Developing countries17

Rigorous studies are more difficult and good record systems less common in developing countries, so there are few reliable sources for estimating prevalence, but data available suggest differences related to the varying spectrum of organic causes, mortality, and social situations. fy,1.6.) Developing countries are not all the same; for example the high infant mortality of most African countries is not shared by China. In some, cretinism due to iodine deficiency disease is an overwhelming cause and can affect over 10 per cent of village populations before salt iodization or similar programmes have much impact. Children with Down syndrome do not generally survive in communities with high infant mortality.

Severe intellectual impairment (IQ < 50), however labelled, will be recognized in all communities. Comparative studies from China show a similar range of prevalence to developed countries, with a few explainable exceptions. A nine-country study showed similar figures, except in South India (Bangalore) where differential migration explained high teenage figures. Such figures cannot be applied to other countries. Precise comparative statistics are not crucial, but descriptive studies establishing locally preventable factors, identifying groups with particular service needs, and estimating the size of groups for resourcing, are important. (17>

Mild intellectual impairment is not much identified in non-technological non-literate societies which provide acceptable roles and adequate support in the family and community, and impose no handicap on those with limited learning and reasoning powers. However, the demands of universal literacy, and modern technology, identify those who function well below average as having problems, which may handicap them in their prospects for employment and marriage. Increasing urbanization may add to their handicap by disrupting extended family networks. These processes can be said to create mild mental retardation out of mild intellectual impairment!

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Break Free From Passive Aggression

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