G1 TMR

THERAPEUTIC
MANAGEMENT
Mentally Retarded
1. INSTITUTIONAL CARE
VS. HOME CARE
HOME CARE
• Today, parents are encouraged to keep retarded (specially abled)
children at home and maintain a home and school environment as near
normal as possible.
• When children are severely retarded, keeping them at home becomes a

more difficult task. If both parents work ,the responsibility for constant
supervision is on the baby sitter, older children or caregiver.
• If your child is home cared, The more information you can tell your healthcare
professional, the better background they will have of your child’s issues. If
possible, before you consult your healthcare professional, keep a diary for a week
or two that describes your child’s behaviour and when and where it occurs. Your
diary could include information about:
• the features of the behavioural change that concern you

• any patterns to the behaviour
• how often the behaviour occurs
• how long the behaviour typically continues before it
stops
• the time of day it occurs
• what was happening before the behaviour began
• what happened after the behaviour.
INSTITUTION
If parents are unable to care for a child at home, a suitable foster home placement may be
possible.
-Institutionalization (forced or voluntary) has been associated with the practice of psychiatry
since its beginnings. It has served as a form of social control of deviant, aberrant, or
undesirable behaviors, as an observational field, and as an adjunct to treatment of mental
disorder.
Halfway houses or group homes provide a care setting in which a home atmosphere as well
as community experience are provided
Psychiatric Hospitals are sometimes referred to as psychiatric wards/units, psych, wards, or
units when they are located in a hospital
State schools are a type of institution for people with intellectual and
developmental disabilities in the United States.
Many psychiatric wards require that patients be admitted on an involuntary
basis, meaning they may not leave the facility on their own. There are
several reasons why a person might be admitted to a psych ward against
their wishes, including:
• Suicidal thoughts • Threatening the safety of others
• Physical harm to self or others • Difficulty coping with one's
• Drug and/or alcohol abuse environment, whether in the home
or community
• Intense emotional distress or
anxiety • Having a mental illness that can't be
managed in an outpatient setting
• Self-destructiveness or being unable
to take care of oneself
• In most cases, patients may leave psychiatric wards when they're no longer a threat
to themselves or others.
2. HEALTH MAINTENANCE NEEDS
• Specially abled children needs the same health maintenance as other

kids.
• Parents may need a special review of precaution against accidents.
• Remind parents to treat children according to their intellectual age .not
their chronologic age.
• People with severe intellectual disability have an average mental age
of between 3 and 6 years. They use single words, phrases and/or
gestures to communicate. They benefit from daily care and support
with activities and daily life.
3.ILLNESS
• It may be difficult to detect illness.

• Such children cannot describe pain ,so may respond by crying
• Parents must observe them closely for symptoms such as:
• Tugging of an ear
• Refusing to swallow food
• Rapid breathing
• limping
4.EDUCATION
• Most mentally ill child will do well in preschool programs.

• The school chosen will depend on the degree of retardation
and the school situations available in the community.
• Mentally retarded children should be mainstreamed in school, incorporated in class
( mild ) with average children as much as possible. It helps them learn and socialize
with people.
• These children needs good instruction on bus safety, locating the correct bus for the
trip home from school.
• If they walk to school, they need instructions and supervision to ensure that they
cross the street safely.
Specific strategies that are useful in teaching a group which includes students with
intellectual disability:
• Provide an outline of what will be taught - highlight key concepts and provide
opportunities to practice new skills and concepts.
• Provide reading lists well before the start of a course so that reading can begin early.
• Consider tailoring reading lists and provide guidance to key texts. Allow work to be
completed on an in-depth study of a few texts rather than a broad study of many.
• Whenever you are introducing procedures or processes or giving directions, for example
in a laboratory or computing exercise, ensure that stages or sequences are made clear
and are explained in verbal as well as written form.
• Students may benefit from using assistive technology.
• Use as many verbal descriptions as possible to supplement material
presented on blackboard or overhead
• Use clear, succinct, straightforward language.
• Reinforce learning by using real-life examples and environments.
• Present information in a range of formats – handouts, worksheets,
overheads, videos – to meet a diversity of learning styles.
• Use a variety of teaching methods so that students are not constrained by
needing to acquire information by reading only. Where possible, present
material diagrammatically - in lists, flow charts, concept maps etc.
• Keep diagrams uncluttered and use color wherever appropriate to
distinguish and highlight.
• Ensure that lists of technical/professional jargon which students will need
to learn are available early in the course.
• Recording lectures will assist those students who have handwriting or coordination
problems and those who write slowly as well as those who have a tendency to
mishear or misquote.
-Students will be more likely to follow correctly the sequence of material in a lecture
if they are able to listen to the material more than once.
• One-to-one tutoring in subjects may be important; this can include peer tutoring.
• Students may benefit from having oral rather than written feedback on their written
assignments.
• It may be helpful for students with intellectual disability to have an individual
orientation to laboratory equipment or computers to minimize anxiety.
5. SELF CARE ACTIVITIES
• They need to learn maximum amount of self-care as this offers them
a sense of control and accomplishment.
• Asses if the child needs special aids to achieve such skills like
brushing teeth, combing hair.
• They may need continued reminder to do them because they are
not aware of the reason of importance of the skill
6. PLAY
• Mentally retarded children enjoy play. Guide parents to

choose the appropriate toys for child’s development.
• Music boxes or record players that cover a wide age
range are good choices
• Assess toys for safety
• Children are stronger than the age of the children the
toys are meant for, toys that are developmentally
correct still may not be appropriate because they break
easily.
7. SOCIAL RELATIONSHIPSS
• Ability to communicate can be delayed. Oftentimes, ability to develop language is

delayed.
• Speech therapy may be necessary to articulate correct sound.
• Talking picture boards –boards with pictures on them can be used to which child
can point if they want something to speed communication
• Teaching early social behavior (saying thank you , excuse me, shaking hands ) is
important so the child can relate with other children and adults.
10 TIPS FOR WORKING WITH PEOPLE WITH
INTELLECTUAL DISABILITIES
1. Do not call them kids.
2. Use clear, simplified language and try speaking slower, not louder. They have an
intellectual disability of varying degrees, but they are not all necessarily hard of hearing—
speaking more loudly won’t make them understand you better.
3. Set expectations. Many of them need to know ahead of time what will happen. As you
go through your procedures, describe what you will be doing now, and perhaps the next
one or two steps that will follow as well.
4. Treat them as you would your peers. Do not speak down to them. They love a good
joke, tease, or challenge just like we do.
•
5. Draw boundaries. Do not allow them to get away with bad behavior—just as you
wouldn't allow someone without intellectual disabilities to behave badly.
• 6. Ask them their thoughts and allow them to answer. Don’t put words in their mouths.
7. Ask if you can help them before acting and assuming they actually need help.
8. Expect to get a lot of questions. Many are very curious about what you are doing and
also just about you. If the questions get too invasive, it’s okay to say, “I’m not comfortable
with answering that.”
9. Have fun and enjoy their candor! Be prepared for their bluntness. Mostly are very
honest.
10. Be enthusiastic, upbeat, and professional. And if it’s overwhelming, it’s also okay to ask
for a break to reset where your mind is.
•Thank You
• Aljrab
• Dayrit
• Aque
• Torremocha

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THERAPEUTIC

• When children are severely retarded, keeping them at home becomes a

• the features of the behavioural change that concern you

• Specially abled children needs the same health maintenance as other

• It may be difficult to detect illness.

• Most mentally ill child will do well in preschool programs.

• Mentally retarded children enjoy play. Guide parents to

• Ability to communicate can be delayed. Oftentimes, ability to develop language is

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