Adolescence

Many parents of younger children with mental retardation express considerable anxiety about the coming of adolescence. Fortunately, more often than not it would appear that reality is not as bad as these fears. In longitudinal studies, (6Z) families find that they have enjoyed their retarded child's teenage years at least as much as when their other children were at the same stage. They say that there is much that they are proud of but there is still much parenting to do as they have to continue to supervise or provide a taxi service for their children long after the others. Parents are understandably anxious about sexuality and particularly about pregnancy. Permanent solutions have been sought, such as sterilization and even hysterectomy to prevent pregnancy and the inconvenience and embarrassment of management of menstruation 'to no purpose'. Such operations present problems that are both legal and ethical. In many cases, parents can be reassured and their daughter protected without resorting to such Draconian methods. Again in comparison with her normal sister, the child with moderate or severe retardation is easily protected. Much more at risk is the rebellious girl with mild retardation trying hard to keep up with her peers. Persistent behaviour problems that started earlier in childhood become an even greater difficulty when the child grows large and strong. Families show remarkable resilience and courage but what has been a worry or a nuisance earlier can turn into a dangerous situation later. Some districts are able to provide nurses with behavioural and other skills. Such domiciliary helpers are invaluable, but emergency hospital beds are essential to prevent permanent removal from home or as a stepping stone to appropriate long-term accommodation.

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