According to the definition of the "American Association for Intellectual and Developmental Disabilities", intellectual disability refers to significantly lower than normal intellectual function during development (from pregnancy to the age of 18), accompanied by defects in adapting to the environment. It is significantly slower than peers of the same age in terms of subject learning and processing of daily life, as well as the understanding of surrounding things and the ability to adapt to the environment. These deficiencies include: communication, self-care, home life, social skills, community adaptation, self-direction, health and safety, functional academic ability, leisure and entertainment, work, etc.

There is a big difference between people with intellectual disabilities, ranging from mild, moderate, severe, and extremely severe. Even the same type of intellectual disabilities will have different degrees of difference, so there will be different levels of education and care. need. According to statistical definitions, the abilities of persons with various levels of disabilities are as follows:

1. Mild: IQ scores are between 55-69 points, mental age is 7-11 years old, social and communication skills can be developed in preschool stage (0-5 years old), feeling and movement are slightly worse, but there is no significant difference from normal children , The difference will show up when you are older. At the school age (6-20 years old), you can learn the skills of the sixth grade until the 18-19 years old, and can receive guidance to meet the social requirements. The adult stage (21 years of age and above) can develop social and vocational skills enough to sustain one's own survival, but if you encounter social or economic difficulties, you need counseling and support.
2. Moderate: IQ scores are between 40-54, mental age is 6-7 years old, can speak or learn to communicate in preschool stage (0 to 5 years old), social perception is not good, movement development is ordinary, and it is easy to learn self-care skills. At school age (6-20 years old), you can learn social and vocational skills. Skills and knowledge beyond the second grade are not easy to learn, and you may be able to learn to go back and forth alone. Where to learn. Adulthood (21 years and older) can support themselves in protective semi-skilled or unskilled workplaces. If you encounter social or economic difficulties, you need counseling and support.
3. Severe: IQ scores between 25-39 points, mental age 3-5 years old, poor motor development in pre-school stage (0-5 years old), little development in spoken language or communication skills, and difficulty in acquiring self-care skills. At school age (6-20 years old), you can learn to communicate or speak. If you are systematically trained, you can learn basic hygiene habits. Adulthood (21 years of age and older) can achieve partial self-reliance under full supervision, and can develop some useful self-protection skills in a controlled situation.
4. Extremely severe: IQ scores below 25, mental age below 3 years old, obvious sluggish intelligence in preschool (0 to 5 years old), poor sensory movements, and need for conservation care. At school age (6-20 years old), he can develop some movements, and his response to self-care skills training is very limited. In the adult stage (21 years of age and older) can develop some movements or spoken language, or can learn limited self-care skills. Conservative care is required.

Causes

1. Congenital organic factors

Many cases are idiopathic. Known possible pathogenic factors include genetic inheritance, chromosomal variation (e.g. Down syndrome, Fragile X syndrome), pre- and post-natal metabolic problems (e.g. hypothyroidism, phenylketonuria), infectious diseases (e.g. maternal rubella infection and syphilis), head abnormalities (e.g. hydrocephalus, microcephaly), poisoning and allergic reactions (e.g. maternal alcoholism, drug abuse), abnormal pregnancy (e.g. premature delivery), and accidents in the delivery process, which are all congenital causes of intellectual disability.

2. Acquired environmental factors

Children in poor environment may suffer from malnutrition, which may affect their physical energy and motivation, viral infection (encephalitis, meningitis), trauma and physical injury (e.g. hypoxia, car accident), or intellectual development disorder due to lack of medical care and delayed treatment of physical, visual and auditory disorders.

How to take care of patients with intellectual disability

Children with intellectual disability will inevitably bring psychological disappointment and harm to their parents. From shock and denial to acceptance, it is often a painful and tormenting journey. Parents' bad adaptation will bring more negative effects to their children. Therefore, early detection and professional assistance can minimize possible damage. Appropriate emotional processing and educational counseling of parents can provide better acquired environment and reduce the negative effects caused by environmental factors. Appropriate special education should be offered to avoid learning setbacks and peer pressure that affect self-esteem development and opportunities to learn professional skills

Mental retardation is often accompanied by emotional disorders, behavioral disturbances and other mental illnesses; especially more serious cases complicated by other mental illnesses are as high as 50%. However, the cognitive impairment with insufficient intelligence and poor speech expression often make their performance different from that of people with normal intelligence, which is difficult to diagnose. It is advisable for pediatric psychiatrists to make detailed diagnosis and treatment, provide appropriate drug therapy, family and school counseling, psychotherapy, functional rehabilitation treatment, and deal with the combined physiological abnormalities in coordination with different specialties in the medical system.

Notes

1. When children have clinical characteristics of intellectual disability, handbooks on physical and mental disabilities should be issued to facilitate access to and application of medical, educational and social resources.
2. Caregivers are advised to use the best treatment period before the age of 6 for early detection and early treatment, and try to cooperate with the treatment content, and continue to practice at home, so as to improve the efficacy.
3. Caregivers are advised to train the case’s individual and group adaptability according to learning characteristics. For example, if the case's operation performance is better than speech ability, they should consider giving less speaking burden and more types of operation assignments, and try their best to let the case study in the way of "demonstration and imitation."
4. Caregivers are advised to gradually improve their children's self-care function and cooperation with group norms to facilitate their subsequent performance in school and employment.

Conclusion

Care for children with mental retardation requires the same treatment as other children, appropriate physical care, proper nutrition, love and interpersonal relationships, expectations in line with their abilities, and appropriate but not excessive assistance, appropriate respect and assistance from siblings, classmates and society, as well as appropriate use of medical, welfare and educational resources.