MENTAL RETARDATION EXPLAINED

World Health Organization has defined it as “a condition of arrested or incomplete development of the mind, which is especially characterized by impairment of skills which contribute to the overall level of intelligence.”During a child’s growing years of 0-18, a delay in the mental growth occurs in some cases which can lead to mental retardation. A mentally retarded patient show signs of below average performance and they face problem in communication, self-care, home living, social skills, community use, self-direction, health and safety, academics, leisure, and work.Mental retardation can be classified into four levels such as mild, moderate, severe, and profound. In accord with the existing international classification system, MR can be grouped depending upon the seriousness of the trauma

Level of Mental Retardation IQ Range Degree of Functioning
Mild Mental Retardation IQ range: 50 to 69
  • Takes longer to learn to talk, but can communicate well once he or she knows how
  • Fully independent in self-care
  • Has problems with reading and writing
  • Is socially immature
  • Is unable to deal with responsibilities of marriage or parenting
  • May benefit from specialized education plans
Moderate Mental Retardation IQ range of 35 to 49
  • Slow in understanding and using language
  • Limited ability to communicate
  • Basic reading, writing, counting skills
  • Could be a slow learner
  • Unable to live independently
  • Can get around on own
  • Can take part in simple social activities
Severe Mental Retardation IQ range of 20 to 34
  • Noticeable motor impairment
  • Severe damage to and/or abnormal development of central nervous system
Profound Mental Retardation IQ of less than 20
  • Unable to understand or comply with requests or instructions
  • Is immobile
  • Uses very basic nonverbal communication
  • Cannot care for own needs
  • Requires constant help and supervision

Symptoms

Some of the symptoms that occur with poor developmental growth include:

  • Lack of attention and concentration power
  • Trouble with memory
  • Reduced language ability
  • Gross and fine motor coordination
  • Learning, logical thinking and problem-solving abilities associated with the comprehension and response
  • Social and self-care skills
  • Ability to control emotion and behavior

When compared to a normal child, the rate of how a mental retarded child adapts to normal activities is lower.

Causes of mental retardation

Mental retardation can be caused by any condition that harms the brain development before birth or after birth or early childhood years. Even though a number of cases have been discovered, some cases of one third people remains to be known.

Here are some of the few risk factors or causes that can lead to mental retardation:

  • Infections that occur either at birth or occurring after birth
  • Genetic abnormalities like Down syndrome, X syndrome, and PKU (phenylketonuria)
  • Metabolic such as hyperbilirubinemia and very high bilirubin levels in babies
  • Toxicity caused by intrauterine exposure to alcohol, cocaine, amphetamines, and other drugs during pregnancy
  • Nutritional deficiencies such as malnutrition during pregnancy
  • Trauma before or during birth such as oxygen loss or early childhood sickness, such as whooping cough, measles, or meningitis
  • Environmental factors like lead or mercury poisoning
  • Unexplained category is the largest category for unexplained occurrences of intellectual disability
Mental Retardation Treatment in India
Mental Retardation Treatment in India

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STEM CELL THERAPY FOR MENTAL RETARDATION

To meet with the different challenges of mental retardation, a multifaceted advancement is needed to deal with the different injuries indicated. While, there are some patients that reach an immobile stage with an extended use of pharmacological, rehabilitative and surgical therapies, with stem cell therapy efforts are being made for the stimulation of the nervous system to heal the injury of the nervous tissues. On the grounds of showing a great potential in the area of mental retardation management, cellular based therapies are given. Properties like self-renewal and differentiation are present in stem cells which help to produce various types of cells. Several other changes in the adjoining tissue regions comprises of alterations in the internal repair process of affected neurons, immune modulation, secretion of various growth factors, secretion of vascular endothelial growth factor (VEGF), formation of new blood vessels, regulation of cell death, reduction of inflammation, and activation of neighboring stem cells.These varying changes greatly develop the functioning capacity of the brain and bring a marked change in the quality of life.

Objective radiological evidence of improvement in mental retardation

In a research trial, improvements in areas of cognition, social interaction, communication, toilet training, self care, home living and so on were seen. The ability of schooling and learning became better making their mental ability suited for their age. Ultimately the pressure of the family eases down because of these factors. In addition, the radiological findings by PET-CT Scan present a marked improvement in the lines of symptomatic factors.

Pre Stem cell therapy PET CT scans showing blue areas with decreased metabolism

Post Stem cell therapy PET CT scan showing decrease in blue areas which is replaced by green areas indicating improved functioning of the brain

An alternative remedy for mental retardation is autologous stem cell therapy. Through the stem cell therapy, the gap that exist that between a patient with a low IQ and a normal IQ comes closer. Certain improvements in the cognition, learning and other functions are seen. This moves a mental retarded patient towards improvement.

Logo_0009_Mental Retardation
Mental-Retardation

Conventional treatment options

To get the best possible treatment for mental retardation, it is essential that one keeps track of the medical history of the patient and their family. An intelligence test is taken based on the IQ factor. One of the most common individual IQ tests taken for adults and children alike is the Wechsler IQ test. According to a survey taken, the IQ level of a mentally retarded patient needs to be equal or less than 70. The treatment options are focused on improving a person’s trouble spots and their injury level intensity.

Through our various treatment options, we are able to improve the person’s mental ability and help them adapt normally into the society. Every mentally retarded patient needs a different kind of medical attention so our treatment relies upon an intensive study of the social, education, psychiatric and environmental requirements. This condition is related with dreadful psychiatric disorders that needs special attention alongside psychosocial support. A treatment inclusive of the right medical supervision with rehabilitation session is precise for patients. Below listed are some treatment options that are needed:

The child’s education:

An all-inclusive treatment session especially meant for a mentally challenged child must be include education. The session should include training in adaptive skills, social skills and vocation. Proper attention and care should be given to improve their social and interactive skills.

Behavior therapy:

This therapy session helps to mould and improve the child’s manner and conduct in society. It better facilitate to reduce their brash behavior.
Cognitive therapy: This therapy session is well suited to meet the challenges faced by a mentally retarded patient. It helps in removing artificial illusions and recreational exercises through instruction.

Psychodynamic therapy:

This therapy session works for both the patient and their family to lessen the disagreement that leads to unrelenting anxiety, rage and depression. There are complications that arise with the issue of adaptation for a mental person.

Family Education:

This session is very much essential as it gives the proper guidance in educating the patient and their family. It talks on several ground issues like improving proficiency and self confidence but still continuing to be realistic. These sessions can succeed through incessant counseling. Both parent and the child should let out their emotions and speak up of their turmoil’s.

The NeuroGen Outcome

We have treated more than 92 patients suffering from a case of mental retardation. After the treatment, we have seen a great improvement in them.

Case Study : Mental Retardation

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Your most common questions answered

What is Mental Retardation exactly?

Mental Retardation is referred to an injury in overall mental ability that affects the daily activities in three major domains:

    • The conceptual domain includes skills in language, reading, writing, math, reasoning, knowledge, and memory.
    • The social domain refers to interpersonal communication skills, empathy, social judgment, the ability to make and retain friendships, and similar capacities.
    • The practical domain centers on self-management in areas such as personal care, job responsibilities, MONEY management, recreation, and organizing school and work tasks.”

How can the diagnosis be made?

Diagnosis can be taken upon the clinical improvements and standardized intellectual testing. An IQ score of 70 or below is still regarded so as to make an analysis of Intellectual Disability.

When is the diagnosis made?

The diagnosis can be made after right after infancy right after the child starts going to school.

How early can parents seek early intervention when their baby is found to be developmentally delayed?

Parents can seek an early intervention as soon as they start noticing that the young child has a delayed development as compared to other normal children or siblings. As a parent, you must resort to quick treatment and guidance before the child reaches an advanced level of development. The first 24 months of a normal child is said to have incredible and swift growth and development.

What is the life span of a child with Mental retardation?

Mental Retardation does not decrease a normal life span. A lot is dependent on the reasons, seriousness of mental retardation, associated medical problems and the level of care taken.

Will I have another child like this?

Before planning on taking the next step, it is important that you go for genetic counseling. This will depend from case to case.

Are there possibilities of other disabilities along with Mental Retardation?

Yes. The most common co morbid disabilities include autism, cerebral palsy, hyperactivity and epilepsy.

Are there medications available to treat Mental Retardation?

Yes there are some medications that are available for reducing symptoms visible in children with mental retardation but there are no exact medicines available yet.

What is available in terms of treating or dealing with Mental Retardation/ Intellectual disability?

A child with Mental retardation or Intellectual Disability needs specific therapists and specialized training and one to one attention.

  • Special educator’s

    makes programs specifically designed to address each individual child’s special needs by modifying teaching methods and the child’s environment.

  • Occupational therapists

    focus on teaching skills in order to make the child capable of carrying out his/her basic activities of daily living. The main goal here is to make the child independent and take care of him without any assistance.

  • Speech Therapist

    guides them on language components which include manipulating sounds, using minimal units of meaning, sentence construction as well as social aspects of communication. It has been found that many children with Intellectual disability experience trouble articulating speech due to which it affects their communication skills and forming friendships.

  • Psychologists

    play a significant role in terms of assessment and classification of mental retardation. Assessment includes carrying out a formal standardized intellectual testing (IQ test) on the child and counseling the parents accordingly. Parents need to realize the capacity or potential of their child and encourage him/her accordingly taking both his strengths and weaknesses into consideration.

Are there different types or levels of Mental retardation?

Yes. There are different levels of Mental retardation which fall into mild, moderate, severe and profound.

  • Mild Mental retardation

    – Children with mild retardation can normally learn reading, writing, and math skills between the third- and sixth-grade levels. After reaching a period of adulthood, they may have jobs and live independently.

  • Moderate mental retardation

    – Children with moderate mental retardation need to learn some basic reading and writing but require supervision and monitoring in day to day living.

  • Severe mental retardation

    – Children with severe retardation may learn self-help skills and routines even if they are not able to read or write.

  • Profound mental retardation

    – Children with profound retardation need thorough support for the rest of their lives. They are reliant on their family for all activities of daily living.

Is it important to send the child to school?

Yes it is important that the child should be sent to a special or a normal school depending on the seriousness of his mental disability. It is essential that the child should be exposed to a learning environment, peers of his age and capabilities from a young age itself. Special schools offer classified education, addressing particular needs. The students to teacher ratios are held in low reserve depending on the children’s needs. There are special schools that offer alteration in order to make learning process simpler.

How does stem cell therapy work?

The biological task of stem cells is to repair and regenerate damaged cells. Stem cell therapy exploits this task by executing these cells in high concentrations directly in and around the damaged tissue, where they move its self healing and restoration forward.

There are certain areas that cause mental damage found in children with mental retardation, and can be seen on the PET CT Scan brain. Stem cells therapy works on these affected areas and help to improve the proper functioning of these areas.

Are there ethical concerns surrounding adult stem cell research and therapy?

Bone marrow transplantation has effectively been used for inherent disorders of blood, such as sickle cell anemia, thalessemia, as well as cancers such as leukemia. Since our therapy uses autologous cells, there are no major ethical concerns. Ethical concerns are mainly based on the use of embryonic stem cells which we do not use.

Does the treatment have any side effects?

Stem cell therapy is invasive and rationally safe. Till date, there is no such patient that has shown any neurological weakening related with the stem cell therapy. Some side effects like headache (spinal headache) lasting 3-4 days which is generally self limiting, neck/back pain, vomiting, some mild rash or pain at the site of bone marrow aspiration/stem cell injection may occur. However, like any other medical or surgical treatment unexpected complications are always a possibility. These complications may be related to the medicines given, the stem cell procedure, the anesthesia, and the rehabilitation or to any of the preexisting medical or neurological conditions.
In case of children with seizures, or previous history of seizures or an abnormal EEG, a small possibility of triggering seizures can be there. However, proper antiepileptic cover/drugs could circumvent this problem.

How long will it take me to know that I have benefitted from the treatment?

Maximum improvements are seen around 3-6 months after the treatment. However, in many patients there are slow progressive improvements that continue for several months or years later. Most patients show immediate improvements even before the discharge.

Is the transplantation of the stem cells done once or more than once?

The decision to do the therapy a second time is taken after studying the progress and improvements after the first therapy. If the patients show positive improvement, then the case is reviewed by the entire medical and rehabilitation team. Certain special imaging tests like PET CT Scan of the brain would be frequent and then a second treatment may be optional. This can be done anytime between 3-6 months of the first therapy.

Can other treatments be taken at the same time?

We will study what other medications the patient is already on. In most cases, we do not put an end to any already going on treatment. However this is decided on a case by case basis. Please inform us about any medications you are taking beforehand.

Will my child improve after stem cell therapy?

We have treated over 25 patients with mental retardation. They were executed with autologous stem cells, intrathecally. On further study, maximum of the patients improved in various areas of symptoms such as cognition, social interaction, communication, toilette training, self care, home living and so on. Their schooling improved and their learning ability improved, so the mental development starts to become age suitable. This in turn eases the pressure of the caretaker and the family. Overall mental development is improved and is recorded as improvement in IQ.