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Mental Retardation Diagnosis

Toddler and Teenager Expert Advice from Carleton Kendrick, Ed.M., LCSW

Q: I have a 7 year old that has been to a doctor. He did 1 test and came back to tell me that she is mentally retarded. She is in the 2nd grade, has passed just fine, the teacher is only concern is that she sometimes has difficulty in following direction, both verbal and written(if she reads them out loud she does much better). The doctor said the IQ test results were 60's and 70's, what is the norm? Where should I go to further my understanding?

A: I am sure that this doctor's diagnosis of mental retardation was both shocking and confusing to you, especially given her doing well in second grade. It would have helped to know why she was tested to give you a more specific response, but allow me to give you a summary of how mental retardation is diagnosed and why it's so vital for this diagnosis to be the result of a thorough, comprehensive evaluation. I am basing my information on current diagnostic criteria and the work of the American Association on Mental Retardation (203-387-1968).

A diagnosis of mental retardation is based on three criteria: 1. IQ below 70-75, 2. Significant limitations in two or more adaptive skill areas (these are daily living skills necessary for life, work and play, like communication, home living, social skills, reading, writing and math) and 3. this condition being present from childhood.

The AAMR recommends a three-step process for diagnosing mental retardation:

  • 1.A qualified specialist should administer one or more standardized IQ tests in addition to standardized adaptive skills tests on an individualized basis.
  • 2.A description of the child's strengths and weaknesses should be documented in four dimensions:
    • 1.Intellectual and adaptive behavioral skills
    • 2.Psychological/emotional considerations
    • 3.Physical/health/etiological considerations
    • 4.Environmental considerations
The child's strengths and weaknesses must be assessed in a multi-dimensional manner: interviews with children close to the child, formal testing, an interview with the child, and interaction with the child in her everyday life.

  • 1.An interdisciplinary team must determine the level of necessary supports across the aforementioned four dimensions. Each support area is assigned a level of intensity -- intermittent, limited, extensive and pervasive.
As you can see, based upon what you reported has been done by this one doctor, the necessary level of investigation has not been performed to accurately arrive at a diagnosis of mental retardation. I need to share with you that there has been an ongoing debate within the psychological community on how much one should rely on specific IQ scores to determine mental retardation. I believe that each child needs to be examined very thoroughly, using all available diagnostic tools, before a useful and accurate diagnosis is given. I strongly suggest that you call the number I gave you for the AAMR. Explain what has been done in your daughter's case and ask them for recommendations. I would also recommend that you contact an educational specialist who is experienced in testing for learning styles. Based upon your report of your daughter's difficulties, your daughter might learn easier and better if her natural learning style and way of processing language and information were considered.

Thanks for writing and please let me know the results of your investigations.

More on: Expert Advice

Carleton Kendrick has been in private practice as a family therapist and has worked as a consultant for more than 20 years. He has conducted parenting seminars on topics ranging from how to discipline toddlers to how to stay connected with teenagers. Kendrick has appeared as an expert on national broadcast media such as CBS, Fox Television Network, Cable News Network, CNBC, PBS, and National Public Radio. In addition, he's been quoted in the New York Times, Washington Post, Chicago Tribune, Boston Globe, USA Today, Reader's Digest, BusinessWeek, Good Housekeeping, Woman's Day, and many other publications.

Please note: This "Expert Advice" area of FamilyEducation.com should be used for general information purposes only. Advice given here is not intended to provide a basis for action in particular circumstances without consideration by a competent professional. Before using this Expert Advice area, please review our General and Medical Disclaimers.


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