The twentieth century has seen very significant changes in the lives of people with mental retardation and in the conceptual frameworks that inform our thinking. Among the most striking have been the changing philosophy, away from segregation, towards integration and a recognition that people with mental retardation represent a highly complex and heterogenous group with a varied range of needs. Equally striking have been advances in the biological and behavioural sciences. In parallel with these developments there has been a very significant shift away from an overly biologically deterministic perspective to a recognition of variability within particular syndromes and an appreciation that special education, skills and communication training, and the provision of appropriate social care can lead to levels of independence and a quality of life that was never aspired to or attained in large institutional settings.

The variability and potential complexity of need among people with mental retardation has been highlighted by epidemiological studies which have demonstrated high rates of additional disability due to the presence of sensory and physical impairments, behavioural and psychiatric disorders, and/or a developmental profile indicative of autism.(!2) The identification of such secondary impairments and disabilities and their treatment or amelioration through a range of interventions helped to replace a feeling of therapeutic nihilism that had been all too pervasive. It became apparent that not only were good education and social care services required but also multidisciplinary and community-based specialist health support should be available to people with mental retardation, particularly those with challenging behaviour and/or mental health needs.(3)

A recognition of this potential complexity of need has meant that no single 'label', whether mental retardation, learning disability, or developmental disability, can adequately describe this group of people. What individuals have in common is a difficulty in the acquisition of basic living, educational, and social skills that is apparent early in life together with evidence of a significant intellectual impairment. However, for some this may be of such severity that meaningful language is never acquired and there are very substantial care needs. For others the presence of subtle signs of early developmental delay, together with evidence of learning difficulties only becomes clearly apparent at school when there is an expectation that more sophisticated skills will be acquired.

In infancy and early childhood the reason for any apparent developmental delay needs to be established. Later in childhood the nature and extent of a child's learning difficulties and a statement of special educational needs may be the main task and later still the main focus may be the assessment of longer-term social care needs.(4) Throughout life there may also be questions about, for example, a child's or adult's behaviour or mental state or physical or sensory impairments and disabilities. The role of assessment is essentially to determine need and to inform the types of intervention and treatments, whether educational, medical, psychological, or social, that are likely to be effective and of benefit to the person concerned. Systems of classification provide a useful framework for such an assessment.

Adult Dyslexia

Adult Dyslexia

This is a comprehensive guide covering the basics of dyslexia to a wide range of diagnostic procedures and tips to help you manage with your symptoms. These tips and tricks have been used on people with dyslexia of every varying degree and with great success. People just like yourself that suffer with adult dyslexia now feel more comfortable and relaxed in social and work situations.

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