Fortunately, most mental retardates do not need to be institutionalized. Mild retardates need classes, which usually emphasize reading and other basic school subjects, budgeting and money matters, and the development of occupational skills have been notably successful, and have helped many mild retardates become independent, productive members of the community. Classes for the moderately and severely retarded usually have more limited objectives, but they emphasize development of self-care and other skills that will enable retardates to function adequately and be of assistance in either a family or institutional setting. Simple job skills can also be learned by these retardates.

Training is built on step by step progression. Target areas of improvement are mapped out, such as improvement in personal grooming, social behavior, basic academic skills, and simple occupational skills. Within each area, specific skills are divided into simple components that can be learned and reinforced before more complex behaviors are required. Target areas are not selected arbitrarily, but realistically reflect the requirements of mentally retardate's life situation.

One problem that inflicts great anxiety on parents is whether or not to institutionalize their mentally retarded child. In general, the ones who are institutionalized fall into two groups:

a) those who, in infancy and childhood, manifest severe mental retardation and associated physical impairment, and who enter the institution at an early age, and

b) those who, in adolescence, usually have no physical impairments but show mild mental retardation and fail to adjust socially,
eventually requiring institutionalization for delinquent or other acting-out behavior.

The families of those in the first group come from all socioeconomic levels, whereas a significantly higher percentage of families of those in the second group come from lower educational and occupational strata.

Institutionalization is not recommended where the child makes a satisfactory adjustment at home and in any special class or training school that he may attend during the day. The effect of institutionalization on a mentally retarded youth depends heavily on the institution's facilities and on the youth himself.

The problem of preventing mental retardation involves the question of genetic factors as well as a wide range of biochemical, neurophysiological, and sociocultural conditions.

The frontiers in this field of prevention are:

1 . Work in genetics has revealed the role of genetic defects in faulty development and tests that have been devised to identify parents who have these faulty genes, thus making it possible to provide them with genetic counseling.

2.  The alleviation of sociocultural conditions, that deprive children of the necessary stimulation, motivation and opportunity for normal learning and development.

The government has taken initiative in this direction to provide adequate medical and general health care for mother and baby- prior to and during pregnancy, and after birth of the baby- particularly for the socially disadvantaged.