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Population distribution according to the law of intelligence, found that intelligence was normal distribution, the formation of an intermediate large and small ends of the curve, according to the distribution of percentile curves, standard deviations, and Wechsler Intelligence Scale for Children (WISC) IQ relationship , we can see the crowd 68.26% plus or minus the mean IQ within one standard deviation; 95.44% in the mean within plus or minus two standard deviations, ie IQ between 70 and 130; IQ high at 130, or less than 70 people account for only 2.27%.
The definition of mental retardation and the prevalence of mental retardation the greatest impact, mainly related to the issue of diagnostic criteria of mental retardation. In the 20th century, 70 years ago, the diagnosis of mental retardation often use a single standard, based only on intelligence derived from psychological tests to diagnose. This theory, the prevalence of mental retardation should be 2.27%. According to the U.S. President in 1962 a single standard of mental retardation group estimated population prevalence of 3% of mental retardation, including mild mental retardation and 87%, 10% with moderate mental retardation, severe and very severe, 3%. 1
The American Association of Mental Retardation 73, also proposed a new definition of mental retardation, mental retardation is defined as the development stage, the general level of intellectual functioning was significantly lower than their peers, accompan


ied by defects in adaptive behavior. This is what we now use the double or multiple standards. Under this standard, the 1978 Mastenbrook with Wechsler Intelligence Scale for Children and adapt behavior rating scale measured the number of children, found that IQ between 50 and 70 are about 300 children, accompanied by defects in adaptive behavior that the adaptive behavior assessment scores of children less than two standard deviations less than 35%, that is, meet two criteria (IQ <70, and adaptive behavior obvious defects), only 100 children, according to results of this study if projections, the prevalence of mental retardation is approximately 1.26 percent, according to countries (regions) of the epidemiological investigation, the prevalence of mental retardation rate of 1% to 2%. Changes in the prevalence of mental retardation, in addition to the definition of mental retardation and related to changes, but also with the past two decades, economic and cultural development of education, on the progress of medical science.
In 1988, China Science and Technology Commission to the National Epidemiological survey of mental retardation of children as a national key project seventy-five This is a status of mental retardation related to large-scale sample survey, the survey showed that overall prevalence rate of mental retardation country 1. 2% (urban population by 30%; rural population weighted at 70%), city O. 70% in rural areas 1.41%. This finding does not mean that our margins and high incidence of mental retardation, mental retardation in these areas the prevalence may be higher, for example, water oak, Shaanxi 1981 survey (mountain) Children with mental retardation prevalence 3.84%; 1985 Survey of Yunnan Ruili (minority) children with mental retardation prevalence 3.6%, which is the level of economic and cultural development of education, such as cretinism and endemic epidemic.

Confused with mental retardation disease 1. Most children with autism autism have varying degrees of intelligence shortcomings, but there are social interaction, verbal communication quality damage, stereotyped and repetitive movements, forced to adhere to the same mode of bizarre behavior. 2. Most children with schizophrenia after the age of onset at 7-8, there is no coherent thinking, delusions, hallucinations, feelings of apathy, etc., in addition to recession, the general mental deficiency was not obvious. 3. Organic psychosis infection, poisoning, trauma history or neurological signs, although the defects associated with intelligence, but not as comprehensive as defects in mental retardation, and other life skills barriers in the light. 1, the first diagnosis of mental retardation should be based on IQ and adaptive behavior and to determine whether age at onset of MR, MR caused further to find the reason. In the diagnosis process, should be collected in detail the history of children's growth and development, a comprehensive physical and neuropsychiatric examination of children of different ages in different stages of growth and development indicators were compared with normal children the same age and compared to determine their level of intelligence and adaptability make clinical judgments. Meanwhile, with the appropriate method of intelligence tests, you can make the diagnosis and determine the severity of MR. 1. History collection (1) family history: whether parents should be aware of next of kin marriage, family, whether blind, dumb, epilepsy, cerebral palsy, congenital malformations, MR and mental illness. (2) mother pregnancy history: the mother asked whether the viral infection during early pregnancy, miscarriage, bleeding, damage, whether to take chemical drugs, exposure to toxins, radiation, is suffering from thyroid dysfunction, diabetes and severe malnutrition, with or without multiple births, and amniotic fluid too much, placental insufficiency, maternal and child blood group incompatibility and so on. (3) birth history: whether preterm or expired products, production methods without exception, whether the birth weight, low birth weight children, whether after birth asphyxia, birth trauma, intracranial hemorrhage, severe jaundice and congenital malformations. (4) history of growth and development: including neuropsychiatric disease, such as the rise, sit, walk and other large movements began to emerge in time, detection of small finger fine motor toys, daily necessities, such as the completion, yelling parents, understand speech language features such as the development of the state, as well as feeding, dressing, bowel and bladder, and other intellectual behavior. (5) medical history, past and present: with or without head injury, bleeding, central nervous system infection, severe systemic infections, seizures and so on. 2. Physical Examination Physical Examination 3. Development examination development checks 4. Neuropsychiatric examination neuropsychiatric examination 5. Laboratory laboratory tests including blood, urine, brain, spinal fluid biochemical tests, skull X ray and CT examination, cerebral angiography EEG, evoked potentials, hearing test, chromosome analysis, pituitary, thyroid, gonadal, adrenal function test, viral (such as cytomegalovirus, rubella virus), protozoa (such as Toxoplasma gondii) and antibody screening. Diagnosis should be based on need to select the project. 6. Intelligence test and conduct that are multi-intelligence test mild MR, severe MR with IQ tests above method is often difficult, must rely on behavior rating scale, while the rating scale when the differential diagnosis of mild MR, and intelligence tests not reliable. Therefore, both methods should be used in conjunction with a comprehensive analysis of test results must be. Intelligence Test Method 1. Screening method, at the general intelligence test method checks, they often take a longer time, sometimes take 1 to 2 hours or more, is not conducive to the general pediatrician or pediatric care census applications, so using some simple screening search method. Most of the content test is the classic intelligence tests from a variety of methods selected. Test to be only a short time when, for the initial screening of the suspected cases. Screening results can only be used as a basis for further examination need not and can not accordingly make a diagnosis. Currently used screening methods are the following. (1) The Denver developmental screening test for mental Law (Denver developmental screening test, DDST): for children from birth to 6 years old, the method is simple, takes less time, tools, simple, reliability and validity were good. This method has been widely adopted around the world. China in the early 80s to be this method. Shanghai and Beijing, according to China's social, economic, linguistic, cultural, educational methods and geographical characteristics, the DDST was standardized, and intellectual development of children drawn Screening Scale (DDST-R). (2) painted Person Test: According to the draw the human form to score, to determine the level of intellectual development for children aged 5 to 12 intelligence screening. Younger children have older children scored higher but there is a trend to lower scores. Intelligence Scale test and the other lead from the IQ test has obvious relevance. 2. Diagnosis (1) Wechsler Intelligence Scale for Children (WISC-CR): for children aged 6 to 16. (2) China - Wechsler Intelligence Scale for Children (CWYCSI): 4 to 6 years for a half children. (3) Infant Development Checklist (Gessell ScaleR) for children aged 0 to 3. Adaptive behavior evaluation method 1. Infants and young children - middle school students in social living scale for 6 months to 13 years old to 15-year-old children. The MR diagnosis and grading scale is an indispensable tool. 2. Neonatal behavioral neurological assessment method (NBNA) has passed the National Association of group research to determine the national newborn NBNA normal range, and its clinical application is gradually carried out. Mental retardation treatment 1. Etiological causes have been identified by the treatment, such as chronic diseases, poisoning, chronic malnutrition, hearing and visual impairment, should seek to remove the cause as possible so that it partially or completely restored intelligence. Hypothyroidism, phenylketonuria and other endocrine and metabolic abnormalities in children should be early diagnosis, early use of thyroid hormone replacement therapy, or phenylketonuria a special diet to improve their level of intelligence. Social psychological and cultural causes of MR, changing environmental conditions, allowed to live in friendship and harmony in the family, strengthen education, the trap can be made to intellectual progress. 2. Training and rehabilitation with the application of medical, social, educational and vocational training and other measures, according to age and severity of MR, the patients were trained to the highest possible level of intelligence. Sooner or later, so that children in the organized sector (such as nurseries and kindergartens) in the integrated trunk lasting accepted education and training. Best to let the care of children with normal children, so that care is more beneficial to open the score. Offer special classes or special schools to improve physical health, training, daily living skills and speech functions, and simple cultural learning. Set up a working medical station, on the one hand production skills training for young patients, on the other hand job security. Also set up specialized hospitals, nursing homes (village), admitted to moderate MR. Cause of mental retardation etiology of factors, including biomedical and psychosocial and cultural reasons. The former refers to the brain during development (prenatal and pre-Wai) received a variety of adverse factors, their brain development can not reach the required standard, the ultimate impact of intelligence. The latter refers to the cultural deprivation, education properly, sensory deprivation and other factors can enter information acquired inadequate or inappropriate, thus affecting the level of intelligence. In accordance with WHO1985 and the National Cooperative Group classification of the findings, the cause into the following types. 1. Infection, poisoning accounted for 12.3%. Infection that during his lifetime and after infection of the brain, such as rubella, cytomegalovirus, toxoplasmosis, herpes simplex virus and many other viral infections. Poisoning, including hyperbilirubinemia, sepsis, lead poisoning, alcoholism and long-term overdose of drugs such as phenytoin or phenobarbital. 2. Hypoxic brain damage and machinery accounted for 19.6%. Before birth and after delivery because of physical or mechanical factors can cause brain damage, such as birth trauma, head injury. Perinatal hypoxia-ischemia or after birth can also damage brain tissue, such as pregnant women, serious blood loss, anemia, heart failure, lung disease and neonatal asphyxia, intracranial hemorrhage, as well as drowning, anesthesia and brain after epileptic seizures hypoxia. 3. Metabolic, nutritional and endocrine disorders accounted for 5.8%. Body amino acid, carbohydrate, fat, mucopolysaccharide, purine metabolism in problems, etc. can affect development and function of nerve cells, as phenylketonuria, galactosemia and hyperlipidemia. Before his death, after birth, nutritional deficiencies, especially protein, iron and other substances lack of will to the fetus, the baby's brain cells reduce the formation or function of the number of poor. Also affect the intellectual development of endocrine disorders, such as hypothyroidism. 4. 0.7% of brain diseases in general. Including cancer, degenerative diseases of unknown cause, neurocutaneous syndrome, and cerebrovascular diseases. 5. Congenital brain malformation or genetic syndrome accounted for 9.5%. Congenital malformations, including hydrocephalus, hydrocephalus malformations, small head malformations, spinal dysraphism, brain malformations me. Genetic syndromes such as adrenoleukodystrophy. 6. 5.1% chromosomal aberrations. Chromosomal aberrations, including autosomal or sex chromosome number or structure changes, such as Down's syndrome, Trisomy 18, C group trisomy, cat syndrome, fragile X syndrome, congenital testicular dysgenesis syndrome congenital hypoplastic ovary syndrome. 7. Perinatal period accounted for 11.8% of other factors. Including the premature children, children with low birth weight, intrauterine growth retardation, nutritional diseases, mother, pregnancy induced psychosis. 8. Associated with autism in infants, such as mental illness, childhood schizophrenia. 9. Social and psychological factors accounted for 8.2%. Such is not the brain in children with organic disease, mainly by neuropsychological impairment and sensory deprivation and other adverse environmental factors, such as severe lack of appropriate early stimulation and education. 10. Special sensory impairment 5.1%. Including the deaf, dumb, blind, and other special sensory defects. 11. 21.9% of unknown etiology. After detailed examination and could not find any clues to the cause, that is of unknown etiology. MR prevalence of mental retardation due to the epidemiological investigation of the MR under the definition, diagnostic criteria, sampling methods and psychological testing methods differ. According to the American Association of Mental Retardation (AAMD) and WHO reported prevalence of child MR 1% to 2%. National Cooperative Group from May 1, 1988 in the north, northeast, northwest, east, southwest and secondary school each administrative region of 85,170 children in the survey, children aged 0 to 14 in the country overall prevalence rate of 1.20 MR %; the city overall prevalence rate was 0.70% and 1.41% in rural areas; boys overall prevalence rate was 1.24%, 1.16% girls; 3 years of age total prevalence rate was 0.76%, for children 3 to 7 years 1.10% 7 to 11 years 1.44% 11 1.50% 14-year-old children, the sick rate of growth tended to increase with age; economic and cultural conditions of different nerve MR prevalence of different cities was 0.78% in rural areas to 2.41 | %, 3.84% mountainous, ethnic minority 3.60%. Clinical manifestations of mental retardation based upon IQ, adaptive behavior defects will MR into mild, moderate, severe and very severe four. 1. Mild MR psychiatry called stupid. 1. Mild MR psychiatry called stupid. IQ of 50 to 70, mild defects in adaptive behavior. Early child development a little slow than normal, and not as lively as normal children, lack of interest in the things around. Dance from work or compliance, or violent action. Language development slightly later, less abstract vocabulary to master. Analysis is poor, superficial understanding of the problem. Worse than the average academic performance of children, can recite the text, but not correct use, arithmetic problems completed application difficulties. Available through special education, practical skills and practical ability to and billboards. Grow up, can be used for general household chores and simple concrete work. Failing the lack of assertive, dependent, are unable to cope with external changes, the impact of vulnerability and domination of others. Under the guidance of adaptation in society. 2. Moderate MR, also known as Yu Lu. 2. Moderate MR, also known as Yu Lu. 35 to 49 IQ, adaptive behavior to moderate defects. Slow the development of children than normal. Language function hypoplasia, spit the word unclear, lack of vocabulary basin, only a simple concrete thinking, abstract manipulation. Poor ability to identify the surrounding environment, can only understand the surface of things and pieces phenomenon. ing and calculations can not make progress. After a long-term education and training, you can learn simple interpersonal effectiveness, basic hygiene, safety habits and simple manual skills. 3. Foolishly, also known as severe MR. 3. Foolishly, also known as severe MR. 20 to 34 IQ, adaptive line severe defects. Various aspects of early growth retardation. Sounds vague, very few words, very poor self-expression. Abstraction lack of understanding is low. Emotional immaturity. Action is very clumsy. Have a certain defense capabilities, to avoid obvious dangerous. After a systematic habit training, can develop a simple life and health habits, but needs to take care of others. Grow up, can be fixed and under the supervision of the easiest to do manual labor. 4. A very heavy MR, also known as an idiot. 4. A very heavy MR, also known as an idiot. IQ below 20, adaptive behavior is extremely flawed. Do not understand everything around. Lack of language features, most would call "Dad", "Mother", but can not really identify the parents, often unconscious cries. Lack of self-preservation instinct, I do not know to avoid obvious hazards. Original emotional response. Significantly diminished sensation and perception. Significant motor function disorders, clumsy or permanently unable to walk. Multiple disabilities and epilepsy are often recurrent. Personal life can not handle, most who died in infancy. Skills training for survivors of the hands and feet can have a reaction. Prevention of mental retardati. Primary prevention include the following: health education and nutritional guidance; prenatal and perinatal care (high-risk pregnancy management, neonatal intensive care, alcohol and tobacco to discourage pregnant women to avoid or disable on fetal development adverse effects of drugs); infectious diseases (viruses, bacteria, protozoa) immunization; inherited metabolic examination and consultation (to avoid the next of kin marriage, found that carriers); Environmental Protection (Prevention of chemical pollution, poisoning and noise damage) ; reduce brain injury and accidents, the correct treatment of brain disease, the seizures; to strengthen pre-school education and early training; neglect and abuse against children. The purpose of these measures is to prevent the occurrence of MR. 2. Secondary prevention measures include: follow-up of high-risk newborns, early detection of disease, given the treatment, in particular, should note that early nutrition (protein and iron, zinc and other trace elements) supply and the appropriate environment to stimulate intellectual development of good effect; regular health checks for pre-school children (physical, nutritional, psychological development, vision and hearing); neonatal metabolic diseases (such as hypothyroidism, phenylketonuria) screening; prenatal diagnosis, amniotic fluid Check (chromosome disease, neural tube defects, metabolic diseases). Secondary prevention is early diagnosis and the major special treatment. 3. Tertiary prevention needs of society, schools, families have their own comprehensive prevention collaboration face. Early detection of MR, early intervention and stimulation; give effective help to the family to maintain the family structure intact so that children's functional MR improved. The fundamental way to prevent the deepening of the etiology of MR, only for the cause to take measures to make prevention more effective.


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