Mental Health

Mild Mental Retardation Case Study: Supporting a 14-Year-Old Toward Independence

Written By

Dr. Amar Shinde

Last Updated on: 23 Jun 2025

Patient Information

Age: 14

Gender: Male

Background: The patient is a school-age child from a middle-class family. He has two parents and one younger sibling, who is a sister. His father operates a shop, and his mother is a stay-at-home mom. The family noticed him learning slower and having social delays early on, but they thought he would "catch up with his age".

History or Cause: The patient had some learning and slowed and delayed speech from the age of 4. He took a long time to remember names and followed simple instructions; he also had some difficulty playing group games with age-appropriate peers. At school, after starting there at 6, the patient consistently underperformed academically and was particularly behind with reading and writing. The patient consistently struggled socially and had an evident lack of desire to engage with others.

Physically, the patient was well, as all developmental milestones were at least delayed by 8-12 months when it came to walking, speech and potty training. Flashbacks of presenting probable developmental delays. The patient had no family background of intellectual disability, but he did suffer a minor complication from birth, where he took a long time to deliver, which clinicians later suspected might have led to oxygen deprivation at birth, a possible contributor to the condition.

Diagnosis

• The patient was referred to Jagruti Rehabilitation Centre for a thorough assessment. We performed an assessment and diagnosis with a multidisciplinary team, including a psychiatrist, psychologist, and special educator.

Diagnostic assessments included:

• IQ Testing (WISC-IV): His IQ was 65, which falls within the range for mild intellectual disability.
• Adaptive Functioning Assessments: The assessment measured his functioning in daily living skills related to communication, self-care, and socialisation, where his adaptive score was at the level of an average 7-year-old.
• Developmental History Assessment: This confirmed that the patient had ongoing impairments in speech, motor skills, and cognitive function.
• Medical Screen: We also conducted a medical screen to rule out other neurological or genetic causes.

The outcome of the Diagnosis:

• 1. Mild Mental Retardation (now referred to as Mild Intellectual Disability)
• 2. Associated delays in academic learning and social development.

Treatment

The aim was to develop the patient’s essential life skills, improve academic learning and promote social interaction. A structured, multidisciplinary rehabilitation programme was created to align with the patient’s mental capacity and learning style.

Program

The patient participated in Jagruti Rehab’s special education and cognitive enhancement programme, which was designed to address:

• Educational Support: Slowed down and repeated informational learning through visuals & storytelling.
• Life Skills Training: Instruction for brushing teeth, dressing, mealtime etiquette and money counting.
• Behavioural Therapy: Instruction on dealing with frustration, tantrum prevention and adherence to rules.
• Parent Training: Education for parents on how to support emotional and practical skills at home.
• Group Activities: Weekly group-based activities, including game-playing, music-based self-efficacy, and role-playing, promote confidence and interaction.

The therapy used an individualised and group approach, 6 days a week and included 4 hours of a mix of group therapy and individual therapy.

Medical Treatments (Optional)

• This child did not need any medication to begin with; the psychiatrist in Mumbai suggested vitamin supplements and regular reviews to assess emotional health and behaviour. Eventually, while the child was still in therapy, a small amount of risperidone was used as well, but this was to help with the child's intermittent irritability as well as some sleep issues.

Therapies 

• Cognitive Behavioural Therapy (CBT): Adapted for children to improve thinking patterns and emotions.
• Occupational Therapy: Focused on hand-eye coordination, fine motor skills and classroom behaviours including holding a pencil.
• Speech and Language: To help the child express needs using short sentences.
• Social Skills: Practised conversation starters, how to introduce themselves or greet people and how to ask for help.
• Art Therapy and Music Therapy: Used as a means of self-expression or to help the child release pent-up emotions.

Improvements / Recovery Timeline

Week 1-2:

• Settled into a new environment with mild resistance
• Struggled to focus for more than 10 minutes each time, but still followed the routine with assistance.

Week 3–4:

• Recognised therapy staff and, at times, responded to his name
• Started in a limited capacity, repeating basic instructions and greeting peers

Week 5-6:

• Managed basic tasks such as zipping his bag and brushing his teeth with assistance.
• Effectively communicated basic needs using short phrases. 

Week 7-8:

• Was able to read 2-letter words and relate to pictures
• Developed a sense of time (morning, evening, today, tomorrow)

Week 9-12:

• Was able to play games in a group with limited prompting
• Started to independently perform chores like folding clothes at home
• Stated to make better eye contact and asked questions such as, "What is this?"

Our Success

After three months at Jagruti Rehabilitation Centre, the child significantly improved. He could accomplish personal hygiene, respond to questions in sentences, and participate in simple classroom activities. Teachers noticed he was able to be attentive and willing to engage with other students.

He became more confident and less frustrated. Most importantly, he began being more expressive of emotions like happiness, anger, or sadness in healthier ways.

Family and Community

The parents were able to be more confident in supporting their son at home. They were supportive of the therapist's recommendations and did a proper routine, which provided a sense of security. Even his younger sister, who was once confused by his behaviour, learnt how to engage in simple games with him that the rehab team taught.

Neighbours and more distant family members became more acceptable after they could understand the nature of his condition. The family reported an improved family atmosphere, feeling more peaceful and more hopeful. The child’s school was willing to transition him into the special learning section at school, where he would have the liberty to learn and be at his development speed, but also feel included.

Lessons Learnt and Expert Recommendations

In this case study, we demonstrated that early diagnosis of mild intellectual disability can be treated with a personalised intervention plan targeting individual needs. The team utilised the major domains of success in rehabilitation: practical application learning, emotional stability, and community awareness.

What We Learnt:

• Children with mild mental retardation can excel and develop with structured learning and patience.
• Families are likewise essential in embracing therapy at home.
• Positive reinforcement surpasses punishment or scolding.

Expert Recommendations:

Never ignore early indicators such as speech delay, social limitations, or learning concerns.

• Be diligent in scheduling developmental assessments during the ages of 2 to 6.
• Schools should be included in the therapy process for smoother inclusion.

Bottom line

This mild mental retardation case study demonstrated that a child, or individual living with intellectual challenges, can live an effective, independent, and purposeful life provided these are fulfilled with attention, care, love, and access to appropriate professional help.

The Jagruti Rehabilitation Centre continues to believe every child has the potential to be fulfilled; they just need support, and you have to be prepared to seek out the best pathway to reach that point.

Dr. Amar Shinde

Dr. Amar Shinde, founder of Jagruti Rehab, is a renowned psychiatrist in India with over two decades of experience in mental health, addiction recovery, and neuropsychiatry, dedicated to holistic, compassionate patient care.