Definition of Mental Retardation-Theoretical Perspectives

Mental retardation is a phenomena that has existed since the beginning of time.

There have always been persons with marked intellectual limitations who have had a hard time meeting the demands of their social environment.

What has changed is our understanding of the nature of the construct to explain limited intellectual functioning and its consequence--social incompetence.

The terms we have used to label the construct have varied over the centuries

What is a construct?

• a term applied to an abstract set of qualities or characteristics which go together to make up a particular phenomenon

Since MR is not a unitary phenomenon, the many definitions which have been formulated over the centuries embody concepts that give this multifaceted construct clarity and meaning.

The definitions reflect out present understanding or meaning of the concept .

As our understanding changes the definition changes.

Since 1921 there have been eight revisions of the AAMD definition.

Definition also varies with the theoretical statements about the underlying nature of the condition.

Theoretical perspectives of mental retardation: clinical, social system, developmental.

Clinical Perspective

• Views mental retardation as a handicapping condition which exits in the individual and can be diagnosed by clinically trained professionals using properly standardized assessment techniques
• Definitions reflecting the clinical perspective have been formulated by professionals in psychology and medicine
• Psychologists define MR in terms of limited mental development as measured by an individual's performance on a psychometric test
• Those in biological sciences define MR as the presence of observable or inferred brain pathology
• Both are important to our understanding of mental retardation as a construct

Biological Concepts

• Organic Impairment
• The medical or pathological model posits the presence of organic impairment (observed anatomical, neurological, or biochemical abnormality) as the essential criterion which defines MR
• Early definitions attributed idiocy to "disturbances of the central brain systems" (Seguin, 1866), "malnutrition or disease of the nervous centers" (Ireland, 1900), "defective development of the brain" (Tredgold & Soddy, 1956)
• This resulted in incomplete mental development manifested in social incompetence
• More recent definitions have attributed mild as well as severe forms of mental retardation to central nervous system impairments
• Tarjan (1970) estimated that about 20% of persons with mild MR have some organic impairment
• Neurological impairment is viewed along a continuum in which marked impairment results in severe retardation and minimal impairment results in mild MR
• Proponents of this view argue that our inability to detect organic elements in mild mental retardation is due to the insensitivity of our diagnostic tools, not to the absence of pathology
• Salvia (1978) regards those cases where structural abnormality is inferred but non observable as "quasi-biological" cases
• "No one seriously doubts that structural abnormality within the central nervous system can have an adverse effect on behavioral development. However, a one-to-one correspondence between CNS structure and behavior has rarely been demonstrated. What has been demonstrated repeatedly is that 1) some persons classified as mentally retarded evidence CNS pathology; 2)some persons classified as mentally retarded do not evidence CNS pathology, even in autopsy; and 3) some persons not classified mentally retarded evidence CNS pathology (Salvia, 1978).
• Biological explanations become problematic in explaining the behavior of mildly retarded person when such evidence is generally absent

Psychological Concepts

• During the first half of the 20th century the mental testing movement pioneered by the work of Alfred Binet, Lewis Terman, And David Wechsler introduced intelligence as a concept to explain cognitive development
• Operationally a person's level of cognitive development is determined by the score obtained on a standardized intelligence test
• On the basis of a statistical model (normal curve) a person whose IQ score deviates significantly from an arbitrarily defined norm is judged to be MR
• Degree of MR is determined by the magnitude of deviation from the norm
• 1900's--Idiots-IQ score of 25 and under , Imbeciles--25-50 , Goddard later introduced moron--IQ scores 50-70
• Proponents of the pathological model contributed low IQ scores to physiological deficit
• The scientific reality of test scores now supplemented the scientific reality of brain disease as the basis for definition
• Where clear evidence of of brain disease was absent, feeblemindedness was attributed to the inheritance of defective genetic material
• Mental retardation caused by genetic factors was referred to as intrinsic retardation
• Damage to the nervous system was the caused of extrinsic retardation
• Intelligence tests dramatically increased the statistical prevalence of feeblemindedness because of those now identified as morons
• Because morons were able to function quite well in society the determinant was rooted in the newfounded intelligence test
• In 1912 Goddard conducted studies which supported that feeblemindedness was due to genetic inheritance (discussed more later) (later came under scientific attack)
• In the 1930's environmentalists argued that social conditions that deprived children of early cognitive stimulation resulted in poor performance on intelligence tests
• The introduction of the concept of IQ helped explain forms of mental retardation where there was no evidence of brain pathology. Thus within the clinical perspective, mental retardation means that an individual has less of an attribute called intelligence.
• Adaptive Behavior
• Biological and psychological criteria are only as good as their ability to predict social competence by multiple measure of achievement
• Neither biological or psychological measures could adequately predict social competence
• Therefore it was necessary to measure this attribute separately
• In 1959 Rick Heber and his associates introduced the concept of adaptive behavior into the official definition of MR
• We're going to define adaptive behavior as we discuss the current definition of MR

AAMD Definition of Mental Retardation

Mental retardation refers to significantly subaverage general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period (Grossman, 1983)

Operationalization of terms:

• Significantly Subaverage Intellectual Functioning is defined as approximately IQ of 70 and below
• Adaptive Behavior is defined as the effectiveness or degree with which individuals meet the standards of personal independence and social responsibility expected for age and cultural group.
• Expectations of adaptive behavior vary for different age groups; DEFICITS IN ADATPIVE BEHAVIOR will vary at different ages
• Developmental Period is defined as the period of time from conception to age 18.

FEATURES OF THE AAMD DEFINITION

• The use of the IQ score alone is not acceptable in the diagnosis of mental retardation. Clinically measured subaverage intellectual functioning and deficits in adaptive behavior must coexist.
• Low intelligence an behavioral deficits must be manifested during the developmental period (conception to 18)--Those who sustains brain injury after 18 cannot be labeled as MR
• The definition avoids mentioning of the etiology of mental retardation, instead it emphasizes present behavioral functioning

SOCIAL SYSTEM PERSPECTIVE

• Derived from the sociological study of deviance and labeling theory
• Jane Mercer--applied the concepts used by deviancy theorists in her formulation of the social system perspective of mild retardation
• She regarded the clinical perspective as applicable for explaining severe retardation but questioned in regard s to mild retardation
• From a social system perspective "mental retardation" is an achieved social status and mental retardation is the role associated with that status
• Mental retardation does not describe individual pathology, but rather refers to the label applied to a person because he occupies the position of mentally retarded in some social system
• Sarason & Doris (1979) mental retardation is not a thing not a set of characteristic inherent in an individual, but a concept that both describes and judges interactions of an individual
• Social system perspective focuses it attention on

1) Social Norms

• Our culture values intelligence and sorts people on the basis of intelligence. To be bright is to command social desirability and to be held in high esteem and discriminates against those with less intelligence.
• Those who are lacking are labeled mentally retarded--this is an ultimate stigma

2) Labeling Process

Children achieve the mentally retarded status as they enter school(failure to meet academic standards, referral, attainment of low IQ score, classification as MR)

Disproportionate number labeled EMR come from various minority groups

Mercer attributes these findings not to genetic intellectual inferiority but to Anglocentric school and intelligence testing procedures that embody the values of the core culture

Cultural bias of tests-----

Diagnosis of MR is based on the failure of the cld to meet the expectations of one social system (school); little consideration given to child's adjustment in other social systems (family & neighborhood)

In an effort to correct these discriminatory practices in the intellectual assessment of children from different cultural backgrounds developed SOMPA (SYSTEM OF MULTICULTURAL PLURALISTIC ASSESSMENT) (talk about when discussing assessment---)

3) Consequences of Labeling

Deviancy theorist emphasize the negative consequences of labeling a person MR

Labels create a stereotype that overshadow the wide range of individual differences

Prevailing stereotype???totally incompetent and dependent and should reside in institutions

Persons labeled MR come to accept the low expectations of themselves (self fulfilling prophecy--even lower self-esteem and achievement)

Stigmatized --devalued, discredited, regarded as superfluous in our society

They have been segregated, stripped of legal rights, become victims of subhuman treatment

The social system perspective shifts attention away from individual to the characteristic of the social settings in which a person is labeled mentally retarded. This perspective tells us something about a society's tolerance for intellectual differences and the methods it has developed to mange those who are judged to be mentally retarded.

THE DEVELOPMENTAL PERSPECTIVE

• The Developmental Perspective is in some ways an outgrowth of the social system perspective--where the emphasis is on external factors that influence an individual's cognitive development
• View holds that persons with MR are not innately "uneducable", "untrainable", or "nonteachable"
• Focus is on the individual educability and the manipulation of the environment to enhance development
• There is a positive expectation that the person can learn, grow and develop
• MR not regarded as a fixed, static condition--but a condition responsive to active treatment
• Advocates of the developmental perspective point to the significant behavioral gains that have been made among persons with MR when expectations are raised and instructional programs designed appropriately

Developmental and Difference Theories

• Developmental Position--the cognitive functioning of persons with MR is similar to that of younger persons without MR
• When MA is used as an estimate of present cognitive ability, a person with MR (older with a lower IQ) and a persons without MR should not differ in performance on a given learning task
• If differences occur they are attributable to experiential and/or motivational factors, not to cognitive factors
• This is supported by Piaget's developmental theory of intelligence--persons with and without MR pass through the same developmental stages
• Difference Position-holds that differences in IQ account for the variance between the performance of persons with MR and persons without MR who are matched on MA
• Lower IQs among persons with MR explain both the quantitative and qualitative differences in performance which is attributed to cognitive deficits that have a neurological basis
• These cognitive differences include defects in short-term memory, input organization, attention, inhibition, and incidental learning
• These deficits were once considered to be irreversible, recent research has demonstrated that persons with MR can be trained in these cognitive processes

SUMMARY

The clinical, social system, and developmental perspectives embody concepts that enhance our understanding the mental retardation construct

These perspectives can be viewed as complementary rather than incompatible

Clinical Perspective focuses on the characteristic of the individual

Social System and Developmental Perspectives focus on the influence of external factors

Clinical perspective most applicable to those referred to as clinically retarded (Moderate to profound; IQ less than 55; diagnosis usually made at birth; condition unchanging throughout life; due to organic defects

Forms of clinical retardation are obvious to the untrained observer--have been described as the "absolute" type of MR because they stand out in any existing culture

Socioculturally retarded--those persons with mild intellectual impairment with IQ's ranging from 55 to 69 (not diagnosed until child enters school; has academic difficulty, seldom marked physical characteristics, laboratory test usually negative [this has changed somewhat with more advanced technology]

Sociocultural retardation is best understood within the social system perspective--label retarded "relative" to the standards of a particular setting of which They are a part

Developmental perspective holds that both groups of MR are capable of behavioral change through appropriate programs of education and habilitation