home living, social skills, community use, self-direction, health and safety, functional academics, leisure, and work skills.
The age of onset refers to a time interval specifying that the disability must occur prior to 18 years of age.

4. Classification
Severity may be discussed in terms of mild, moderate, severe, or profound retardation.
Use of scores on intelligence tests
Indicators of adaptive behavior
Educability expectations are
Mild - Educable (IQ 55 to70)
Moderate - Trainable (IQ 40 to 55)
Severe - Custodial (IQ 40 to 20)
Profound – (IQ below 20)
Classification: the purpose of classification systems is to provide a frame of reference for studying, understanding, and providing supports and services for people with mental retardation. Various classification systems are used.
Educable: second to fifth grade achievement in academic areas. Social adjustment will permit some degree of independence in the community. Occupational sufficiency with permit partial or total self support.
Trainable: learning is primarily in the area of self help skills; some achievement occurs in academic areas. Social adjustment is often limited to the home and nearby area. Employment opportunities often include supported work in a community job.
Custodial: may be unable to achieve sufficient skills to care for basic needs. However, many children labeled as custodial only a few years ago are now receiving educational experiences that are increasing their adaptive skills in family and community settings. Today,the term is rarely used.

5. Classification Cont… Medical descriptors
Classification based on needed support
Intermittent supports
Limited supports
Extensive supports
Pervasive supports
Intermittent supports are provided on an “as-needed basis”
Limited supports are required for a short time only.
Extensive supports are characterized by regular involvement (e.g. daily)
Pervasive supports are characterized by constancy and high intensity and provided across environments.

6. Prevalence
11% of all students with disabilities are classified with mental retardation
611,076 children aged 6-21
Approximately 2.5% (6 million) of the general population would be classified as mildly retarded
The remaining 0.5% (over 1 million) would fall into the range of moderate through profound mental retardation.

7. Down Syndrome http://www.ndss.org/ 1 in every 1,000 children
47 chromosomes vs 46

8. Characteristics Learning and Memory Self regulation Adaptive skills
Academic achievement
Motivation
Speech and language characteristics
Physical characteristic
Learning and memory:
People with mental retardation are less able to grasp abstract concepts; they benefit from instruction that is concrete, meaningful, and useful.
People with MR learn at a slower rate and are often unable to generalize learned information to new situations without additional instruction and support.
Memory problems in individuals with MR have been attributed to difficulty focusing on relevant stimuli n learning situations.
Self regulation:
Individuals with MR do not appear to develop efficient learning strategies.
Students with MR also experience difficulties with metacognitive processes and experience difficulties finding, monitoring, or evaluating the best strategy to use when confronted with a new learning situation.
Adaptive skills:
The ability to adapt to the demands of the environment.
Higher rates of distractibility and inattentiveness
Poor interpersonal skills related to working cooperatively with peers, social perceptions, failure to read social cues, use of socially acceptable language, and acceptable responses to teacher direction and cues.
Lower self image and a greater expectancy for academic and social failure.
Poor emotional development related to avoidance of work and social experiences as exemplified by tardiness, idleness, and social withdrawal.
Academic achievement:
Significant deficits in the areas of reading and mathematics.
Poor reading mechanics and comprehension when compared to their nondisabled peers.
Can be taught to read at least protective or survival vocabulary.
Motivation
Associated with history of failure and difficulties related to memory and learning. The results are often learned helplessness.
Speech and language characteristics:
Articulation, voice, and stuttering problems are most common.
Language problems are generally associated with delays in language development.
Physical characteristics:
Significant probability of related physical problems
The more severe the mental retardation, the greater the probability of multiple disabilities.
Increasing health problems may be associated with genetic or environmental factors and living conditions.

9. Causation Sociocultural influences Biomedical factors
Behavioral factors
Traumas or physical agents
Unknown prenatal influences

10. Sociocultural Influences
Living in adverse economic conditions.
Receiving poor nutritional and medical care.
Living in an environment that offers few opportunities for learning.
For the majority of people with moderate, sever, profound mental retardation, problems are evident at birth.

11. Biomedical Factors Chromosomal abnormalities Metabolism and nutrition
Postnatal brain disease
Chromosomal abnormalities: defects resulting from chromosomal abnormalities are typically dramatic; that is, such defects are often severe and accompanied by visually evident abnormalities. The most widely recognized chromosomal abnormality is down syndrome.
Metabolism and nutrition: metabolic problems are characterized by the body’s inability to process certain substances that can become poisonous and damage tissue in the central nervous system. Metabolic disorders include phenylketonuria (PKU) and galactosemia.
Postnatal brain disease: several disorders are associated with gross postnatal brain disease, such as neurofibromatosis and tuberous sclerosis.

12. Behavioral Factors Infection and intoxication
Maternal infection, such as congenital rubella, HIV, and toxoplasmosis
Intoxication refers to cerebral damage that occurs when an excessive level of some toxic agent is present in the mother-fetus system. Mental retardation may result from postnatal infections
Damage may be caused by excessive maternal alcohol consumption, excessive use of tobacco products, exposure to certain environmental hazards (e.g. x-rays, insecticides) the use of drugs during pregnancy or incompatible blood types between the fetus and mother. Maternal substance abuse is also associated with other gestation disorders involving premature birth and low birth weight.
Postnatal infections:(encephalitis, measles, mumps) and toxic excesses (lead poisoning, carbon monoxide poisoning, drugs)

13. Traumas Or Physical Agents
Traumas or physical agents may occur either prior to birth, during delivery, or after the baby is born.
Traumas or physical agents may occur either prior to birth, during delivery, or after the baby is born.

14. Unknown Prenatal Influences
Several conditions associated with unknown prenatal influences can result in extremely severe disorders, such as anencephaly and hydrocephalus.
Several conditions associated with unknown prenatal influences can result in extremely severe disorders, such as anencephaly and hydrocephalus.

15. Prevention Immunization Proper nutrition
Appropriate prenatal and neonatal care
Genetic screening

16. The Early Childhood Years
Early intervention in assessment, curriculum, and instruction technologies.
Intervention techniques focus on the acquisition of sensorimotor functions and intellectual development
Developmental milestones approach
Head Start
Intervention which is based upon normal patters of growth are referred to as the developmental milestones approach.

17. The Elementary School Years
Motor skills
Self-help skills
Social skills
Communication skills
Functional academic skills
Motor skills: skills are developed in two motor area domains: Gross motor development involves general mobility, including the interaction of the body with the environment. Fine motor development includes reaching, grasping, and manipulating objects.
Self help skills:
Eating skills, ranging from finger feeding, drinking from a cup, and practicing proper table behaviors to serving food and demonstrating proper etiquette.
Dressing skills, including buttoning, zipping, lacing and trying
Personal hygiene skills including activities such as toileting and shaving.
Social skills:
Social skills training emphasizes the importance of good physical appearance, proper manners, appropriate use of leisure time, appropriate sexual behavior, and development of personality characteristics conducive to successful integration in society.
Communication skills:
Communication systems for children with MR may focus on verbal language, augmentative communication
Functional academic skills:
Is intended to expand the child’s knowledge in daily living, recreation, and employment areas.
Uses authentic instructional materials (real money, newspapers, menus) to teach skills in the context of the child's environment.

18. The Adolescent Years
Personal independent and participation in the community.
Employment preparation
Personal independent and participation in the community:
Independence, which refers to the development and application of skills that lead to greater self-sufficiency in daily personal lives.
Participation in the community, which includes access to those community programs, facilities, and services that people who are not disabled often take for granted.
Employment preparation:
Successful transition to the adult years requires that students receive:
Employment training in community settings prior to graduation from high school.
Employment training which focuses on work opportunities present in the local area.
Specific employment training as the student approaches graduation.
Employment training which reflect a collaborative effort between school and adult service agencies.

19. Inclusive Education
Inclusive education of students with mental retardation in general education classrooms with nondisabled peers, consistent with an established individualized educational program
Special schools are designed as facilities exclusively for student with disabilities

20. Task analysis of brushing teeth
Grasp side of medicine cabinet with left hand
Pull cabinet door open
Grasp toothpaste with left hand
Lift toothpaste out of cabinet
Grasp toothbrush in right hand
Pull toothbrush out of holder
With 2 fingers, grab the cap of toothpaste
Twist the cap counterclockwise until it is off the tube

21. Today’s Activity
Perform a daily task and analyze the specific steps involved to complete the steps.
Write down each minuet step.
Follow your written steps to see if you can complete the task by following your steps.
If you cannot, revise your task analysis to include all steps necessary to complete the task.