Mental retardation

From Mental retardation statistically speaking, around three percent of the population are affected. A distinction is made between different degrees of severity, from so-called "borderline intelligence" to "most severe intellectual disabilities". It is an impairment of mental abilities.

What is intellectual disability?

Is defined Mental retardation as an incomplete or stalled development of mental abilities affecting the level of intelligence (language, cognition, social and motor skills). Depending on the intelligence quotient, a distinction is made between different levels: An IQ of 70 to 84 is referred to as "borderline intelligence". Affected people learn more slowly and have difficulty taking up school material.

A slight intellectual disability is characterized by an IQ between 50 and 69, which corresponds to the age of a nine to twelve year old child. Those affected can usually be accommodated in special schools for the learning disabled and are capable of school. A moderate intellectual disability describes an IQ between 35 and 49, which corresponds to the intelligence level of six to nine year olds.

If the intelligence age is three to less than six years (which corresponds to an IQ of 20 to 34), experts speak of severe inadequate talent. If the IQ is below 20, the diagnosis is severe intellectual disability, which leads to severe impairment of speech, continence and mobility. Depending on the severity, those affected need more or less care and a protected environment.

causes

The causes of an intellectual disability can often no longer be precisely determined. However, there are some risk factors that significantly increase the likelihood of being less gifted later on. Often an intellectual disability is genetically chromosomal (for example in trisomy 21, also called Down's syndrome), metabolism-related disorders are also conceivable.

Inadequate talent can also be the result of an organic brain development defect, such as occurs in epilepsy, or it can be hormonal. It is also possible that the mother contracted viral or bacterial infections (such as rubella) or consumed drugs (nicotine, heroin), medication or alcohol or was malnourished or malnourished during pregnancy.

Premature birth or birth trauma can also result in permanent damage and represent causes. In some cases, however, the intellectual disability also occurs postnatally. It can accompany an infection such as meningitis, which is transmitted by tick bites. It was also found that vaccine damage or low vitamin D blood values ​​can play a role, as the latter are unfavorable for brain performance.

Symptoms, ailments & signs

There are numerous symptoms, ailments, and signs that indicate intellectual disability. However, it is important to differentiate this from other mental illnesses and from dementia. This is the task of a careful diagnosis.

In general, the following signs often occur in the case of under-gifted people: Those affected often show pronounced passivity and psychological dependence as well as a low tolerance for frustration. For this reason, they are very often dependent on care and a safe environment. Impulse control disorders, self-harm, and aggressiveness can also be indicators of intellectual disability.

People with less talent also have a reduced ability to adapt to the demands of everyday life and are very often disturbed in verbal and non-verbal communication, which can make coexistence with the environment difficult, as they often find it difficult to make themselves understood and on their part have massive difficulties in understanding.

Even simple tasks can pose insurmountable problems, which can inhibit those affected in their social development. Social adjustment disorders, behavioral problems and possibly also physical symptoms are further signs of being less gifted.

Diagnosis & course of disease

In order to make the correct diagnosis, there are essentially two instruments available: on the one hand, the clinical impression resulting from the observation and, on the other hand, the measurement of the intelligence quotient using intelligence tests.The latter provide reliable information about the severity of the talented person.

If there is a reduction in intelligence, it can no longer be reversed, but only slightly alleviated in its effects. Those affected are dependent on good living and working conditions and often on intensive care, otherwise there is a risk of social withdrawal, loneliness and isolation, as the environment usually shows little understanding.

Complications

The effects and symptoms of an intellectual disability depend very much on the severity of the disease. As a rule, the patient's everyday life is made considerably more difficult by the reduced intelligence. Parents and relatives also very often suffer from psychological complaints or depression. Most patients are restricted in their thinking and acting as a result of this impairment.

Furthermore, there can be strong mood swings or thought disorders. In the worst case, those affected are aggressive and can also show self-harming behavior. It is not uncommon for an intellectual disability to lead to social problems, so that children in particular are excluded from groups in school or kindergarten. Bullying or teasing can also occur.

Learning is also made significantly more difficult by the intellectual disability, so that the adult patient will in most cases also suffer from this disease. The treatment of this disease takes place through various therapies and grants. In some cases, patients need special protection because they do not correctly assess the dangers and could injure themselves in the process.

In some cases, treatment in a closed clinic is also necessary. However, it cannot be universally predicted whether the treatment of intellectual disability will lead to a positive course of the disease.

When should you go to the doctor?

A medical check-up is not always necessary in the case of an intellectual disability. No doctor is required if normal everyday demands can be carried out. In some cases, the affected person needs more time to complete pending tasks due to the reduced intelligence. If there is a greatly reduced intelligence, the person affected often needs help and support in coping with everyday life. In order to be able to assess exactly how the mental performance potential is, an IQ test should be carried out as soon as children or adolescents show clear differences compared to their peers.

If the person concerned quickly seems overwhelmed or finds it difficult to learn new things, an assessment of the existing intelligence is recommended. A doctor should be consulted in the event of delays in development, severe forgetfulness or a premature intellectual development stop. If the person concerned often seems absent, there are significant delays in learning or if new skills can only be acquired very slowly and with great effort, a doctor should be consulted. To promote the existing intelligence, a doctor can give important information about training or regularly applicable exercise units. If there are disturbances in memory, if there is a significant loss of existing mental performance or if there is an unnatural mental deterioration in the course of life, it is advisable to consult a doctor.

Therapy & Treatment

Treatment of the cause of the intellectual impairment is usually no longer possible, as this is usually irreversible due to organic brain factors. This makes prevention and prevention all the more important. However, it is possible to support those affected very early in their development and in this way to strengthen existing resources and alleviate weaknesses. A good integration in families or in special institutions is also necessary if there is a need for care.

Affected people often need special protection, as their psychosocial constitution means that they are more likely to be neglected or abused. Depending on the degree of severity, special schools are also suitable for people with learning disabilities if they are fit for school. The less gifted generally need optimal living and working conditions in order to be able to develop as best as possible.

While they were mostly housed in homes in the past, other forms of life are now being promoted. For example, there are assisted living and various integrative therapy programs that are intended to improve social integration and prevent hospitalization. In this way, those affected should be enabled to participate in social life.

If behavior disorders are present in addition to the intellectual disorder, drug therapy can also make sense in order to reduce the level of suffering for those affected and for the environment. However, there is no drug therapy for the intellectual disability itself. This can only be moderated slightly, but not canceled.

Outlook & forecast

An intellectual disability has an unfavorable prognosis. The disorders of the brain are irreparable, so that a cure cannot take place. With targeted trainings and courses that are tailored to the individual needs of the person affected, improvements in cognitive performance can be achieved. These lead to an increase in general intellectual abilities and a stability of the knowledge acquired. An intelligence in the normal range is not achieved despite all efforts.

The aim of therapy is to improve the existing skills as much as possible so that the day-to-day tasks can be partially or almost completely taken over by the person concerned. Verbal and non-verbal communication is also trained to improve interpersonal interactions. This improves wellbeing and increases the general quality of life.

If chronic diseases are present, there is no prospect of stabilizing cognitive skills. The prognosis for these patients is particularly poor. Due to the underlying disease, there is a continuous decline in mental performance, which cannot be interrupted with conventional medical options. Treatment attempts to influence the progression of the disease. This is intended to delay the degradation processes and to maintain an existing level for as long as possible. In these cases, it is not possible to rebuild mental performance.

prevention

In order to prevent an intellectual disability, preventive measures should first be taken during pregnancy. Many undesirable developments can be identified and stopped prenatally. Expectant mothers should also ensure a healthy lifestyle and avoid drugs and alcohol in any form.

In childhood, parents should take measures for the early detection of possible diseases so that they can intervene in good time. Ultimately, prevention is the best alternative for the less gifted, as it can only be improved slightly later, but cannot be reversed.

Aftercare

Follow-up care proves to be relatively difficult in most cases of intellectual disability, so that this disease cannot always be completely cured. In some cases this reduction can also be alleviated, whereby the further course also depends very much on the underlying disease and also on the time of diagnosis. However, it cannot heal independently.

Most of those affected are dependent on the support of their own family and friends in their everyday life as part of an intellectual disability. It is not uncommon for you to be unable to cope with everyday life on your own and therefore require intensive care. Loving conversations with your own family are also very important, as this may also prevent depression or other psychological upsets.

Contact with other sufferers with the same illness can also be very useful, as this leads to an exchange of information. Often those affected have to be accommodated in a special facility. If the intellectual disability occurs due to a genetic disease, genetic testing and counseling should be carried out if you want to have children. This can prevent the degradation from occurring again.

You can do that yourself

As a rule, the person affected cannot take any measures that have a causal effect, since the disorder is usually caused by the brain and is irreversible. In addition, the patient is often unable to help himself due to his or her mental retardation. Instead, the relatives and the near social field are required.

Parents who observe developmental disorders in their child should act promptly. Cognitive impairments in children are usually shown by the fact that both their motor and social skills do not develop in an age-appropriate manner. Many affected children also show severely delayed language development. The vocabulary and the ability to form complex sentence structures are far behind those of the same age. In such cases, parents should immediately consult a doctor to clarify the causes. If there is actually an intellectual disability, it is important that the child is optimally supported as early as possible. Existing deficits cannot always be compensated for by means of psychological and educational measures, but they can usually be reduced.

In addition, children with an intellectual disability can rarely go to normal school. Since suitable special school places are often scarce, it is important that the families of those affected look for a suitable childcare place at least twelve to 18 months before they reach school age. If it becomes apparent that the person concerned will be reliant on a protected environment for life, parents should inform themselves in good time about all available care alternatives in order to be able to guarantee the best possible care for their child.