Counseling Psychology with Mentally Challenged Personalities

1. Dr. Shamanthakamani Narendran
MD (Pead), PhD (Yoga Science)

2. YOGA THERAPY FOR MENTALLY
CHALLENGED CHILDREN
Inverted poses
 Psychic union pose (Viparitakarani)
 Shoulder Stand (Sarvangasana)
 Fish Pose (Matsyasana)
 Plough pose (Halasana)
Standing poses
 Hands to Feet pose (Padahastasana)
 Triangle pose (Trikonasana)
Flow of blood to the brain is enhanced and
brain cells are stimulated by yogasanas

3. improve concentration
Balancing poses
 Tree pose (Vrksasana),
 Half Moon pose (Ardha Chandrasana)
 Headstand (Sirsasana)

4. physical flexibility & self confidence
Postures to increase physical flexibility:
 Surya Namaskars done with coordinated
breathing.
Back bending poses:
 Cobra pose (Bhujangasana)
 Camel pose (Ushtrasana)
 Wheel pose (Chakrasana) (help enhance
their levels of self confidence and also
body posture).

5. Breathing exercises
 Dog breathing,
 Rabbit breathing,
 Lion breathing,
 Tiger breathing,
 Cat stretch.

6. om shanti om…
 It is tough to teach these kids meditation,
even though it is the most crucial aspect of
Yoga for better brain functioning.
 For this reason incantations of Aaah,
Uuuh, Mmm, and OM besides loud
chanting of longer mantras help bestow
the same effect in these kids.

7. mentally challenged
 Subaverage cognitive functioning and
deficits in two or more adaptive behaviors
with onset before the age of 18.
 A mentally challenged child is able to
pick up things at a far slower rate than
normal kids.
 At maturity that person’s capability for
understanding and learning will also be
far lower than average.

8. (Intelligence Quotient) IQ!!!
 IQ indicates a person's mental abilities
relative to others of approximately the
same age.

9. IQ - Equation
 Potential that denotes their skill in handling
different circumstances is called the Mental
Age (MA).
 Their real age is called the Chronological
Age (CA).
 Calculated by multiplying Mental Age (MA)
with 100, and then dividing the number with
the Chronological Age (CA) is the
Intelligence Quotient (IQ).
IQ = (100*MA) / CA

10. classification
 Mild
 Moderate
 Severe and profound handicaps.
educable

11. classification of mentally subnormal
 < 20 Profound mental retardation
(highly severe)
 20 – 34 Severe mental retardation
 35–49 Moderate mental retardation
(trainable)
 50 – 69 Mild mental retardation
(educable)
 70 – 79 Borderline intellectual
functioning

12. Grading of IQ
 < 20 Idiot
 20 – 49 Imbecile
 50 – 69 Moran
 70 – 79 Backward
 80 – 89 Dullard
 90 – 109 Normal
 110 – 119 Superior
 120 – 139 Very superior
 140 + Genius

14. CAUSES
 Several biomedical,
 Sociocultural and
 Psychological factors.
 Prenatal (during pregnancy),
 Natal (during birth), and
 Postnatal (after birth).

15. prenatal causes
 Metabolic conditions in the fetus like
phenylketonuria, Galactosemia,
Mucopolysaccharidosis.
 Neurodegenerative disorders
 Chromosomal disorders like Down's
syndrome, Klinfelter syndrome
 Tuberous sclerosis.
 Cretinism
 Maternal conditions like drug abuse,
intrauterine infections, placental insufficiency
or exposure to radiation during pregnancy.

16. natal factors
 Birth injuries
 Hypoxic, ischemic encephalopathy
 Intracerebral hemorrhage

17. postnatal factors
 Infections of the central nervous system
 Head injuries
 Post vaccination encephalopathies
 Jaundice
 Hypoglycemia
 Hypoxia
 Malnutrition
 Iron deficiency
 Child abuse
 Autism.

18. predisposing factors
 Low socioeconomic status,
 low birth weight,
 advanced maternal age and
 consanguinity of parents
Associated with an increased risk for mental
retardation in the children.

19. DIAGNOSIS
 Complete general and neurological
examination must be carried out by the
physician.
 IQ testing should be done.
 Down's syndrome, cretinism and other
conditions should be ruled out.
 Urine tests for metabolic disease like
phenylketonuria and galactosemia are
done in familial cases of mental
retardation.

20. SYMPTOMS
 Learning disabilities,
 Hyperactivity,
 Distractibility,
 Short span of
attention,
Poor concentration
 Poor memory,
 Impulsiveness,
 Awkward clumsy movements,
 Disturbed sleep,
 Emotional instability
 Low frustration
tolerance.

21.  Associated defects of the bone, muscle,
vision, speech and hearing are often found
in the mentally handicapped children.
 Congenital birth defects, apart from the
neurological system may be found if the
cause is prenatal.
 Convulsions (fits) are common in the
mentally handicapped children.

22.  Investigations to rule out hypothyroidism
are also done.
 Radiological investigations like CT and
MRI scans are helpful in revealing brain
abnormalities like leukodystrophies,
cerebral atrophy, hydrocephalus, tuberous
sclerosis and other conditions.

23. PREVENTION
 Genetic counseling: Risk of recurrence in
autosomal recessive disorders is high in
consanguineous marriages. Parents should
be informed about the possibility of
prenatal diagnosis. Mothers older than 35
years should have antenatal screening for
Down's syndrome.
 Rubella vaccine should be given to all
girls to prevent this infection in first
trimester of pregnancy.

24.  During pregnancy teratogenic drugs,
hormones, iodides and antithyroid drugs
should be avoided. Mothers should be
protected from contact with patients
suffering from viral illness.
 During labor, good obstetric supervision
is essential to prevent occurrence of birth
injuries.

25.  Neonatal infection of the central nervous
system should be diagnosed early and
treated promptly. Jaundice should be
managed correctly. Iron deficiency should
be treated in the early childhood.

26. MANAGEMENT
 To strengthen areas of reduced function
 To prevent or minimize further cognitive
deterioration.
 Interventions should begin early and be
sustained.
 Goals should be appropriate and
achievable.
 Approach should be collaborative and
multidisciplinary.

27.  In the teen years, an emphasis should be
placed on vocational goals, including
social adaptation, and vocational
professionals should be part of the
multidisciplinary team.

28. general measures
 Requires ongoing health surveillance
similar to normal children.
 Developmental, academic, and
psychosocial progress should be
monitored.
 Slower developmental progress should be
expected with increasing severity of
cognitive-adaptive disability.

29.  Parents should be counseled together.
 Diagnosis of the child should be fully
explained to them, and also the prognosis.
 Principles of management should be
explained in detail.
 Parental feelings and the home situation
should also be discussed.
 Mentally retarded child needs the same
basic care as any other child.

30.  Physiotherapy is often also needed.
 Anticonvulsant treatment is prescribed for
seizures.
 Specific management of metabolic and
endocrine disease should be done.
 Children need warmth, love and
appreciation, as well as discipline.
 Institutionalization should be avoided.
 Day care centers and schools and
integrated schools are useful.

31. Thank You