The term is a challenging one and is often fraught with emotional and social stigma. This term is different from developmental delay which is appropriately used for those individuals less than 5 years of age, who are too young for testing in a formal manner. To establish a diagnosis of mental retardation, the intelligence has to be atleast 2 standard deviations less than the mean intelligent quotient. Mental retardation can be categorized into mild, moderate, severe and profound based on the intelligent quotient and of these, mild mental retardation accounts for more than 85 percent of the cases. The intelligent quotient is between 50-55 to 70 and the standard deviation below mean is 2-3. According to Reschly, "MMR was the official designation of a level of MR that involved current intellectual functioning performance between 2 and 3 standard deviations below the population mean and significant limitations in some, but not all, facets of everyday adaptive functioning." The DSM criteria for mental retardation includes "significantly sub-average intellectual functioning- an IQ of approximately 70 or below, trouble with functioning in multiple areas of life and onset before age 18." Since those with MMR do not have much biological or physical involvement, there is no biological stigmata associated with the diagnosis. On the other hand, in those with levels of mental retardation beyond MMR, the diagnosis is often made in preschool years and the setting of identification is usually a health care system. (Reschly, 2009). The comprehensiveness of the individual is poor and affects performance of the individuals in all social setting and also functional roles. Biological stigmata is always present with the diagnosis (Reschly, 2009). Diagnosis of MMR is often complex and also controversial because of lack of unequivocal symptoms and signs (Hegde and Pomaville, 2008). The diagnosis of MMR was recognized formally about a century ago and has been described in the earlier versions of American Association on Mental Retardation Disabilities (Reschly, 2009). When compared to other levels of mental retardation, MMR is usually not diagnosed until the child attains school age and the diagnosis usually occurs subsequent to referral from the class teacher of the child for suboptimal academic performance. Individuals with MMR typically do not exhibit any physical characteristics, neither do they have much impairment of comprehension (Reschly, 2009). When compared to other levels of mental retardation, MMR is usually not diagnosed until the child attains school age and the diagnosis usually occurs subsequent to referral from the class teacher of the child for suboptimal academic performance. Individuals with MMR typically do not exhibit any physical characteristics, neither do they have much impairment of comprehension (Reschly, 2009). Recent formulations for grading the severity of mental retardation are based on the levels of support needed rather than intelligent quotient. This is because; support levels are anyway related conceptually to impairment levels. Four levels of support are described in this regard and they are analogous to the four levels of impairment used earlier (Reschley, 2009). In this essay, communication problems, their evaluation tools, and treatment will be discussed with reference to MMR. Since there are several causes of MMR and it is beyond the purview of this essay to discuss them, one cause of MMR, the William syndrome will be discussed. Speech and language characteristics of the disorder The permanence in MMR is variable and its identification is unlike during preschool age period and adulthood.