Abstract
The problems of mentally retarded children stem primarily from the deficits in intellectual and cognitive ability implicit in the diagnosis. In addition, these children are subject to stresses and emotional and social problems similar to, or even greater than, those experienced by children of normal and superior cognitive ability. The retardation, however, limits their ability to deal effectively with these problems. Although the degree of emotional disturbance is not directly related to the intellectual handicap, some mentally retarded children are able to cope with stress better than others. Also mentally retarded children experience stresses that children of normal intelligence do not, such as family reactions to their retardation, be it overt or covert rejection or over-protectiveness. The influence these factors have on the retarded child varies with the child’s age and developmental capacities and with the obviousness of the defect. Often it is the emotional and behavioural problems of the retarded child that cause the greatest difficulties for the family, the school, and society. These problems, rather than the retardation itself, may be the reasons that institutionalization of the child or his removal from the home is sought. The first person with whom the family discusses these problems is usually their family practitioner or paediatrician, rather than a psychiatrist.
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Recommended For Further Reading
BAKER, B. L. and WARD, M. H. “Reinforcement Therapy for Behavior Problems in Severely Retarded Children”. Amer. J. Orthopsychiat. 41: 124–35, 1971. —good examples of behaviour therapy are contained in this description of a project in behaviour modification of severely retarded children.
BAKWIN, H. and BAKWIN, R. M. Clinical Management of Behavior Disorders in Children. Philadelphia, W. B. Saunders, 1966. —deals primarily with the management of the behavioural difficulties presented by some retarded children to their families and others.
CLARKE, A. M., and CLARKE, A. D. B. Mental Deficiency. 3rd ed. New York, Free Press, 1975. —a major reference work.
CYTRYN, L., and LOURIE, R. S. “Mental Retardation”, in Freedman, A. M., and Kaplan, H. I., eds., Comprehensive Textbook of Psychiatry, 817–56, Baltimore, Williams and Wilkins, 1967. —provides a summary of the genetic and biochemical abnormalities often associated with syndromes featuring severe retardation, as well as discussing psychiatric aspects of retardation and the diagnostic process. Good discussion of primary, secondary, and tertiary prevention.
EYSENCK, H. J. Uses and Abuses of Psychology. Harmondsworth, England, 1966. —a useful discussion of the content, selection, and limitations of psychological testing.
FOTHERINGHAM, J. B.; SKELTON, M.; and HODDINOTT, B. A. “The Effects On the Family of the Presence of a Mentally Retarded Child”. Canad. Psychiat. Assoc. J. 17: 283–90, 1972. —this thoughtful but technical presentation considers the presence of a retarded child within a family as a source of ongoing stress, and considers the various mechanisms and resources the family may use to cope with this stress.
FOTHERINGHAM, J. B.; SKELTON, M.; and HODDINOTT, B. A. The Retarded Child and His Family. Toronto, The Ontario Institute for Studies In Education, Monograph Series 11, 1973. —focuses on the two main alternatives for the retarded child’s care—home and institution—examining the advantages and disadvantages of each for both the retarded child and his family.
FRANCIS, S. H. “The Effects of Own-Home and Institution-Rearing on the Behavioural Development of Normal and Mongol Children”. J. Child Psychol. Psychiat. 12: 173–90, 1971. —compares both normal children and mongols who live at home with those in institutions. Discusses reasons for behavioural differences and the lower developmental level of the institution-reared children.
HILUARD, L. T., and KIRMAN, B. H. Mental Deficiency. 2nd ed. Boston, Little, Brown, 1965. —a general textbook.
KOCH, R., and DOBSON, J. C. The Mentally Retarded Child and His Family. New York, Brunner/Mazel, 1971. —an integrated but multidisciplinary approach directed towards all professionals involved with the retarded child and his family. Deals authoritatively with such areas as educational training, psychosocial aspects of retardation, the supporting role of community services.
MASLAND, R. L.; SARASON, S. B.; and GLADWIN, T. Mental Sub-Normality. New York, Basic Books, 1958. —a general textbook.
MENOLASCINO, F. J. Psychiatric Approaches to Mental Retardation. New York, Basic Books, 1970 —deals primarily with the psychiatric consequences of retardation for child and family.
Mental Retardation: A handbook for the primary physician. A report of the American Medical Association Conference on Mental Retardation held in Chicago, 1964. Published by American Medical Association, Chicago, III. —an excellent general handbook.
The Paediatrician and the Child with Mental Retardation. Prepared by the Committee on Children with Handicaps, published by the American Academy of Paediatrics, Evanston, III. 1968–71. —another useful handbook for the paediatrician or primary physician.
POTTER, H. W. “The Needs of Mentally Retarded Children for Child Psychiatry Service”. J. Amer. Acad. Child Psychiat. 3: 352–74, 1964. —reviews the historical background of retardation, the interference of anxiety with the adaptation of the mildly retarded child, and the general lack of availability of psychiatric services for these children.
STONE, N. D. “Effecting Interdisciplinary Coordination in Clinical Services to the Mentally Retarded”. Amer. J. Orthopsychiat. 40: 835–40, 1970. —advocates shifting the focus from the microcosm of the restricted clinical team to include the patient and his network of significant relationships as an integral part of a therapeutic system for the mentally retarded. The importance of clear role definition is stressed.
TARJAN, G.; WRIGHT, S. W.; EYMAN, R. K.; and KEERAN, C. V. “Natural History of Mental Retardation: Some Aspects of Epidemiology”. Amer. J. Ment. Def. 77: 369–79, 1973. —an overview of current care of the retarded, emphasizing the prevalence, the process of institutionalization, and recent trends in management.
WORTIS, J. Mental Retardation and Developmental Disabilities: An Annual Review. Vol. 5. New York, Brunner/Mazel, 1973. —covering developmental disabilities as well as mental retardation, this annual review deals with clinical, educational, employment, sexual behaviour, and other areas related to the management of the retarded child.
Additional Reading
MURPHY, A., and POUNDS, L. “Repeat Evaluations of Retarded Children”. Amer. J. Orthopsychiat. 42: 103–9, 1972.
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© 1977 Macmillan Publishers Limited
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Hawke, W.A. (1977). Psychiatric Aspects of Mental Retardation. In: Steinhauer, P.D., Rae-Grant, Q. (eds) Psychological Problems of the Child and His Family. Palgrave, London. https://doi.org/10.1007/978-1-349-81464-0_13
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DOI: https://doi.org/10.1007/978-1-349-81464-0_13
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