Book Review: Mental Retardation: Intellectual Disability: Understanding its Development, Causes, Classification, Evaluation and Treatment

Mental Retardation Intellectual Disability: Understanding Its Development, Causes, Classification, Evaluation and Treatment James C Harris. New York (NY): Oxford University Press; 2006. 429 p. US$45.00. Reviewer Rating: Excellent Review by Bruce D McCreary, MD, FRCPC Kingston, Ontario James C Harris is professor of psychiatry and behavioural sciences, mental hygiene, and pediatrics at Johns Hopkins University School of Medicine. Readers interested in developmental neuropsychiatry will be familiar with his widely read, 2-volume text devoted to the field, published by Oxford University Press in 1995. His aim in this new book is to provide a comprehensive review of intellectual disabilities, a topic covered as mental retardation in 35 pages of his earlier text. Intellectual Disability has 10 chapters and 7 appendices. Chapter 1 outlines the content of each of the following chapters and highlights Harris' approach: emphasis in this book is on the development of the person, the provision of interventions for associated behavioural and emotional problems and the needed positive supports for self determination.p5 Chapter 2 is devoted to origins, changing concepts, and legal safeguards; as do most of the appendices, it reflects the author's US perspective. rest of the text will be more useful to readers in Canada and elsewhere. Those interested in the legacy of John F Kennedy will be impressed by the continuing impact of his various presidential advisory committees on intellectual disabilities, whose contributions have, sadly, no federal counterpart in Canada. Chapter 3 concerns the classification of intellectual disability and illustrates the use of methodologies developed by the American Association on Mental Retardation, the ICD-10, and the DSM-IV-TR. Chapter 4 discusses epidemiologic considerations. Here, the author observes that mental disorders are 3 to 4 times more prevalent in individuals with intellectual disabilities and that, unfortunately, less than one-third of those with identified psychopathology receive mental health services. Harris' review of etiology and assessment in Chapter 5 identifies the multiplicity of causes for intellectual disability and stresses the growing significance of epigenetics, that is, The study of process by which genotypes give rise to phenotypes as the developmental program unfolds.p 101 importance of systematic clinical assessments, supplemented as needed by special genetic investigations or neuroradiologic examination, is noted; the cause of intellectual disability can be identified in 40% to 60% of those evaluated. …

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