ISSN : 2241-4665
ISSN : 2241-4665
Ημερομηνία έκδοσης: Αθήνα 27 Ιουνίου
2018
« Nοητική Ανεπάρκεια »
της Δρ. Ευθαλίας Τσεγγελίδου
« Mental deficiency
»
by
Dr. Efthalia Tsengelidou
Περίληψη
Η παρούσα μελέτη
αποτελεί τμήμα της διδακτορικής μου διατριβής που πραγματοποίησα
το 2013. Η μελέτη αναφέρεται στη νοητική υστέρηση, μία παθολογική κατάσταση, η
οποία εμφανίζεται κατά την περίοδο ανάπτυξης του ατόμου.
Abstract
This study is part of my doctoral dissertation
in 2013. The study refers to
mental deficiency, a condition that occurs during the person's development.
Mental
deficiency
Mental
deficiency is conceived as a global deficiency which targets the entire
personality, structure, organization, intellectual, affective, psycho-motor,
behavioural-adaptive, hereditary or acquired development, due to an organic or
functional lesion of the central nervous system, manifested in the first years
of life in different degrees of severity relative to the average population
level, with direct consequences in terms of the social-professional adaptation,
personal and social competence and autonomy.
The complexity of this psychic dysfunction is also obvious in the
plurality of notions used with the same meaning: mental backwardness,
oligophrenia, mental retardation, developmental delay, intellectual disability,
mental impairment (apud Radu 1999).
J. de Ajuriaguerra (apud Radu 2000) states that "in order to reach
a useful definition, it is necessary to bring together a great deal of
information: biological, socio-cultural, emotional, without which we cannot conceive
the temporal and spatial dimensions of personality. (...) the concept cannot
have an absolute value as long as we use only one criterion.
R. Zazzo (Zazo 1979) affirms that: „feeble-mindedness is
the first area of mental impairment - relative impairment to society's demands,
variable requirements from one society to another, from one age to another - an
impairment whose determinant factors are biological and with irreversible effect in the current study of knowledge".
According to Gh. Ionescu (apud Radu 2000), the definitions of mental
deficiency can be grouped into three categories:
a) Structural-etiological definitions;
b) Functional-asserting definitions;
c) Operational-behavioural definitions.
A.R. Luria (apud Radu 2000) considers mental deficiency as "a
serious brain involvement of the child before or during the first childhood,
which causes a disturbance of the brain's normal development and numerous
anomalies of mental development".
J. Lang (apud Radu 2000) states that mental deficiency corresponds to an
impossibility or insufficiency (impairment) of functioning, capability or
functional organization.
The American Association on Intellectual and Developmental Disabilities
considers that mental deficiency refers to an under-average functionality of
general intelligence that originates in the development period and is
associated with disorders of the adaptive behaviour (Radu 2000).
A difficult problem is the classification of mental deficiency, taking
into account the wide variety of clinical forms and types, the wide range of
aetiology and the extremely rich symptomatology.
Using the term of amentia (the absence of intelligence), A. F. Tredgold
(1908, 1922, 1929, 1937), classifies it into 4 groups (apud Radu 2000):
·
Primary
amentia (intellectual deficit is caused by hereditary heritage)
·
Secondary
amentia (extrinsic deficit)
·
Mixed
amentia
·
Amentia
without direct detected cause.
In
fact, he introduces the dichotomy:
·
Endogenous
debility
·
Exogenous
debility later also used by other authors such as: Laresen (1931), Lewis
(1939), Werner (1934), Stromm (1969) (apud Radu 2000).
Matty
Chiva (1973) (apud Radu 2000), transfers this classification into:
·
Normal
debility
·
Pathological
debility.
According to M.S. Pevzner (apud Radu 2000) there are 4 categories:
·
Primary
or basic oligophrenia;
·
Oligophrenia
with significant perturbations of the cortical neurodynamics;
·
Oligophrenia
with perturbation of basic nervous processes;
·
Oligophrenia
with notable deficiencies of the frontal lobes;
The classification of intellectual disability
is also based on the measurement of the intelligence quotient (by means of
tests), the psychological development quotient, the evaluation of the
possibilities of adaptation and integration, the formation of personal
autonomy, the elaboration of the communicational and relational behaviours.
The best-known classical psychometric scale for
determining intelligence is that of Terman and Merill (apud Radu 2000). They
classify the mentally-impaired into the following categories:
|
Category |
C.I. |
|
Idiots |
0 – 24 |
|
Imbeciles
|
25 – 49 |
|
Retards
|
50 – 69 |
|
Limit
cases |
70 – 79 |
|
Tardy |
80 – 90 |
|
Normals |
A 90 |
Gradually using the term of mental debility, Ursula Şchiopu and
Emil Verza (1994), propose the following
classification of mental retardation:
·
Mild
debility - IQ: 50-85
·
Moderate
debility - IQ:35-50
·
Severe
debility - IQ: 20-25
·
Deep
debility - IQ: sub 20
Among
these children may appear the so-called scholar idiots - that is, mental
retards with some skills that underlie remarkable performances (for example,
mathematical computing performance).
Four degrees of severity can be specified, reflecting the level of
intellectual deterioration: mild, moderate, severe and deep.
·
Mild
mental retardation - IQ level from 50-55
to approximately 70
·
Moderate
mental retardation - IQ level from 35-40
to 50-55
·
Severe
mental retardation - IQ level from 20-25
to 35-40
·
Deep
mental retardation - IQ level below 20
or 25
·
Mental
retardation of unspecified severity can be used when there is a strong
presumption of mental retardation, but the person's intelligence cannot be
tested by standard tests (for example, in too-impaired or uncooperative
individuals or in infants).
The mild mental retardation is largely
equivalent to what is used to refer to the educational class as "educated ".
This group is the largest (almost 85%) segment of those with this disorder.
Considered as a group, these individuals with this level of mental retardation
typically develops social and communication skills during preschool (0-5
years), have a minimal impairment in the sensory-motor areas, and often do not
differ from children without mental retardation until later. By the end of
their adolescence, they can acquire appropriate schooling skills around the
level of the sixth grade, during the adult period they usually acquire
appropriate social and professional skills for a minimum of self-care, but may
require supervision, guidance and assistance, particularly in conditions of
inhabitual economic or social stress. With the right support, individuals with
mild mental retardation can, as a rule, live successfully in the community,
either independently or under supervision.
The moderate mental retardation is largely
equivalent to what is used to refer to the educational category of
"trainable." This out-dated term should not be used because it
mistakenly implies that people with moderate mental retardation cannot benefit
from educational programs. This group accounts for almost 10% of the entire
population of people with mental retardation. Most individuals with this level
of mental retardation acquire early communication skills in the young
childhood. They receive professional training and, with moderate supervision,
can participate in their own personal care. They can also benefit from training
in social and professional skills but are unable to progress beyond the second
grade in terms of schooling. They can learn to travel independently through
familiar places; during adolescence, their difficulties in recognizing social
conventions can interfere with relationships with peers, in the adulthood, most
are able to perform unskilled or semi-skilled work under supervision in
protected workshops or in general labour. They adapt well to community life,
usually under supervision.
The group of those with severe mental
retardation accounts for 3% - 4% of the total number of individuals with mental
retardation. In their young childhood, they acquire very little or no
communicative language, during the schooling period, they can learn to speak
and be trained in elementary self-care skills. They benefit only in a small
amount from pre-school education, such as alphabet and numeracy
familiarization, but they can acquire skills such as learning to read at first
glance words of "survival"; in the adulthood period, they may be able
to perform simple tasks, under strict supervision conditions. Most people adapt
well to life in the community, in their homes or in their families, unless they
have a disability that requires specialized nursing or other type of care.
The group of individuals with deep mental
retardation accounts for approximately 1% - 2% of the total number of individuals
with mental retardation. Most individuals with this diagnosis have an
identified neurological condition that justifies their mental retardation
during their young childhood; they have considerable impairments in the
sensory-motor function. Optimal development can occur in a highly structured
environment with constant help and supervision and a personalized relationship
with a nurse. Motor development, self-care and communication skills can improve
if a proper training is provided. Some can perform simple tasks under strict
protection and supervision.
Diagnosis of mental retardation of unspecified
severity should be used when there is a strong presumption of mental
retardation, but the person cannot be tested successfully with standard
intelligence tests. This may be the case when children, adolescents or adults
are too impaired or non-cooperative in testing, or in the case of infants when
there is a clinical judgement of significantly below average intellectual
activity, but the tests do not provide IQ values (for example, the Bayley
Scales of Infant and Toddler Development, Cattell's scales assessing the
infant's intelligence and others). Generally the lower the age, the more
difficult it is to assess the presence of mental retardation, except in cases
of deep deterioration.
Bibliography
Ainscow, M. (1991). Effective Schools for All, Fullton, H.
Brookes, London.
Ainscow, M. (1994). Special Needs in the Classroom. A Teacher
Education Guide, Jessica Kingsley Publisher, UNESCO, Paris.
Ainscow, M. (1999). Understanding the development of Inclusive
Schools,Falmer Press, London.
Αmerican Psychiatry Association
(1994). Diagnostic and Statistical Manual
of Mental Disorders (fourth edition).
Buica, C. (2004). The basics of defectology, Bucharest:
Ed. Aramis
Borkowski, J.G.,Peck, V.A. &
Damberg, P.R. (1986) Attention, Memory
and Cognition. In: Matson, M & Mulick, J. (eds) Handbook of Mental Retardation. Pergamon Press.
Campione, J.C., Brown, A.L.,
Ferrara, R.A.(1982) Mental retardation
and intelligence. In: Sternberg, R.J. (ed.) Handbook of Human Intelligence. Campridge University Press.
Dougherty, J., Moran, J.D.III.
(1983) The relationship of Piagetian
stages to mental retardation, Education and Training of the Mentally Retarded,
18, 260-265.
Henley, M.A. (1980) Developmental model for the education of the
children evaluated mentally retarded. Paper presented at the Annual
Presidential Lecture Series (1st, Westfield, MA), 31p.
Hoover, J.H., Wade, M.G. (1985) Motor learning theory and mentally retarded
individuals: a historical review. Adapted Physical Quarterly, 2, 228-252.
Klein, N., Safford, P. (1977)
Application of Piaget’s Theory to the study of thinking of the mentally
retarded children: a review of research. The
Journal of Special Education, 11, 201-216.
Paunescu, C., Muşu, I. (1997). Integrated special psychopedagogy.
Bucharest: Ed. Prohumanitate.
Popovici, D. V. (1999). Elements of integration psycho-pedagogy. Bucharest: Pro Humanity
Popovici, D.V. (2007). Theoretical and practical guidelines in integrated education. Arad:
Un
Radu, G. (1999). Psychopedagogy for the Development of Disabled Schools. Bucharest:
E.D.P.
Radu, G. (2000). Psychopedagogy of mentally disabled school children. Bucharest: Ed.
Prohumanitate.iv. Aurel Vlaicu
Verza, E. (1988). Some personality structures
in the psychology of mentally disabled. Problems
of defectology, University of Bucharest: 11-26.
Vlad, E. (1999). Evaluation in the educational-therapeutic act .Bucharest: Ed.
Prohumanitate.
Wullenweber Ernst, Theunissen Georg & Muhl
Heinz (Hrsg.) (2006) Padagogik bei geistigen
Behinderungen ein Handbuch fur Studiurn und Praxis Stuttgart: Kohlhammer
Zazo, R. (1979). Mental debility. Bucharest: E.D.P.
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