The diagnosis of mental retardation in a child - the causes of mental retardation, the first signs and features. Mental retardation in a child Young children mental retardation

Mental retardation (or ZPR for short) is characterized by a lag in the formation of mental functions. Most often, this syndrome is detected before admission to school. The child's body realizes its capabilities in slow motion. The delay in mental development is also characterized by a small stock of knowledge in a preschooler, the scarcity of thinking and the inability to engage in intellectual activity for a long time. For children with this deviation, it is more interesting to just play, and it is extremely problematic for them to focus on learning.

Mental retardation captures not only the psychological aspects of the personality. Violations are observed in different types of activity, physical and mental.

Mental retardation is an intermediate form of disorders in the development of the baby. Some mental functions develop more slowly than others. There is damage or defective formation of individual areas. The degree of underformation or the depth of damage present may vary from case to case.

• problems during pregnancy (past infections, injuries, severe toxicosis, intoxication), fetal hypoxia recorded during the gestation period;
• prematurity;
• birth trauma, asphyxia;
• diseases in infancy (trauma, infection, intoxication);
• genetic predisposition.

Social reasons:

• long-term isolation of the child from society;
• frequent stresses and conflicts in the family, in the garden, situations that cause psychological trauma.

There is a combination of a number of factors. Two or three causes of mental retardation may be combined, resulting in aggravation of disorders.

Types of ZPR

ZPR of constitutional genesis

This type is based on hereditary infantilism, affecting the mental, physical and psychological functions of the body. The emotional level with this type of developmental delay, as well as the level of the volitional sphere, are more reminiscent of the levels of primary school age, which means they occupy an earlier stage of formation.

What is the general characteristic of this species? It is accompanied by a wonderful mood, easy suggestibility, emotional behavior. Vivid emotions and experiences are very superficial and unstable.

ZPR of somatogenic genesis

This species is associated with somatic or infectious diseases in a child, or chronic diseases of the mother. Mental tone in this case decreases, emotional developmental delay is diagnosed. Somatogenic infantilism is supplemented by various fears that are associated with the fact that children with developmental delay are not confident in themselves or consider themselves inferior. The uncertainty of a preschooler is caused by multiple prohibitions and restrictions that take place in the home environment.

Children with developmental delay should have more rest, sleep, be treated in sanatoriums, as well as eat right and receive appropriate treatment. The health status of young patients will influence the favorable prognosis.

An unhealthy family environment and constant bans can also cause a child's mental retardation.

ZPR of psychogenic origin

This type is caused by frequent stressful situations and traumatic conditions, as well as poor education. Environmental conditions that do not correspond to the favorable upbringing of children can worsen the psychoneurological state of a child with developmental delay. Vegetative functions are among the first to be violated, and then emotional and psychological ones.

A species that involves a partial violation of some body functions, which is combined with the immaturity of the nervous system. The defeat of the central nervous system is of an organic nature. The localization of the lesion does not affect the further impairment of mental activity. The defeat of the central nervous system of such a plan does not lead to mental disability. It is this variant of mental retardation that is widespread. What are the symptoms for him? It is characterized by pronounced emotional disturbances, and the volitional aspect also suffers extremely. A noticeable slowdown in the formation of thinking and cognitive activity. This type of developmental delay is generally characterized by a slowdown in the maturation of the emotional-volitional level.

ZPR of cerebral-organic genesis is characterized by impaired development of the emotional-volitional sphere

Features of the manifestation of ZPR

Physical development

In children with developmental delay, it is always quite difficult to diagnose the syndrome. This is especially difficult to understand in the early stages of growth. What are the characteristics of children with mental retardation?

For such children, a slowdown in physical education is characteristic. The most frequently observed signs of poor muscle formation, low muscle and vascular tone, growth retardation. Also, children with developmental delay learn to walk and talk late. Playful activity and the ability to be neat also come with a delay.

Will, memory and attention

Children with mental retardation have little interest in their activities or work being evaluated, praised, they do not have the liveliness and emotional perception inherent in other children. Weakness of will is combined with monotony and monotony of activity. The games that children with developmental delay prefer to play are usually completely uncreative, they lack fantasy and imagination. Children with developmental delay quickly get tired of work, because their internal resources are instantly depleted.

A child with mental retardation is characterized by poor memory, inability to quickly switch from one type of activity to another, and slowness. He cannot fix attention for a long time. As a result of a delay in a number of functions, the baby needs more time to perceive and process information, visual or auditory.

One of the most striking signs of developmental delay is that the child is unable to force himself to do something. The work of the emotional-volitional sphere is inhibited, and, as a result, there are problems with attention. It is difficult for the child to concentrate, he is often distracted and cannot "collect his strength" in any way. At the same time, an increase in motor activity and speech is likely.

Perception of information

It is difficult for children with developmental delay to perceive information in whole images. For example, it will be difficult for a preschooler to identify a familiar object if it is placed in a new place or presented in a new perspective. The abruptness of perception is associated with a small amount of knowledge about the world around. The speed of perception of information also lags behind and orientation in space is difficult.

Of the features of children with mental retardation, one more thing should be highlighted: they remember visual information better than verbal information. Passing a special course on mastering various memorization techniques gives good progress, the performance of children with mental retardation becomes better in this regard compared to children without deviations.

Special courses or correctional work of specialists will help improve the memory and susceptibility of the child.

Speech

The child lags behind in the development of speech, which leads to various problems in speech activity. Distinctive features of the formation of speech will be individual and depend on the severity of the syndrome. The depth of the ZPR can affect speech in different ways. Sometimes there is some delay in speech formation, which practically corresponds to the level of full development. In some cases, there is a violation of the lexical and grammatical basis of speech, i.e. in general, underdevelopment of speech functions is noticeable. An experienced speech pathologist should be consulted to restore speech activity.

Thinking

Considering the issue of thinking in children with mental retardation, it can be noted that the greatest problem for them is the solution of logic tasks offered in verbal form. Developmental delay also occurs in other aspects of thinking. Approaching school age, children with developmental delays have poor ability to perform intellectual actions. They cannot, for example, generalize, synthesize, analyze or compare information. The cognitive sphere of activity in case of mental retardation is also at a low level.

Children suffering from mental retardation are much worse than their peers are savvy in many matters related to thinking. They have a very meager supply of information about the world around them, have a poor idea of ​​spatial and temporal parameters, their vocabulary also differs significantly from that of children of the same age, and not for the better. Intellectual work and thinking do not have pronounced skills.

The central nervous system in children with developmental delay is immature, the child is not ready to go to the first grade at the age of 7. Children with mental retardation do not know how to perform basic actions related to thinking, are poorly oriented in tasks and cannot plan their activities. Teaching children with mental retardation to write and read is extremely problematic. Their letters are mixed, especially those that are similar in spelling. Thinking is inhibited - it is very difficult for a preschooler to write an independent text.

Children with developmental delays who enter a regular school become underachieving students. This situation is extremely traumatic for an already damaged psyche. As a result, there is a negative attitude towards all learning in general. A qualified psychologist will help to solve the problem.

Creation of favorable conditions

For the complex development of the child, it is necessary to create external favorable conditions that would contribute to successful learning and stimulate the work of various parts of the central nervous system. It is important to create a developing subject environment for classes. What does it include? Developing game activities, sports complexes, books, natural objects and more. Communication with adults will also play an important role. Communication should be meaningful.

For such children, it is extremely important to get new impressions, communicate with adults and friendly-minded peers.

The game is the leading activity for a child of 3-7 years old. Practical communication with an adult who would teach a child to manipulate this or that object in a playful way is of paramount importance for children with mental retardation. In the process of exercises and classes, an adult helps the child to learn the possibilities of interaction with other objects, thereby developing his thought processes. The task of an adult is to stimulate a child with a developmental delay to learn and explore the world around him. You can consult a psychologist for advice on these issues.

Educational games

Corrective classes for children with mental retardation should be diversified with didactic games: nesting dolls and pyramids, cubes and mosaics, lacing games, Velcro, buttons and buttons, inserts, musical instruments, playing devices with the ability to extract sounds. Also, sets for comparing colors and objects will be useful, where different-sized homogeneous things that are different in color will be presented. It is important to "provide" the child with toys for role-playing games. Dolls, cash register, kitchen utensils, cars, home furniture, animals - all this will be extremely useful for full-fledged activities and games. Children are very fond of all kinds of activities and exercises with the ball. Use it for rolling, tossing or teaching your child to throw and catch the ball in a playful way.

Play with sand, water and other natural materials should often be referred to. With such natural "toys" the child really likes to play, besides, they do an excellent job of forming tactile sensations using the play aspect.

The physical education of a preschool child and his healthy psyche in the future directly depend on the game. Active play and exercise on a regular basis will be excellent methods for teaching a child to control his body. It is necessary to do exercises constantly, then the effect of such exercises will be maximum. Positive and emotional communication during the game between the baby and the adult creates a favorable background, which also contributes to the improvement of the nervous system. Using imaginary characters in your games, you help your child to show imagination, creativity, which will contribute to the formation of speech skills.

Communication as a development aid

Talk to your child as often as possible, discuss every little thing with him: everything that surrounds him, what he hears or sees, what he dreams about, plans for the day and weekends, etc. Build short, clear sentences that are easy to understand. When talking, consider not only the quality of words, but also their accompaniment: timbre, gestures, facial expressions. When talking to your child, always make eye contact and smile.

Mental retardation involves the inclusion of listening to music and fairy tales in the correctional training program. They have a positive effect on all children, regardless of whether they have any disabilities or not. Age also does not matter, they are equally loved by children of 3 and 7 years old. Their benefits have been proven by years of pedagogical research.

Books will help you develop your speech in the process of learning. Children's books with bright pictures can be read together, studying the drawings and accompanying them with voice acting. Encourage your child to repeat what they heard or read. Choose the classics: K. Chukovsky, A. Barto, S. Marshak - they will become faithful assistants in the formation of the child's personality.

Mental retardation - what is mental retardation?

Mental retardation (MPD) is a child's developmental delay in accordance with the calendar norms of his age, without impaired communication and motor skills. ZPR is a borderline condition and may indicate serious organic brain damage. In some children, mental retardation may be the norm of development, a special mentality (increased emotional lability).

If mental retardation persists after age 9, the child is diagnosed with mental retardation. The slowdown in the rate of mental development is due to the slower maturation of neural connections in the brain. The cause of this condition in most cases is birth trauma and intrauterine fetal hypoxia.

Types of mental retardation (ZPR) in children.

The RRP is classified as follows:

Delayed psychoverbal development of constitutional origin. Briefly, this is a feature of the mental structure of an individual child, corresponds to the norm of development. Such children are infantile, emotionally similar to younger children. Correction in this case is not required.

Somatogenic mental retardation refers to sick children. Weakened immunity, frequent colds, allergic reactions lead to slow development of the brain and neural connections. In addition, due to poor health and hospitalization, the child spends less time playing and studying.

ZPR of a psychogenic nature- arises due to an unfavorable situation in the family, insufficient attention of relatives, pedagogical neglect.

The above types of ZPR do not pose a threat to the further development of the child. Pedagogical correction is enough: to do more with the child, sign up for a development center, perhaps, go to a defectologist. In the practice of the center, we have never come across children with severe mental retardation, with whom little attention is paid or left unattended. Based on the experience of the center, parents of children with mental retardation are very sensitive to the issues of upbringing, development and education. The main cause of mental retardation in children is still an organic lesion of the central nervous system.

Cerebro-organic nature of ZPR (cerebrum - skull).

With this form of mental retardation, parts of the brain are slightly affected. Those areas that are not directly included in the provision of human life are primarily affected, these are the most “external” parts of the brain, closest to the cranium (cortical part), especially the frontal lobes.

It is these fragile areas that are responsible for our behavior, speech, concentration, communication, memory and intelligence. Therefore, with mild CNS damage in children (it may not even be visible on an MRI), mental development lags behind the calendar norms of their age.

Causes of mental retardation (ZPR) of organic origin

• Organic brain damage in the prenatal period: hypoxia, fetal asphyxia. It is caused by a number of factors: improper behavior of a pregnant woman (taking illegal substances, malnutrition, stress, lack of physical activity, etc.)
• Mother-borne viral infectious diseases. More often - in the second, third trimester. If a pregnant woman has had whooping cough, rubella, cytomegalovirus infection, and even SARS at an early stage of pregnancy, this entails a much more severe developmental delay.
• Aggravated obstetric history: trauma during childbirth- the child gets stuck in the birth canal, with weak labor activity, stimulants, epidural anesthesia, forceps, vacuum are used, which is also a risk factor for the newborn.
• Complications during the natal period: prematurity, infectious or bacterial disease in the neonatal period (up to 28 days of life)
• Congenital malformations of the brain
• An infectious or viral disease transferred by a child. If the disease proceeded with complications in the form of meningitis, encephalitis, neurocysticercosis, mental retardation most often passes into the diagnosis of mental retardation (set after 9 years).
• External factors - complications after vaccination, antibiotics
• Household injuries.

The most common cause of mental retardation (MPD) is birth trauma. You can read more about birth trauma here.

Signs of mental retardation (MPD) in children

The game is distinguished by the poverty of imagination and creativity, monotony, monotony. These children have low performance as a result of increased exhaustion. In cognitive activity, there are observed: weak memory, instability of attention, slowness of mental processes and their reduced switchability.

Symptoms of mental retardation (MPD) at an early age (1-3 years)

Children with mental retardation have a reduced concentration of attention, a lag in the formation of speech, emotional lability (“looseness of the psyche”), communication disorders (they want to play with other children, but they do not succeed), reduced interests due to age, hyperexcitability, or, conversely, lethargy.

• The lag of age norms for the formation of speech. Often a child with mental retardation later starts to walk, babble.
• They cannot differentiate the subject (“show the dog”) by the year (provided that they are engaged with the child).
• Children with mental retardation cannot listen to the simplest rhymes.
• Games, cartoons, listening to fairy tales, everything that requires understanding, does not arouse their interest, or their attention is concentrated for a very short time. However, a child of 1 year old normally does not listen to a fairy tale for more than 10-15 minutes. A similar condition should alert at 1.5-2 years.
• There are violations of coordination of movements, fine and large motor skills.
• Sometimes children with mental retardation begin to walk later.
• Profuse salivation, protruding tongue.
• Children with mental retardation may have a severe character, they are irritable, nervous, capricious.
• Due to disturbances in the central nervous system, a child with mental retardation may have problems falling asleep, sleeping, excitation and inhibition processes.
• They do not understand the addressed speech, but listen carefully, make contact! This is important for differentiating mental retardation from more severe disorders such as autism.
• They do not distinguish colors.
• Children with mental retardation at the age of one and a half cannot fulfill requests, especially complex ones (“come into the room and bring a book from the bag”, etc.).

• Aggression, tantrums over trifles. Due to mental retardation, babies cannot express their needs and emotions and react to everything with a cry.

Signs of mental retardation in preschool and school age (4-9 years)

When children with mental retardation grow up, begin to associate and feel their body, they may complain of headaches, they often get sick in transport, there may be nausea, vomiting, dizziness.

In psychological terms, children with mental retardation are hard to perceive not only by their parents, but also suffer from this condition themselves. With mental retardation, relationships with peers develop poorly. From misunderstanding, from the inability to express themselves, children "close in themselves." They can become angry, aggressive, depressed.

Children with mental retardation often have intellectual development problems.

• Poor reckoning
• Can't learn the alphabet
• Frequent motor problems, clumsiness
• In the case of a rough ZPR, they cannot draw, they do not hold a pen well
• Speech is slurred, monotonous
• Vocabulary - poor, sometimes completely absent
• Poor contact with peers, due to mental retardation, they prefer to play with kids
• Emotional reactions of schoolchildren with mental retardation do not correspond to their age (they become hysterical, laugh when it is inappropriate)
• They do poorly at school, they are inattentive, mentally, game motivation prevails, as in younger children. Therefore, it is extremely difficult to get them to learn.

The difference between mental retardation (MPD) and autism.

Mental retardation may correlate with autism spectrum disorders. When the diagnosis is difficult and the features of autism are not so pronounced, they talk about ZPR with elements of autism.

Differentiation of mental retardation (MPD) from autism:

1. With ASD, the child has eye contact, children with autism (specifically autism, not an autistic disorder such as Asperger's syndrome) never make eye contact, even parents.
2. Both children may be speechless. A child with mental retardation in this case will try to turn to an adult with gestures, show with a finger, will mumble or hum. With autism, there is no interaction with another person, a pointing gesture, children use the hand of an adult if they need to do something (press a button, for example).
3. With autism, children use toys for other purposes (turning the wheels of the car instead of carrying it). Children with mental retardation may have problems with educational toys, they may not get figures into the holes of the desired shape, but already at the age of one they will show emotions for plush toys, they can kiss and hug them if asked.
4. An older child with autism will refuse contact with other children, while children with mental retardation want to play with others, but since their mental development corresponds to the younger one, they will experience problems with communication and expression of emotions. Most likely they will play with younger children, or be shy.

1. A child with mental retardation can also be aggressive, "heavy", silent, withdrawn. But autism is distinguished from mental retardation by the lack of communication in principle, plus everything - the fear of change, the fear of going out into the street, stereotyped behavior, and much more. For more information, see the article “Signs of Autism”.

Treatment for mental retardation (MPD)

Traditional care for children with mental retardation is either teaching or brain stimulation through drug treatment. In our center, we offer an alternative - to influence the very root cause of mental retardation - an organic lesion of the central nervous system. Eliminate the consequences of birth trauma with the help of manual therapy. This is the author's technique of cranio-cerebral stimulation (cranium - skull, cerebrum - brain).

Pedagogical correction of children with mental retardation is also very important for the subsequent elimination of the delay. But you need to understand that the correction of ZPR is not a cure.

In the center, Dr. Lev Levit, the rehabilitation of children with severe forms of mental retardation brings good results, which parents could not achieve through drug therapy or pedagogy and speech therapy.

cranial therapy and author's technique of cranio-cerebral stimulation- a very mild technique for the treatment of mental retardation and other developmental disorders in children. Outwardly, these are gentle touches on the head of a child. By palpation, the specialist determines the cranial rhythm in a child with mental retardation.

This rhythm occurs due to the processes of fluid movement (liquor) in the brain and spinal cord. Liquor washes the brain, removes toxins and dead cells, and saturates the brain with all the necessary elements.

Most children with mental retardation (MPD) have impaired cranial rhythm and fluid outflow due to birth trauma. Cranial therapy restores the rhythm, restores fluid circulation, improves brain activity, and with it understanding, psyche, mood, sleep.

Cranio-cerebral stimulation works on areas of the brain that are not functioning well enough. Many of our children with speech delay (SSP) experience a jump in speech. They begin to pronounce new words, link them into sentences.

For more information about speech delay in children and treatment at the center, see

Head. the doctor of the center, Dr. Lev Isaakievich Levit, also owns a range of osteopathic techniques (30 years of practice in osteopathic rehabilitation). If necessary, the consequences of other injuries are eliminated (deformation of the chest, problems with the cervical vertebrae, sacrum, etc.).

Let's summarize. The method of cranial therapy and cranio-cerebral stimulation is aimed at:

• normalization of the normal functioning of the brain;
• improvement of the metabolism of nerve cells (the metabolism of the whole organism also improves);
• elimination of the consequences of birth trauma - work with the bones of the skull;
• stimulation of brain areas responsible for speech, intelligence, associative and abstract thinking

MAIN INDICATORS FOR CONSULTATION WITH A CRANIAL THERAPIST:

1. If the child was born during pathological, difficult, intensive childbirth.

2. Anxiety, crying, causeless crying of the child.

3. Strabismus, salivation.

4. Developmental delay: does not follow the toy with his eyes, cannot take the toy in his hands, does not show interest in others.

5. Complaints about headaches.

6. Irritability, aggressiveness.

7. Delay in intellectual development, difficulties in learning, memorization, figurative thinking.

The above symptoms of mental retardation correspond to a direct indication for a consultation with a cranial therapist. With treatment, in most cases, we achieve high positive results. This is noted not only by parents, but also by kindergarten teachers and school teachers.

You can watch video reviews of parents on the results of mental retardation treatment

The work of Clara Samoilovna and Viktor Vasilievich Lebedinsky (1969) is based on the etiological principle, which makes it possible to distinguish 4 variants of such development:

1. ZPR of constitutional origin;

2. ZPR of somatogenic origin;

3. ZPR of psychogenic origin;

4.ZPR of cerebro-organic origin.

In the clinical and psychological structure of each of the listed options for mental retardation, there is a specific combination of immaturity of the emotional and intellectual spheres.

1.ZPR constitutional origin

(HARMONIC, MENTAL and PSYCHOPHYSIOLOGICAL INFANTILISM).

This type of mental retardation is characterized by an infantile body type with childish plasticity of facial expressions and motor skills. The emotional sphere of these children is, as it were, at an earlier stage of development, corresponding to the mental makeup of a younger child: the brightness and liveliness of emotions, the predominance of emotional reactions in behavior, play interests, suggestibility and insufficient independence. These children are tireless in the game, in which they show a lot of creativity and invention, and at the same time quickly become fed up with intellectual activity. Therefore, in the first grade of school, they sometimes have difficulties associated with both a low focus on long-term intellectual activity (they prefer to play in the classroom) and an inability to obey the rules of discipline.

This "harmony" of the mental appearance is sometimes violated in school and adulthood, because. immaturity of the emotional sphere makes social adaptation difficult. Unfavorable living conditions can contribute to the pathological formation of an unstable personality.

However, such an "infantile" constitution can also be formed as a result of mild, mostly metabolic-trophic diseases suffered in the first year of life. If at the time of intrauterine development, then this is genetic infantilism. (Lebedinskaya K.S.).

Thus, in this case, there is predominantly a congenital-constitutional etiology of this type of infantilism.

According to G.P. Bertyn (1970), harmonic infantilism is often found in twins, which may indicate the pathogenetic role of hypotrophic phenomena associated with multiple pregnancy.

2. ZPR of somatogenic origin

This type of developmental anomalies is caused by long-term somatic insufficiency (weakness) of various origins: chronic infections and allergic conditions, congenital and acquired malformations of the somatic sphere, primarily the heart, diseases of the digestive system (V.V. Kovalev, 1979).

Prolonged dyspepsia during the first year of life inevitably leads to a developmental delay. Cardiovascular insufficiency, chronic inflammation of the lungs, kidney disease are often found in the anamnesis of children with somatogenic developmental disorders.

It is clear that a poor somatic condition cannot but affect the development of the central nervous system, delaying its maturation. Such children spend months in hospitals, which naturally creates conditions for sensory deprivation and also does not contribute to their development.

Chronic physical and mental asthenia inhibits the development of active forms of activity, contributes to the formation of personality traits such as timidity, timidity, self-doubt. The same properties are largely determined by the creation of a regime of restrictions and prohibitions for a sick or physically weakened child. Thus, to the phenomena caused by the disease, artificial infantilization is added, caused by the conditions of overprotection.

3. ZPR of psychogenic origin

This type is associated with unfavorable upbringing conditions that prevent the correct formation of the child's personality (incomplete or dysfunctional family, mental trauma).

The social genesis of this developmental anomaly does not exclude its pathological nature. As you know, unfavorable environmental conditions that arise early, long-acting and have a traumatic effect on the child's psyche, can lead to persistent shifts in his neuropsychic sphere, disruption of autonomic functions first, and then mental, primarily emotional, development. In such cases, we are talking about the pathological (abnormal) development of the personality. BUT! This type of mental retardation should be distinguished from the phenomena of pedagogical neglect, which are not a pathological phenomenon, but are caused by a lack of knowledge and skills due to a lack of intellectual information. + (Pedagogically neglected children, meaning “pure pedagogical neglect”, in which the lag is due only to social reasons, domestic psychologists do not include in the category of ZPR. Although it is recognized that a prolonged lack of information, the lack of mental stimulation during sensitive periods can lead the child to reduce potential opportunities for mental development).

(It must be said that such cases are recorded very rarely, as well as a DDD of somatogenic origin. There must be very unfavorable conditions, somatic or microsocial, for the DDD of these two forms to occur. Much more often, we observe a combination of organic CNS insufficiency with somatic weakness or with the influence unfavorable conditions of family education).

ZPR of psychogenic origin is observed, first of all, with abnormal personality development according to the type of mental instability, most often caused by the phenomena of gopoopeky - conditions of neglect, under which the child does not develop a sense of duty and responsibility, forms of behavior, the development of which is associated with active inhibition of affect. The development of cognitive activity, intellectual interests and attitudes is not stimulated. Therefore, the features of pathological immaturity of the emotional-volitional sphere in the form of affective lability, impulsiveness, increased suggestibility in these children are often combined with an insufficient level of knowledge and ideas necessary for mastering school subjects.

Variant of abnormal personality development like "family idol" due, on the contrary, to overprotection - an incorrect, pampering upbringing, in which the child does not instill the traits of independence, initiative, and responsibility. Children with this type of mental retardation, against the background of general somatic weakness, are characterized by a general decrease in cognitive activity, increased fatigue and exhaustion, especially during prolonged physical and intellectual stress. They get tired quickly, they need more time to complete any training tasks. Cognitive and educational activities suffer SECONDARY due to a decrease in the overall tone of the body. This type of psychogenic infantilism, along with a low capacity for volitional effort, is characterized by features of egocentrism and selfishness, dislike for work, and a focus on constant help and guardianship.

Variant of pathological personality development neurotic type It is more often observed in children whose families have rudeness, cruelty, despotism, aggression towards the child and other family members. In such an environment, a timid, timid personality is often formed, whose emotional immaturity is manifested in insufficient independence, indecision, low activity and lack of initiative. Unfavorable conditions of upbringing also lead to a delay in the development of cognitive activity.

4. ZPR of cerebro-organic origin

This type of ZPR occupies the main place in this polymorphic developmental anomaly. It is more common than other types of CRA; often has great persistence and severity of disturbances both in the emotional-volitional sphere and in cognitive activity. It is of the greatest importance for the clinic and special psychology due to the severity of the manifestations and the need (in most cases) for special measures of psychological and pedagogical correction.

The study of the anamnesis of these children in most cases shows the presence of mild organic insufficiency N.S. - RESIDUAL CHARACTER (remaining, preserved).

Abroad, the pathogenesis of this form of delay is associated with "minimal brain damage" (1947), or with "minimal brain dysfunction" (1962) - MMD. → These terms emphasize the NON-EXPRESSION, CERTAIN FUNCTIONALITY OF CEREBRAL DISORDERS.

Pathology of pregnancy and childbirth, infections, intoxication, Rh factor incompatibility between mother and fetus, prematurity, asphyxia, trauma during childbirth, postnatal neuroinfections, toxic-dystrophic diseases and injuries of the NS in the first years of life. - The causes are to some extent similar to the causes of oligophrenia.

COMMON for this form of mental retardation and oligophrenia- is the presence of the so-called EASY BRAIN DYSFUNCTION (LDM). ORGANIC CNS DAMAGE (RETARDATION) AT THE EARLY STAGES OF ONTOGENESIS.

Terms close in meaning: “minimal brain damage”, “mild infantile encephalopathy”, “hyperkinetic chronic brain syndrome”.

Under LDM- refers to a syndrome that reflects the presence of mild developmental disorders that occur mainly in the perinatal period, characterized by a very diverse clinical picture. This term was adopted in 1962 to refer to minimal (dysfunctional) brain disorders in childhood.

FEATURE OF ZPR- is a qualitatively different structure of intellectual insufficiency in comparison with u / o. Mental development is characterized by uneven disturbances of various mental functions; while logical thinking m.b. more preserved compared to memory, attention, mental performance.

In children with LIMITED CNS LESION, a multidimensional picture of cerebral insufficiency is much more often observed, associated with immaturity, immaturity and, therefore, greater vulnerability of various systems, including vascular and cerebrospinal fluid.

The nature of dynamic disorders in them is more severe and more frequent than in children with mental retardation of other subgroups. Along with persistent dynamic difficulties, there is a primary deficiency in a number of higher cortical functions.

Signs of a slowdown in the rate of maturation are often found already in early development and concern almost all spheres, in a significant part of cases up to the somatic. So, according to I.F. Markova (1993), who examined 1000 primary school students of a special school for children with mental retardation, a slowdown in the pace of physical development was observed in 32% of children, a delay in the formation of locomotor functions in 69% of children, a long delay in the formation of skills neatness (enuresis) - in 36% of cases.

In tests for visual gnosis, difficulties arose in the perception of complicated variants of subject images, as well as letters. In praxis tests, perseverations were often observed when switching from one activity to another. In the study of spatial praxis, poor orientation in the "right" and "left", mirroring in writing letters, and difficulties in differentiating similar graphemes were often noted. In the study of speech processes, disorders of speech motor skills and phonemic hearing, auditory memory, difficulties in constructing a detailed phrase, and low speech activity were often found.

Special studies of LDM showed that

RISK FACTORS ARE:

Late age of the mother, height and body weight of a woman before pregnancy, beyond the age norm, first birth;

Pathological course of previous pregnancies;

Chronic diseases of the mother, especially diabetes, Rh conflict, premature birth, infectious diseases during pregnancy;

Psychosocial factors such as unwanted pregnancy, big city risk factors (daily long commute, city noises, etc.)

The presence of mental, neurological and psychosomatic diseases in the family;

Low or, conversely, excessive (more than 4000 kg.) Weight of the child during childbirth;

Pathological childbirth with forceps, caesarean section, etc.

DIFFERENCE FROM U/O:

1. The massiveness of the lesion;

2. Time of defeat. - ZPR is much more often associated with later ones,

exogenous brain damage affecting the period,

when the differentiation of the main brain systems is already in

largely advanced and there is no danger of their rude

underdevelopment. However, some researchers suggest

and the possibility of genetic etiology.

3. Delay in the formation of functions is qualitatively different than with

oligophrenia. In cases with ZPR - you can observe the presence

temporary regression of acquired skills and their subsequent

instability.

4. Unlike oligophrenia, children with mental retardation lack inertia

mental processes. They are capable of not only accepting

to use help, but also to transfer the learned skills to the mental

activities in other situations. With the help of an adult, they can

carry out the intellectual tasks offered to them at close to

normal level.

5. The predominance of later terms of the defeat causes along with

with phenomena of IMMUNITY almost constant PRESENCE

DAMAGE N.S. → Therefore, unlike oligophrenia, which

often occurs in the form of uncomplicated forms, in the structure of the ZPR

OF CEREBRAL-ORGANIC GENESIS- almost always present

a set of encephalopathic disorders (cerebroasthenic,

neurosis-like, psychopathic), testifying to

damage to N.S..

CEREBRAL-ORGANIC INSUFFICIENCY first of all, it leaves a typical imprint on the structure of the mental retardation itself - both on the features of emotional and volitional immaturity, and on the nature of cognitive impairment

Data from neuropsychological studies have revealed a certain THE HIERARCHY OF COGNITIVE DISORDERS IN CHILDREN WITH CEREBRAL-ORGANIC GENESIS. Yes, in more mild cases it is based on neurodynamic insufficiency, associated primarily with the EXHAUSTIBILITY of MENTAL FUNCTIONS.

With a greater severity of organic brain damage, more severe neurodynamic disorders, expressed in the inertia of mental processes, are joined by PRIMARY DEFICIENCY OF INDIVIDUAL CORTICAL-SUBCORTICAL FUNCTIONS: praxis, visual gnosis, memory, speech sensorimotor. + At the same time, a certain PARTIALITY, MOSAICITY OF THEIR VIOLATIONS is noted. (Therefore, some of these children experience difficulties mainly in mastering reading, others in writing, others in counting, etc.). PARTIAL INSUFFICIENCY OF CORTIC FUNCTIONS, in turn, leads to underdevelopment of the most complex mental neoplasms, including voluntary regulation. Thus, the hierarchy of disorders of mental functions in mental retardation of cerebral-organic genesis is the reverse of that which exists in oligophrenia, where the intellect suffers primarily, and not its preconditions.

1. EMOTIONAL-volitional immaturity is represented by organic infantilism. With this infantilism, children lack the liveliness and brightness of emotions typical of a healthy child. Children are characterized by a weak interest in evaluation, a low level of claims. There is a high suggestibility and rejection of criticism in his address. Game activity is characterized by the poverty of imagination and creativity, certain monotony and originality, the predominance of the component of motor disinhibition. The very desire to play often looks more like a way of avoiding difficulties in tasks than a primary need: the desire to play arises precisely in situations where purposeful intellectual activity and lesson preparation are necessary.

Depending on the prevailing emotional background, one can distinguish II MAIN TYPES OF ORGANIC INFANTILISM:

1) UNSTABLE - with psychomotor disinhibition, a euphoric shade of mood and impulsiveness, imitating childish cheerfulness and spontaneity. Characterized by a low ability for volitional effort and systematic activity, the absence of persistent attachments with increased suggestibility, poverty of the imagination.

2) BRAKE - with a predominance of a low mood background, indecision, lack of initiative, often timidity, which may be a reflection of congenital or acquired functional insufficiency of autonomic N.S. type of neuropathy. In this case, there may be a violation of sleep, appetite, dyspepsia, vascular lability. In children with organic infantilism of this type, asthenic and neurosis-like features are accompanied by a feeling of physical weakness, timidity, inability to stand up for themselves, lack of independence, and excessive dependence on loved ones.

2. COGNITIVE DISORDERS.

They are caused by insufficient development of the processes of memory, attention, the inertia of mental processes, their slowness and reduced switchability, as well as the deficiency of individual cortical functions. There is instability of attention, insufficient development of phonemic hearing, visual and tactile perception, optical-spatial synthesis, motor and sensory aspects of speech, long-term and short-term memory, hand-eye coordination, automation of movements and actions. Often there is a poor orientation in the spatial concepts of "right - left", the phenomenon of mirroring in writing, difficulties in differentiating similar graphemes.

Depending on the predominance of phenomena in the clinical picture, either emotional-volitional immaturity, or cognitive impairment ZPR of CEREBRAL GENESIS can be subdivided

on the II MAIN OPTION:

1. organic infantilism

Its various types represent a milder form of mental retardation of cerebral-organic origin, in which functional disorders of cognitive activity are caused by emotional-volitional immaturity and mild cerebrosthenic disorders. Violations of cortical functions are dynamic in nature, due to their insufficient formation and increased exhaustibility. Regulatory functions are especially weak in the control link.

2. ZPR with a predominance of functional disorders of cognitive activity - with this variant of ZPR, symptoms of damage dominate: pronounced cerebrosthenic, neurosis-like, psychopathic-like syndromes.

In essence, this form often expresses a state that is borderline with u / o (of course, the variability of the state in terms of its severity is also possible here).

Neurological data reflect the severity of organic disorders and a significant frequency of focal disorders. There are also severe neurodynamic disorders, deficiency of cortical functions, including local disorders. Dysfunction of regulatory structures is manifested in the links of both control and programming. This variant of ZPR is a more complex and severe form of this developmental anomaly.

CONCLUSION: The presented clinical types of the most persistent forms of mental retardation mainly differ from each other precisely in the peculiarity of the structure and the nature of the ratio of the two main components of this developmental anomaly: the structure of infantilism and the peculiarities of the development of mental functions.

P.S. It should also be noted that within each of the listed groups of children with mental retardation there are variants that differ both in severity and in the characteristics of individual manifestations of mental activity.

CLASSIFICATION OF ZPR L.I. PERESLENI and E.M. Mastyukova

II TYPE ZPR:

1) Type BENIGN (NON-SPECIFIC) DELAY- is not associated with brain damage and is compensated with age under favorable environmental conditions, even without any special therapeutic measures. This type of mental retardation is due to a slow maturation of brain structures and their functions in the absence of organic changes in the central nervous system.

Benign (non-specific) developmental delay manifests itself in a certain delay in the formation of motor and (or) psychomotor functions, which can be detected at any age stage, is relatively quickly compensated and is not combined with pathological neurological and (or) psychopathological symptoms.

This type of mental retardation is easily corrected by early stimulation of psychomotor development.

It can manifest itself both in the form of a general, total retardation in development, and in the form of partial (partial) delays in the formation of certain neuropsychic functions, especially often this applies to a lag in the development of speech.

Benign nonspecific retention may be a familial trait and is often seen in physically debilitated and preterm infants. It can also take place with insufficient early pedagogical influence.

2) Type SPECIFIC (or CEREBRAL-ORGANIC) DEVELOPMENT REST- associated with damage to brain structures and functions.

Specific or cerebro-organic developmental delay is associated with changes in the structural or functional activity of the brain. Its cause may be disorders of intrauterine brain development, fetal hypoxia and asphyxia of the newborn, intrauterine and postnatal infectious and toxic effects, trauma, metabolic disorders and other factors.

Along with severe diseases of N.S., which cause developmental delay, most children have mild neurological disorders, which are detected only during a special neurological examination. These are the so-called signs of MMD, which usually occur in children with cerebral-organic mental retardation.

Many children with this form of mental retardation already in the first years of life show motor disinhibition - hyperactive behavior. They are extremely restless, constantly on the move, all their activities are not purposeful, they cannot complete any work they have started. The appearance of such a child always brings anxiety, he runs, fusses, breaks toys. Many of them are also characterized by increased emotional excitability, pugnacity, aggressiveness, and impulsive behavior. Most children are not capable of playing activities, they do not know how to limit their desires, they react violently to all prohibitions, and are stubborn.

Many children are characterized by motor clumsiness, they have poorly developed fine differentiated movements of the fingers. Therefore, they hardly master the skills of self-service, for a long time they cannot learn how to fasten buttons, lace up their shoes.

From a practical point of view, the differentiation of specific and non-specific developmental delay, i.e. essentially, pathological and non-pathological delay, is extremely important in terms of determining the intensity and methods of stimulating age-related development, predicting the effectiveness of treatment, learning and social adaptation.

Delay in the development of certain psychomotor functions SPECIFIC FOR EACH AGE STAGE OF DEVELOPMENT.

Yes, during the period NEWBORN - such a child does not form a clear conditioned reflex to time for a long time. Such a baby does not wake up when he is hungry or wet, and does not fall asleep when he is full and dry; all unconditioned reflexes are weakened in him and are called after a long latent period. One of the main sensory reactions of this age is weakened or does not appear at all - visual fixation or auditory concentration. At the same time, unlike children with CNS lesions, he does not show signs of dysembryogenesis, malformations, including those that are minimally expressed. He also has no violations of crying, sucking, assimilation of muscle tone.

Aged 1-3 MONTHS such children may show some delay in the pace of age development, the absence or a weakly expressed tendency to lengthen the period of active wakefulness, a smile when communicating with an adult is absent or manifests itself inconsistently; visual and auditory concentrations are short-lived, humming is absent or only a few rare sounds are observed. Progress in its development begins to be clearly outlined by 3 months of life. By this age, he begins to smile and follow a moving object. However, all these functions can manifest themselves inconsistently and are characterized by rapid exhaustion.

At all subsequent stages of development, benign developmental delay is manifested in the fact that the child in his development goes through stages that are more characteristic of the previous stage. However, ZPR can manifest itself at each age stage for the first time. For example, a 6-month-old child with this form of developmental delay does not give a differentiated reaction to acquaintances and strangers, the development of babbling may also be delayed, and a 9-month-old child may be insufficiently active in communicating with adults, he does not imitate gestures, he has weak game contact is developed, babble is absent or weakly expressed, intonation-melodic imitation of a phrase is not manifested, it can hardly capture or not capture small objects at all with two fingers or respond insufficiently clearly to verbal instructions. The slow rate of motor development is manifested in the fact that the child can sit, but does not sit down on his own, and if he sits, he does not make attempts to stand up.

benign developmental delay 11-12 MONTHS It manifests itself most often in the absence of the first babble words, weak intonational expressiveness of voice reactions, indistinct correlation of words with an object or action. A delay in motor development is manifested in the fact that the child stands with support, but does not walk. The lag in mental development is characterized by weakness of repeated actions and imitative games, the child does not confidently manipulate with two hands, does not grasp objects with two fingers sufficiently.

Nonspecific developmental delay in the first THREE YEARS OF LIFE most often manifests itself in the form of a lag in the development of speech, insufficiency of play activity, a lag in the development of the function of active attention that regulates the function of speech (the child's behavior is poorly controlled by the instruction of an adult), insufficient differentiation of emotional manifestations, and also in the form general psychomotor disinhibition. It can also be manifested by a lag in the development of motor functions. At the same time, in the FIRST MONTHS OF LIFE, the pace of normalization of muscle tone, the extinction of unconditioned reflexes, the formation of rectifying reactions and balance reactions, sensory-motor coordination, voluntary motor activity and especially fine differentiated movements of the fingers lag behind.

B 4. PSYCHOLOGICAL PARAMETERS OF ZPR

Sometimes students are difficult to educate and educate, and the main reason for this is a special, in contrast to the norm, state of the mental development of the individual, which is called “mental retardation” (ZPR) in defectology. Every second chronically underachieving child has a ZPR.

The essence of the disease

In general terms, this condition is characterized by a slow development of thinking, memory, perception, attention, speech, emotional-volitional aspect. Due to the limitation in mental and cognitive abilities, the child is not able to successfully fulfill the tasks and requirements imposed on him by society. For the first time, these limitations are clearly manifested and noticed by adults when the child comes to school. He cannot conduct stable purposeful activity, he is dominated by play interests and play motivation, while there are pronounced difficulties in distributing and switching attention. Such a child is not able to make mental efforts and strain when performing serious tasks, which quickly leads to school failure in one or more subjects.

The study of students with mental retardation showed that the basis of school difficulties is not intellectual insufficiency, but impaired mental performance. This is manifested in the difficulties of long-term concentration on cognitive tasks, in the low productivity of activity during the study period, in excessive fussiness or lethargy, and in disturbances in switching attention. Children with mental retardation have a qualitatively different structure of the defect, in contrast to mentally retarded children, in their violation there is no totality in the underdevelopment of mental functions. Children with mental retardation better accept the help of adults and are able to transfer the shown mental techniques to a new, similar task. Such children need to be provided with comprehensive assistance from psychologists and teachers, which includes an individual approach to learning, classes with a teacher of the deaf, a psychologist, along with drug therapy.

Constitutional ZPR

Developmental delay has a form determined by heredity. For children with this type of mental retardation, a harmonious immaturity of the physique and at the same time the psyche is characteristic, which indicates the presence of harmonic psychophysical infantilism. The mood of such a child is mostly positive, he quickly forgets insults. At the same time, due to the immature emotional-volitional sphere, the formation of educational motivation does not work. Children quickly get used to school, but do not accept the new rules of behavior: they are late for classes, they play in the lessons and involve their neighbors in the desk, turn letters in notebooks into flowers. Such a child does not divide grades into “good” and “bad”, he rejoices at having them in his notebook.

From the very beginning of study, the child turns into a persistently underachieving student, for which there are reasons. Due to the immature emotional-volitional sphere, he performs only what is connected with his interests. And because of the immaturity of intellectual development in children of this age, mental operations, memory, speech are not sufficiently formed, they have a small stock of ideas about the world and knowledge.

For the constitutional ZPR, the prognosis will be favorable with a targeted pedagogical impact in an accessible game form. Work on the correction of development and an individual approach will remove the above problems. If you need to leave children for the second year of study, this does not injure them, they will easily accept the new team and get used to the new teacher painlessly.

Somatogenic CRA

Children of this type of disease give birth to healthy parents. Developmental delay occurs due to past diseases that affect brain functions: chronic infections, allergies, dystrophy, persistent asthenia, dysentery. Initially, the child's intellect was not disturbed, but because of his distraction, he becomes unproductive in the process of learning.

At school, children of this type of mental retardation experience serious difficulties in adapting, they cannot get used to the new team for a long time, they get bored and often cry. They are passive, inactive and lack of initiative. They are always polite with adults, adequately perceive situations, but if they are not provided with a guiding influence, they will be disorganized and helpless. Such children at school have great difficulties with learning, arising from a reduced motivation for achievement, there is no interest in the proposed tasks, there is an inability and unwillingness to overcome difficulties in their implementation. In a state of fatigue, the child's answers are thoughtless and absurd, affective inhibition often occurs: children are afraid to answer incorrectly and prefer to remain silent. Also, with severe fatigue, a headache increases, appetite decreases, pain occurs near the heart, which children use as a reason to refuse to work if difficulties arise.

Children with somatogenic mental retardation need systematic medical and educational assistance. It is best to place them in sanatorium-type schools or in ordinary classes to create a medical-pedagogical regimen.

Psychogenic mental retardation

Children of this type of mental retardation are distinguished by normal physical development, they are somatically healthy. As has become clear from research, many children have brain dysfunction. The reason for their mental infantilism is a socio-psychological factor - unfavorable conditions of education: monotonous contacts and habitat, emotional deprivation (lack of maternal warmth, emotional relationships), deprivation, poor individual motivation. As a result, the child's intellectual motivation decreases, there is a superficiality of emotions, lack of independence in behavior, and infantilism in relationships.

This childhood anomaly is often formed in dysfunctional families. In an asocial-permissive family, there is no proper supervision of the child; there is emotional rejection along with permissiveness. Due to the lifestyle of the parents, the baby has impulsive reactions, involuntary behavior, his intellectual activity is extinguished. This state often becomes fertile ground for the emergence of stable asocial attitudes, the child is pedagogically neglected. In an authoritarian-conflict family, the atmosphere of a child is saturated with conflicts between adults. Parents influence the baby through suppression and punishment, systematically injuring the child's psyche. He becomes passive, dependent, downtrodden, feels increased anxiety.

not interested in productive activities, have unstable attention. Their behavior manifests bias, individualism, aggression, or excessive humility and adaptability.

The teacher must show interest in such a child, in addition, there must be an individual approach and intensive training. Then the children will easily fill in the gaps in knowledge in an ordinary boarding school.

ZPR of a cerebro-organic nature

In this case, the violation of personality development is due to a local violation of brain functions. Causes of deviations in brain development: pathology of pregnancy, including severe toxicosis, viral influenza suffered by the mother, alcoholism and drug addiction of parents, birth pathologies and injuries, asphyxia, serious illnesses in the 1st year of life, infectious diseases.

All children of this type of mental retardation have cerebral asthenia, which manifests itself in excessive fatigue, reduced performance, poor concentration and memory. Thought processes are imperfect, and the performance indicators of such children are close to those of oligophrenic children. They acquire knowledge in fragments, and they quickly forget, so at the end of the school year, students turn into persistently underachieving guys.

The lag in the development of the intellect in these children is combined with an immature emotional-volitional sphere, the manifestations of which are deep and coarse. Children learn the rules of relationships for a long time, do not correlate their emotional reactions with a certain situation, and are insensitive to mistakes. They are driven by the game, so there is always a conflict between "I want" and "I need to."

Teaching children of this type of mental retardation according to the usual program is futile. They need systematic competent correctional and pedagogical support.

• Causes of CRA
• Symptoms
• Treatment

Mental retardation in children (the disease is often referred to as ZPR) is a slow rate of improvement of some mental functions: thinking, emotional-volitional sphere, attention, memory, which lags behind generally accepted norms for a particular age.

The disease is diagnosed in the preschool or primary school period. It is most often detected during pre-testing before entering school. It is expressed in the limited ideas, lack of knowledge, inability to intellectual activity, the predominance of gaming, purely children's interests, immaturity of thinking. In each individual case, the causes of the disease are different.

Causes of CRA

In medicine, various causes of mental retardation in children are determined:

1. Biological:

• pregnancy pathologies: severe toxicosis, intoxication, infections, injuries;
• prematurity;
• intrauterine fetal hypoxia;
• asphyxia during childbirth;
• infectious, toxic, traumatic diseases at an early age;
• genetic predisposition;
• trauma during childbirth;
• lagging behind peers in physical development;
• somatic diseases (disturbances in the work of various organs);
• damage to certain parts of the central nervous system.

2. Social:

• limitation of life for a long time;
• mental trauma;
• unfavorable living conditions;
• pedagogical neglect.

Depending on the factors that eventually led to mental retardation, several types of the disease are distinguished, on the basis of which a number of classifications have been compiled.

Types of mental retardation

In medicine, there are several classifications (domestic and foreign) of mental retardation in children. The most famous are M. S. Pevzner and T. A. Vlasova, K. S. Lebedinskaya, P. P. Kovaleva. Most often in modern domestic psychology, the classification of K. S. Lebedinskaya is used.

1. Constitutional ZPR determined by heredity.
2. Somatogenic CRA acquired as a result of a disease that has affected the brain functions of the child: allergies, chronic infections, dystrophy, dysentery, persistent asthenia, etc.
3. Psychogenic mental retardation is determined by the socio-psychological factor: such children are brought up in adverse conditions: a monotonous environment, a narrow circle of friends, lack of maternal love, poverty of emotional relationships, deprivation.
4. Cerebral organic mental retardation observed in the case of serious, pathological abnormalities in the development of the brain and is most often determined by complications during pregnancy (toxicosis, viral diseases, asphyxia, alcoholism or drug addiction of parents, infections, birth injuries, etc.).

Each of the species according to this classification differs not only in the causes of the disease, but also in the symptoms and course of treatment.

ZPR symptoms

With confidence, it is possible to make a diagnosis of mental retardation only on the threshold of the school, when there are obvious difficulties in preparing for the educational process. However, with careful observation of the child, the symptoms of the disease can be noticed earlier. These may include:

• lagging skills and abilities from peers: the child cannot perform the simplest actions characteristic of his age (shoes, dressing, personal hygiene skills, independent food);
• unsociableness and excessive isolation: if he shuns other children and does not participate in common games, this should alert adults;
• indecision;
• aggressiveness;
• anxiety;
• during infancy, such children begin to hold their heads later, take their first steps, and speak.

With a delay in mental development in children, manifestations of mental retardation and signs of a violation in the emotional-volitional sphere, which is very important for the child, are equally possible. Often there is a combination of them. There are cases when a baby with mental retardation practically does not differ from the same age, but most often the retardation is quite noticeable. The final diagnosis is made by a pediatric neurologist during a targeted or preventive examination.

Differences from mental retardation

If by the end of junior (grade 4) school age the signs of mental retardation remain, doctors begin to talk about either mental retardation (MR) or constitutional infantilism. These diseases are:

• with UO, mental and intellectual underdevelopment is irreversible, with mental retardation, everything is fixable with the proper approach;
• children with mental retardation differ from the mentally retarded in the ability to use the help that is provided to them, independently transfer it to new tasks;
• a child with mental retardation tries to understand what he has read, whereas with VR there is no such desire.

When making a diagnosis, do not give up. Modern psychology and pedagogy can offer comprehensive assistance to such children and their parents.

Treatment of mental retardation in children

Practice shows that children with mental retardation may well become students of an ordinary general education school, and not a special correctional one. Adults (teachers and parents) should understand that the difficulties of teaching such children at the very beginning of school life are not at all the result of their laziness or negligence: they have objective, rather serious reasons that must be jointly and successfully overcome. Such children should be provided with comprehensive assistance from parents, psychologists, teachers.

It includes:

• individual approach to each child;
• classes with a psychologist and a teacher of the deaf (who deals with the problems of teaching children);
• in some cases - drug therapy.

Many parents find it difficult to accept the fact that their child, due to the nature of their development, will learn more slowly than other children. But this must be done to help the little schoolboy. Parental care, attention, patience, coupled with the qualified help of specialists (a teacher-defectologist, a psychotherapist) will help to provide him with targeted education, create favorable conditions for learning.

The diagnosis of mental retardation is made mainly at preschool or school age, when the child is faced with learning problems. With timely correction and medical care, it is possible to completely overcome developmental problems, but early diagnosis of pathology is rather difficult.

What is mental retardation?

Mental retardation, abbreviated as ZPR, is a lag in development from the norms accepted for a certain age. With mental retardation, certain cognitive functions suffer - thinking, memory, attention, emotional sphere.

Causes of underdevelopment

ZPR can arise due to various reasons, they can be conditionally divided into biological and social.

Biological reasons include:

• damage to the central nervous system during fetal development: injuries and infections during pregnancy, bad habits of the mother, fetal hypoxia;
• prematurity, symptoms of jaundice;
• hydrocephalus;
• malformations and neoplasms of the brain;
• epilepsy;
• congenital endocrine pathologies;
• hereditary diseases - phenylketonuria, homocystinuria, histidinemia, Down syndrome;
• severe infectious diseases (meningitis, meningoencephalitis, sepsis);
• diseases of the heart, kidneys;
• rickets;
• violation of sensory functions (vision, hearing).

Social causes include:

• limitation of the life of the baby;
• unfavorable conditions of education, pedagogical neglect;
• frequent psychotrauma in a child's life.

Symptoms and signs of developmental delay

Signs of mental retardation can be suspected by paying attention to the features of mental functions:

1. Perception: slow, inaccurate, inability to form a complete image. Children with mental retardation perceive information better visually than by ear.
2. Attention: superficial, unstable, short-term. Switching attention is facilitated by any external stimulus.
3. Memory: visual-figurative memory prevails, mosaic memorization of information, low mental activity when reproducing information.
4. Thinking: violation of figurative thinking, abstract and logical thinking only with the help of a teacher or parent. Children with mental retardation cannot draw conclusions from what has been said, summarize information, and draw a conclusion.
5. Speech: distortion of articulation of sounds, limited vocabulary, difficulties in constructing statements, impaired auditory differentiation, delayed speech development, dyslalia, dyslexia, dysgraphia.

Psychology of children with mental retardation

1. Interpersonal communication: children without developmental disabilities rarely communicate with lagging babies, do not accept them in games. In a peer group, a child with mental retardation practically does not interact with others. Many children prefer to play alone. In the classroom, children with mental retardation work alone, cooperation is rare, communication with others is limited. Lagging children in most cases associate with children younger than themselves, who are better at accepting them. Some kids avoid contact with the team altogether.
2. Emotional sphere: children with mental retardation are emotionally unstable, labile, suggestible and dependent. They are often in a state of anxiety, restlessness, affect. They are characterized by frequent mood swings and contrast in the manifestation of emotions. Inadequate cheerfulness and elevation of mood may be observed. Children with mental retardation cannot characterize their emotional state, find it difficult to identify the emotions of others, and are often aggressive. Such children are characterized by low self-esteem, insecurity, attachment to one of their peers.

As a result of problems in the emotional sphere and the sphere of interpersonal relations, children with mental retardation often prefer loneliness, they are unsure of themselves.

According to the classification of K. S. Lebedinskaya, according to the etiopathogenetic principle, ZPR is of the following types:

1. The delay in the development of constitutional etiology is an uncomplicated psychophysical infantilism, in which the cognitive and emotional spheres are at an early stage of development.
2. ZPR of somatogenic etiology - occurs as a result of severe diseases suffered in early childhood.
3. ZPR of psychogenic etiology - is the result of unfavorable conditions of education (overprotection, impulsiveness, lability, authoritarianism on the part of parents).
4. ZPR of cerebro-organic etiology.

Complications and consequences of ZPR

The consequences of ZPR are more reflected in the psychological health of the individual. If the problem is not corrected, the kid continues to move away from the team, his self-esteem decreases. In the future, the social adaptation of such children is difficult. Along with the progression of ZPR, writing and speech deteriorate.

Diagnosis of ZPR

Early diagnosis of AD is difficult. This is due to the fact that in order to confirm the diagnosis, a comparative analysis of the mental development of the child with age norms is necessary.

The degree and nature of developmental delay is determined collectively by a psychotherapist, psychologist, speech therapist, defectologist.

Mental development includes an assessment of the following criteria:

• speech and pre-speech development;
• memory and thinking;
• perception (knowledge of objects and body parts, colors, shapes, orientation in space);
• Attention;
• gaming and visual activity;
• level of self-service skills;
• communication skills and self-awareness;
• school skills.

For examination, the Denver test, the Bailey scale, the IQ test and others are used.

Additionally, the following instrumental studies can be shown:

• CT and MRI of the brain.

How to cure an STD

The main help for children with mental retardation is long-term psychological and pedagogical correction, which is aimed at improving the emotional, communicative and cognitive spheres. Its essence lies in conducting classes with a psychologist, speech therapist, defectologist, psychiatrist.

If psychocorrection is not enough, it is supported by drug treatment with nootropic drugs at the core.

The main drugs for medical correction:

• Piracetam, Encephabol, Aminalon, Phenibut, Cerebrolysin, Actovegin;
• Glycine;
• homeopathic preparations - Cerebrum compositum;
• vitamins and vitamin-like agents - vitamin B, Neuromultivit, Magne B6;
• antioxidants and antihypoxants - Mexidol, Cytoflavin;
• general tonic drugs - Cogitum, Lecithin, Elkar.

Prevention of developmental problems

To avoid CRP, you need to follow simple rules:

• create favorable conditions for the course of pregnancy and childbirth;
• create a friendly atmosphere in the family;
• closely monitor the condition of the child from the first days of life;
• timely treat any kind of disease in a baby;
• engage with the child and develop it from an early age.

An important role in the prevention of mental retardation is given to the bodily-emotional contact between mother and baby. Hugs, kisses, touches help the child feel calm and confident, navigate in a new environment, adequately perceive the world around him.

doctor pays attention

1. There are 2 dangerous extremes that many parents of children with mental retardation fall into - overprotection and indifference. Both in the first and in the second option, the development of the personality is inhibited. Hyper-custody does not allow the baby to develop, since parents do everything for him, they treat the student as if they were small. Indifference on the part of adults takes away from the child the incentive and desire to develop and learn something new.
2. There are special schools for children with mental retardation or separate classes in general education schools that are based on a correctional and developmental model of education. In special classes, optimal conditions have been created for teaching special children - low occupancy, individual lessons that allow you not to miss the psychological characteristics of the child, useful for his development.

The sooner parents pay attention to mental retardation or stop denying it, the higher the likelihood of full compensation for shortcomings in the emotional and cognitive spheres. Timely correction will prevent future psychological trauma associated with the realization of one's insolvency and helplessness in the flow of general learning.

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