Contamination of food: mycotoxins and metals.

Most of the points that apply to dysphasic patients can usefully be remembered when dealing with the mentally handicapped, especially the following. (1) Use simple sentences, but do not "talk down." (2) Put instructions in writing; there will usually be someone in the patient's environment who can read. (3) Both truculence and shyness are often due to being in an unfamiliar environment, so putting the patient at ease achieves better communication. (4) There is an increasing use of sign language among the mentally handicapped attending centres and in institutions. If your patient starts making strange gestures he may well be trying to communicate.