An 18-year-old mongoloid girl (trisomy 21) of Asian descent presented two symptoms rarely associated with mongolism (Down’s syndrome). (1) Brain stem calcification; the first case diagnosed in vivo in mongolism on computerized axial tomography. (2) Hallucinatory psychotic depression; the first case successfully treated, to full recovery from the psychosis, in a mongoloid child with known brain stem calcification. The psychotic depression was related to moderate environmental stress. While being treated in her parent’s home, in their native land, for more than 1 year, the psychosis remained unresponsive to tranquilizers. Following hospital admission in the USA, rapid improvement was obtained within a few weeks through intensive milieu therapy.
A discussion is provided of issues related to neuropsychological assessment of mentally retarded individuals. The first matters considered are test selection in relation to mental age and diagnostic issues. Various methods of evaluation are then considered, including assessment of orientation to sound and visual stimuli, language comprehension, right-left discrimination, and abstract and symbolic processes. Methods are also reviewed for detailed evaluation of language functions including testing for aphasia and for academic skills such as reading, writing, and calculation, as well as for spatial and constructional abilities. A section is devoted to use of neuropsychological assessment for rehabilitation of various disorders such as congenital aphasia, alexia, and spatial-constructional disorders.
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