Al-Ghad International Colleges for

Applied
Medical Sciences

Mental disorders

Psychiatric /mental health nursing

)Theory(
NURS 413
LEVEL 7

:Lecturer
Dr. Reda Shehata
 MENTAL RETARDATION
Definition
Mental retardation (MR) is a generalized

disorder appearing before adulthood,

characterized by significantly impaired
cognitive functioning and deficits in two or
more adaptive behaviors.
It has historically been defined as an
Intelligence Quotient score under 70
 Intelligence Quotient (IQ)
An intelligence quotient, or IQ, is a score

derived from one of several different

standardized tests designed to assess

intelligence.
Grades of IQ
140 + Genius
120 to 140 Very superior intelligence
110 to 119 Superior intelligence
90 to 109 Normal or average
intelligence
80 to 89 Dull
70 to 79 Borderline deficiency
Under 70 Definite feeble mindedness
 Causes Of Mental
:Retardation

Prenatal

Natal

Postnatal
Prenatal
Inborn errors of metabolism.

Brain malformations such as genetic

hydrocephalus
Deficiencies , such as iodine deficiency and

folic acid deficiency

Using substances such as alcohol

Exposure to other harmful chemicals such as

pollutants, heavy metals, harmful medications

 Complications of pregnancy
Diseases in mother such as
Third trimester
heart and kidney disease
( late pregnancy)
and diabetes
Placental dysfunction

Severe prematurity, very

Nat low birth weight, birth
Labor asphyxia
al (during delivery) Difficult and/or complicated
delivery
Birth trauma

Neonatal Septicemia, severe

(first four weeks
jaundice, hypoglycemia
of life)
 Brain infections such as
tuberculosis, encephalitis,
Postnatal
and bacterial meningitis
(in infancy
Head injury
and
Severe and prolonged
childhood)
malnutrition
Common features of MR

Delays in oral language development

Deficits in memory skills

Difficulty learning social rules

Difficulty with problem solving skills

Delays in the development of adaptive

behaviors such as self-help or self-care

skills .
 :Diagnosis of MR
1/ an IQ below 70

2/ significant limitations in two or

more areas of adaptive behavior
(communication, self-help skills,
interpersonal skills, and more)

3/ evidence that the limitations

became apparent before the age of
18 .
:Grades of MR
According to IQ :

Profound mental retardation Below 20

Severe mental retardation 20–34

Moderate mental retardation 35–49

Mild mental retardation 50–69

Borderline intellectual functioning70--84

Management of MR
By most definitions mental retardation

is more accurately considered a

disability rather than a disease.
Currently, there is no "cure" for an

established disability, though with

appropriate support and teaching, most
individuals can learn to do many things
The mainstay of treatment of MR is
developing a comprehensive management
plan for the condition. The complex
rehabilitation plan for the individual requires
input from care providers from multiple
disciplines, including special educators,
language therapists, behavioral therapists,
occupational therapists, and community
services that provide social support and
respite care for families affected by MR.
 :Prevention of MR
Genetic: Prenatal screening for genetic

defects and genetic counseling for families

at risk for known inherited disorders can
decrease the risk of inherited mental
retardation.
Social: Government nutrition programs are

available to poor children in the first and

most critical years of life. These programs
can reduce retardation associated with
malnutrition.
Toxic: Environmental programs to

reduce exposure to lead, mercury,

and other toxins will reduce toxin-
associated retardation. Increased
public awareness of the risks of
alcohol and drugs during
pregnancy can help reduce the
incidence of retardation
Infectious: The prevention of

congenital rubella syndrome is

probably one of the best examples of a
successful program to prevent one
form of mental retardation. limiting
exposure to cat litter that can cause
toxoplasmosis during pregnancy, helps
reduce retardation that results from
this infection.
AUTISM
 Overview
What is Autism?

What causes Autism?

How is Autism diagnosed?

What are the characteristics of Autism?

What are the most effective approaches

to treating Autism? Is there a cure?

?WHAT IS AUTISM
Very complex, “Auto” – children are

“locked within themselves.”

Autism disorders are

neurodevelopmental disorders, meaning

they are caused by abnormalities in the
way the brain develops and works.
 ?WHAT IS AUTISM
Autism impacts normal development

of the brain in areas of social

interaction and communication skills.
Difficult to communicate with others

and relate to the outside world.

Occasionally, aggressive and/or self-

injurious behavior may be present.

 ?WHAT IS AUTISM
May exhibit repeated body movements

(hand flapping, rocking).

Unusual responses to people

Attachment to objects

Resistance to change in routine

 Causes of autism
Good agreement in general that autism is

caused by abnormalities in brain

development, and genetic factors

CHARACTERISTICS
1. Communication/Language
2. Social Interaction

3. Behaviors

4. Sensory and movement

disorders
Communication/language .1

Broad range of abilities, from

no verbal communication to

quite complex skills

 Social Interaction .2

1. Impaired use of nonverbal behavior

2. Lack of peer relationships

3. Failure to spontaneously share

enjoyment, interests, etc. with others

 Behaviors .3
Repetitive behaviors, including

obsessions, and tics

A. Self-injurious behavior

B. Aggression
Sensory and movement .4
disorders
Abnormal posture and movements of

the face, head, trunk, and limbs

Abnormal eye movements

Repeated gestures and mannerisms

Movement disorders can be detected

very early – perhaps at birth

?How is Autism Diagnosed
No definitive medical test

Team uses interviews, observation, and

specific checklists developed for this

purpose.
Team might include neurologist,

psychologist, developmental pediatrician,

speech/language therapist, learning
consultant, etc.
Interventions

1. Individualization and early

intervention are the keys
2. Include life skills, functional
academics, and vocational
preparation
3. Positive behavior support
4. Social stories
Conduct
Disorder
 Students with
Conduct Disorder
Differ from peers
Persistence of such
conduct beyond age at
which most children
have adopted less
aggressive behaviors
How Do Students with
Conduct Disorder Do in
?School
Teachers see these students as:
Uninterested
Careless
Students with Conduct Disorder
have:
Poor interpersonal relations
Rejected by their peers
Poor social skills
Students with Conduct Disorder are
most likely to be:
Left behind in grades
Show lower achievement levels
 Conduct Disorder
Males exhibit:
Fighting
Stealing
Overly aggressive
Females exhibit:
Lying
Running away
Substance abuse
Prostitution
Less aggressive
Classification of Conduct
:Disorder

Mild (resulting in only minor harm

to others)
Moderate

Severe (causing considerable

harm to others)
Separation
Anxiety
Birth to Age 5
 How Separation Anxiety
Develops
Separation anxiety is a normal part of child
development
Separation anxiety varies widely from child
to child

It may end when toddlers begin to

understand that parents may be out of sight,
but they will return later

Some children will undergo some degree of

anxiety when placed in unfamiliar situations,
especially when separated from parents.
Situations that can trigger stress
and anxiety for young children
include
New child care setting or teacher

New brother or sister

Moving to a new home

Tension at home (such as a divorce,

death, or serious illness)
When feeling anxious about separation,
young children display many different
:behaviors, including

Crying or whining

holding hand or leg, wanting to be held,

hiding behind parent

Shyness

Silence (instead of constant talking or

babbling)

Unwillingness to interact with others,

even if they are familiar people
Examples of Anxiety
Disorders
 Generalized Anxiety Disorder (GAD)

 Separation Anxiety Disorder (SAD)

 Obsessive Compulsive Disorder (OCD)

 Post-Traumatic Stress Disorder (PTSD)

 Treatment
Identifying anxious thoughts
Helping the child understand that the parent
will return
Offering possible explanations for where the
parent is
Make new surroundings as familiar as possible
Honor all commitments to the child, especially
time commitments. Pick up the child up at
the specified time you told him or her. This
builds trust and security.
A good first step would be to have one parent
leave for 15 minutes while the child stays with
the other parent. This will build trust with
both parents
1. Intelligence Quotient (IQ) of mental retardation is:

A. Above 140

B. From 90 to 109

C. Below 70

D. Below 10
2. How do students with conduct disorder do in school?

A.Poor interpersonal relations

B.Show high achievement levels

C.Accepted by their peers

D.Interested in learning