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Mental retardation in infants is a critical test for all members of a family. Parents often try to search the causes of their unhappiness, pestering doctors with a volley of questions regarding who should be blamed for the fact that the development was affected. Parents often support their own interpretation of what happened and wait for confirmation of a doctor. For example, the father blames his wife who suffered a cold during pregnancy, dressing elegantly but insufficiently to protect from cold. At the same time, the mother blames her husband for his habitual drinking and inherited factors such as epilepsy in the family. Finally, both parents often blame gynecologists and other doctors who allegedly overlooked or neglected something.
Somehow, it has happened. As a rule, there is no definitive answer to the question “who is to blame”, and this issue will remain in silence until the quest arises regarding the possibility of the next child. In such a case, both parents have to undergo a series of tests and genetic counseling. Under these conditions, undoubtedly, the search for the culprit is destructive. These conditions, further, reflect a sense of guilt, as well as their attempt to subdue those experiences that can further lead to deterioration of relationship in the family. When a problem of a mentally retarded infant occurs in a family, all family members need to support each other as moral support of each family member plays a powerful role in overcoming depressive moments.
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It becomes the responsibility of the parents to accept the child, create favorable conditions for his or her development and at the same time not to overlook his capabilities and demands. Otherwise, it may create a cult of complexes based on parents’ belief that the child may not be lucky to them. These conditions further affect the psychology of the infant leading to his being self-centered, poorly adapted and under-trained. With the right approach, the infant starts enjoying life and developing the ability to enjoy communication with the parents , despite the fact that the success may be moderate. A mentally retarded infant always be under the supervision of a psychiatrist who knows the medical history of a family, and parents should not rush from one psychiatrist to another in search of a miraculous healer. Competent psychiatrists constantly observe the child’s needs. Their periodical checkups improve the child’s development thus preventing a child from further related neurotic reactions. Hence, a mental disability can blanket family shame of the chronic traumatic factor so that the kid can bring joy to his/her parents just as other healthy children. It all depends upon the attitude of parents towards him/her, and proper attitude towards the tasks of treatment and education is the correct approach (Baird & Sadovnick, 1985).
The Concept of Mental Retardation
According to local experts, mental retardation is a consistent violation of certain mental quality structure in an infant’s nervous system. Mental retardation leads to the failure of cognitive activity and causes persistent underdevelopment of abstract processes of generalization combined with the inertia of mental processes. Based primarily on data from psychometric research, the literature defines the several approaches to the definition of infant mental retardation (Baroff, 1991).
The Main Forms of Mental Retardation
There are two basic types of mental retardation: oligophrenia and dementia.
When mental retardation occurs early in Uterus, underdevelopment of the brain takes place. It is caused by hereditary influences or a variety of damaging environmental factors. This fatal development occurs at birth and during the first year of infant life. When there is an increase in mental retardation, the intellectual defect occurs. The behavior of mental disorders associates with the age patterns of the child’s development. Oligophrenia is a total underdevelopment characteristic of neuropsychological functions with primary failures of abstract forms of thought. Intellectual defect combines with impaired motor skills, speech, perception, memory, attention, emotional development, as well as arbitrary behavior. Hypoplasia of cognitive activity in oligophrenia demonstrates the primary failure of logical thinking, mobility impairments of mental processes, and the inertia of thinking. In such cases, weakness of logical thinking is rooted in the low level of generalization, comparison of objects and phenomena of reality, as well as inability to understand the metaphorical meaning of proverbs and metaphors. Further, thinking slows down and typical inertia of mental processes does not transfer a learning mode of action to the new conditions. In mentally retarded infants underdevelopment of thinking affects the flow of mental processes. In perception, memory affects primarily the functions of abstraction and generalization, i.e., always broken components of mental activity affect the analytic-synthetic activity of the brain. Hence, the emotional volitional sphere reflects the low complex emotions and arbitrary behavior (Palmer & Capute, 1994).
When the intellectual defect is persistent, severe forms can be noticed in the first months of infant’s life. In oligophrenia, there are three degrees of mental retardation: debility, imbecility, and idiocy. Debility is the lightest degree and the most common form of mental retardation (IQ 50-69). In the absence of complicating intellectual impairment disorders as well as early and appropriate corrective measures, social outlook is favorable. More severe mental retardation is imbecility (IQ 20-49), when imbecility grossly violates the ability to abstract and to the formation of the concepts. The most severe degree of mental retardation is idiocy (IQ less than 20) characterized by gross underdevelopment of all mental functions (Matson & Sevin, 1994).
Dementia is a decay process more or less formed in the intellectual and other mental functions, i.e., dementia occurs because of the acquired intellectual defect.
At an early age, distinguishing between dementia and mental retardation is a challenge. The fact is that any disease or damage to the brain results in the loss of previously acquired skills and decay generated by intellectual functions endnotes delay in mental development in general. Therefore, at an early age it is extremely difficult to distinguish between acquired and innate intellectual failure. In connection with acquisition of the intellectual defect that associates with progressive organic brain disease, epilepsy and schizophrenia beginning in the first years of life need to be considered. This process has a complex structure. It includes both individual features of dementia and mental retardation. In the event of dementia in children within three years, delimitation of mental retardation becomes clearer. For differentiation of these forms of intellectual disturbances, it is essential to bear in mind that in dementia mental retardation occurs during normal intellectual development. Furthermore, the structure of mental disorders in dementia has its own characteristics which illustrate uneven cognitive failure of various functions. Dementia may be a discrepancy between the amount of knowledge and a limited capacity to implement it (Kolevzon, Gross, & Reichenberg, 2007).
The disturbances of mental capacity, memory, attention, behavior regulation, and motivation mark typical signs of dementia at an early age, and dementia manifests as late loss of acquired skills. For example, if dementia occurs in a child aged three, it, first of all, causes him to miss initial skills of self and neatness. The child may then lose previously acquired skills such as walking and a sense of attachment to the nearest ones.
One form of the disease similar to oligophrenia that includes features of dementia and mental retardation is Rett syndrome. The Austrian psychiatrist A. Rhett was the first who described this disease about 20 years ago. It occurs only in girls with a frequency of 1:12500. Symptoms of the development of the Rett syndrome become apparent at the age of 12-18 months, when the girl begins to lose barely formed speech, locomotors-static and object manipulative skills.
The characteristic feature of this disease is a combination of loss of purposeful hand skills and stereotypes (uniform) actions of the hands in the form of rubbing and wringing. The monotonous rubbing of hands in some children has peculiar movements of arms in front of the chest or chin. At an early age, clearly identified movement shows the difficulty in walking.
When Rett syndrome symptoms manifest themselves, one may see pale skin, constantly cold hands and feet, general somatic weakness, sharply decreased appetite, and difficulty in chewing and swallowing. Girls hold food in their mouth for a long time without swallowing it. Many patients have to be fed because they do not know how to use a spoon or a fork.
Further, the Rett syndrome shows characteristics by the violation of posture and the gradual development of scoliosis. Posture and movement of infant girls become extremely monotonous and motor awkward. They find it difficult to manipulate objects, and they do not play with dolls and other toys. Neurologists usually say that they have the overall muscle tone reduced.
Difficulties in mastering walking and simplest object actions, lack of coordination of movements, and low muscle tone are typical features not only of the Rett disease, but the cerebral palsy as well. Hence, sometimes children ill for a long time can be misdiagnosed as having the cerebral palsy.
The characteristic feature of the Rett syndrome is a persistent lack of imitative activity, and delays in the development of material and practical activities, and speech communication. The sick kids have faces that are hardly expressive; they look "lifeless" or "unhappy". One often encounters a look of a still, focusing on an object for a long time.
Although several factors such as degree and cause of severity change from person to person, there are some general predisposing factors connected with infant mental retardation. The first of factors of this type are hereditary factors, for example, an infant may be suffering from inborn errors of metabolism (these occur when the infant body cannot transform food into energy, such as in the case of Phenylketonuria disorder), single genetic abnormalities, and several chromosomal aberrations (Piecuch, Leonard, Cooper, & Sehring, 1997).
Another reason of infant mental retardation is the mother’s exposure to teatogens, or external factors that the mother can encounter during pregnancy, which damages the progressing baby in the womb. Teratogens can contain toxins in such women who use drugs or medications during pregnancy or suffer from exposure to diseases or infections. Several other factors during the stage of pregnancy that can influence a child to develop mental retardation are fetal malnutrition, hypoxia, prematurity, or trauma. Environmental effects may also play a crucial role: for example, infants brought up in extremely destitute environments may develop mental retardation. Besides, some other mental disorders can cause infants to have mental retardation, for example, Autism Spectrum Disorder, or other Pervasive Developmental Disorders. Finally, overall medical conditions obtained in infancy may also cause mental retardation. These include infections such as measles or meningitis. These, if not treated properly, may cause retardation or exposure to certain toxins such as lead or mercury (AAIDD, 2002).
Mental disability in infants can occur when the fetus does not develop inside the mother’s womb. Moreover, prenatal reasons comprise congenital infections such as toxoplasmosis, cytomegalovirus, herpes, rubella, syphilis, and human immunodeficiency virus. Complications of prematurity, in low weight infants, can also lead to mental retardation (Daily, Ardinger, & Holmes, 2000).
Mental retardation in infants is a genetic disorder which usually manifests itself in below average intellectual functioning and deficiency in adaptive behavior. Several genetic or multiple factors can create mental retardation in infants. In at least 25 to 40% of cases, doctors cannot determine the etiology despite thorough assessment. The systematic review of infants should be conducted with individual attention to growth problems, lethargy, history of seizures, and episodic vomiting.
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