Mental retardation and its characterization

The term mental retardation is not in itself a diagnosis as it does not inform about aetiology, prognosis, or specific treatments. Rather, it refers to a clinical state that is developmental in origin and affects intellectual and social functioning. The diagnosis is the identification of the underlying cause for the observed developmental delay. These are covered in more detail in a separate chapter and are mainly the province of paediatrics or clinical genetics. However, a distinction between 'organic' and 'subcultural' can be helpful as the differences highlighted in may help to determine the extent to which specific investigations are indicated for any given individual.

The extent of early developmental delay can be measured against standardized developmental scales (e.g. Bayley or Griffiths Developmental Scales), and during childhood and adult life there are also well-established specific assessments of intellectual, language, and functional abilities. These primarily include standardized tests of intellectual ability and tests of functional ability. These assessments are descriptive in nature in that they provide a profile of a person or group of people that can be compared against the norms for age and a given population (see Iable.4). Investigating aetiology and arriving at a diagnosis will be informed by taking a history and by physical examination (e.g. presence of a family history of similar disorder or not, evidence of the characteristics of a particular syndrome). Chromosomal, biochemical, and molecular genetic studies may also be necessary.

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