MENTAL RETARDATIONS

Mental retardation is not a medical diagnosis, bur serious cognitive l imitation is a neurologic symptom that requires medical assessment. Se vere mental retardation is medically equivalent to brain damage or bra in dysfunction. The new American Association on Mental Retardation def inition of mental retardation is not compatible with a biomedical appr oach. There exist no generally accepted clinical practice guidelines f ar the medical assessment of mental retardation and developmental dela y, The physician who is participating in the assessment needs to inves tigate developmental processes and possible medical etiologies. Attemp ts should be made to assess language and nonverbal problem-solving abi lities separately, even in infancy and early childhood. A number of fa ctors from the history (e.g., fetal hypoactivity) and physical examina tion (e.g., minor dysmorphic features) can he quite useful components of the assessment. More problems and unanswered clinical questions occ ur at the boundary between mild mental retardation and developmental d elay (development that is slow bur not quite slow enough to qualify fo r a formal diagnosis of mental retardation). Current medical research is fragmenting mental retardation into diverse and quite specific synd romes. (C) 1998 Wiley-Liss, Inc.