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Sunday, January 29, 2012

Causes of Mental retardation

Sunday, January 29, 2012
DEFINITION
Mental retardation (Mental Retardation, RM) is a condition characterized by general intelligence functions that are below average accompanied by a reduced ability to adapt (berpelilaku adaptive), which began to arise before the age of 18.

People who are mentally retarded, have developmental intelligence (intellectual) are lower and have difficulty in learning and social adaptation. Three percent of the total population of mentally retarded.


CAUSE
Level of intelligence is determined by heredity and environment. In most cases of RM, the cause is unknown; only 25% of the cases had a specific cause.

Roughly speaking, the cause of RM is divided into several groups:

1. Trauma (before and after birth)
- Intracranial hemorrhage before or after birth
- Injury to hypoxia (oxygen deficiency), before, during or after birth
- A severe head injury
2. Infection (congenital and after birth)
- Rubella kongenitalis
- Meningitis
- Congenital cytomegalovirus infection
- Encephalitis
- Toxoplasmosis kongenitalis
- Listeriosis
- HIV Infection
3. Chromosomal abnormalities
- Errors in the number of chromosomes (Down syndrome)
- Defects in chromosome (fragile X syndrome, Angelman syndrome, Prader-Willi syndrome)
- Translocation of chromosomes and cri du chat syndrome
4. Genetic abnormalities and inherited metabolic disorders
- Galactosemia
- Tay-Sachs Disease
- Phenylketonuria
- Hunter syndrome
- Hurler's syndrome
- Sanfilippo Syndrome
- Leukodistrofi metakromatik
- Adrenoleukodistrofi
- Lesch-Nyhan syndrome
- Rett Syndrome
- Sclerosis tuberosa
5. Metabolic
- Reye's Syndrome
- Dehydration hipernatremik
- Congenital Hypothyroidism
- Hypoglycemia (diabetes mellitus is not well controlled)
6. Poisoned
- The use of alcohol, cocaine, amphetamines and other drugs in pregnant women
- Methylmercury poisoning
- Lead poisoning
7. Nutrient
- Kwashiorkor
- Marasmus
- Malnutrition
8. Environment
- Poverty
- Low economic status
- Deprivation syndrome.


SYMPTOMS
Levels of Mental Retardation

Children with mild MR (IQ 52-68) could reach the capability to read to grade 4-6. Despite having difficulty reading, but they can learn basic educational skills needed in everyday life. They need supervision and guidance as well as education and specialized training. Usually not found physical abnormalities, but they can suffer from epilepsy.

They often do not mature and lack the capacity development of their social interactions. They have difficulty in adjusting to new circumstances and may have a poor ratings. They seldom make a serious assault, but could commit crimes impulsively.

Children with RM moderate (IQ 36-51) are clearly experiencing a delay in learning to talk and delay in reaching the level of other developments (such as sitting and talking). With training and support from their environment, they can live with a certain degree of independence.

Children with severe RM (IQ 20-35) can be trained, although somewhat more difficult than with moderate RM. Children with very severe RM (IQ 19 or less) usually can not learn to walk, speak or understand. Life expectancy for children with RM probably be shorter, depending on the cause and severity of RM. Typically, the more severe the smaller RMnya life expectancy.


Diagnosis
RM shows the development of a child who is significantly slower than other children the same age. Intelligence levels are below the average could be identified and measured through standardized intelligence tests (IQ tests), which showed less than 2 SD (standard deviation) below the average (usually with numbers less than 70, from an average of 100) .


TREATMENT
The main goal of treatment is to develop a child's potential to the maximum extent possible. As early as possible given the education and specialized training, which includes education and training of social skills to help the child function as normally as possible. Behavioral approaches are very important in understanding and working with children RM.


PREVENTION
Genetic counseling will provide knowledge and understanding to parents of children about the causes of RM RM. MMR vaccination has dramatically lowered the incidence of rubella (German measles) as one cause of RM.

Amniocentesis and chorion villus sample is a diagnostic examination that can find a number of abnormalities, including genetic disorders and spinal cord or brain abnormalities in the fetus. Every pregnant woman over the age of 35 years are encouraged to undergo amniocentesis and chorion villus examination, because they have the risk of babies suffering from Down syndrome.
Ultrasound can also help find abnormalities of the brain.

To detect Down syndrome and spina bifida can also be carried out measurements of serum alpha-protein levels. RM's diagnosis established before the baby is born, will give you the option of abortion or family planning to parents.

Other precautions that can be done to prevent the occurrence of RM:

* Genetic
Screening Prenatal (before birth) for genetic disorders and genetic counseling for families at risk can reduce the incidence of RM that the cause is genetic.
* Social
Government social programs to eradicate poverty and provide education that can either reduce the incidence of mild RM due to poverty and low economic status.
* Poisoning
Environmental programs to reduce lead and mercury and other toxins will reduce the RM due to poisoning.
Increasing public awareness of the effects of the use of alcohol and drugs during pregnancy can reduce the incidence of RM.
* Infection
Prevention of rubella kongenitalis is a good example of a successful program to prevent one form of RM.
Constant vigilance (eg relating to cats, toxoplasmosis and pregnancy), helps reduce the RM due to toxoplasmosis.

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