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A 27-year-old male is pleasant, emotionally warm, and happy. He lives with his parents, works in a sheltered
workshop, did not complete high school and talks in 3 word sentences. Which of the following is the most likely
diagnosis?
A. Autistic disorder
B. Childhood disintegrative disorder
C. Mental retardation
D. Mixed receptive-expressive language disorder
E. Rett's syndrome
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C. Mental retardation??????
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Explanation:
The correct answer is C. This young man is displaying simple mental retardation. He is affable, interacts well
with others to the point that he can work in a sheltered workshop, could not complete high school and talks in
three word sentences.
Autistic disorder (choice A) is not correct because persons with this diagnosis are rarely able to interact with
others to the point of holding a job, and they characteristically do not use language for purposes of
communication.
Childhood disintegrative disorder (choice B) is characterized by the clinically significant loss of previously
acquired skills. This does not allow them to function well even in sheltered workshops.
Mixed receptive-expressive language disorder (choice D) is a neurologic condition and affects language skills.
This man does have both receptive and expressive language skills, which he can use to the point of being
productively employed.
Rett's syndrome (choice E) is associated with severe impairment, including loss of social engagement and
previously acquired (before the age of 30 months) skills, and characteristic hand wringing movements. This
condition is confined to females. Very recent evidence suggests a genetic etiology for Rett's syndrome.
