Mental Retardation and Developmental Disability Planner.

Autism and mental retardation are closely related. Although the nature of the relationship between the two is not fully understood, the importance of early diagnosis and timely intervention is well documented.

Dendritic abnormalities appear to have syndrome-specific pathogenesis and evolution, which correlate to some extent with their cognitive profile. The significance of dendritic pathology in synaptic circuitry and the role of animal models in the study of MR-associated dendritic abnormalities are also discussed. Finally, a model of genotype to neurologic phenotype pathway in MR, centered in dendritic abnormalities, is postulated.

Diagnosing mental disorders in mentally retarded adults presents several difficulties. First, the diagnostic criteria for most mental disorders use subjective criteria, such as reporting mood, loss of energy, grandiose thoughts, delusions and hallucinations. Mentally retarded patients, however, often cannot report their subjective experiences accurately. Some of these patients even have little or no ability to speak. Second, the differentiation of developmental behavior and thinking from psychopathology presents difficulties.

For both children with mild and severe MR, risk was increased among males, low birth weight children, and children born to women of black race, older age at delivery, and lower level of education. Increased risk for mild MR was found for multiple births, second or later-born children, and children whose mothers were born outside of California. Increased risk for severe MR was observed among children born to Hispanic mothers; children born to Asian mothers also had increased risk for severe MR but decreased risk for mild MR.

Applied behaviour analysis methods for the assessment and treatment of behaviour disorders continue to be the focus of research, and continue to result in positive outcomes. Recent data show the value of using applied behaviour analysis technologies as a service model for people with behaviour disorders. Pharmacological treatments, especially risperidone, also have a developing evidence base despite a lack of understanding of their mechanisms of action. A number of questions about behaviour disorders remain unanswered, especially whether early intervention may be effective and their putative relationship with psychiatric conditions.

The majority of adults with mental retardation continue to be excluded from the nation's work force, unable to obtain or maintain employment.

Persons with mental retardation are living longer and integrating into their communities. Primary medical care of persons with mental retardation should involve continuity of care, maintenance of comprehensive treatment documentation, routine periodic health screening, and an understanding of the unique medical and behavioral disorders common to this population. Office visits can be successful if physicians familiarize patients with the office and staff, plan for difficult behaviors, and administer mild sedation when appropriate. Some syndromes that cause mental retardation have specific medical and behavioral features. Health issues in these patients include respiratory problems, gastrointestinal disorders, challenging behaviors, and neurologic conditions. Some commonly overlooked health concerns are sexuality, sexually transmitted diseases, and end-of-life decisions.

We focus on the nature of memory deficits in individuals with mental retardation with the hope of contributing to the development of a more general cognitive theory of mental retardation.

Conclusion : Neuroimaging should be the standard clinical practice for a child with global developmental delay where no cause is apparent after examination and relevant investigations.