Diagnosis of Mental retardation

Diagnosis of Mental retardation: medical news summaries:

The following medical news items are relevant to diagnosis and misdiagnosis issues for Mental retardation:

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Diagnostic Tests for Mental retardation: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about diagnostis of Mental retardation.

MENTAL RETARDATION: Ask the Following Questions:
(Algorithmic Diagnosis of Symptoms and Signs)

1. Is there decreased hair and skin pigment? These findings would suggest phenylketonuria.
2. Are there abnormal secondary sex characteristics? These findings would suggest Klinefelter's syndrome, Turner's syndrome, and Laurence-Moon-Bardet-Biedl syndrome.
3. Are there abnormalities of the skull present? Findings of deformities or enlargement of the skull should suggest rickets, microcephaly, hypertelorism, oxycephaly, and hydrocephalus, among other things.
4. Is there hepatosplenomegaly? The findings of hepatosplenomegaly suggest galactosemia, Hurler's disease, and Gaucher's disease, among other diagnostic possibilities.
5. Are there skin changes? Sturge-Weber syndrome, tuberous sclerosis, neurofibromatosis, and cretinism may present with skin changes. Kernicterus is associated with jaundice.
6. Are there other neurologic signs? Tay-Sachs disease, congenital syphilis, Arnold-Chiari malformation, and cerebral diplegia are just a few of the causes of mental retardation that may present with other neurologic signs.

DIAGNOSTIC WORKUP

Routine laboratory tests include a CBC, sedimentation rate, chemistry panel, serum galactose level, VDRL test, thyroid profile, and urine screen for carbohydrates, amino acids, and organic acids. Chromosomal analysis may detect Klinefelter's syndrome, Turner's syndrome, mongolism, and other disorders. If there are deformities of the skull present, a skull x-ray should be done.

An EEG, CT scan of the brain, and psychometric testing will often need to be done, but a referral to a neurologist should be made before ordering these expensive tests.

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Source: Algorithmic Diagnosis of Symptoms and Signs, 2003

Mental retardation: Diagnosis
(Professional Guide to Diseases (Eighth Edition))

CONFIRMING DIAGNOSIS A score of less than 70 on a standardized IQ test confirms the diagnosis of mental retardation.

The IQ test primarily predicts school performance and must be supplemented by other diagnostic evaluations.

For example, the Adaptive Behavior Scale deals with behaviors important to activities of daily living. This test evaluates self-help skills (toileting and eating), physical and social development, language, socialization, and time and number concepts. It also examines inappropriate behaviors, such as violent or destructive acts, withdrawal, and self-abusive or sexually aberrant behavior.

Age-appropriate adaptive behaviors are assessed by using developmental screening tests such as the Denver Developmental Screening test. These tests compare the subject’s functional level with the normal level for the same chronologic age. The greater the discrepancy between chronologic and developmental age, the more severe the retardation. In most European and North American cultures, the Vineland Social Maturity Scale, a tool used to determine social competence, is recommended for use when appropriate.

In children, the functional level is based on sensorimotor skills, self-help skills, and socialization. In adolescents and adults, it’s based on academic skills, reasoning and judgment skills, and social skills.

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Source: Professional Guide to Diseases (Eighth Edition), 2005

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