Home Orthopedics How to determine that a child has a mental retardation. Mental retardation (MDD) - causes, signs, treatment in Israel

Orthopedics

How to determine that a child has a mental retardation. Mental retardation (MDD) - causes, signs, treatment in Israel

Delay mental development is a condition in which patients experience disturbances of an emotional and psychological nature. In patients with mental retardation, thinking processes are inhibited, memory and attention skills are impaired.

What causes ZPR - reasons

In approximately 75% of cases, the exact cause of the disease is unknown. We can only assume that the problem is due to defects in genes (or chromosomes), injuries or conditions that develop in the fetus in the womb, diseases of early life and environmental influences.

The role of genetics

If one or both parents have mental retardation, their children are much more likely to also have the condition. There are many genetic (inherited) causes of mental retardation, which occur due to deficiencies or omissions in the genetic material passed from parent to child.
Sometimes mental retardation is caused by abnormalities in chromosomes rather than individual genes. Down syndrome, one of the most common causes of mental retardation, is caused by an extra chromosome in cells. Another fairly common chromosomal defect, called fragile X syndrome, causes PD mainly in boys.

* Genes are chemicals in the body that help determine a person's characteristics, such as hair or eye color, and are inherited from his parents. They are located on chromosomes found in the cells of the body.
* Chromosomes (KRO-mo-somes) are thread-like structures inside the nucleus of cells on which genes are located.

Problems during pregnancy

Infections in pregnant women, such as rubella or toxoplasmosis, also cause mental retardation in children. Despite the fact that the mother may not suffer from the infection, the developing fetus becomes infected through the maternal body and has damage to certain areas of the central nervous system and other organs and systems.
Pregnant women who drink alcoholic beverages are at risk of having a mentally retarded child through a condition known as fetal alcohol syndrome (FAS). This is a common and preventable cause of PVD.
Some drugs (such as cocaine or amphetamines), when taken during pregnancy, can harm the baby's mental development.
Maternal malnutrition and radiation exposure during pregnancy can also cause similar developmental disorders.

Birth injuries

Oxygen starvation in the fetus during childbirth is also a cause of mental retardation. Babies born prematurely are usually mentally retarded, especially if the baby weighs less than 1.5 kg.

Disorders that occur after birth

PVD can be caused by problems such as lead or mercury poisoning, severe malnutrition, accidents that cause severe head injuries, interruption of oxygen supply to the brain (such as near drowning), or diseases such as encephalitis, meningitis and untreated hypothyroidism in infants.

It is important to understand: before starting treatment and correction of the child’s condition, it is necessary to determine the roots of the problem.

Main types of ZPR

Mental retardation is classified into four main types.

ZPR of a constitutional nature

Reasons: genetics.
Symptoms: playful mood regardless of age, unstable manifestations of affection, disorder, frequent mood swings.

ZPR of a somatogenic nature

Causes: serious illnesses with complications of brain function. Pathology can be caused by previous surgical interventions, diseases of cardio-vascular system, dystrophies of various origins and severity, allergic manifestations.
Symptoms: causeless whims, increased nervousness, excessive complex.

Mental retardation disorder of a psychogenic nature

Reasons: lack of parental attention and love, errors in upbringing, unfavorable living conditions.
Symptoms: psychosis, attacks of nervousness, disturbance intellectual sphere, which results in general psychological immaturity.

ZPR of cerebral-organic nature

Causes: intrauterine disorders that can occur due to a woman taking alcohol, toxic and narcotic substances during pregnancy. Sometimes the cause of the development of this particular type of pathology can be birth injuries and oxygen starvation brain during childbirth.
Symptoms: instability of mental state.

Symptoms of mental retardation in children at different age intervals

Sometimes signs of the disorder can be observed in children immediately after birth, and in some cases, problems begin to appear at school age and later. It is important to learn to recognize your baby’s characteristics in time.

Let's look at the main alarming symptoms for different age categories of children:

Mental developmental development up to one year: late starts to hold up head, crawl, walk, talk, use cutlery.
Signs of mental retardation per year - a quiet, unemotional child, with limited or absent simple words, does not show any reaction when addressed to him.
ZPR 2 years old - no desire to learn something new by repeating after others, a primitive set of words (up to 20), no ability to compose logical phrases and sentences, limited memory skills.
Symptoms of mental retardation in children 3 years old - rapid unconscious speech with swallowing sounds, syllables or word endings, when answering a question, can think for a long time and repeat the question itself, movements are slow or hyperactivity appears, cognize the world no desire, aggressiveness, increased salivation, a narrow range of emotions, signs of cerebral palsy may appear.
Mental retardation 4 years – tearfulness, aggressiveness, emotional instability, causeless laughter or hysteria, underdeveloped speech, ignoring requests from adults, difficulty communicating with others.
Mental retardation in a 5-year-old preschooler – ignoring peers, aggressiveness or complete passivity, sudden changes moods, speech difficulties, especially in constructing even a simple dialogue, difficulties with memory, lack of simple everyday skills.
Mental retardation 6 years old - behavioral disorders, difficulty concentrating, performing basic everyday skills, noticeable lag behind peers in speech, emotional and intellectual development.
Symptoms of mental retardation in children aged 7 years - difficulties with reading, problems with logical problems and mathematical calculations, lack of emotional contact with peers, poor vocabulary, difficulties in voicing their thoughts and requests, problems behavioral nature(aggression, tearfulness, whining, withdrawal, unreasonable laughter, etc.).
Features of mental retardation in adolescents - mental instability, undeveloped self-esteem, no resistance to criticism, trying to avoid the team, psychomotor disinhibition and excitability, suppressed cognitive activity, limited memory (usually short-term), impaired verbal-figurative, visual-figurative and visual-effective thinking , speech disorders, lack of motivation, development of infantilism. A characteristic symptom of psychophysical infantilism is hysteroid psychopathy and depressive states.

IN early age It is problematic to diagnose mental retardation. Maximum severe symptoms can be observed in preschool age, when self-service skills, spatial orientation, communication skills, fully developed memory and formed speech should already be formed.
Regardless of the age at which mental retardation was diagnosed, correction this state must begin immediately.

Screening and tests

Diagnosis of mental retardation can only be performed by a certified psychologist capable of administering, scoring, and interpreting an intelligence or cognition test.
Screening for the disease includes tests to analyze the child's intellectual and adaptive development, including the Denver Abnormal Development Test and IQ testing (these tests are performed on children and adolescents under 18 years of age.)

Children with an IQ of less than 70 and with limitations in two or more areas of adaptive behavior (eg, motor skills, communication abilities, self-help and independent living skills, and other daily living skills) generally may be considered intellectually disabled.

Complications and consequences

Late diagnosis of children with mental retardation and correction of this complex mental state can forever leave an imprint on the child’s life. Adolescence for a full-fledged child goes through difficulties, and for a child with mental retardation, inferiority complexes may additionally develop, which provoke a number of difficulties in communicating with the opposite sex and with peers.
Low self-esteem leaves a negative imprint on academic performance and aspiration, and as a result, increased conflict appears in the team and family. Neglected situations can lead to irreversible consequences – severe form depression and suicide.
ZPR can provoke the development of chronic and incurable defects: various mental disorders, violation of written, speech, everyday skills.
IN mature age can be observed by working in a team, creating a family.

Rules for raising a child with mental retardation

After hearing a diagnosis, every parent, first of all, must emotionally gather themselves and prepare for the difficult struggle for a full-fledged future for the child. After all, in medical practice There are quite a lot of examples where children, after being diagnosed with mental retardation, studied in regular schools and demonstrated, if not high, but average educational success.
The second thing you need to understand is that something doesn’t work out for a child not because of laziness, it’s just that everything comes a little more difficult and slower to him.
There is no need to independently develop a sense of inferiority in your baby with constant reproaches and abuse. The main task of parents is to support, motivate, help, demonstrate understanding and love.

Is it possible to prevent PPD?

Does not exist a certain way prevent mental retardation. Improved health care, prenatal testing, and public health education can help prevent some cases of BD.
People who want to become parents can get genetic counseling to determine the likelihood of mental retardation from an inherited disorder. Medical tests such as amniocentesis, chorionic villus sampling, and ultrasonography may help identify hereditary disorders metabolism and chromosomes associated with mental retardation.
Vaccinations can protect pregnant women from infections that harm the fetus.
Newborn blood test screening can detect some disorders at birth, allowing for more early treatment. It is also important to protect children from lead poisoning and head injuries.

* Amniocentesis (am-nee-o-sen-TEE-sis) is a test in which a long, thin needle is inserted into the mother's uterus to obtain a sample of amniotic fluid. Fetal cells in the fluid are examined for genetic defects.
* Chorionic villus sampling (VOR-lus KOR-ee-on-ik sampling) is a test in which a small tube is inserted through the cervix and a small piece of the placenta supporting the fetus is removed for genetic testing.
* Ultrasonography (ul-tra-so-NOG-ra-fee) is a painless test that uses high-frequency sound waves to record and display the shape of the fetus in the mother's uterus.

Life with mental retardation

There is no cure for mental retardation. Treatment focuses on helping people by building learning, behavior and self-care skills. For children with mental retardation, the support of parents, specially trained teachers and society helps them achieve their maximum abilities and become a full-fledged part of society.

ICD-10 code

F80-F89 - mental development disorder

A person’s mental development is no less important than physical development. Each process has its own time to arise and develop. However, it is difficult to say when a person begins to remember and to what extent. It's also difficult to talk about others mental processes, therefore, children with mental retardation are identified at an early school age, when it is already possible to note educational failure and inability to adapt socially - the main features and characteristics of children with. The learning of such children becomes slower and more difficult than that of schoolchildren with normal development.

Psychologists note children with mental retardation more and more often, which is most likely due to social conditions life. After all, mental activity must not only manifest itself, but also have its own development. And it happens only thanks to external conditions life. If parents do not create special conditions in which the child will develop mental level, then he will lag behind his peers. The same applies to bodily development: if you do not take care of your body, then it will not be strong, resilient, or tempered.

It should be understood that mental retardation is not mental retardation or infantilism, but these diagnoses can be made if mental retardation is observed already in adolescence. Usually this pathology is eliminated at the stage of primary school age, if in fact everything is normal with the child, it’s just that no one has been involved in his mental development.

If the child is healthy, then he has only two problems: social inadaptability and academic failure. These factors are quickly eliminated when the child begins to study. At the same time, his physiological parameters in development remain within normal limits.

If the child is unwell, then his mental underdevelopment is often the result of various diseases, which can also be noted by physical underdevelopment. For example, oligophrenia has many signs of its manifestation, which are noted not only in the mental and emotional development, but also on the physical body.

Who are children with mental retardation?

Children with mental retardation (mental retardation), according to the online magazine website, are marked by a delay in the development of mental activity in whole or in part. So, they differ:

Immaturity of thinking.
Limited vocabulary.
Dominance of gaming interests.
Lack of motivation.
Instant oversaturation with activities.

Depending on the type of developmental delay observed, 4 groups of children are distinguished:

The first group includes children of a constitutional type, whose height is short, and whose facial features remain childish even at school age. Their distinctive feature is emotional immaturity. They seemed to have stopped in their development. They prefer to play, they are characterized by mood swings and emotional outbursts.
The second group includes children with somatogenic signs of mental retardation. This means that such children often suffer from various body disorders, in particular bronchial asthma, stomach diseases and bronchitis. They do not experience a delay in the development of the central nervous system, but rather its late maturation.
The third group includes children with psychogenic symptoms that arise in them as a result of an unfavorable situation in the family. Thus, a child can be raised with excessive care, neglect or under constant strict control. If a child grows up neglected, he loses initiative, intellectual development is delayed, and emotional impulsive outbursts are observed. With overprotection, the child develops self-centeredness and weak character traits, and an inability to be independent.
The fourth group includes children with cerebral-organic signs that develop as a result of poisoning or intoxication of the mother during pregnancy, asphyxia or difficult childbirth. It can also develop as a result of a developmental disorder of the central nervous system before 2 years of age.

Development of children with mental retardation

Delayed mental development is not detected earlier than the period when the child begins to be educated. Even at preschool age, it is impossible to determine exactly how well a child is developing. However, already in elementary school it becomes clear that about 50% of all underachieving children are sick with mental retardation. This is noted in:

Personal immaturity.
Retardation in intellectual development.
Low speeds of mental processes.

A child enters school with a limited amount of knowledge. Moreover, all this can be corrected, which is what teachers in special institutions do. The child has practically no intellectual work skills, so teachers compensate for all the shortcomings of upbringing. The skills of individual goal setting and teamwork are also developed here.

The development of children with mental retardation is carried out through a variety of work activities. The child does not play, but learns real life directly through work, where he performs actions that are feasible and understandable to his mind. It all starts with minor work and ends with complex tasks, where you already need to think, choose, and build an action plan.

The following help in eliminating SPD:

Practical lessons.
Creation.

Let’s not forget that it is creative tasks that allow a child to open up, pacify his emotions, realize them, and also solve various problems. Practical activities help the child adapt to the world around him. By practicing useful skills, a child learns about the world.

One should not think that children with mental retardation are a final diagnosis. All purchased psychical deviations can be made up, which will allow the child to adolescence reach the level of your peers.

Characteristics of children with mental retardation

Children with mental retardation are very difficult to recognize in preschool age, but they demonstrate their characteristics well already in school, compared to their peers. Features of children with mental retardation are:

Lack of necessary skills and knowledge that would allow the child to be ready to learn school curriculum. Speech in children with mental retardation is quite behind age characteristics. The child has a small number of words, so he is not able to compose a short story. His sentences are often short and even poorly composed. At the same time, the articulatory apparatus itself is also quite undeveloped.
They cannot write, read, or speak.
They lack voluntary activity skills. The child is unable to motivate himself to do any activity because he does not even understand why he needs it.
Inability to adhere to school procedures and rules. Naivety, directness and lack of independence make the child unable to build relationships with other children and teachers. With ZPR it is quite difficult to adhere to certain frameworks and rules. At the same time, the child runs away into the game with pleasure. However, he cannot play role-playing games that cause him fear.
Difficulties in mastering school material. A child with mental retardation needs repeated repetitions, simple knowledge and visual material to remember something. And this takes a lot of time.
Low performance compared to peers.
Impulsiveness, physical activity, lethargy, disinhibition.
Lack of curiosity and inquisitiveness.
Focusing on minor details, missing logical connections, inability to reproduce the order of events correctly.
Tendency to jump from topic to topic.
Superficiality of learning. Usually a child pays attention to what first catches his eye, missing everything else and not getting to the point.
Reluctance to strain your mind, which forces the child to perform actions that are familiar to him.
Anxiety around strangers.
Lack of desire to ask adults questions.
Lack of need for active communication with adults and peers.
Difficulties in adapting to a team, interest in games, aggressive behavior, emotional instability, fussiness, mood swings, lack of self-control, familiarity, mannerisms, uncertainty.
Fear of everything new and unknown.
failure to long time do work. The maximum amount of time a child can devote to studying is 15 minutes.

Working with children with mental retardation

When a child has a mental retardation, they should be treated by specialists who work on special program. There are stages here, which begin with first correcting all compensatory mechanisms. The teacher Vygotsky proposed giving children work that is understandable and familiar to them, feasible, and within their reach.

Teachers direct their work to improve the health of the child’s body, to stabilize it nervous processes(emotionality), on the development of sensory motor skills, and then on replenishing the missing knowledge. Children with mental retardation can be brought up to the level of their peers, but this will take time and patience.

Practical activity becomes the main thing in the whole process, since only through work can a child understand why he performs certain actions and gains specific knowledge.

Education of children with mental retardation

Education of children with mental retardation should take place in specialized schools, since they are not able to master school material at the pace offered in educational institutions. In order not to further traumatize the child and not make him an outcast in the class, you need to identify signs of mental retardation in him in time and send him to a specialized institution.

Training will be carried out according to an easier and different program. At first, children will be taught the basics, and then the knowledge that is taught at school. With proper work, a child can be completely cured, unless his condition is associated with congenital or acquired pathologies of the body.

Bottom line

Parents are responsible for the development of their child. However, the problem of many modern parents is that they mainly give birth to children in order to compensate for their shortcomings, solve problems, or “on the fly.” When a baby appears, they may not be cared for, not given due attention, or, conversely, overprotected. All this leads to the child becoming mentally unhealthy.

Disorders are not always obvious developmental deviations. A child may be completely healthy at all levels, but lag behind in learning and not want to make contact with peers. This is often due to the lack of an individual approach from adults to the child, who can gain knowledge and contact with others.

These three ominous letters are nothing more than mental retardation. Doesn't sound too nice, does it? Unfortunately, today you can often find such a diagnosis in a child’s medical record.

These three ominous letters are nothing more than impaired mental function. Doesn't sound too nice, does it? Unfortunately, today in medical card It is not uncommon to encounter such a diagnosis in a child.

Over the past few years, there has been increased interest in the problem of ZPR, and there has been a lot of controversy surrounding it. All this is due to the fact that such a deviation in mental development itself is very ambiguous and can have many different prerequisites, causes and consequences. A phenomenon that is complex in its structure requires close and thorough analysis and an individual approach to each specific case. Meanwhile, the diagnosis of mental retardation is so popular among doctors that some of them, based on a minimal amount of information and relying on their professional instincts, unjustifiably easily sign their autograph under it, often without thinking about the consequences. And this fact is already quite enough to get to know the problem of ZPR more closely.

What suffers

ZPR belongs to the category of mild deviations in mental development and occupies an intermediate place between normality and pathology. Children with mental retardation do not have such severe developmental disabilities as mental retardation, primary underdevelopment of speech, hearing, vision, or motor system. The main difficulties they experience are primarily related to social (including school) adaptation and learning.

The explanation for this is the slowdown in the rate of maturation of the psyche. It should also be noted that in each individual child, mental retardation may manifest itself differently and differ both in time and in the degree of manifestation. But, despite this, we can try to identify a range of developmental features that are characteristic of the majority of children with mental retardation.

Researchers call the most striking sign of mental retardation immaturity of the emotional-volitional sphere; in other words, it is very difficult for such a child to make a volitional effort on himself, to force himself to do something. And from here they inevitably appear attention disorders: its instability, decreased concentration, increased distractibility. Attention disorders may be accompanied by increased motor and speech activity. Such a complex of deviations (attention deficit + increased motor and speech activity), not complicated by any other manifestations, is currently referred to as “attention deficit hyperactivity disorder” (ADHD).

Perception disturbance is expressed in the difficulty of constructing a holistic image. For example, it may be difficult for a child to recognize familiar objects from an unfamiliar perspective. This structured perception is the cause of insufficient, limited knowledge about the world around us. The speed of perception and orientation in space also suffers.

If we talk about memory features in children with mental retardation, one pattern was found here: they remember visual (non-verbal) material much better than verbal material. In addition, it was found that after a course of special training various techniques The memory performance of children with mental retardation improved even compared to normally developing children.

ZPR is often accompanied speech problems, related primarily to the pace of its development. Other Features speech development V in this case may depend on the form of severity of mental retardation and the nature of the underlying disorder: for example, in one case there may be only a slight delay or even compliance normal level development, while in another case there is a systemic underdevelopment of speech - a violation of its lexico-grammatical aspect.

In children with mental retardation there is delay in the development of all forms of thinking; it is detected primarily during solving problems of verbal and logical thinking. Back to top schooling Children with mental retardation do not fully master all the intellectual operations necessary to complete school assignments (analysis, synthesis, generalization, comparison, abstraction).

At the same time, the developmental disability is not an obstacle to the development of general education programs, which, however, require certain adjustments in accordance with the characteristics of the child’s development.

Who are these children

Experts' answers to the question of which children should be included in the group with mental retardation are also very ambiguous. Conventionally, they can be divided into two camps.

The first adhere to humanistic views, believing that the main causes of mental retardation are primarily social and pedagogical in nature (unfavorable family conditions, lack of communication and cultural development, difficult living conditions). Children with mental retardation are defined as maladapted, difficult to teach, and pedagogically neglected. This view of the problem prevails in Western psychology, and Lately it has become widespread in our country too. Many researchers provide evidence that mild forms of intellectual underdevelopment tend to concentrate in certain social strata, where parents have an intellectual level below the average. It is noted that hereditary factors play a significant role in the genesis of underdevelopment of intellectual functions.

It is probably best to take both factors into account.

Thus, as the reasons leading to mental development delays, domestic specialists M.S. Pevzner and T.A. Vlasov is distinguished as follows.

Unfavorable course of pregnancy:

maternal illnesses during pregnancy (rubella, mumps, influenza);
chronic maternal diseases (heart disease, diabetes, thyroid disease);
toxicosis, especially in the second half of pregnancy;
toxoplasmosis;
intoxication of the mother’s body due to the use of alcohol, nicotine, drugs, chemicals and medicines, hormones;
incompatibility of the blood of mother and baby according to the Rh factor.

Pathology of childbirth:

injuries due to mechanical damage to the fetus when using various means of obstetrics (for example, applying forceps);
asphyxia of newborns and its threat.

Social factors:

pedagogical neglect as a result of limited emotional contact with the child both in the early stages of development (up to three years) and in later age stages.

Types of child development delays

Mental retardation is usually divided into four groups. Each of these types is due to certain reasons and has its own characteristics of emotional immaturity and impaired cognitive activity.

The first type is ZPR of constitutional origin. This type is characterized by a pronounced immaturity of the emotional-volitional sphere, which seems to be at an earlier stage of development. Here we are talking about the so-called mental infantilism. It is necessary to understand that mental infantilism is not a disease, but rather a certain complex of sharpened character traits and behavioral characteristics, which, however, can significantly affect the child’s activities, primarily his educational abilities, his adaptive abilities to a new situation.

Such a child is often not independent, has difficulty adapting to new conditions for him, is often strongly attached to his mother and feels helpless in her absence; it is characterized by a heightened background of mood, a violent manifestation of emotions, which at the same time are very unstable. TO school age such a child still has gaming interests in the foreground, whereas normally they should be replaced by learning motivation. It is difficult for him to make any decision without outside help, make a choice, or make any other volitional effort on himself. Such a child can behave cheerfully and spontaneously; his developmental delay is not noticeable, but when compared with his peers, he always seems a little younger.

To the second group - somatogenic origin- include weakened, often ill children. As a result of long-term illness, chronic infections, allergies, birth defects development, mental retardation may occur. This is explained by the fact that during a long illness, against the background of general weakness of the body mental condition the baby also suffers and, therefore, cannot fully develop. Low cognitive activity, increased fatigue, dulling of attention - all this creates a favorable situation for slowing down the pace of mental development.

This also includes children from families with overprotection - excessive attention to the upbringing of the child. When parents care too much about their beloved child, they do not let him go a single step, they do everything for him, fearing that the child may harm himself, that he is still small. In such a situation, loved ones, considering their behavior as an example of parental care and guardianship, thereby hinder the child’s expression of independence, and therefore, knowledge of the world around him, and the formation of a full-fledged personality. It should be noted that the situation of overprotection is very common in families with a sick child, where pity for the baby and constant worry about his condition, the desire to supposedly make his life easier ultimately turn out to be bad helpers.

The next group is ZPR psychogenic origin. The main role is given to social situation baby development. The cause of this type of mental retardation is dysfunctional situations in the family, problematic upbringing, and mental trauma. If there is aggression and violence in the family towards a child or other family members, this may lead to a predominance in the child’s character of such traits as indecisiveness, lack of independence, lack of initiative, timidity and pathological shyness.

Here, in contrast to the previous type of mental retardation, there is the phenomenon of hypoguardianship, or insufficient attention to the upbringing of the child. The child grows up in a situation of neglect and pedagogical neglect. The consequence of this is a lack of ideas about moral standards of behavior in society, an inability to control one’s own behavior, irresponsibility and inability to answer for one’s actions, and an insufficient level of knowledge about the world around us.

The fourth and final type of mental retardation is of cerebral-organic origin. It occurs more often than others, and the prognosis further development for children with this type of mental retardation, compared to the previous three, it is usually the least favorable.

As the name suggests, the basis for identifying this group of mental retardation is organic disorders, namely, insufficiency of the nervous system, the causes of which can be: pathology of pregnancy (toxicosis, infections, intoxication and trauma, Rh conflict, etc.), prematurity, asphyxia, birth trauma, neuroinfections. With this form of mental retardation, the so-called minimal brain dysfunction (MMD) occurs, which is understood as a complex of mild developmental disorders that manifest themselves, depending on the specific case, in a very diverse manner in various areas of mental activity.

MMD researchers have identified the following risk factors for its occurrence:

late age of the mother, height and weight of the woman before pregnancy, beyond the age norm, first birth;
pathological course of previous births;
chronic maternal diseases, especially diabetes, Rhesus conflict, premature birth, infectious diseases during pregnancy;
psychosocial factors such as unwanted pregnancy, risk factors of a large city (long daily commute, city noise);
presence of mental, neurological and psychosomatic diseases in family;
pathological birth with forceps, caesarean section and so on.

Children of this type are distinguished by weakness in the expression of emotions, poverty of imagination, and disinterest in how others evaluate themselves.

About prevention

The diagnosis of mental retardation appears in the medical record most often closer to school age, at 5-6 years old, or already when the child is directly faced with learning problems. But with timely and competently constructed correctional pedagogical and medical care partial and even complete overcoming of this developmental deviation is possible. The problem is that diagnosing mental retardation in the early stages of development seems quite problematic. His methods are based primarily on comparative analysis development of the child with age-appropriate standards.

Thus, the first place comes prevention of mental retardation. Recommendations on this matter are no different from those that can be given to any young parents: first of all, this is the creation of the most favorable conditions for pregnancy and childbirth, avoidance of the risk factors listed above, and of course, close attention to the development of the baby from the very beginning. days of his life. The latter simultaneously makes it possible to recognize and correct developmental deviations in a timely manner.

First of all, it is necessary to show the newborn to a neurologist. Today, as a rule, all children after 1 month are sent for examination to this specialist. Many receive referrals directly from the maternity hospital. Even if both pregnancy and childbirth went perfectly, your baby feels great, and there is not the slightest reason for concern - do not be lazy and visit a doctor.

A specialist, having checked the presence or absence of various reflexes, which, as is known, accompany the child throughout the entire period of newbornness and infancy, will be able to objectively assess the development of the baby. The doctor will also check your vision and hearing and note the peculiarities of interaction with adults. If necessary, he will prescribe neurosonography - ultrasound examination, which will provide valuable information about brain development.

Knowing the age norms, you yourself can monitor psychomotor development crumbs. Today, on the Internet and various printed publications, you can find many descriptions and tables that show in detail what a baby should be able to do at a given age, starting from the first days of life. There you can also find a list of behavioral features that should alert young parents. Be sure to read this information, and if you have even the slightest suspicion, immediately go to see a doctor.

If you have already been to an appointment and the doctor has deemed it necessary to prescribe medications, do not neglect his recommendations. And if doubts haunt you, or the doctor does not inspire confidence, show the child to another, third specialist, ask questions that concern you, try to find the maximum amount of information.

If you are confused by a medicine prescribed by a doctor, do not hesitate to ask more about it, let the doctor tell you how it works, what substances are included in it, and why your child needs it. After all, under the hour, under threatening-sounding names, relatively “harmless” drugs are hidden, acting as a kind of vitamins for the brain.

Of course, many doctors are reluctant to share such information, not without reason believing that there is no need to introduce people who are not related to medicine into purely professional matters. But trying is not torture. If you were unable to talk to a specialist, try to find people who have faced similar problems. Here again the Internet and relevant literature will come to the rescue. But, of course, you shouldn’t take on faith all the statements of parents from Internet forums, because most of them do not have medical education, but only share their personal experience and observations. It would be more effective to use the services of an online consultant who can give qualified recommendations.

In addition to visiting doctors' offices, several points can be highlighted regarding the interaction of parents with children, which are also necessary for the normal and full development of the child. The components of communication with a baby are familiar to every caring mother and are so simple that we don’t even think about their colossal impact on the growing body. This bodily-emotional contact with the baby. Skin contact means any touching of the child, hugging, kissing, stroking the head. Since in the first months after birth the baby’s tactile sensitivity is very developed, physical contact helps him navigate a new environment and feel more confident and calm. The baby must be picked up, caressed, stroked not only on the head, but also all over the body. The touch of gentle parental hands on the baby’s skin will allow him to form the correct image of his body and adequately perceive the space around him.

A special place is given to eye contact, which is the main and most effective way of transmitting feelings. This is especially true, of course, for infants who do not yet have access to other means of communication and expression of emotions. A kind look reduces the baby’s anxiety, has a calming effect on him, and gives him a feeling of security. And, of course, it is very important to pay all your attention to the baby. Some people believe that by indulging a baby's whims, you are spoiling him. This is, of course, not true. After all, the little man feels so insecure in a completely unfamiliar environment that he constantly needs confirmation that he is not alone, that someone needs him. If a child did not receive enough attention in early childhood, this will certainly affect him later.

Needless to say, a baby with certain developmental disorders needs the warmth of his mother’s hands, her gentle voice, kindness, love, attention and understanding a thousand times more than his healthy peers.

What is ZPR?

These three ominous letters are nothing more than delay mental development. Doesn't sound too nice, does it? Unfortunately, today you can often find such a diagnosis in a child’s medical record.

What suffers

Researchers call the most striking sign of mental retardationimmaturity of the emotional-volitional sphere; in other words, it is very difficult for such a child to make a volitional effort on himself, to force himself to do something. And from here they inevitably appearattention disorders: its instability, decreased concentration, increased distractibility. Attention disorders may be accompanied by increased motor and speech activity. Such a complex of deviations (attention deficit + increased motor and speech activity), not complicated by any other manifestations, is currently referred to as “attention deficit hyperactivity disorder” (ADHD).

Perception disturbanceis expressed in the difficulty of constructing a holistic image. For example, it may be difficult for a child to recognize familiar objects from an unfamiliar perspective. This structured perception is the cause of insufficient, limited knowledge about the world around us. The speed of perception and orientation in space also suffers.

If we talk aboutmemory featuresin children with mental retardation, one pattern was found here: they remember visual (non-verbal) material much better than verbal material. In addition, it was found that after a course of special training in various memorization techniques, the performance of children with mental retardation improved even in comparison with normally developing children.

ZPR is often accompanied speech problems , related primarily to the pace of its development. Other features of speech development in this case may depend on the form of severity of mental retardation and the nature of the main disorder: for example, in one case it may be only a slight delay or even compliance with the normal level of development, while in another case there is a systemic underdevelopment of speech - a violation of its lexical grammatical side.

In children with mental retardation there isdelay in the development of all forms of thinking; it is detected primarily during solving problems of verbal and logical thinking. By the beginning of school, children with mental retardation do not fully master all the intellectual operations necessary to complete school assignments (analysis, synthesis, generalization, comparison, abstraction).

Who are these children

Experts' answers to the question of which children should be included in the group with mental retardation are also very ambiguous. Conventionally, they can be divided into two camps.

The first adhere to humanistic views, believing that the main causes of mental retardation are primarily social and pedagogical in nature (unfavorable family conditions, lack of communication and cultural development, difficult living conditions). Children with mental retardation are defined as maladapted, difficult to teach, and pedagogically neglected. This view of the problem prevails in Western psychology, and recently it has become widespread in our country. Many researchers provide evidence that mild forms of intellectual underdevelopment tend to concentrate in certain social strata, where parents have an intellectual level below the average. It is noted that hereditary factors play a significant role in the genesis of underdevelopment of intellectual functions.

It is probably best to take both factors into account.

Thus, as the reasons leading to mental development delays, domestic specialists M.S. Pevzner and T.A. Vlasov is distinguished as follows.

Unfavorable course of pregnancy:

maternal illnesses during pregnancy (rubella, mumps, influenza);
chronic maternal diseases (heart disease, diabetes, thyroid disease);
toxicosis, especially in the second half of pregnancy;
toxoplasmosis;
intoxication of the mother’s body due to the use of alcohol, nicotine, drugs, chemicals and medications, hormones;
incompatibility of the blood of mother and baby according to the Rh factor.

Pathology of childbirth:

injuries due to mechanical damage to the fetus when using various means of obstetrics (for example, applying forceps);
asphyxia of newborns and its threat.

Social factors:

pedagogical neglect as a result of limited emotional contact with the child both in the early stages of development (up to three years) and in later age stages.

Types of Delay

Mental retardation is usually divided into four groups. Each of these types is due to certain reasons and has its own characteristics of emotional immaturity and impaired cognitive activity.

The first type is ZPR of constitutional origin. This type is characterized by a pronounced immaturity of the emotional-volitional sphere, which seems to be at an earlier stage of development. Here we are talking about the so-called mental infantilism. It is necessary to understand that mental infantilism is not a disease, but rather a certain complex of sharpened character traits and behavioral characteristics, which, however, can significantly affect the child’s activities, primarily his educational abilities, his adaptive abilities to a new situation.

Such a child is often not independent, has difficulty adapting to new conditions for him, is often strongly attached to his mother and feels helpless in her absence; it is characterized by a heightened background of mood, a violent manifestation of emotions, which at the same time are very unstable. By school age, such a child still has gaming interests in the foreground, whereas normally they should be replaced by educational motivation. It is difficult for him to make any decision without outside help, make a choice, or make any other volitional effort on himself. Such a child can behave cheerfully and spontaneously; his developmental delay is not noticeable, but when compared with his peers, he always seems a little younger.

To the second group - somatogenic origin- include weakened, often ill children. As a result of long-term illness, chronic infections, allergies, and congenital malformations, mental retardation may occur. This is explained by the fact that during a long illness, against the background of general weakness of the body, the baby’s mental state also suffers, and, therefore, cannot fully develop. Low cognitive activity, increased fatigue, dulling of attention - all this creates a favorable situation for slowing down the pace of mental development.

The next group is mental retardation of psychogenic origin. The main role is given to the social situation of the baby’s development. The cause of this type of mental retardation is dysfunctional situations in the family, problematic upbringing, and mental trauma. If there is aggression and violence in the family towards a child or other family members, this may lead to a predominance in the child’s character of such traits as indecisiveness, lack of independence, lack of initiative, timidity and pathological shyness.

The fourth and final type of mental retardation is of cerebral-organic origin. It occurs more often than others, and the prognosis for further development for children with this type of mental retardation, compared with the previous three, is usually the least favorable.

MMD researchers have identified the followingrisk factors for its occurrence:

late age of the mother, height and weight of the woman before pregnancy, beyond the age norm, first birth;
pathological course of previous births;
chronic maternal diseases, especially diabetes, Rh conflict, premature birth, infectious diseases during pregnancy;
psychosocial factors such as unwanted pregnancy, risk factors of a large city (long daily commute, city noise);
presence of mental, neurological and psychosomatic diseases in the family;
pathological birth with forceps, cesarean section, etc.

Children of this type are distinguished by weakness in the expression of emotions, poverty of imagination, and disinterest in how others evaluate themselves.

About prevention

The diagnosis of mental retardation appears in the medical record most often closer to school age, at 5-6 years old, or already when the child is directly faced with learning problems. But with timely and well-structured correctional, pedagogical and medical assistance, partial and even complete overcoming of this developmental deviation is possible. The problem is that diagnosing mental retardation in the early stages of development seems quite problematic. His methods are based primarily on a comparative analysis of the child’s development with age-appropriate norms.

Thus, the first place comesprevention of mental retardation. Recommendations on this matter are no different from those that can be given to any young parents: first of all, this is the creation of the most favorable conditions for pregnancy and childbirth, avoidance of the risk factors listed above, and of course, close attention to the development of the baby from the very beginning. days of his life. The latter simultaneously makes it possible to recognize and correct developmental deviations in a timely manner.

A specialist, having checked the presence or absence of various reflexes, which, as is known, accompany the child throughout the entire period of newbornness and infancy, will be able to objectively assess the development of the baby. The doctor will also check your vision and hearing and note the peculiarities of interaction with adults. If necessary, he will prescribe neurosonography - an ultrasound examination that will provide valuable information about brain development.

Knowing the age norms, you yourself will be able to monitor the psychomotor development of the baby. Today, on the Internet and various printed publications, you can find many descriptions and tables that show in detail what a baby should be able to do at a given age, starting from the first days of life. There you can also find a list of behavioral features that should alert young parents. Be sure to read this information, and if you have even the slightest suspicion, immediately go to see a doctor.

Of course, many doctors are reluctant to share such information, not without reason believing that there is no need to introduce people who are not related to medicine into purely professional matters. But trying is not torture. If you were unable to talk to a specialist, try to find people who have faced similar problems. Here again the Internet and relevant literature will come to the rescue. But, of course, you should not take on faith all the statements of parents from Internet forums, because most of them do not have a medical education, but only share their personal experiences and observations. It would be more effective to use the services of an online consultant who can give qualified recommendations.

In addition to visiting doctors' offices, several points can be highlighted regarding the interaction of parents with children, which are also necessary for the normal and full development of the child. The components of communication with a baby are familiar to every caring mother and are so simple that we don’t even think about their colossal impact on the growing body. Thisbodily-emotional contact with the baby. Skin contactmeans any touching of the child, hugging, kissing, stroking the head. Since in the first months after birth the baby’s tactile sensitivity is very developed, physical contact helps him navigate a new environment and feel more confident and calm. The baby must be picked up, caressed, stroked not only on the head, but also all over the body. The touch of gentle parental hands on the baby’s skin will allow him to form the correct image of his body and adequately perceive the space around him.

Today we will try to understand one abbreviation that brings fear to many parents. ZPR - what is it? Can this condition be corrected?

In medicine, this is referred to as hyperactivity: the child fidgets, cannot stand still, is unable to wait for his turn in a game, answers without hearing the question to the end, and is unable to speak or play quietly.

Violations with ZPR

What it is is now clear. Mental retardation is often expressed in the rate of speech development. As a rule, a child with this communication problem pays more attention to gestures and intonation, having limited lexicon. Violations in this case are reversible and can be corrected. Every year the child catches up more and more with his peers, overcoming speech impairment.

Such children also exhibit a lag in all forms of thinking (analysis, generalization, synthesis, comparison). They cannot identify, for example, the main features when generalizing. Answering the question: “How can you call a dress, trousers, socks, sweater in one word?” - such a child will say: “This is everything a person needs” or “This is all in our closet.” At the same time, children with mental retardation can easily supplement the proposed group of items. When comparing objects, this process is carried out according to random characteristics. “What is the difference between people and animals?” - “People wear coats, but animals don’t.”

Problems of communicative adaptation of children with mental retardation, what is it?

A distinctive feature of children with mental retardation is the problematic nature of interpersonal relationships for them, both with peers and with adults. The need for communication in such children is reduced. In relation to the adults on whom they depend, many are found increased anxiety. Such children are attracted to new people much less than new objects. When problems arise, the child would rather stop his activities than turn to anyone for help.

Children with mental retardation, as a rule, are not ready for “warm” relationships with peers, reducing them to purely “business” ones. Moreover, in games, the interest of only one side is taken into account, and the rules are always rigid, excluding any variations.