A National Survey of State Legislation defining mental retardation: implications for policy and practice after Atkins

In Atkins v. Virginia 2002, the U.S. Supreme Court held that the Eighth Amendment prohibits executing offenders who are mentally retarded. Rather than adopting a uniform definition of mental retardation, the court charged each state with defining mental retardation in a manner that enforces the constitutional restriction. An unanswered question is how states define mental retardation after Atkins, which has implications for capital defendants and forensic evaluators who conduct capital mitigation evaluations. This project identified the statutory definitions of mental retardation in each state, and grouped the definitions based on consistency with accepted clinical criteria for mental retardation. Results show that definitions of mental retardation vary considerably by state. The large majority of states, both overall and specifically among death penalty states, use criteria for mental retardation that are not entirely consistent with accepted clinical standards. As such, it is not clear whether the majority of states are effectuating the intent of Atkins. The implications of these findings for both policy and practice are discussed.     

An 8q21 deletion in a patient with comorbid psychosis and mental retardation

Systematic investigations indicate that some of the recognized psychiatric disorders can be identified among those with mental retardation due to chromosomal abnormalities. We report a psychotic patient with mild mental retardation (intelligence quotient: 68) and minor anomalies that had a chromosomal aberration not previously described in a psychotic patient. Our patient highlights the importance of the cytogenetic study in psychiatric patients with comorbid mental retardation or minor anomalies. In addition, her psychosis symptoms may be helpful to propose a new candidate gene for psychosis.     

Living circumstances of children and adults with mental retardation or developmental disabilities in the United States, Canada, England and Wales, and Australia

The purpose of this article was to collate evidence to describe where people with mental retardation or developmental disabilities live in five developed countries: United States, Canada, England, Wales, and Australia. Family homes are important dwelling places for people with mental retardation. They are the home of the great majority of children with mental retardation and a considerable proportion of adults with mental retardation. The likelihood of placement outside the family home increases with adulthood and progressively as people age. Adults with mental retardation live in a wide variety of settings, with formal residential provision frequently dependent on the arrangements that the authorities responsible for providing service support have chosen to make. There has been a considerable move away from accommodating people in large segregated and geographically isolated institutions in the countries considered. However, the current range of accommodation includes much with a distinctively different character to the homes where other citizens live. Many people still live in larger groups than would be ordinarily found in typical homes and this may necessitate departure from the architectural norm. In all of the countries considered, there has been a recent trend towards small community settings, compatible with typical housing architecture. This appears furthest advanced in the U.S. but is discernible elsewhere. Availability of residential services at a national level varies between 100 and 155 places per 100,000 total population. Regional variation within countries is even greater. In no case is the national availability considered adequate to meet the demand arising from changing need or expectations. MRDD Research Reviews 7:115-121, 2001. (c) 2001 Wiley-Liss, Inc.     

Can defendants with mental retardation successfully fake their performance on a test of competence to stand trial?

The purpose of this study was to determine whether criminal defendants with mental retardation can feign poor performance on a test of competence to stand trial. Four groups of adjudicated criminal defendants were given a test of competence to stand trial. In the experimental condition, defendants with mental retardation (MR) and mentally typical defendants (non-MR) were given instructions to fake their performance on the test. In the control, MR defendants and non-MR defendants took the test under standard conditions. The results indicated that both the MR and non-MR fakers scored significantly lower than the MR and non-MR controls. There was no significant difference in the scores of the MR and non-MR fakers. The results suggest that defendants with mental retardation may be able to successfully fake their performance in certain circumstances. Implications of these findings are discussed.     

Intelligence Testing and its Implications for Disability Evaluation in Individuals with Mental Retardation

Disability evaluation in mental retardation, which is done through assessment of intelligence, has certain inherent problems. The situation gets more complex if the person has additional disabilities, which is very likely in mental retardation. As an initiative, this study aims to study problems faced in intelligence testing in persons with mental retardation. The study included 88 randomly selected files of the individuals with mental retardation registered at the National Institute for the Mentally Handicapped (NIMH) Regional Centre, Kolkata during 2007-08. Each file was reviewed for information on diagnosis mental retardation, associated conditions and the intelligence testing reports. The results indicated that specific factors including both the characteristics of mental retardation and the nature of the tests available were interfering with intelligence testing. The problems are discussed in the context of current constructs related to mental retardation, diagnostic systems and legislation.     

Prompt-aided instruction of mirror-image discriminations: Abrupt prompt removal,time delay,and self-evaluation

This study compared three types of prompt-elimination procedures for helping children respond to left-right mirror-image stimuli. Three populations participated: normally developing preschoolers, students with mild mental retardation, and students with moderate mental retardation. All subjects were first trained to discriminate the stimuli in the presence of multiple pictorial prompts. These prompts required the subjects to discriminate the compounds on the basis of orientation. Then the prompts were eliminated, abruptly, with a time-delay procedure, or with a procedure requiring subjects to use the prompts to self-evaluate the accuracy of their responses. The results showed the following. First, most subjects rapidly discriminated the compound stimuli. Second, about 50% of the subjects of each population discriminated the task stimuli even when the prompts were abruptly removed. Time delay was highly effective with the normally developing preschoolers and students with mild mental retardation, but not with students with moderate mental retardation. The self-evaluation procedure was effective with all three populations.     

Cognitive correlates of laterality in mental retardation

Correlations of various laterality score for 202 persons with cognitive test scores in the seventies of mental retardation are presented.     

A national survey of U.S. statutes on juvenile transfer: implications for policy and practice

A survey of the statutes on juvenile transfer and cecertification in the U.S. federal and 50 state jurisdictions, and the District of Columbia, was performed. Relevant information was obtained on the procedures in each jurisdiction by which a juvenile can be tried in criminal court, whether there are applicable decertification (“transfer back”) procedures in jurisdictions permitting criminal court processing through automatic file or prosecutorial discretion, and the burden and allocation of proof in relevant proceedings. We also identified four criteria relevant to the mental, emotional, and developmental functioning of juveniles that are used in various jurisdictions in making transfer and decertification decisions: treatment needs and amenability, risk assessment of future criminality, the presence of mental retardation or mental illness, and certain kinds of offense characteristics. The majority of jurisdictions now allow 14-year-old juveniles to be tried in criminal court. Treatment needs/amenability and risk assessment are set forth as criteria relevant to transfer in the majority of jurisdictions as well, with the presence of mental retardation or mental illness explicitly relevant in a small number of jurisdictions. The patterns of these findings are discussed in their implications for social policy and for the forensic mental health assessment of juvenile transfer and decertification, with needed areas of research identified within each. ©1997 John Wiley & Sons, Ltd.     

The Relationship of Functional Variables and Psychopathology to Aggressive Behavior in Persons With Severe and Profound Mental Retardation

A number of hypotheses have emerged regarding the etiology of physical aggression in persons with mental retardation. Although a multicomponent model is appropriate, results of functional analysis-based studies have yielded promising results in identifying instigating and maintaining factors of aggression. However, the relationship between functional variables and conditions such as psychiatric diagnosis to aggressive behavior has yet to be investigated in persons with mental retardation. We conducted a study examining the prevalence of environmental or physical factors in aggressive behavior in mentally retarded persons with and without psychiatric disturbance. One hundred and thirty-five individuals with mental retardation who exhibited physical aggression were assessed with the Questions About Behavior Function Scale (QABF) to identify environmental or physical contribution to aggressive behavior. One or more behavioral functions were identified for 75% of the participants. Additionally, of 66 of the participants scoring above the clinical cutoff on an assessment for dual diagnosis, 75% met criteria for an environmental or physical function for aggression. No significant differences in number of participants with an identifiable function of aggression were found between the no dual diagnosis and dual diagnosis groups. Our findings underscore the importance of identifying functions underlying aggressive behavior in persons with mental retardation, and the need to consider functional variables regardless of psychiatric condition in treatment planning efforts for such individuals.     

Visual masking,mental age,and retardation

Performance of retarded subjects under both forward and backward masking was less accurate than either an equivalent chronological age or equivalent mental age group of normals. It was suggested that the iconic memory impairment of retarded subjects in attributable in part to mental retardation and not simply to low mental age.     

Modularity,mental retardation and speed of processing

This paper briefly outlines Anderson's (1992) theory of the minimal cognitive architecture underlying intelligence and development and briefly discusses its application to understanding mental retardation and specific cognitive deficits. An experiment on the relationship between face perception and mental retardation serves as an illustration of how the theory might be informative about the relationship between intelligence and cognitive architecture.     

Equivalence relations in individuals with language limitations and mental retardation

The study of equivalence relations exhibited by individuals with mental retardation and language limitations holds the promise of providing information of both theoretical and practical significance. We reviewed the equivalence literature with this population, defined in terms of subjects having moderate, severe, or profound mental retardation. The literature includes 55 such individuals, most of whom showed positive outcomes on equivalence tests. The results to date suggest that naming skills are not necessary for positive equivalence test outcomes. Thus far, however, relatively few subjects with minimal language have been studied. Moreover, we suggest that the scientific contributions of studies in this area would be enhanced with better documentation of language skills and other subject characteristics. With recent advances in laboratory procedures for establishing the baseline performances necessary for equivalence tests, this research area is poised for rapid growth.     

Behavioral aspects of epilepsy in children with mental retardation

Epilepsy and mental retardation, two relatively common childhood conditions, are both associated with a wide range of behavioral disorders. This article reviews the behavioral disturbances found in children with epilepsy, mental retardation, and both conditions. The behavioral disturbances found in children with epilepsy are associated with seizure-related, cognitive, developmental, and psychosocial factors. Although children with mental retardation also demonstrate a broad spectrum of behavioral disturbances, children with specific mental retardation syndromes have better-defined patterns of psychopathology. The presence of epilepsy and mental retardation seems to increase the severity of psychopathology. Further studies are needed, however, to define better the interaction of these two conditions and how they impact the behavior of children.     

Sexual Abuse Prevention for Individuals with Mental Retardation: Considerations for Genetic Counselors

It is now widely recognized that children, adolescents, and adults with mental retardation are especially vulnerable to sexual abuse. Because at least 10% of genetic conditions are reported to include mental retardation as a feature, the provision of services to individuals with mental retardation represents a substantial portion of the case load for many genetic counselors. Our objective is to educate genetic counselors and other health professionals about this vulnerable population in order to enhance the frequency and efficacy of inquiry into sexual education and sexual abuse prevention training for patients with mental retardation. The following review article is intended to assist genetic counselors by increasing their knowledge of factors that lead to sexual abuse and provides recommendations for integrating this information into the counseling interaction.     

The abilities of children with mental retardation to remember personal experiences: implications for testimony

Investigated the abilities of children with mental retardation to remember the details of a personally experienced event. A simulated health check was administered to 20 children with mental retardation and 40 normally developing children, half matched on mental age (MA) and half matched on chronological age (CA) with the children with mental retardation. The children's memory was assessed immediately after the health check and 6 weeks later. Overall, the children with mental retardation accurately recalled the health check features, provided detail, and resisted misleading questions about features that did not occur. The group with mental retardation performed similarly to the MA matches on virtually all of the memory variables. The children with mental retardation performed worse than the CA matches on most of the memory variables, although they were able to recall a similar number of features. The findings are discussed in terms of the ability of children with mental retardation to provide accurate testimony.     

Brief report: Contact desensitization in the treatment of dog phobias in persons who have mental retardation

In comparison with the research done on phobias in non-retarded individuals, there is a paucity of research in the treatment of phobias in persons with mental retardation. In this study, contact desensitization was evaluated as a treatment for two individuals who have mental retardation and an intense fear of dogs. Following base-line assessment using a behavioral avoidance test (BAT) measuring actual approach behavior, treatment was implemented in a multiple base-line across subjects design. Contact desensitization resulted in the elimination of avoidance behavior in both subjects during the BAT. Measures of generalization in an outdoor setting, and maintenance during a two-month follow-up, showed that the clients continued to be free of avoidance behavior. The implications for further application and research are discussed.     

The involvement of epigenetic defects in mental retardation

Mental retardation is a group of cognitive disorders with a significant worldwide prevalence rate. This high rate, together with the considerable familial and societal burden resulting from these disorders, makes it an important focus for prevention and intervention. While the diseases associated with mental retardation are diverse, a significant number are linked with disruptions in epigenetic mechanisms, mainly due to loss-of-function mutations in genes that are key components of the epigenetic machinery. Additionally, several disorders classed as imprinting syndromes are associated with mental retardation. This review will discuss the epigenetic abnormalities associated with mental retardation, and will highlight their importance for diagnosis, treatment, and prevention of these disorders.     

Identification of special education students with mental retardation: Correlates of state child-count data

The number of children identified as mentally retarded by the special education system in the United States has declined dramatically over the past 15 years. Hypotheses regarding this decline have generally focused on changes in state definitions and social factors related to the stigma of the mental retardation classification. In the present study, we investigated differences in state definitions of mental retardation as well as demographic and economic variables as predictors of states' MR identification rates. Definition variables failed to relate significantly to identification rates while several race and per capita expenditure variables were significant predictors. Results are discussed in terms of the importance of investigating demographic and economic variables in understanding the variation in state MR identification rates.     

INCREASING SELF-DETERMINATION: TEACHING PEOPLE WITH MENTAL RETARDATION TO EVALUATE RESIDENTIAL OPTIONS

The community living preferences of 4 institutionalized adults with mild mental retardation were identified using photographs that depicted a variety of residential characteristics. Individuals then were taught to obtain information regarding their preferences during tours of community group homes, to report that information to their social worker, and to evaluate the homes based on the information obtained. A multiple baseline across participants design showed that all 4 participants substantially increased their skills at asking questions, reporting information, and evaluating homes. The results indicate that people with mental retardation can take an active role in major lifestyle decisions that others have typically made for them.