Assessment

Assessment is a task that is undertaken to addressspecific issues in the context of a particular conceptual framework and that is informed both by theory and established systems of classification. The above systems of classification provide a framework for such an assessment but it is clear that a truly holistic assessment involves many different disciplines. In principle the psychiatric assessment of people with mental retardation is not dissimilar to general child or adult psychiatry. The two main differences are as follows:

1. special care may have to be taken in assessing an individual's mental state and, where language development is impaired, a greater reliance may have to be placed on information from an informant;

2. a good developmental history is essential to map early development and the potential developmental origins of the individual's present state.

Psychiatric assessment is an iterative process and it is therefore helpful to make a distinction between:

1. the characterization of the nature and extent of the mental retardation and the identification of its aetiology;

2. the identification of the nature and extent of additional problem behaviours (these are essentially descriptive);

3. the determination of the putative aetiology of some aspect of the person's behaviour,(10) such as psychiatric diagnosis or the identification of factors that might have precipitated and are now maintaining a particular behaviour.

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