Mental retardation is diagnosed primarily on the basis of intelligence testing, but affected children often demonstrate other brain problems such as attention deficits, movement problems, and perceptual difficulties. Dexterity and coordination also may be limited. If the child's doctor suspects a problem, parents may be referred to a psychologist or other mental health expert, who can administer a number of special tests, including standardized intelligence tests and a standardized adaptive skills test. Next, an expert should describe the child's strengths and weaknesses in intellectual and adaptive behavior skills, emotions, physical health, and environment. These skills can be assessed by formal testing, observations, interviews, and interacting with the child in daily life.

Intelligence testing alone is only one measure of functioning ability, however. A child with limits in intellectual functioning who does not have limits in adaptive skill areas may not be diagnosed as having mental retardation. "Adaptive skill areas" are those daily living skills needed to live, work, and play in the community and include communication, self-care, home living, social skills, leisure, health and safety, self-direction, functional academics (reading, writing, basic math), community use, and work. Adaptive skills are assessed in the child's typical environment.

Careful assessment is important because many children have been misdiagnosed with mental retardation, particularly at a young age, and are later diagnosed with profound learning disabilities but with average or above average intelligence.

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