Persons with moderate mental retardation

[clinedavis]

I have a new client who tested on the WASI as full scale IQ approximation of 51. This appears to reflect his actual IQ as he tested at 50 while in school. Paris (TX) is a rural community and he will be the only client I will have with an IQ approximation of 70 or below. There are no providers near here who have experience with such persons and transportation is a problem so he cannot travel. The last moderate M/R S/O here (before I moved to Paris) made national news as he was sent to prison which appeared inappropriate. Not accepting him as a client will likely mean prison for him as well. I welcome any comments or suggestions relating to this situation including suggestions for individual treatment for a person with the above IQ.

[PMH]

Moderate MR? Poor verbal skills? Requires some supervision, if he isn't an SO. By definition he should have difficulty in recognizing social convention (for example, appropriate sexuality). Even in the workplace, if he is really Moderate MR, he would require a sheltered workshop or an on-the-job job coach.

Maybe you could recommend state school, rather than prison for him.

Otherwise, it seems like they are asking you to move him from Moderate MR to Mild MR.

Where were the people who should have been supervising him when his offense occurred? Maybe they should share in the culpability of his offense.

PMH

[clinedavis]

Poor verbal skills, yes - could not read the example sentences on the WRAT-4 sentence comprehension subtest. Mid 2nd grade word reading. He has significant deficits as indicated on both the Bender Gestalt and Trails, as would be expected. I had to use the Carlson, which indicated that he is a Type 6, and the Abel and Becker Cotnitions Scale which indicated that he believes a child having a sexual experience with an adult would look back on the experiencde as an adult as positive. He also has a history of aggressive behavior when he feels provoked.

He lives with his mother who appears to make excuses for him and her "supervision" of him appears to fall in the "do whatever your want and don't bother me" category. He has a live-in girlfriend and a baby. Word is that he impregnated a 10 year old girl in the past but was not charged. His current victim is age 10-11 and was very angry that police broke up her affiar with the perpetrator. Although he admitted his offense to police upon questioning, including inappropriate sexual texting and intercourse, now both he and his victim deny it happened.

As to the Moderate/Mild question, I noticed that I gave him a diagnosis of Mild MR, as he fell in the crease that could go either way.

I am considering meeting with him several times to get more of a feel for making a recommendation. I would also like to see some school records rather than relying on statements by the probation officer and prosecutor. Although the Static 99 places him at Low risk, I blieve his dynamic risk is much higher.

[jlooman]

You haven't said how old this guy is. Given that he has a live-in girlfriend and baby he is obviously not a child, but how old is he? I agree that his dynamic risk is high, given what you have described.

It sounds as though this is outpatient, which I think would be very difficult as you would be relying on him to manage himself essentially. I agree that some sort of inpatient setting should be recommended.

I agree however that prison should be avoided if possible. We have a couple of these guys and they are victimized and stigmatized horribly.

Jan

[clinedavis]

Jan, the client is 22 years of age and obviuosly cannot manage himself as he missed his first appointment following testing this afternoon.

[PMH]

Jun 3, 2010 17:42:15 GMT -6 jlooman said:

We have a couple of these guys and they are victimized and stigmatized horribly.

Jan

I feel a soapbox moment coming ...



There, I let it pass.

PMH