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In Atkins v. Virginia (2002), the United States Supreme Court held that executing criminal offenders who are mentally retarded violates several provisions of the United States Constitution. This chapter discusses forensic mental health assessments conducted to determine whether criminal offenders are mentally retarded and, therefore, ineligible for the death penalty. It also closely examines how states have defined mental retardation in the wake of Atkins, and whether those definitions are consistent with accepted clinical standards. Assessing for mental retardation in capital contexts raises a variety of clinical challenges for forensic mental health professionals, including how intellectual functioning and adaptive deficits are assessed among correctional populations. In addition, this chapter discusses the procedural and substantive laws that govern Atkins-type evaluations.

In this chapter the basis and nature of genomic disorders are described with examples including DiGeorge Syndrome, Williams-Beuren syndrome, Charcot Marie Tooth disease, Prader-Willi, and Angelman syndromes. The mechanisms whereby chromosomal rearrangements may lead to genomic disorders are described, the nature of reciprocal genomic disorders involving deletion or duplication of particular genomic regions and of genomic disorders involving parent of origin effects are also described. Mechanisms leading to genomic disorders through disruption of control of gene expression are also described. Diseases arising from terminal and subtelomeric deletions are highlighted together with the occurrence of inversions in both healthy individuals and those with diseases such as haemophilia A. The application of array comparative genome hybridisation (arrayCGH) techniques to define submicroscopic structural variation responsible for mental retardation is reviewed to illustrate the clinical utility and application of this approach.

This chapter examines how deprivation became an accepted etiological factor for intellectual disability, appearing in all the major classifications of the time and readily adopted by psychiatrists. It suggests that theories of deprivation helped shift the focus from the profoundly disabled to the large group of children who were diagnosed at the time with “mild mental retardation”. It also examines how theories of deprivation provided the scientific framework that enabled the diagnoses of a disproportionately large number of African American children as “mildly mentally retarded”.

The topic of this chapter is neurodevelopmental disabilities, with discussion focused on three prototypic neurodevelopmental disorders: mental retardation, autism, and cerebral palsy. These disorders are highlighted because the epidemiologic knowledge is more advanced; however, many of the important methodologic issues apply to other neurodevelopmental disorders. The chapter discusses the particular research challenges in achieving complete case ascertainment due to the problems of case finding and case confirmation. It presents information about the prevalence of each of these disorders and temporal changes in frequency over time, as well as the possible factors contributing to increased recognition of these disorders. The chapter summarizes investigations of risk factors for each disorder, including genetic factors and possible environmental etiologies.

This chapter discusses legal cases relevant to forensic mental health professionals involved in capital cases. After providing a brief historical overview of death as a punishment, this chapter focuses on death penalty jurisprudence in the United States, with a particular focus on cases decided when the modern era of the death penalty began in 1972. The chapter discusses cases that address whether certain classes of offenders, such as those with mental retardation, are eligible for the death penalty. It also discusses cases that address the constitutional requirement that offenders be competent for execution. Although the focus of this chapter is predominantly on cases decided by the United States Supreme Court, it also discusses several influential and informative cases from lower federal and state courts.

This chapter uses the clinical entity of mental retardation to trace the paradigmatic changes occurring soon after World War II that introduced genetics into epidemiology and influenced public health practices. Four different classes of disorder, each underlying a distinctive form of mental retardation, will serve to illustrate this theme and this time. For each class the potential for primary and secondary prevention exists. Epidemiologic studies have furthered understanding of these quite different genetic phenomena.

This chapter examines how disability diagnoses and parental practices are distributed across different groups of parents and what kinds of arguments about parents' involvement can initially be made based on this distribution. The findings reveal the shift in the number of learning disability (LD) diagnoses from the privileged to the less privileged children. This chapter also considers other disabilities such as mental retardation and autism spectrum disorders and compares the diagnoses of these disabilities with that of LD.

This chapter discusses the measurement of genius in Alfred Binet's “measuring scale of intelligence,” which he devised and successively refined between 1905 and 1911 (the year he died). Here, the chapter shows how experimental psychology had its own part to play in forming the basis of the child prodigy. And Binet's invention put France at the forefront of developmental psychology. In the words of the American introduction to the 1916 translation of Les Idées modernes sur les enfants, Binet's measuring scale was a “magnum opus” whose rapid acceptance worldwide was “little less than marvelous.” This invention established a language in which genius could be quantified, and precocity plotted against scientifically established developmental norms.

This chapter describes screening and diagnosis for congenital hypothyroidism (CH). CH is a well-established cause of mental retardation which can be prevented by screening and treatment with thyroxine.

This chapter examines violence and aggressive behaviour in psychiatric populations. The result indicate that two major psychoses, schizophrenia and mood disorders, can involve increased aggressive behaviour. Mental and behavioural problems originating in childhood, such as mental retardation and hyperactivity, may also include excessive aggressive behaviour. This chapter explains that intermittent explosive disorder, which includes outbursts of assaultive behaviours, has many characteristics resembling those of seizures associated with aggression. It also explores various treatment methods for brain dysfunction.

This chapter uses the history of Kew Cottages, (1887-2008), the first purpose-built institution for people with intellectual disabilities in Australia, as a lens through which to explore the history of Australian intellectual disability policy and practice. Influenced by international thinking, the broad outline of Australia’s policy history follows a similar pattern to other western countries. In the first decades of the twentieth century, in an atmosphere of anxiety about the ‘menace of the feeble-minded’, policy emphasised institutional segregation. In its last decades, policies of normalisation and deinstitutionalisation promised to return people with intellectual disabilities to the community. Yet the life stories of the Cottages’ residents recounted here reveal that in the nexus between policy and practice, the lives of people with intellectual disabilities could prove paradoxical.

This chapter examines psychologists’ involvement in the 1960s and 1970s in inventing a diagnosis known as “minimal brain dysfunction” (MBD) – a precursor to attention deficit attention disorder (ADHD). Although asserted to be a physiological matter, one best treated with stimulant drugs like methylphenidate (Ritalin), MBD was not based on a clear medical symptom. Quite soon, the modal individual for whom Ritalin became considered the most appropriate treatment was a white and middle-class child. As desegregation was often followed by the new phenomenon of tracking within schools, and as more African American children were labeled as suffering from “mild mental retardation,” the contrasting diagnosis of MBD represented a new disease entity to address the cognitive challenges sometimes faced by privileged children of the predominantly white suburbs. Simultaneously, a growing number of commentators, both African American and anti-racist white, came fiercely to protest what they perceived to be a disturbing tendency to overprescribe stimulant medications to poor children of color.

The Kennedy family, though extremely keen on physical fitness, was plagued by illness and untimely death. In the years before John F. Kennedy was elected to the presidency, two of his siblings had suffered violent deaths in plane crashes, and his sister Rosemary had been institutionalized after a horribly botched lobotomy operation. Less than a year into his presidency, JFK’s father, Joseph P. Kennedy, was felled by a near-fatal and debilitating stroke that robbed him of his ability to communicate in speech or writing. During the difficult times that marked his tenure in office, the effects of these tragedies was incalculable, especially the loss of his father, upon whom he had always relied for counsel, encouragement, and reassurance. The family’s woes also played a part in Kennedy’s appointment of a presidential panel on mental retardation and in his support for a major health-care legislation.

This concluding chapter discusses the kinds of reforms that are necessary to ensure that all children can receive a free and appropriate public education regardless of their disability status. It first cites data showing that African Americans are still disproportionately tracked in the “mental retardation” and “emotional disturbance” categories while also subject to much higher rates of suspension from school. In contrast, the high-quality private schools for children with autism are more likely to be filled with white children whose parents have been able to take advantage of funding under the Individuals with Disabilities Education Act (IDEA). This chapter also provides suggestions to make the IDEA a more effective tool for children and their families and how it could transform the public schools into a site of excellent education for children with disabilities rather than a mechanism that diverts resources from public schools to private schools.