32 Miss. Code. R. 22-3.16.3 - Classification & Coding Of Mental Retardation

The American Association on Mental Deficiency developed the definition of mental retardation used by RSA in 1961. This reads as follows:

Mental retardation refers to sub-average intellectual functioning which originates during the development period and is associated with impairment in adaptive behavior. This may be reflected in:

A. Maturation: rate of sequential development of self-help skills of infancy and early childhood

B. Learning: the facility with which knowledge is acquired as a function of experience

C. Social Adjustment: the degree to which the individual is able to maintain himself or herself independently in the community and in gainful employment as well as by his or her ability to meet and conform to other personal and social responsibilities and standards set by the community.

As so defined, sub-average general intellectual functioning refers to performance on an individual test of intelligence which is more than one standard deviation below the mean or an IQ Score of 84 on the Wechsler and 83 on the Stanford-Binet. (The standard deviation on the Wechsler is 15 while the Stanford-Binet is 16). It is, however, important to note that a measured intelligence quotient in and of itself is insufficient diagnostic evidence of the existence of mental retardation and that the presence of maladaptive behavior associated with subnormal intellectual functioning must also be established. It is this factor of maladaptive behavior which is particularly important in determining whether an individual who achieves an IQ in the 70-84 range may or may not be classified as mentally retarded since many people in this borderline area may neither experience any particular problems or adjustment nor demonstrate any evidence of maladaptive behavior.

It is the behavioral component of mental retardation rather than the measured intelligence quotient which is meaningful in determining the individual's need for vocational rehabilitation services as well as his or her ultimate employment potential on the completion of such services. At the same time, it must be realized that the IQ can be of great importance to the counselor, especially in evaluating the client's readiness for academic training. The IQ should be obtained on the basis of an appropriate individual intelligence test administered by a qualified psychologist or psychometrist in all cases where the existence of mental retardation is suspected.

As an indicator of severity of retardation, impairment in adaptive behavior is used as the basic criterion for classifying mental retardates into three (3) levels of functioning: Mild, Moderate, and Severe. Those sometimes termed profoundly retarded are generally found in institutions where they must receive continuing care and supervision, are incapable of gainful employment and, thus, not suitable candidates for vocational rehabilitation.

For coding purposes, the three levels may be described as follows:

Mild: Persons who, with the provision of appropriate rehabilitation services, can become capable of independent living in the community and engage in competitive employment. Generally, they will require supervision and guidance only under conditions of particular social and economic stress. Code as 530

Moderate: Persons capable of maintaining themselves in the community and performing adequately in low-demand competitive employment, but who will require continuing supervision and assistance in the management of personal affairs. Code as 532

Severe: Persons capable of productive work but only under sheltered, non-competitive conditions in a protective environment. Code as 534

There are problems inherent in the practical application of any classification system based on adaptive behavior. There are no objective scales that will determine with reasonable objectivity the functioning level of adaptive behavior to which a person should be assigned. It will be necessary for the counselor, with assistance from the psychologist, to use judgment to properly classify MR clients. The following sources of information may be considered to help make such decisions: personal client observations, review of all available case history, results of medical/psychosocial/vocational evaluation, reports from schools, and other sources who have provided services to the individuals.

Notes

32 Miss. Code. R. 22-3.16.3