I. Definitions

  1. Current definition
    1. Two or more deficits in adaptive behaviors
  2. Old definition
    1. IQ <70

II. Comorbid Conditions: Physical

  1. Poor dental hygiene (recommend regular dental care)
  2. Skin Breakdown
    1. Observe perineum and decubitus areas
  3. Sleep Apnea
  4. Methicillin-resistant Staphylococcus aureus
    1. Associated with PEG or tracheotomy sites
  5. Aspiration
    1. Consider checking Pulse Oximetry with feedings
    2. Consider speech pathology evaluation
  6. Gastroesophageal Reflux disease
  7. Constipation and Fecal Impaction
    1. Maintain bowel regimen to prevent Constipation
  8. Pelvic Pain in women
    1. Control Dysmenorrhea (signalled by behavior change)
    2. Consider STD or pregnancy
  9. Seizures
    1. Differentiate from extrapyramidal drug effects
  10. Neuromuscular Scoliosis, Contractures, Spasticity
    1. Consult with orthopedics and physical therapy
  11. Osteoporosis

III. Comorbid Conditions: Behavioral

  1. General
    1. May be due to stress, pain, anger, fear...
    2. Carefully evaluate for cause
    3. Benzodiazepines may exacerbate in 10% of cases
  2. Sexually offending behavior
  3. Self-injury (e.g. head-banging)
  4. Aggressive behavior
  5. Insomnia or other sleep problems
  6. Hyperactivity
  7. Repetitive behaviors

IV. General Measures to Assist Appointment

  1. Person well known to patient should accompany them
  2. Brief social visits can desensitize patient to office
  3. Talk the patient through examination
  4. Engage the patient in decision making
  5. Consider Ativan 2 mg taken 2 hours before appointment

Images: Related links to external sites (from Google)

Ontology: Mental Retardation (C0025362)

Definition (NCI) A developmental disorder characterized by less than average intelligence and significant limitations in adaptive behavior with onset before the age of 18.
Definition (MSH) Subnormal intellectual functioning which originates during the developmental period. This has multiple potential etiologies, including genetic defects and perinatal insults. Intelligence quotient (IQ) scores are commonly used to determine whether an individual has an intellectual disability. IQ scores between 70 and 79 are in the borderline range. Scores below 67 are in the disabiled range. (from Joynt, Clinical Neurology, 1992, Ch55, p28)
Definition (PSY) Impaired intellectual (IQ below 70) and adaptive functioning manifested during the developmental period. Use a more specific term if possible. Use for both the concept of the disorder itself and for populations of mentally retarded persons.
Definition (CSP) subnormal intellectual functioning which originates during the developmental period; multiple potential etiologies, including genetic defects and perinatal insults; intelligence quotient (IQ) scores are commonly used to determine whether an individual is mentally retarded; IQ scores between 70 and 79 are in the borderline mentally retarded range and scores below 67 are in the retarded range.
Concepts Mental or Behavioral Dysfunction (T048)
MSH D008607
ICD9 317-319.99
ICD10 F79 , F70-F79.9, F70-F79
SnomedCT 154978008, 110359009, 154979000, 268732001, 192157003, 91138005, 228156007, 1855002, 192557008
English Unspecified mental retardation, Mental Retardation, RETARDATION MENTAL, MENTAL RETARDATION, Retardation, Mental, Mental retardation, NOS, Mental retardation NOS, Intellectual functioning disab, [X]Unspecif mental retardation, [X]Unspecified mental retardation, Unspecif mental retardation, mental retardation diagnosis, mental retardation, mr, mental retardation (diagnosis), Retardation mental, Mental retardation NOS (disorder), Intellectual disability (disorder), [X]Unspecified mental retardation (disorder), Disabilities, Intellectual, Intellectual Disabilities, Mental Retardation [Disease/Finding], Deficiency;mental, mental retardations, Disability;intellectual, Retardation;mental, disability intellectual, disabilities intellectual, Mental retardation (F70-F79), INTELLECTUAL DISABILITIES, Disability, Intellectual, Intellectual Disability, Mental retardations, Mental retardation, Intellectual functioning disability, MR - Mental retardation, Intellectual disability, Intellectual functioning disability (finding), Intellectual limitation, Mental retardation (disorder), Retardation (Mental), intellectual disability
Italian Ritardi mentali, Ritardo mentale non specificato, Disabilità intellettuale, Ritardo mentale
Swedish Psykisk utvecklingsstörning, FORSTANDSHANDIKAPP
Czech duševně postižení, mentální retardace, Blíže neurčená mentální retardace, Mentální retardace, Retardace mentální, Snížená intelektuální schopnost
Finnish Älyllinen kehitysvammaisuus, KEHITYSVAMMAISUUS
Spanish Retardo mental, Retrasado mental, Retraso mental no especificado, Discapacidad intelectual, [X]retraso mental no especificado (trastorno), [X]retraso mental no especificado, Mental retardation NOS, discapacidad en el funcionamiento intelectual (hallazgo), discapacidad en el funcionamiento intelectual, discapacidad intelectual (concepto no activo), discapacidad intelectual, limitación intelectual, retardo mental (trastorno), retardo mental, retraso mental, SAI (trastorno), retraso mental, SAI, retraso mental, Retraso mental, Retraso Mental
French Retardation mentale, Retardation mentale non précisée, Arrieration mentale, Handicap intellectuel, Arriérations mentales, Oligophrénie, Retard mental, Arriération mentale, Retards mentaux
Dutch retardatie mentaal, zwakzinnigheid , niet-gespecificeerd, mentale retardatie, Mentale retardatie/intell achterst, intellectuele handicap, Mentale retardatie, geestelijke retardaties, Niet gespecificeerde zwakzinnigheid
German unspezifische geistige Behinderung, geistige Retardierung, Behinderung geistig, Nicht naeher bezeichnete Intelligenzminderung, mentale Retardierung/Minderbegabung, intellektuelle Behinderung, Schwachsinn, Geistige Retardierung, Retardierung, geistige, Geistig verzögerte Entwicklung
Portuguese Atraso de desenvolvimento mental, Atraso mental NE, Atraso mental, Incapacidade intelectual, Retardamento Mental, Atrasos mentais, Retardo Mental
Norwegian PSYKISK UTVIKLINGSHEMMET - f70 - f71 - f72 - f73 - f78 - f79
Danish Psykisk udviklingshaemning
Hungarian szellemi visszamaradottsag, Intellektualis rokkantság, Mentalis retardatio, Mentális retardációk, Mentális retardatio, Nem meghatározott mentalis retardatio
Japanese セイシンチタイ, ショウサイフメイノセイシンチタイ, 詳細不明の精神遅滞, 精神薄弱, 精神的障害, 精神発達遅滞-心理社会的, 知能遅延, 白痴, 心理社会的精神発達遅滞, 精神薄弱-心理・社会的, 知的障害, 知恵遅れ, 社会心理的精神発達遅滞, 心理社会的精神薄弱, 精神薄弱-心理社会的, 精神遅滞, チテキショウガイシャ, 知的障害者, 精神発達遅滞, 社会心理的精神薄弱
Korean 상세불명의 정신 발육지연
Hebrew pigur sixli
Polish Opóźnienie umysłowe, Idiotyzm, Niedorozwój umysłowy, Upośledzenie umysłowe