Zpr treatment. What is ZPR (delayed psychoverbal development in children) With a pronounced form of mental retardation, it is possible

Mental retardation (PDD) is a violation of normal development, in which a child who has reached school age continues to remain in the circle of preschool, play interests. The concept of "delay" emphasizes the temporary (discrepancy between the level of development and age) and, at the same time, the temporary nature of the delay, which is overcome with age the more successfully, the sooner adequate conditions for the education and development of children of this category are created.

In the psychological, pedagogical, as well as medical literature, other approaches are used to the considered category of students: "children with learning disabilities", "learning disabilities", "nervous children". However, the criteria on the basis of which these groups are distinguished do not contradict the understanding of the nature of mental retardation. In accordance with one socio-pedagogical approach, such children are called “children at risk” (GF Kumarina).

Study history.

The problem of mild deviations in mental development arose and acquired special significance, both in foreign and domestic science only in the middle of the 20th century, when, due to the rapid development of various fields of science and technology and the complication of the programs of general education schools, a large number of children appeared who were experiencing difficulties in learning. Educators and psychologists attached great importance to the analysis of the reasons for this failure. Quite often, it was explained by mental retardation, which was accompanied by the sending of such children to auxiliary schools that appeared in Russia in 1908 - 1910.

However, during clinical examination, more and more often, many of the children who poorly mastered the curriculum of the general education school failed to detect the specific features inherent in mental retardation. In the 50s and 60s. This problem acquired special significance, as a result of which, under the leadership of M.S. Pevzner, a student of L.S.Vygotsky, a specialist in the field of mental retardation clinic, a comprehensive study of the causes of academic failure was started. The sharp increase in academic failure against the background of the complication of educational programs made her assume the existence of some forms of mental deficiency, manifested in conditions of increased educational requirements. A comprehensive clinical, psychological and pedagogical examination of persistently unsuccessful pupils from schools in various regions of the country and an analysis of a huge array of data formed the basis for the formulated ideas about children with mental retardation (MDD).

This is how a new category of abnormal children appeared who were not subject to referral to an auxiliary school and constituted a significant part (about 50%) of unsuccessful students of the general education system. The work of M.S. Pevzner "Children with developmental disabilities: the delimitation of oligophrenia from similar conditions" (1966) and the book "To the teacher about children with developmental disabilities", written jointly with T.A. Vlasova (1967), are the first in the series psychological and pedagogical publications dedicated to the study and correction of cerebrovascular accidents.

Thus, a complex of studies of this developmental anomaly, begun at the Research Institute of Defectology of the USSR Academy of Pedagogical Sciences in the 1960s. under the leadership of T.A. Vlasova and M.S. Pevzner, was dictated by the pressing needs of life: on the one hand, the need to establish the causes of academic failure in mass schools and search for ways to combat it, on the other hand, the need for further differentiation of mental retardation and other clinical disorders cognitive activity.

Comprehensive psychological and pedagogical studies of children with diagnosed mental retardation over the next 15 years made it possible to accumulate a large amount of data characterizing the uniqueness of the mental development of children in this category. For all the studied indicators of psychosocial development, children of this category qualitatively differ from other dysontogenetic disorders, on the one hand, and from "normal" development, on the other, occupying an intermediate position in terms of mental development between mentally retarded and normally developing peers. So, according to the level of intellectual development, diagnosed using the Wechsler test, children with CRD often find themselves in the zone of the so-called borderline mental retardation (IQ from 70 to 90 conventional units).

According to the International Classification, CRD is defined as “a general disorder of psychological development”.

In foreign literature, children with mental retardation are viewed either from a purely pedagogical standpoint and are usually described as children with learning difficulties, or defined as unadapted, mainly due to unfavorable living conditions, pedagogically driven, subjected to social and cultural deprivation. This group of children also includes children with behavior disorders. Other authors, according to the idea that developmental delay, manifested in learning difficulties, is associated with residual (residual) organic brain damage, children of this category are called children with minimal brain damage or children with minimal (mild) brain dysfunction. The term “children with attention deficit hyperactivity disorder” (ADHD) is widely used to describe children with specific partial learning disabilities.

Despite the rather large heterogeneity related to this type of dysontogenetic disorders, they can be defined as follows.

Children with mental retardation include children who do not have pronounced deviations in development (mental retardation, severe speech underdevelopment, pronounced primary deficiencies in the functioning of individual analyzer systems - hearing, vision, motor system). Children of this category experience difficulties in adaptation, including school adaptation, due to various biosocial reasons (residual phenomena of minor injuries of the central nervous system or its functional immaturity, somatic weakness, cerebrasthenic states, immaturity of the emotional-volitional sphere of the type of psychophysical infantilism, as well as pedagogical neglect as a result of unfavorable socio-pedagogical conditions in the early stages of child's ontogenesis). Difficulties experienced by children with CRD can be caused by deficiencies both in the regulatory component of mental activity (lack of attention, immaturity of the motivational sphere, general cognitive passivity and reduced self-control), and in its operational component (reduced level of development of certain mental processes, motor disorders , malfunctioning). The characteristics listed above do not interfere with the development of general educational development programs by children, but make it necessary to adapt them to the psychophysical characteristics of the child.

With the timely provision of a system of correctional-pedagogical, and in some cases, medical assistance, partial and sometimes complete overcoming of this developmental deviation is possible.

For the mental sphere of a child with CRD, a combination of deficient functions with intact ones is typical. Partial (partial) deficiency of higher mental functions can be accompanied by infantile personality traits and behavior of the child. At the same time, in some cases, the child's working capacity suffers, in other cases - arbitrariness in the organization of activity, in third - motivation for various types of cognitive activity, etc.

Mental retardation in children is a complex polymorphic disorder in which different components of their mental, psychological and physical activity suffer in different children.

In order to understand what is the primary disorder in the structure of this deviation, it is necessary to recall the structural and functional model of the brain (according to A.R. Luria). In accordance with this model, three blocks are distinguished - an energy block, a block for receiving, processing and storing information, and a programming, regulation and control block. The coordinated work of these three blocks ensures the integrative activity of the brain and the constant mutual enrichment of all its functional systems.

It is known that in childhood, functional systems with a short time period of development tend to be more damaged. This is typical, in particular, for the systems of the medulla oblongata and median brain. The signs of functional immaturity are shown by systems with a longer postnatal period of development - the tertiary fields of the analyzers and the formation of the frontal region. Since the functional systems of the brain mature heterochronously, a pathogenic factor that acts at different stages of the prenatal or early postnatal period of a child's development can cause a complex combination of symptoms, both mild damage and functional immaturity of various parts of the cerebral cortex.

The subcortical systems provide optimal energy tone to the cerebral cortex and regulate its activity. With non-functional or organic inferiority, neurodynamic disorders occur in children - lability (instability) and exhaustion of mental tone, impaired concentration, balance and mobility of excitation and inhibition processes, the phenomenon of vegetative-vascular dystonia, metabolic-trophic disorders, affective disorders. (ten)

Tertiary fields of analyzers relate to the unit for receiving, processing and storing information from the external and internal environment. The morpho-functional dysfunction of these areas leads to a deficiency of modal-specific functions, which include praxis, gnosis, speech, visual and auditory memory.

The formations of the frontal region belong to the block of programming, regulation and control. Together with the tertiary zones of the analyzers, they carry out complex integrative activity of the brain - they organize the joint participation of various functional subsystems of the brain for the construction and implementation of the most complex mental operations, cognitive activity and conscious behavior. The immaturity of these functions leads to the emergence of mental infantilism in children, the lack of formation of arbitrary forms of mental activity, to violations of the inter-analytic cortical-cortical and cortical-subcortical connections.

Structural and functional analysis shows that with CRD, both the individual above-named structures and their main functions in various combinations can be primarily violated. In this case, the depth of damage and / or the degree of immaturity may vary. This is what determines the variety of mental manifestations encountered in children with CRD. Various secondary layering further enhances intragroup variance within this category.

Causes of mental retardation.

The reasons for mental retardation are manifold. Risk factors for the onset of CRA in a child can be conditionally divided into main groups: biological and social.

Among biological factors, there are two groups: biomedical and hereditary.

Medical and biological reasons include early organic lesions of the central nervous system. Most children have a history of a burdened perinatal period associated primarily with an unfavorable course of pregnancy and childbirth.

According to neurophysiologists, active growth and maturation of the human brain is formed in the second half of pregnancy and the first 20 weeks after birth. The same period is critical, since the structures of the central nervous system become the most sensitive to pathogenic influences that retard growth and impede the active development of the brain.

Risk factors for intrauterine pathology include:

Elderly or very young mother's age,

Mother's burden of chronic somatic or obstetric pathology before or during pregnancy.

All this can manifest itself in a low birth weight of a child, in syndromes of increased neuro-reflex excitability, in sleep and wakefulness disorders, in increased muscle tone in the first weeks of life.

Often, MRI can be caused by infectious diseases in infancy, craniocerebral trauma, severe somatic diseases.

A number of authors identify hereditary factors of CR, which include congenital and including hereditary inferiority of the central nervous system of the child. It is often observed in children with delayed cerebral-organic genesis, with minimal brain dysfunctions. For example, according to clinicians, 37% of patients diagnosed with MMD have brothers and sisters, cousins, and parents with signs of MMD. In addition, 30% of children with locomotor defects and 70% of children with speech defects have relatives with similar disorders in the female or male line.

The literature emphasizes the predominance of boys among patients with CRD, which can be explained by a number of reasons:

Higher vulnerability of the male fetus in relation to pathological influences during pregnancy and childbirth;

A relatively lower degree of functional interhemispheric asymmetry in girls compared to boys, which leads to a greater reserve of compensatory capabilities in case of damage to the brain systems that provide higher mental activity.

Most often in the literature, there are indications of the following adverse psychosocial conditions that aggravate mental retardation in children. It:

Unwanted pregnancy;

Single mother or raised in single-parent families;

Frequent conflicts and inconsistencies in approaches to education;

The presence of a criminal environment;

Low level of education of parents;

Living in conditions of insufficient material security and a dysfunctional life;

Big city factors: noise, long commute to work and home, unfavorable environmental factors.

Features and types of family education;

Early mental and social deprivation of the child;

Prolonged stressful situations in which the child is, etc.

However, a combination of biological and social factors plays an important role in the development of CRA. For example, an unfavorable social environment (outside and within the family) provokes and aggravates the influence of residual organic and hereditary factors on the intellectual and emotional development of the child.

Indicators of the incidence of mental retardation in children are not uniform. For example, according to the Ministry of Education of Russia (1997), over 60% of first-graders are at risk of school, somatic, and psychophysical maladjustment. Of these, about 35% are those who are already in younger groups kindergarten were found obvious disorders of the neuropsychic sphere.

The number of primary school students who do not meet the requirements of the standard school curriculum has increased 2-2.5 times over the past 20 years, reaching 30% or more. According to medical statistics, the deterioration of the health status of students over 10 years of study (in 1994, only 15% of school-age children were considered healthy) is becoming one of the reasons for the difficulties of their adaptation to school loads. The tense regime of school life leads to a sharp deterioration in the somatic and neuropsychiatric health of a weakened child.

The prevalence of mental retardation, according to clinicians, ranges from 2 to 20% in the population, according to some data, it reaches 47%.

This spread is primarily due to the lack of unified methodological approaches to the formulation of the diagnosis of CRI. With the introduction of a comprehensive medical and psychological system for the diagnosis of cerebrovascular disease, its prevalence rates are limited to 3-5% among the child population. (5; 6)

Clinical and psychological characteristics of children with mental retardation.

Clinical characteristics of mental retardation.

In the clinical and psychological-pedagogical literature, there are several classifications of CRA.

Outstanding child psychiatrist G. E. Sukhareva, studying children suffering from persistent school failure, emphasized that the disorders diagnosed in them must be distinguished from mild forms of mental retardation. In addition, as noted by the author, mental retardation should not be equated with a delay in the rate of mental development. Mental retardation is a more persistent intellectual disability, while mental retardation is a reversible condition. Based on the etiological criterion, that is, the reasons for the onset of PDR, G.E.Sukhareva identified the following forms:

intellectual disability due to unfavorable environmental conditions, upbringing or pathology of behavior;

intellectual impairment in prolonged asthenic conditions caused by somatic diseases;

intellectual disabilities in various forms of infantilism;

secondary intellectual disability due to impairment of hearing, vision, speech, reading and writing defects;

5) functional and dynamic intellectual disorders in children in the residual stage and in the long-term period of infections and injuries of the central nervous system. (25)

Research by M.S. Pevzner and T.A. Vlasova made it possible to distinguish two main forms of mental retardation

mental retardation due to mental and psychophysical infantilism (uncomplicated and complicated underdevelopment of cognitive activity and speech, where the main place is occupied by underdevelopment of the emotional and volitional sphere)

mental retardation due to prolonged asthenic and cerebrasthenic conditions. (eighteen)

V.V. Kovalev identifies four main forms of CRA. (five)

dysontogenetic form of CRA, in which the deficiency is due to the mechanisms of delayed or distorted mental development of the child;

encephalopathic form of CR, which is based on organic damage to cerebral mechanisms at the early stages of ontogenesis;

CRA due to the underdevelopment of analyzers (blindness, deafness, speech underdevelopment, etc.), due to the action of the sensory deprivation mechanism;

CRA caused by defects in upbringing and information deficit from early childhood (pedagogical neglect).

Table. Classification of forms of borderline forms of intellectual disability according to V.V. Kovalev

Classification V.V. Kovaleva is of great importance in the diagnosis of children and adolescents with mental retardation. However, it should be borne in mind that the author considers the problem of cerebral palsy not as an independent nosological group, but as a syndrome with various forms of dysontogenesis (infantile cerebral palsy, speech impairment, etc.).

The most informative for psychologists and teachers is the classification of K.S. Lebedinskaya. On the basis of a complex clinical, psychological and pedagogical study of underachieving primary schoolchildren, the author has developed a clinical systematics of mental retardation.

As well as the classification of V.V. Kovalev, classification by K.S. Lebedinskaya is based on the etiological principle and includes four main options for mental retardation: (6)

Delayed mental development of constitutional origin;

Delayed mental development of somatogenic origin;

Delayed mental development of psychogenic origin;

Delayed mental development of cerebral-organic genesis.

Each of these types of CRD has its own clinical and psychological structure, its own characteristics of emotional immaturity and impaired cognitive activity, and is often complicated by a number of painful signs - somatic, encephalopathic, neurological. In many cases, these painful signs cannot be regarded only as complicating, since they play a significant pathogenetic role in the formation of the MR itself.

The presented clinical types of the most persistent forms of cerebrovascular accidents mainly differ from each other precisely by 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 characteristics of the development of mental functions.

Clinical and psychological characteristics of children with mental retardation

Delayed mental development of constitutional origin

Delayed mental development of constitutional origin is diagnosed in children with manifestations of mental and psychophysical infantilism. In the psychological literature, it means developmental retardation, manifested by the preservation of the physical structure or character traits inherent in childhood in the adult state.

The prevalence of mental infantilism, according to some authors, is 1.6% among the child population.

Its causes are most often relatively mild brain damage: infectious, toxic, and others, including trauma and fetal asphyxia.

In clinical practice, two forms of mental infantilism are distinguished: simple and complicated. In further studies, four of its main variants were identified: harmonic (simple), disharmonic, organic and psychogenic infantilism.

Harmonious (simple) infantilism manifests itself in a uniform delay in the rate of physical and mental development of the individual, which is expressed in the immaturity of the emotional-volitional sphere, which affects the child's behavior and his social adaptation. The name "harmonic infantilism" was proposed by G.E. Sukhareva. (25; 26)

His clinical picture is characterized by features of immaturity, "childishness" in the somatic and mental appearance. Children in terms of height and physical development are 1.5-2 years behind their peers, they are characterized by lively facial expressions, expressive gestures, fast, impulsive movements. Tirelessness in the game and quick fatigability when performing practical tasks come to the fore. Especially quickly they get bored with monotonous tasks that require keeping focused attention for quite a long time (drawing, counting, reading, writing). With full intelligence, insufficiently expressed interests in writing, reading, and counting are noted.

Children are characterized by a weak ability for mental stress, increased imitation, suggestibility. However, by the age of 6-7 years, the child already understands and regulates his behavior quite well, depending on the need to perform this or that work.

Children with infantile behavioral traits are dependent and uncritical of their behavior. In the classroom, they "turn off" and do not perform tasks. They can cry over trifles, but quickly calm down when switching their attention to the game or to something that gives them pleasure. They love to fantasize, replacing and displacing life situations that are unpleasant for them with their fictions.

Disharmonic infantilism can be associated with endocrine diseases. So, with insufficient production of adrenal hormone and hormones of the gonads at the age of 12-13 years, there may be a delay in puberty in both boys and girls. At the same time, peculiar features of the adolescent psyche are formed, characteristic of the so-called hypogenital infantilism. More often, the traits of immaturity appear in boys. Adolescents are slow, get tired quickly, their performance is very uneven - higher in the first half of the day. Decrease in memory is detected. Attention quickly dissipates, so the student makes many mistakes. The interests of adolescents with a hypogenital form of infantilism are unique: for example, boys are more interested in quiet activities. Motor skills and abilities are not sufficiently developed, they are clumsy, slow and clumsy. These children with good intelligence, are distinguished by great erudition, however, they cannot always use their knowledge in the classroom, since they are very absent-minded and inattentive. They are prone to fruitless reasoning on any topic. They are very touchy, painfully experiencing their failures in school and difficulties in communicating with peers. I feel better in the company of adults, where they are reputed to be erudites. Signs of hypogenital infantilism in the outward appearance of a teenager are not tall, fullness, a "moonlike" face, a squeaky voice.

The endocrine forms of infantilism also include pituitary dwarfism (dwarfism). In such children, there is a combination of signs of an immature child's psyche with traits of old-fashionedness, pedantry, a tendency to reasoning and instruction. School failure is often the result of weak volitional effort, slowness, attention disorder and logical memory. The child cannot on long time focus, distraction, which often leads to mistakes in assignments. Slowly learns new material, but, having mastered it, he operates well with the rules, the multiplication table, reads at a sufficient pace, has a good mechanical memory. Children suffering from pituitary dwarfism show some lack of independence, require the care of their elders. Sometimes these children have undesirable reactions: persistent low mood, sleep disturbance, limited communication with peers, decreased academic performance, refusal to attend school. If this condition does not go away after a short period of time, it is necessary to consult a neuropsychiatrist.

The neuropathic variant of complicated infantilism is characterized by the presence of weak mental traits. Usually these children are very timid, fearful, dependent, overly attached to their mother, difficult to adapt in children's educational institutions. From birth such children fall asleep with great difficulty, having restless sleep... Timid, shy in nature, they find it difficult to get used to the children's team. In the classroom, they are very passive, they do not answer questions in front of strangers. In their intellectual abilities, they are sometimes ahead of their peers, but they do not know how to show their knowledge - in the answers one feels uncertainty, which worsens the teacher's idea of \u200b\u200btheir true knowledge. Such children often have a fear of verbal response. Their performance is quickly depleted. Infantilism also manifests itself in complete practical inability. The motor skills are marked by angularity and slowness.

Against the background of these features of the psyche, so-called school neuroses can arise. The child goes to school with great reluctance. Any somatic disease is welcomed with joy, as there is an opportunity to stay at home. This is not laziness, but the fear of separation from the familiar environment, mother. Difficulty adapting to school leads to a decrease in the assimilation of educational material, memory and attention deteriorate. The child becomes lethargic and absent-minded.

Psychogenic infantilism, as a special variant of infantilism, has not been sufficiently studied in Russian psychiatry and psychology. This option is considered as an expression of anomalous personality formation under conditions of improper education. (5) It usually happens in families where there is one child who is taken care of by several adults. This often impedes the development of the child's independence, will, ability, and then the desire to overcome the slightest difficulties.

Under normal intellectual development such a child learns unevenly, since he is not accustomed to work, does not want to independently complete and check tasks.

Adaptation in a team of this category of children is difficult because of such character traits as selfishness, opposing oneself to the class, which leads not only to conflict situations, but also to the development of a neurotic state in the child.

Children with so-called microsocial neglect should be singled out in particular. These children have an insufficient level of development of skills, abilities and knowledge against the background of a full-fledged nervous system due to a long stay in conditions of a lack of information, not only intellectual, but also very often emotional. Unfavorable conditions of upbringing (with chronic alcoholism of parents, in conditions of neglect, etc.) determine the slow formation of the communicative and cognitive activity of children in early age... L.S. Vygotsky repeatedly stressed that the process of the formation of the child's psyche is determined by the social situation of development, which is understood as the relationship between the child and the social reality surrounding him. (2; 3) In dysfunctional families, the child experiences a lack of communication. This problem arises with all its acuteness at school age in connection with school adaptation. With preserved intelligence, these children cannot independently organize their activities: they experience difficulties in planning and isolating its stages, they cannot adequately assess the results. There is a pronounced violation of attention, impulsivity, lack of interest in improving their performance. Tasks are especially difficult when it is necessary to perform them according to verbal instructions. On the one hand, they experience increased fatigue, and on the other, they are very irritable, prone to affective outbursts and conflicts.

With appropriate training, children with infantilism are able to receive secondary or incomplete secondary education, they have access to vocational education, secondary specialized and even higher. However, in the presence of unfavorable environmental factors, negative dynamics is possible, especially with complicated infantilism, which can manifest itself in the mental and social maladjustment of children and adolescents.

So, if we evaluate the dynamics of the mental development of children with infantilism as a whole, then it is predominantly favorable. Experience shows that the manifestation of pronounced personal emotional-volitional immaturity tends to decrease with age.

Delayed mental development of somatogenic origin

The reasons for this type of mental retardation are various chronic diseases, infections, childhood neuroses, congenital and acquired malformations of the somatic system. With this form of CRD, children may have a persistent asthenic manifestation, which reduces not only the physical status, but also the psychological balance of the child. Fear, shyness, self-doubt are inherent in children. Children of this category of DPD communicate little with their peers because of the guardianship of parents who try to protect their children from what they think is too much communication, so they have an underestimated threshold of interpersonal connections. With this type of RPD, children need treatment in special sanatoriums. The further formation and education of these children depends on their state of health.

Delayed mental development of psychogenic origin

Its appearance is due to unfavorable conditions of upbringing and education, which hinder the correct formation of the child's personality. We are talking about the so-called social genesis, when unfavorable conditions of the social environment arise very early, have a long-term effect, traumatizing the child's psyche, accompanied by psychosomatic disorders, autonomic disorders. KS Lebedinskaya emphasizes that this type of mental retardation should be distinguished from pedagogical neglect, which is largely due to the shortcomings of the child's learning process in kindergarten or school. (6)

The development of the personality of a child with mental retardation of psychogenic origin follows the main three options.

The first option is mental instability that arises as a result of hypo-care. The child is brought up in conditions of neglect. Disadvantages of upbringing are manifested in the absence of a sense of duty, responsibility, adequate forms of social behavior, when, for example, in difficult situations, he fails to cope with the affect. The family as a whole does not stimulate the child's mental development, does not support his cognitive interests. Against the background of insufficient knowledge and ideas about the surrounding reality, which prevents the assimilation of school knowledge, these children show the traits of pathological immaturity of the emotional and volitional spheres: affective lability, impulsivity, and increased suggestibility.

The second option - in which hyperprotection is expressed - is a pampering upbringing, when the child is not instilled with the traits of independence, initiative, responsibility, and conscientiousness. This often happens with late-born children. Against the background of psychogenic infantilism, in addition to the inability to volitional effort, the child is characterized by egocentrism, unwillingness to work systematically, an attitude to constant help, the desire to always be looked after.

The third option is an unstable parenting style with elements of emotional and physical violence in the family. Its occurrence is provoked by the parents themselves, who are rude and cruel to the child. One or both parents can be despotic, aggressive towards their own son or daughter. Against the background of such intra-family relations, pathological personality traits of a child with mental retardation are gradually formed: shyness, fearfulness, anxiety, indecision, lack of independence, lack of initiative, deceit, resourcefulness and, often, insensitivity to someone else's grief, which leads to significant problems of socialization.

Delayed mental development of cerebral-organic genesis. The last among the considered type of mental retardation takes the main place within the boundaries of this deviation. It occurs in children most often and it also causes in children the most pronounced disturbances in their emotional-volitional and cognitive activity in general.

This type combines signs of immaturity of the child's nervous system and signs of partial damage to a number of mental functions. She distinguishes two main clinical and psychological variants of mental retardation of cerebral-organic genesis.

In the first variant, the features of the immaturity of the emotional sphere of the type of organic infantilism prevail. If encephalopathic symptomatology is noted, then it is represented by non-severe cerebrasthenic and neurosis-like disorders. At the same time, higher mental functions are not sufficiently formed, exhausted and deficient in the level of control of voluntary activity.

In the second variant, the symptoms of damage dominate: “there are persistent encephalopathic disorders, partial disturbances of cortical functions and severe neurodynamic disorders (inertia, tendency to perseverations). The regulation of the child's mental activity is disturbed not only in the field of control, but also in the field of programming of cognitive activity. This leads to a low level of mastery of all types of voluntary activities. The child has a delay in the formation of subject-manipulative, speech, play, productive and educational activities.

The prognosis of mental retardation of cerebral-organic genesis largely depends on the state of higher cortical functions and the type of age-related dynamics of its development. As I.F. Markovskaya, with a predominance of general neurodynamic disorders, the prognosis is quite favorable. (11) When combined with a pronounced deficiency of individual cortical functions, a massive psychological and pedagogical correction is required, carried out in a specialized kindergarten. Primary persistent and widespread disorders of programming, control and initiation of voluntary mental activities require their separation from mental retardation and other serious mental disorders.

Differential diagnosis of mental retardation and conditions similar to it

Many Russian scientists (M.S. Pevzner, G.E.Sukhareva, I.A.Yurkova, V.I. Lubovsky, S.D. Zabramnaya, E.M. Mastyukova, G.B.Shaumarov, O. Monkevichene, K. Novakova and others).

In the early stages of a child's development, it is difficult to distinguish between cases of gross speech underdevelopment, motor alalia, oligophrenia, mutism and delayed speech development.

It is especially important to distinguish mental retardation and DPD of cerebral-organic genesis, since in both cases children have deficiencies in cognitive activity in general and a pronounced deficiency of modal-specific functions.

Let us dwell on the main distinguishing features that are significant for distinguishing between mental retardation and mental retardation.

1. Disorders of cognitive activity in PDD are characterized by partial, mosaic nature in the development of all components of the child's mental activity. With mental retardation, the totality and hierarchy of violations of the child's mental activity is noted. A number of authors use such a definition as "diffuse, diffuse damage" of the cerebral cortex to characterize mental retardation.

2. Compared to mentally retarded children, children with CRD have much higher potential for the development of their cognitive activity, and especially the higher forms of thinking - generalization, comparison, analysis, synthesis, distraction, abstraction. However, it should be remembered that some children with mental retardation, like their mentally retarded peers, find it difficult to establish causal relationships and have imperfect generalization functions.

3. The development of all forms of mental activity in children with mental retardation is characterized by an abruptness of its dynamics. While in mentally retarded children this phenomenon has not been experimentally detected.

In contrast to mental retardation, in which the actual mental functions - generalization, comparison, analysis, synthesis - suffer, with mental retardation, the prerequisites for intellectual activity suffer. These include such mental processes as attention, perception, the sphere of images-representations, visual-motor coordination, phonemic hearing and others.

When examining children with mental retardation in comfortable conditions for them and in the process of purposeful upbringing and education, children are capable of fruitful cooperation with an adult. They accept the help of an adult and even the help of a more advanced peer well. This support is even more effective if it is in the form of play tasks and is focused on the child's involuntary interest in the activities being performed.

Playful presentation of tasks increases the productivity of children with mental retardation, while for mentally retarded preschoolers, it can serve as a reason for the child to involuntarily slip off the task. This happens especially often if the proposed task is at the limit of the capabilities of a mentally retarded child.

Children with mental retardation have an interest in subject-manipulative and play activities. The play activity of children with mental retardation, in contrast to that of mentally retarded preschoolers, is more emotional in nature. Motives are determined by the goals of the activity, the ways to achieve the goal are correctly chosen, but the content of the game is not developed. It lacks its own plan, imagination, the ability to present the situation in a mental sense. Unlike normally developing preschoolers, children with mental retardation do not move without special training to the level of role-playing games, but "get stuck" at the level of plot games. At the same time, their mentally retarded peers remain at the level of subject-play actions.

Children with mental retardation are characterized by a high brightness of emotions, which allows them to focus for a longer time on tasks that arouse their immediate interest. Moreover, the more the child is interested in completing the task, the higher the results of his activity. A similar phenomenon is not observed in mentally retarded children. The emotional sphere of mentally retarded preschoolers is not developed, and excessively playful presentation of tasks (including during a diagnostic examination), as already mentioned, often distracts the child from solving the task itself and makes it difficult to achieve the goal.

The majority of preschool children with CRD have a varying degree of skill in visual arts. Mentally retarded preschoolers do not develop visual activity without special training. Such a child stops at the level of the premises of object images, that is, at the level of sketching. In the best case, some children have graphic stamps - schematic images of houses, "cephalopods" images of a person, letters, numbers, chaotically scattered over the plane of a sheet of paper.

In the somatic appearance of children with CRD, dysplasticity is generally absent. While in mentally retarded preschoolers, it is observed quite often.

In the neurological status of children with CRD, there are usually no gross organic manifestations, which is typical of mentally retarded preschoolers. However, even in children with delay, one can see neurological microsymptomatics: a venous mesh expressed on the temples and bridge of the nose, slight asymmetry of facial innervation, hypotrophy of individual parts of the tongue with its deviation to the right or left, revitalization of tendon and periosteal reflexes.

Pathological hereditary burden is more typical for the history of mentally retarded children and is practically not observed in children with mental retardation.

Of course, these are not all the distinguishing features that are taken into account when distinguishing between CRA and mental retardation. They are not all the same in their importance. However, knowledge of these aforementioned features makes it possible to clearly differentiate both states under consideration.

Sometimes it is necessary to differentiate mental retardation and mild organic dementia. With PDD, there is no such disorder of activity, personal decay, gross uncriticality and complete loss of functions, which are noted in children with organic dementia, which is a differential sign.

The distinction between mental retardation and severe speech impairments of cortical genesis (motor and sensory alalia, early childhood aphasia) presents particular difficulties. These difficulties are due to the fact that in both conditions there are similar external signs and the primary defect should be distinguished - whether it is a speech disorder or intellectual impairment. This is difficult, since both speech and intellect belong to the cognitive sphere of human activity. In addition, they are inextricably linked in their development. Even in the writings of L. S. Vygotsky, indicating the age of 2.5-3 years, it is said that it was during this period that "speech becomes meaningful, and thinking becomes verbal." (2; 3)

Therefore, if a pathogenic factor acts during these periods, it always affects both named spheres of the child's cognitive activity. But also on early stages The primary impairment of the child's development can delay or disrupt the development of cognitive activity as a whole.

For differential diagnosis, it is important to know that a child with motor alalia, in contrast to a child with CRD, is characterized by extremely low speech activity. When trying to make contact with him, he often displays negativism. In addition, it must be remembered that with motor alalia, sound pronunciation and phrasal speech suffer the most, and the ability to master the norms of the native language is steadily violated. The child's communicative difficulties are increasing more and more as, with age, speech activity requires more and more automation of the speech process. (thirteen)

Difficulty in diagnosis is the distinction between CRD and autism. A child with early childhood autism (EDA), as a rule, has impaired all forms of pre-verbal, non-verbal and verbal communication. Such a baby differs from a child with DPD by low-expressive facial expressions, lack of eye contact ("eye to eye") with the interlocutor, excessive fearfulness and fear of novelty. In addition, in the actions of children with RDA, there is a pathological stuck on stereotypical movements, refusal to act with toys, and unwillingness to cooperate with adults and children.

Output. Mental retardation (PDD) is one of the most common forms of mental disorders. This is a violation of the normal pace of mental development. The term "delay" emphasizes the temporary nature of the disorder, that is, the level of psychophysical development as a whole may not correspond to the passport age of the child. (1)

The specific manifestations of CRD in a child depend on the causes and time of its occurrence, the degree of deformation of the affected function, its significance in the general system of mental development.

Thus, we can distinguish the following most important groups of reasons that can determine the developmental delay:

Biological reasons that prevent the normal and timely maturation of the brain;

General lack of communication with others, causing a delay in the child's assimilation of social experience;

Lack of full-fledged, age-appropriate activity, giving the child the opportunity to “appropriate” social experience, timely formation of internal mental actions;

Social deprivation that prevents timely mental development.

All deviations in such children from the nervous system are variable and diffuse and are temporary. In contrast to mental retardation, with CRD, the reversibility of the intellectual defect takes place.

This definition reflects both biological and social factors of the emergence and deployment of such a state in which the full development of the body is hampered, the formation of a personality developed individual is delayed and the formation of a socially mature personality is ambiguous.

First of all, let's figure out what mental retardation (PDD) is. Strictly speaking, in the modern international classification of diseases adopted in Russia, we will not find such a diagnosis. But this does not mean that it does not exist, it is just that CRA is divided into different categories (for example, developmental disorders of speech and language, developmental disorders of educational skills, developmental disorders motor functions, mixed specific disorders of mental development) and is included in the section called "Disorders of psychological development." However, for convenience, all these complex headings are often replaced by three letters - ZPR. So should you be afraid of this abbreviation?

Parents need to know that mental retardation (PDD) belongs to the category of mild deviations in mental development and occupies an intermediate place between norm and pathology. CRD is characterized by the reversibility of many disorders, i.e. with thoughtful rehabilitation and correctional work, the prognosis of the child's development is relatively favorable.

There are primary and secondary mental retardation. Children with primary mental retardation usually do not have such severe developmental abnormalities as mental retardation, congenital underdevelopment of speech, hearing, vision, motor system, characteristic of secondary retardation (delay occurs due to congenital underdevelopment of vision or hearing). Here we will talk about primary latency.

As a rule, these children experience the main difficulties in social (especially school) adaptation and learning, due to the immaturity of the emotional-volitional sphere. It is she who is the most striking sign of DPD: it is extremely difficult for a child to make a willful effort over himself, to force himself to do something. Immaturity in turn leads to attention problems (eg, instability, decreased concentration, increased distraction). Often, attention disorders are accompanied by increased motor and speech activity. All this together leads to impairment of perception, memory, difficulties in drawing correct conclusions. For example, a child may have difficulty recognizing familiar objects from an unusual perspective (for example, the child does not recognize the outlines of objects drawn on top of each other), learn even short poems with difficulty and forget them very quickly. And it is clear that his knowledge of the world around him will be insufficient and limited.

Mental retardation can range from mild to severe. However, the following signs are characteristic of all types of CRD: delayed development of motor skills, speech, difficulties in mastering the norms of social behavior, emotional immaturity, uneven development of individual mental functions and, finally, the most important thing is the reversible nature of these disorders.

With a slight degree of delay, the acquisition of age-related skills lags slightly behind the generally accepted standards, and the lag is compensated for with little effort on the part of specialists. Often all the necessary corrective work can be done by the parents themselves.

When medium the child's acquisition of age-related motor and speech skills, emotional reactions, the formation of fine motor skills, the improvement of communicative interactions are delayed more significantly. Additionally, the child may experience noticeable difficulties in interacting with both adults and children. In this case, in order to compensate for the developmental delay, it takes much more time, efforts of parents, as well as the obligatory participation of specialists.

With a pronounced degree, the lag in the acquisition of age-related skills is significant: such children begin to walk very late, later the skills of neatness are formed, etc. Along with a significant lag, various somatic disorders are noted - insufficient muscle tone, signs of hydrocephalus and cerebral hypertension, etc. Here, the help of doctors, defectologists and a psychologist is required.

The first signs of CRD can be seen at a very early age (up to 2.5 years). However, it manifests itself in a delay in the maturation of motor functions, therefore, usually at this age they talk about a delay in psychomotor development.

When a child reaches 2.5-3 years old, it becomes possible to identify the main features characteristic of PDA (delayed development of motor skills, speech, difficulties in mastering the norms of social behavior; emotional immaturity; uneven development). Therefore, CRD is usually diagnosed starting from the age of three. But there are always nuances, for someone this diagnosis can be made earlier, someone later. When the child reaches primary school age, such a diagnosis is either withdrawn (which happens more often), or revised.

Usually, attentive parents notice by the age of 2-3 that “something is wrong” in the development of their baby. And the question arises: "Is it worth seeking special advice?" The answer is obvious: of course it is. Even if the child has a mild delay, qualified specialists will advise how to deal with him, suggest possible educational approaches, and, if necessary, recommend attending special classes or a specialized preschool / school institution.

First of all, if there is a suspicion of CRD, parents should contact a neurologist and psychiatrist to clarify the diagnosis, determine the degree of delay, and possible reasons and the appointment of treatment and additional examinations, if necessary (eg, electroencephalogram). The next specialist you need to go to is a defectologist. He will help you choose the most suitable activities or create a program for teaching your child at home. If you have speech problems, you should also visit a speech therapist. Do not forget about the psychologist, his tasks include working with the child to overcome emotional-volitional immaturity and introduction into activities (for example, the child learns to listen and analyze instructions for assignments, etc.), to expand his horizons, and also help parents in building effective interaction with their child.

Some children with mental retardation are not ready for school. They have not formed personal and intellectual readiness for schooling, there is a lack of knowledge and ideas about the world around them, as well as imperfection of educational skills for mastering the program material of school. Such children cannot master counting, reading and writing without special help. It is also difficult for them to systematically observe the norms and rules of behavior adopted at school. Pupils of elementary grades with mental retardation quickly get tired, especially with intense intellectual work. Subjective difficulties in the assimilation of educational material can lead to refusal to fulfill the teacher's tasks both in the classroom and at home. Therefore, before sending a child to a school with a “good” or “strong” program, parents should assess the capabilities of their future first grader so that the school does not become torture for the child.

Once again, I would like to note that mental retardation is not a sentence. With the right approach and understanding of the needs and characteristics of development child DPR completely surmountable. Often children with mental retardation do not have this diagnosis by the time they start school and are quite successfully adapting both in school and in adult life.

In this article:

Children with mental retardation both in preschool and school age require a special approach in education and training. The constantly growing number of children with such a diagnosis suggests the development of new techniques, in accordance with which it is possible to correct deficiencies in mental development. Let's talk about what features children with mental retardation have and how to properly build work on their upbringing and education.

Impaired mental function

Mental retardation (MAD) is understood as a syndrome of temporary lag in the development of both the entire psyche and its individual functions. The second variant of the delay can often be diagnosed only when the baby enters school. The main manifestations in this case are:

A long-term study of the behavior of children with mental retardation made it possible to obtain information about the main causes of the problem, and also became an incentive for the creation of numerous specialized institutions of both preschool and school type, where children are taught according to a special correction program.

It is customary to divide children with CRD into four main groups.

First group

The first group includes children with developmental delay. constitutional type. The main signs of such children are infantilism, both mental and psychophysical. They can be identified by a number of external signs. Children from the first
the groups have short stature and too childish facial features that persist even at school age.

The most noticeable among these guys is the lag in the development of the emotional world. They seem to have stopped at the lowest rung of the emotional development ladder. Such babies are characterized by bright emotional outbursts, frequent and abrupt mood swings, lability of emotions. They love to play more than anything else, even after they become schoolchildren.

Second group

The second group includes children with CRD syndrome somatogenic type. Their features are mostly associated with prolonged and severe somatic diseasestransferred at an early age. It's about disease respiratory tract, including allergic ones, as well as problems with the digestive system.

Protracted dyspepsia in the first year of life becomes one of the main causes of mental retardation. We are talking about such diseases as:

• bronchial asthma;
• pneumonia;
• disorders in the work of the kidneys;
• heart failure, etc.

In such cases, the characteristics of children are of a temporary nature and are associated not with deficiencies in the development of the central nervous system, but with some lag in the process of its maturation.

Third group

The third group includes children with developmental delay. psychogenic nature. The main reasons for the developmental deficiency in this case are associated with conditions of upbringing that are unfavorable for the development of the child, which impede the formation of a full-fledged personality.

When it comes
about unfavorable conditions, it means excessive custody, excessive cruelty or neglect. The latter causes an unstable expression of emotions in the baby with increased impulsivity, a lack of desire to take initiative, as well as a delay in intellectual development.

Too strong guardianship leads to the fact that the baby grows up as a weak, egocentric personality, unable to show independence and motivate himself.

Fourth group

Representatives of the fourth group are found most often. This includes children with mental retardation cerebral-organic genesis. The main reason for the delay is this is a difficult childbirth with trauma or asphyxiation of the baby, suffered by the mother during pregnancy, infection or poisoning.

Diseases of the nervous system up to two years can also affect the delay. Most often, it is they that become the impetus for the development of organic infantilism, which is directly related to damage to the central nervous system of an organic nature.

Emotional mental retardation syndrome

Manifestations of DPD are observed in almost all areas of the baby's activity, including creative. Children with similar disabilities, for example, show minimal interest in drawing, which can be seen when analyzing their drawings. As a rule, the works do not have any emotional connotation.

In general, you can
to note that the state of the emotional world for mental development is extremely important. Children with CRD, as a rule, show themselves poorly organized, unable to give themselves adequate self-esteem. Their emotions are shallow, changeable, so children are susceptible to suggestion, trying to find someone who can be imitated in everything.

Features in emotional development children with CRD syndrome:

1. Unstable emotional-volitional sphere, against the background of which there is an inability to concentrate on one activity for a long time. The main cause of the problem is a reduced level of mental activity.
2. Difficulty trying to establish new contacts, lack of communication.
3. Whole line emotional disorders, characterized by anxiety, fears, the desire for actions of an affective nature.
4. Bright impulsive flashes.
5. Hyperactive behavior in society.

Children with a pronounced symptom of CRD, as a rule, cannot be independent, are unable to control their own actions, do not know how to reach the end by completing tasks. They are not characterized by lightness and ease in communication.

The brightest
features are manifested in older preschool and school age, when children are faced with the need to find solutions in various situations.

The main task of specialized institutions aimed at correcting the behavior of children with mental retardation is to create comfortable conditions for them that contribute to the development of positive aspects of the personality.

Learning activities in the life of children with mental retardation

Children with CRD have their own characteristics when it comes to learning activities. Unlike children with mental retardation, children with mental retardation are able to find solutions in accordance with their age level, are able to accept the offered help, understand the meaning of pictures, can grasp the plot of the story, understand the problem and find a solution.

At the same time, such students are characterized by increased fatigue and a reduced level of cognitive activity.
Together, these features are becoming a serious problem that inhibits the natural process of learning and development.

Children from this category assimilate educational material worse, are unable to remember the condition of the problem, confuse and forget words, make simple mistakes, and cannot assess their actions. They also have rather narrow ideas about the world around them.

Pupils with mental retardation are unable to concentrate on the task, do not follow the rules, and are looking for an opportunity to quickly switch to play activities. At the same time, it can be noted that at the initial stages of classes they are active, working with the class on assignments, but they get tired faster than others, they turn off the process and stop assimilating the material, as a result of which their gaps in knowledge increase.

Supporting activities of teachers

Reduced activity of mental activity, as well as the limitation of such
important processes, as a synthesis, analysis and generalization, the peculiarities of memory and poor attention should be noted by teachers and educators in preschool and school institutions. Teachers should provide assistance to each such kid on an individual basis, paying attention to the emergence of gaps in knowledge, trying to fill them in accessible ways:

• re-explaining the material;
• including additional work exercises;
• using visual didactic aids and pictures.

The teacher's task is to get the student's attention and keep it while explaining the material, to motivate the child to work in the lesson.

Results of timely support for children with mental retardation

During different periods of learning, each of the above support options can have a positive effect and help you achieve results. As a result, the student does not feel mentally retarded in the team. Some lag in development is recorded in him, which results in slow mastering of the material, but no more.

During the period of active working capacity in children with CRD syndrome, a number of positive personal and mental qualities can be observed. As a rule, they appear at a time when
the child gets the opportunity to work on an interesting task for him in a pleasant and friendly atmosphere.

During such periods, having the opportunity to receive help and support from the teacher on an individual basis, the student can quite easily cope with tasks of an intellectual nature, practically keeping up with ordinary peers. It will not be difficult for him to draw causal relationships, determine the moral of a fable, or understand the figurative meaning of a number of proverbs.

Roughly the same effect can be achieved during teamwork in the classroom. If the atmosphere in the class is inviting, the student is interested in the topic and what is happening around, then he will easily learn the material, quickly and correctly complete the tasks, and adequately respond to possible comments and requests to amend the work.

By about 3-4 grade, some children with CRD have a strong desire to read as much as possible. Most often this is the merit of parents, teachers and educators. In moments of increased efficiency, students are able to retell in detail what they read, answer questions about the text, highlight the main idea, share the emotions caused by the story.

Interests of children with mental retardation

Outside of school or kindergarten, the features of children with CRD are almost invisible. They have their own range of interests, as diverse as those of normally developing children. Some children may prefer calm and measured activities related to creativity, but more often children with DPD are enthusiastic about active games. However, both calm and active children practically do not have imagination in independent games.

All without exception
children with disabilities love to go on excursions, get great pleasure from being in theaters, museums or cinema. After visiting, they are impressed for several days. With great joy, such children perceive the opportunity to take part in sports games and activities, while it can be noted that they have motor awkwardness, lack of coordination, inability to perform tasks in accordance with a given rhythm.

Children with a pronounced symptom of CRD cope better and with pleasure in mechanical work that does not require mental effort, although prolonged mechanical actions also cause boredom.

The importance of an individual approach in the process of teaching children with mental retardation

The aforementioned features of children with mental retardation may seem insignificant at a passing acquaintance, as a result of which an erroneous assumption arises that such children can study in the normal conditions of a general education school. In fact, research results indicate something completely different. Teaching methods that apply to healthy children are not suitable for children with psychobiological disabilities.

Students with CRD can work productively, assimilating the material, for no more than 15-20 minutes. Longer sessions lead to a loss of interest in the material, state
fatigue, which in turn provokes rash actions, as a result of which the student makes many simple mistakes.

Awareness of powerlessness affects different children in different ways. Some protest in silence, not wanting to delve into the teacher's words, others get irritated and refuse to continue working. The amount of knowledge that children receive during the working period cannot be assimilated as needed, and even more so it is not associated with the subsequent material entering the child's brain.

As a result, the information remains "suspended in the air", unsecured. The result is low self-esteem of a child with mental retardation, unwillingness to learn, inability to complete even simple tasks on their own due to increased nervousness.

The mental characteristics of children with IDD in most cases lead to poor performance in school, because the knowledge they receive does not meet educational standards.The most obvious problems in children with IDD occur during periods when they are required to do serious mental work to establish connections between phenomena and objects involved in the learning process.

As a result, children cannot adapt to school due to the inability to follow the principle of systematic education. They also find it difficult to adhere to an active and conscious position in the learning process. Despite the ability to remember
a number of rules (mechanical memory is triggered), students cannot follow them in practice.

Working in writing, children correct a lot, make mistakes that they do not notice, do not adhere to the work algorithm, forgetting about whole blocks of tasks. These features are primarily due to the impulsive nature of the students and the disorganization of their activities.

Correctional and developmental education for children with mental retardation

The low level of knowledge among pupils with mental retardation is a confirmation of the ineffectiveness of teaching such children in regular classes of a general education school. To achieve a positive result, it is necessary to find means and methods of teaching that correspond to the peculiarities of the development of children and have a correctional focus.

A healthy, normally developing preschooler is able to master the basic mental operations and methods of mental activity even before he enters the first grade - this is a well-known and proven fact. Failure to master
such operations and methods in children with mental retardation leads to unpleasant consequences.

The fact is that schoolchildren are entirely dependent on a certain situation, and this leaves an imprint on the knowledge they acquire: for the most part, they are not systematized and are limited to personal sensory experience. The bottom line is disappointing: this kind of knowledge is not an impetus for mental development. Due to their fragmentation and the impossibility of building into a single logical chain, they cannot act as a basis for the mental growth of a student and a means to stimulate his cognitive activity.

An important part of the correctional education of children with mental retardation is the creation of conditions conducive to the normalization of their educational activities and the elimination of impulsive, disorganized behavior. It is important to teach students to draw up a plan of action and monitor its implementation, bring the matter to the end, following the ultimate goal.

Disruptions in the activity of children with RPD inhibit not only learning, but also general development. Ways to normalize activities will help to establish remedial training such students. It is necessary to work with children both in the classroom and after school hours in special classes.

In conclusion, it can be noted that the characteristics of children with mental retardation require an individual approach to the process of their correctional education.

If you create the necessary conditions for the education of such children, then they will be able to assimilate all the educational material developed for ordinary students of a comprehensive school. This fact is confirmed by the vast experience of teaching such children in special classes with subsequent transfer to regular classes.

All responsibility for teaching children with CRD in specialized conditions, as well as creating a comfortable environment conducive to their development, lies with adults: family members, educators, teachers and educators. They should promptly identify the characteristics of such children and take appropriate measures.

Crumbs have ZPR (mental retardation)

CRITCH has ZPR: NO PANIC! (Our special child)

Imagine: you come with your baby to a psychologist for testing, and your beloved baby, so dear and very, very clever, can not answer almost a single question. On the playground, in the circle of the same mothers, you never have to boast of his successes: “And you can imagine mine! - I've already learned how to put letters into syllables, and all by myself, without help! " In the kindergarten, your little one is rarely praised, and even then - for exemplary behavior in the classroom. And where does "not approximate" come from, if he can not answer anything. People just shake their heads softer, and who will quit in the heat of the moment: "Well, what a fool!"

Unfortunately, it is getting easier for kids to get into the category of “fools”. Requirements for the intellectual consistency and success of the child are growing, and the attitude of society towards “losers” is still at the level of people of the Stone Age. Such "antihumanistic", sometimes bordering on cruelty, attitude of people towards children who "do not pull" the school curriculum is dictated not only by the dense ignorance of our mothers and fathers. The roots of intransigence to any deviation always lie in inner fear: "What if this happens to mine?" However, if you hang up a "tag", brush aside the problem, then it's not scary: “Katya's child is a fool, but I have - thank God! - clever ". It is automatically concluded that not everything is all right with Katya either.

However, the whole irony lies in the fact that all of us, falling into different life circumstances, often look like "fools": we failed in exams, were fired from our jobs, succumbed to the persuasion of "scammers". Does this speak of our intellectual inconsistency? Even if the IQ level of you and your neighbor is with a difference of 20 points (not in favor of the neighbor), it will never occur to anyone that she has only failures and stupidity in her life. Full of "limited" people with higher education, at a good job. It is absolutely also necessary to consider children with an unpleasant, but not final diagnosis of mental retardation: mental retardation. Competent psychoneurologists and defectologists will never make this diagnosis earlier than 7-8 years old, however, almost a fifth of preschool children feel all the consequences of the careless words of doctors. As you know, all of us, mothers, have to be not only competent cooks, nutritionists and educators, but also defectologists, if life has turned like that. Mom's reaction to the words of a specialist about a possible DPD can be different. From protest ("It can't be! You are a bad specialist, I'll go to another!") To indifferent ("Well, well ... It's okay"). Very rarely, a mother reacts correctly to the results of the examination: at first she deeply experiences the situation, and then begins to methodically collect all the information about the problem and work together with her baby to correct the impaired development.

The plot of "Channel One" filmed in the "Success" children's club about children with DPD
(mental retardation)

Dmitrieva Daria, speech therapist-defectologist of the children's club "Success": with the advent of gadgets in the family, the relationship between parents and children is radically changing. It is easier to give a child a tablet than to talk again. This greatly inhibits the development of children, and makes life easier for mothers. Roughly speaking, when children ask for attention, parents switch them to a TV, tablet or phone. The child stops developing at this moment. What if the child didn't start talking on time? The first and surest step is to immediately contact a specialist.

Forewarned is forearmed

Delayed mental development is a partial underdevelopment of higher mental functions, which is temporary and can be compensated for with special training and education in childhood or adolescence.

First of all, remember that mental retardation is just a delay. Standing in a traffic jam on the highway, you know for sure that you will soon move on. CRA can be corrected and corrected almost completely. CRA is not mental retardation. What is the difference between these two diagnoses?

1. Mental retardation (ID) does not disappear without a trace, the child can only be very well adapted to life and work. The possibilities of such a kid have their own "ceiling". For example, even at the age of 15, a teenager with UO will not understand the figurative meaning of the phrase "Under a lying stone and water does not flow." Abstract-symbolic thinking will never develop to a normal level. Children with DPD fully compensate for their disadvantage in the process of special education. They grow into ordinary people who are able to master any profession and work successfully.
2. The brain of a baby with UO suffered globally, that is, all higher mental functions were affected: memory, attention, thinking, imagination, emotional and personal sphere. A child with CRD has only partial damage to certain brain structures and not so deep.
3. The level of learning of children with EE and CRA is completely different. If you start working with a child with CRD on time, he can reach the developmental level of a normal baby of his age. This is not possible with EE.

It's hard to say exactly about the reasons occurrence of CR... These include absolutely all the "harmfulness" of intrauterine development: illness and stress of a pregnant mother, fetal injuries, smoking, alcoholism, and not only mothers, but also fathers. Difficulties in childbirth, of course, can also be the culprit behind the developmental lag in the baby. The first months of his life are also very important: what surrounded him, what he was ill with, whether he started sitting, getting up, walking on time. A separate reason and even fertile soil for any developmental delays is an unfavorable environment in the family: alcoholic parents, physical punishment, verbal rudeness of adults (threats, shouts, obscenities), the primitiveness of their desires and aspirations, improper upbringing. Nothing can grow and develop without love. Children - especially.

Miracles, and more!

The most striking thing about defectology is the unpredictability of the development of a particular baby. The doctrine of compensation and overcompensation, set forth by L.S. Vygotsky, clearly shows us that miracles happen. For example, a baby who was born with asphyxia (suffocation), and as a result of this received organic brain damage, by definition, must have certain deviations in development: speech impairment, possibly mental retardation, or maybe he will simply be hyperactive and inattentive. But no one will ever be able to accurately predict how the body of such a crumb will cope with the birth trauma, how it will be able to overcome and overcome the ailment. Very often, such children develop well already in the 1st year of life, and with proper upbringing based on the love and support of mom and dad, such a baby may not be any different from his peers. The baby's body compensated for the problem (injury) received during childbirth. And in the case of overcompensation, children born, for example, with congenital deafness, with age, discover ingenious abilities, for example, for handicraft, and become famous artists, sculptors, and designers. The body has not only adapted to deafness, but also opened up those hidden opportunities that would not have opened if the baby was born hearing.

Let's figure it out

The delay in mental development is different. The most unpleasant and difficult to overcome is caused by organic brain damage. The brain cells in this case (for example, if the baby had an infectious disease in utero together with his mother), as if "falling asleep". Some of them can be "woken up" and made to work, and some - not. But you can ask for help from neighboring, mature cells, and help the body compensate for the defect if it cannot cope. It is on this principle that defectologists work. In the case of cerebrovascular accidents of organic origin, both medical intervention and the well-coordinated work of many specialists over the years will be required.

Also, ZPR is isolated in children weakened by endless diseases. How does the brain develop if the body is regularly shaken by severe infections? Here, the salvation of itself comes to the fore for the body, and all the vitality is spent on this. Such a kid looks pale, thin, lethargic, as if soaring in the clouds. Development is also delayed because mom simply has no time for classes: permanent hospitals, medicines, doctors and a lot of fear. Of course, such a family needs the help of a good psychotherapist or psychologist, and the education of the child needs to be established in the conditions of both the hospital and the sanatorium. There is no need for extra medications to overcome DPD: the poor kid has already overestimated them.

But, in spite of such difficult cases, nevertheless, the most dead-end, in the opinion of defectologists, is the situation when CRA is provoked in healthy baby social environment. In general, the low socio-cultural level of parents cannot be raised in any way. Experience shows that the established traditions of upbringing in such families are so strong that they cannot be changed either by conversations, or by recommendations, or by warnings. As a rule, a mother generally does not understand well that her child is lagging behind his peers, and if he does, then she does nothing. It is very disappointing when CRA is acquired, when the baby is simply “dull” from inattention to himself, rough treatment, lack of new impressions.

We test ourselves!

Any developmental delay is not noticeable immediately, but as the baby grows up, when the requirements for his small achievements are growing more and more. At about 2-3 years old, an attentive, sensitive mother creeps in a suspicion that "something is wrong." By the age of 4, a child is usually consulted by a speech therapist or a neuropathologist, rarely by a defectologist. At 5-6 years old, the baby is noticeably inferior to his peers in the development of speech, logical thinking, the development of the emotional-volitional sphere.

Unfortunately, parents do not always have the opportunity to show their baby to a doctor or a defectologist. But there is still anxiety for the fate of the crumbs! How can parents who are far from defectology understand what is happening to their little man? How to determine on your own whether he has a DPD or not, or maybe something more serious should be suspected. Here are some tests that will help, if not calm down mom and dad, then at least sort out the problem and start helping the child in time:

Test number 1: based on the simplest observations of the baby in the first year of his life. Write down all the main "steps" of the baby's development: when he began to hold his head (this should happen no later than 1.5 months), when he began to roll over (at 3-5 months), grab the toy (at about 4 months), when sit (no later than 8 months), get up (8-10 months), walk (at the latest - in 1 year 2 months). Each mom is looking forward to the first words of the baby: the baby should be walking at 2 months, and babbling - from 6-8 months. Point your finger at an object or person, try to name it with a syllable or sound - at 10-12 months. The first "mom" you should hear around the baby's first birthday. If all these age limits are strongly stretched, and the baby is low-emotional, does not recognize loved ones for a long time, there is cause for concern.

Test number 2: for babies 9-10 months old, playing "Ku-ku" is a very good indicator of the timely development of the baby. She is well known to all mothers. You hide a toy under the box in front of the child. "Where is the pussy?" - you are surprised. A nine-month-old baby should, with the confidence of a pioneer, remove the box from the pussy and be extremely happy with what was found. The kid already "sees" through the walls, that is, he already understands that this toy has not disappeared without a trace. The simplest thinking skills are formed.

Test number 3: suitable for babies from 1 to 1.5 years old. The simplest thing that will help you to "grasp" the problem in time is to assess the speech and motor activity of the baby. If he observes a new toy or object with interest, tries to grab it, taste it; if he is loudly indignant, for example, during a massage, and joyfully "gaggles" and reaches out with his arms to his mother who has returned from work; if, playing with himself, all the time something "mutters" or "hums" under his breath - then the development of the crumbs goes, most likely, by age. If activity (including cognitive) is low, there is no interest in the world around you, sound the alarm.

Test number 4: for children from 2 to 3 years old. Everyone is well aware of toys where you need to insert figures that fit into the holes. For the test, you can take, for example, an "active cube", on each side of which such holes are cut. Such a cube can be easily disassembled, and for the test we will take the simplest part of it: with a circle, square, triangle. Place the side of the cube in front of the baby and 3 figurines that match it. Watch what he does. If he is not familiar with the game, first teach him how to correctly nest geometric shapes. Then leave it to him to handle the task. It is very important to determine how the kid is able to learn, how he applies the knowledge gained from the adult. If you managed to put in the figures, there is no question of gross developmental delays. If even after repeated tests the crumb did not cope with the task, it is worth contacting a good neuropsychiatrist or defectologist.

Test number 5: for children from 3 to 5 years old. Speech becomes the main criterion for assessing good intellectual development. A lot can be understood by how, what and how much the baby says. You can evaluate his stock of knowledge about the environment, hear grammatical and sound pronunciation inaccuracies, determine the level of understanding of addressed speech, all the subtleties and shades of meaning. Completely such a diagnosis should be carried out by a speech therapist, but parents can also do something. Ask your child to explain what a vacuum cleaner, computer, sunset, thunderstorm, transport are. Can you understand his explanation? Of course, a child's small outlook is not yet an indicator of whether he has a mental retardation, but in conjunction with other "pitfalls", it only emphasizes the existing problem.

Test number 6: for kids 5-6 years old. There are so many requirements for the mental, including intellectual, development of the five-year plan that you and I can get into the category of ZPR. However, here we will restrict ourselves to the most striking signs of delay, which cannot be overlooked.

1. SCORE: A 5-year-old child should not only count confidently to ten, but also perform the simplest computational operations for addition and subtraction. Play: put 3 balls on your palm, show them to the kid, let him count. Make a fist and hide behind your back. Behind your back, transfer 1 ball from one fist to another and show the baby the same palm, but with 2 balls. Keep your other hand in a fist in front of the child. "How many balls do you think are in your fist?" Having counted the 2 remaining balls, a five-year-old child should confidently say that 1 ball is hidden in his fist. If it is difficult for him not only to count the balls, but to concentrate on the task in general, if even counting up to 5 causes difficulties - urgently hurry to the specialists.
2. FORM AND SIZE: At the age of 3, a child understands where there is "one" and where there is "many", where a circle is drawn, and where is a triangle, where is a big apple, and where is a small one (everything that is bigger - you always need to save for yourself). If, at the age of 5, these concepts are difficult for a child, he cannot remember the names of geometric shapes, numbers, letters - there is every reason to assume he has DPD. Also, guys with CRA do not know how to correctly assemble a pyramid of 8-10 rings at the age of 5. The concepts of size, size are poorly formed, with a delay.
3. COLORS AND SHADES: It is believed that at 2 years old, the baby is already able to find objects of the same color, and at 3 years old, recognize and name the main colors: red, blue, yellow. Can you imagine how a baby feels if he is already 5 years old, but he does not know flowers? In the kindergarten, they laugh, mom gets angry, and grandfather just throws up his hands. But what if the baby simply cannot remember and distinguish colors from one another? We need to help the little one and start working to establish the cause of such a delay in development and start practicing. It's never too late to do this - at 2 years old and at 6 years old.
4. PRODUCTIVE ACTIVITIES: At 5-6 years old, the above activity will tell us a lot about the baby. It includes drawing, modeling, construction, that is, all types of activities where the child expresses himself. But if the stock of images in memory is small, the details of objects are constantly slipping away - you will never get a beautiful, believable drawing or construction. It is worth worrying if a 5-year-old toddler is still drawing "cephalopods", that is, people without a body, endless "kalyak-malyak", and when doing small work his fingers tremble, the pressure on the pencil is weak. Often such guys will not learn how to write even the simplest letters: they draw sticks in different directions, and even from right to left. Usually, the coordination of movements leaves much to be desired.

Who will help?

If the parents have suspicions about the insufficiently good development of the baby, first they need to visit a neuropsychiatrist. Not a neuropathologist, but a neuropsychiatrist. If a doctor is a good specialist, he will not cut from the shoulder and give out diagnoses with might and main, one is worse than the other. You should not believe such a doctor: impaired development is not an obvious disease of the organ, such a violation must also be proved. Of course, an experienced doctor will immediately notice that something is wrong with a 5-7 year old child, but even in this case, you need to undergo a series of examinations, on the basis of which the neuropsychiatrist will draw a final conclusion. At the first appointment with a doctor (and a speech therapist, a psychologist, anywhere!), Many children are shy, withdrawn, do not behave quite adequately, which, of course, affects the results of the examination. How often doctors, without thinking, label such a child with "autism", "oligophrenia", "alalia" (lack of speech). Each parent is obliged to protect their child, including from hasty conclusions would-be doctors.

So where do we start?

Let's say that a neuropsychiatrist turned out to be a conscientious specialist and suspected a malfunction in your 5-year-old baby. In this case, the doctor is obliged to collect anamnesis, that is, to ask you about how the pregnancy, childbirth, the first years of your baby's life proceeded. Based on even this first conversation, he may ask you to take the child for an EEG (electroencephalogram) or echo-EEG (this study is considered more accurate). You will also need to visit an ENT doctor in order to exclude hearing impairment (in hearing impaired children, DPD occurs as a result of this defect). Then - an ophthalmologist (and in children with low vision, there is a PDA as a secondary developmental disorder). Well, of course, you need to undergo a thorough examination by a speech therapist. The speech therapist should clarify whether the child has an RRP (one or another delay in the development of speech). If it is not there, then there is no need to talk about any ZPR. If you have the opportunity, go to a good (that is, an experienced and kind) defectologist. He will not only confirm or deny the diagnosis of DPD once again, but will also be able to figure out what caused the DPD: it happens that DPD acts as an independent developmental disorder, and it happens that due to, for example, pedagogical neglect. Also, the defectologist will determine what kind of CRA the baby has: organic, somatic or social. All this is important for work planning, because in each case the correction is different.

If there is a ZPR

Parents should not be ashamed of this diagnosis, because this problem lends itself well to correction. For example, a good defectologist of 10 children in a group for school, eight have this diagnosis removed. So, what to do if mental retardation is beyond doubt, and all examinations have been passed. Parents of such a baby have the right to be enrolled in a group for children with disabilities, which are usually completed in ordinary kindergartens. For example, there are 8 groups in the kindergarten, two of which are for children with mental retardation. No more than 10 people are recruited there. And they carefully plan correctional and pedagogical work. In addition to the defectologist, a speech therapist is engaged with the children (often these positions are combined by one person). The psychologist must also be with such a group. All other classes are conducted by the teacher in the same way as in ordinary groups. There is no special program approved by the Ministry of Education. Children are regularly examined by the listed specialists, they make interim diagnostics in order to determine the dynamics of the development of each child, they try to work together.

In general, the tasks of specialists include the development of thinking, memory, attention of children to the maximum possible level, teaching role-playing games, communication, correct speech. Of course, the children are taught literacy and the basics of mathematics. Much attention is paid to working with parents. Classes with children, whose parents ignore parental meetings, the homework of the defectologist, the advice of a psychologist and educators, are very ineffective. As a rule, such children turn out to be insufficiently prepared for school, even if they were trained by first-class specialists. If, according to the results of testing by a school psychologist, a child will definitely not be able to study well in grade 1 of a regular school, then this is not a reason for panic. Too many moms and dads even ask to define their child in a correction (or alignment, which is the same thing) class. Unfortunately, not every school has such classes, although the demand for them is enormous. It is not uncommon for parents to start developing their child only when he was 6 years old. But what can you do in kindergarten in 1 year? Almost nothing. There are often cases when the child could not be accurately diagnosed, as the mother did not fight. Hearing from doctors and speech therapists the same thing: “Nothing, come at 5 years old. Now all children start talking late ”, parents are often delusional. And if at the same time the baby is also extremely painful, then what kind of kindergarten is there! And so it turns out that by the age of 7, the question arises of where to study the baby: in a regular class or in an equalization class. In such a class, a very gentle environment, although the curriculum is the same as for everyone. In a class of 10-12 people, the teacher has the opportunity to pay attention to each student. A speech therapist and a psychologist are sure to work with young students. After elementary school, that is, after grade 4, children move to the usual 5th grade, and study there, like other students. Alignment has completed successfully.

Expanding the boundaries

Strange as it may seem, but it is very interesting for both the mother and the specialist to deal with the children with DPD. It's nice to see the results of your work, and they are visible almost immediately. Establishing life and education of such a baby at home, a responsible mother will always use the Internet and find a lot of everything interesting and useful for her little one. Many mothers are so addicted to new educational technologies that they subsequently go to study at the defectological faculty of institutes. And these mothers always become the best, progressive teachers who work "with a soul." But still, do not get too carried away with newfangled ideas. Let's figure out which common pedagogical systems and methods are harmful to a child with mental retardation, and which ones are beneficial.

Montessori Pedagogy – optimal choice for children with developmental disabilities. The fact is that only here the whole world experience of pedagogical innovations, time-tested, is summarized. The scientifically grounded, verified to the smallest detail, the system of Maria Montessori never ceases to amaze defectologists and speech therapists. Parents are not only surprised, but also actively accept her. Here your kid with DPD will have a unique opportunity to work and develop according to their own internal laws. Observation for the Montessori teacher is the main tool in the work. Observing each child, the teacher draws up his psychological and personal "portrait", outlines a work plan and, together with the child, brings it to life, somewhere directing the child, and somewhere allowing him to cope on his own. It is this approach that will make the kid not a submissive student-performer, but a little man who demonstrates all his hidden capabilities, an independent personality. There is no need to talk about intellectual development in such groups. All graduates are always ready for school, read, write, operate with multiple-digit numbers, and can work both independently and in a team.

And here Waldorf pedagogy not very suitable for guys like the pedagogical system. Here the teacher acts in his authoritarian, dominant role, where the student is assigned the role of a listener-performer. The personality of a child with CRD is very peculiar and easy to suppress. Many children also suffer from infantilism, which can only be fought by giving the child more freedom in choice and independence. Unfortunately, in Waldorf Gardens this is more difficult to implement.

As the only optimal method of teaching literacy, the method of N.A. Zaitsev. "Zaitsev Cubes" - adequate educational technology, especially for children with mental retardation. Not only do kids learn to read faster than their peers using the Cubes, but also the learning itself is joyful, rich, with "running around". The quality of training is very high: already at the age of 5, children with DPD seemed to themselves, without coercion, have learned what an accent is, a capital letter, a period, and the rules zhi-shi, cha-schu, chu-schu are not questioned at all. Many children with PDD are hyperactive, inattentive, and have difficulty learning the concepts of "letter", "syllable", "word". “Cubes” are the only methodology today where these concepts are given in an accessible playful form, where “workarounds” in learning are invented, where all the intact functions of the body are involved.

Great harm for "special" kids comes from learning to read according to the method Glen Doman... These classes cannot even be called “literacy training”; children do not become literate. Learning by this technique, the child's brain is "loaded" with the same type of information: visual images of words on cards. In principle, the idea itself is not new: from time immemorial, global reading has been used in teaching deaf children. But always (!) At a certain stage they move away from global reading in order to give the child a feel for the language itself, in all its diversity of linguistic forms. By showing the child cards with words, the very possibility of mastering the endings (cases, gender, number) is excluded. The child perceives the word as a picture that he simply “recognizes” from a number of others. For a toddler with CRD, this approach is destructive. Not only will the memory of children with DPD never master such a volume of "pictures", but also the development of speech suffers. The kids have poor vocabulary, a huge number of agrammatisms (incorrect use of just endings, suffixes, stress, misunderstanding of the relationship of words in sentences). It is very important to work on meaningful literacy training, in the process of which the child clearly sees how words change, how new ones are obtained: CAT - KITTEN - KITTENS; GO - COME - LEAVE; SNOW - SNOWFLAKE - SNOWMAN; BALL - TO BALL - BALL - ABOUT BALL, etc.

Some computer programs are very good for the development of children with DPD, for example, "Games for Tigers", "Seeker. Dreamer "," Go there - I don't know where. " And for the pupils of the correction class, for example, the useful program "Living Planet" is suitable, which will perfectly develop the outlook of the student.

Many childcare centers have interesting activities that are very suitable for children with mental retardation. For example, Lego therapy classes, sand therapy (using sand), play therapy, and fairy tale therapy will perfectly stimulate the development of the baby.

The golden rules of defectology

1. The earlier the correction work is started, the better the result will be.
2. It is necessary to see not only the weaknesses of the baby with CRD, but also the strong, intact sides of his entire personality. There are ALWAYS such sides.
3. The problem should be approached in a comprehensive manner, that is, various specialists should be involved in training and treatment.
4. Respectful, kind attitude towards special children. The feelings of the child, caused by ridicule or condemnation of others, are no less strong and deep than those of other children.

The main thing for parents of a toddler with CRD is never to give up. And then, at the reception already at the school psychologist, and on the playground, you can rightfully be proud of your baby and yourself much more than others: after all, you have accomplished a small feat - you changed the fate of the little man for the better!

The concept of mental retardation.

Mental retardation (PDD) -a special type of anomaly, manifested in a violation of the normal pace of the child's mental development. It can be caused by various reasons: defectsconstitution of the child (harmonic infantilism),somatic diseases, organic lesions of the central nervous system (minimal brain dysfunction).

Children with CRD are unsuccessful from the very beginning. However, the inadequacy of their intelligence is more correctly defined not as backwardness, but as lagging behind. In Russian science, the CRA refers to the syndromes of a temporary lag in the development of the psyche as a whole or of its individual functions (motor, sensory, speech, emotional-volitional), the slowed-down rate of realization of the organism properties encoded in the genotype. As a consequence of temporarily and mildly acting factors (early deprivation, poor care, etc.), CRA can be reversible. Constitutional factors, somatic diseases, and organic insufficiency of the nervous system play a role in the etiology of cerebrovascular accidents.

Classification ZPR K.S. Lebedinskaya.

The main clinical types of CR are differentiated according to the etiopathogenetic principle: CR of constitutional origin, CR of somatogenic origin, CR of psychogenic origin, CR of cerebral-organic origin.

Each of these types of CRD has its own clinical and psychological structure, its own characteristics of emotional immaturity and impairments to cognitive activity, and is often complicated by a number of painful signs - somatic, encephalopathic, and neurological.

The presented clinical types of the most persistent forms of cerebrovascular accidents mainly differ from each other precisely by the structural features and the nature of the ratio of the two main components of this developmental anomaly: the structure of infantilism and the nature of neurodynamic disorders.

When CRA of constitutional originwe are talking about the so-called harmonious infantilism, in which the emotional-volitional sphere is, as it were, at an earlier stage of development, in many respects resembling the normal structure of the emotional makeup of younger children. Characterized by the predominance of emotional motivation of behavior, an increased background of mood, spontaneity and brightness of emotions with their superficiality and lack of persistence, easy suggestibility.

CRA of somatogenic origin due to long-term somatic insufficiency of various genesis: chronic infections and allergic conditions, congenital and acquired malformations of the somatic sphere. Often there is a delay in emotional development - somatogenic infantilism, due to a number of neurotic layers - uncertainty, fearfulness, capriciousness associated with a feeling of physical inferiority.

CRD of psychogenic origin is associated with unfavorable conditions of upbringing that prevent the correct formation of the child's personality (the phenomenon of hypo-care, hyper-care, etc.). The traits of pathological immaturity of the emotional-volitional sphere in the form of affective lability (instability of mood with pronounced manifestations of often changing emotions), impulsivity, increased suggestibility, indecision in these children are often combined with an insufficient level of knowledge and ideas necessary for mastering school subjects.

CRA of cerebral organic origin occurs more often than the other types described above, often has a greater persistence and severity of violations both in the emotional-volitional sphere and in cognitive activity.

The study of the anamnesis of these children in most cases shows the presence of a mild organic failure of the nervous system. Depending on the prevalence in clinical picture the phenomena of either emotional-volitional immaturity, or disturbances in the cognitive activity of cerebral genesis cerebral locomotion can be conditionally divided into two main variants: 1) organic infantilism; 2) mental retardation with a predominance of functional disorders of cognitive activity.

Usually, different kinds organic infantilism is a milder form of cerebral-organic developmental retardation, in which functional disorders of cognitive activity are caused by emotional-volitional non-maturity and mild cerebrasthenic disorders.

In CRD with a predominance of functional disorders, 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, visual-motor coordination, automation of movements and actions. Often there are poor orientation in "right - left", the phenomenon of specularity in writing, difficulties in differentiating similar graphemes.

At the same time, a certain partialness, mosaicity of violations of individual cortical functions is noted. Obviously, in this regard, some of these children experience predominant difficulties in mastering reading, others in writing, and still others in counting, fourths exhibit the greatest lack of motor coordination, fifths in memory, etc. X. Spionek (1972) emphasizes that such a child does not have a sufficient number of premises on which logical thinking is built.

School applicants children with mental retardation a number of specific features are inherent. On the whole, they are not ready for schooling. They have insufficiently formed the skills, skills and knowledge necessary for mastering the program material, which normally developing children usually master in the preschool period. In this regard, children are unable (without special assistance) to master counting, reading and writing. It is difficult for them to comply with the accepted norms of behavior at school. They have difficulty in organizing their activities voluntarily: they do not know how to consistently follow the teacher's instructions, switch from one task to another at his direction. Their difficulties are aggravated by the weakened nervous system. Students with a delay in mental development quickly get tired, their performance decreases, and sometimes they simply stop performing the activity they have begun.

Decreased performance and instability inherent in these children attention have different forms of individual manifestation. In some children, the maximum tension of attention and the highest working capacity are found at the beginning of the task and steadily decrease as the work continues; for others, concentration of attention occurs only after a certain period of activity; in others, periodic fluctuations in attention and uneven performance are noted throughout the entire duration of the task.

It has been found that many of these children have difficulty in the process perception ... First of all, this is manifested in the fact that children do not perceive the presented educational material with sufficient completeness. Much is misunderstood by them. This is important to keep in mind, as it is easy to assume that children who have no hearing or vision impairments should not have difficulty in perceiving.

All children with mental retardation also have disadvantages memory: moreover, these shortcomings concern all types of memorization: involuntary and voluntary, short-term and long-term. First of all, as shown in the studies of V.L.Podobed, they have a limited memory capacity and reduced strength of memorization. This extends to memorizing both visual and (especially) verbal material, which cannot but affect academic performance.

A significant lag and originality is also found in the development of their mental activity ... Both are most evident in the process of solving intellectual problems. Thus, when independently analyzing the objects he proposed for describing, children with mental retardation emit significantly fewer signs than their normally developing peers.

The most typical mistakes of children with mental retardation are the substitution of comparison of one object with all the others by pairwise comparisons (which does not give a true basis for generalization) or generalization based on inessential signs. The mistakes that normally developing children make when performing such tasks are due only to an insufficiently clear differentiation of concepts.

The fact that, after receiving help, the children of the group under consideration are able to perform the various tasks offered to them at a level close to the norm, allows us to speak of their qualitative difference from mentally retarded children. Children with mental retardation have much greater potential in terms of the ability to master the educational material offered to them.

One of the psychological characteristics of children with mental retardation is that they have a lag in the development of all types of thinking. This lag is found to the greatest extent during the solution of tasks involving the use of verbal-logical thinking.

The development of visual-figurative thinking in children lags significantly behind. It is especially difficult for these children to operate in their minds with parts of images (S.K.Sivolapov). Least of all, their visual-active thinking lags behind in development. Children with mental retardation who study in special schools or special classes begin to solve problems of a visual-effective nature at the level of their normally developing peers by grade IV. As for the tasks related to the use of visual-figurative and verbal-logical thinking, they are solved by the children of the group in question at a much lower level.

Differs from the norm and speech children with mental retardation. Many of them have pronunciation defects, which naturally leads to difficulties in the process of mastering reading and writing. Children of the considered group have a poor vocabulary (especially active), they poorly form empirical grammatical generalizations; therefore, in their speech there are many incorrect grammatical constructions.

They are distinguished by significant originality behavior and activity these children. After entering school, they continue to behave like preschoolers. The leading activity remains the game. Children do not have a positive attitude towards school. Learning motivation is absent or extremely weak. It was suggested that the state of their emotional-volitional sphere corresponds, as it were, to the previous stage of development.

It is very important to note that under the conditions of a mass school, a child with mental retardation for the first time begins to clearly realize his inconsistency, which is expressed primarily in academic failure.This, on the one hand, leads to the appearance of a feeling of inferiority, and on the other, to attempts at personal compensation. in any other area. Such attempts are sometimes expressed in various behavioral disorders ("antics").

Under the influence of failures, a child with mental retardation rapidly develops a negative attitude toward learning. This can and should be avoided. It is necessary to carry out an individual approach to each such child, based on a deep knowledge of the peculiarities of the development of his mental processes and personality as a whole. The teacher must in every possible way support the child's initially positive attitude towards school. One should not emphasize the lack of success in educational activities and criticize for not quite adequate behavior. Sometimes it is necessary to encourage the child to perform the proposed tasks based on the play motivation of the activity.

If the indicated lag and not quite adequate behavior cannot be overcome in the conditions of a mass school, it is necessary, having prepared a detailed psychological and pedagogical description with a description of all the features of the child's behavior in the classroom and in his free time, send the child to a medical and pedagogical commission, which will resolve the issue on the advisability of transferring him to a special school for children with mental retardation.

Features of the manifestation of ZPR

Children with mental retardation are the most difficult to diagnose, especially in the early stages of development.

Children with CRD in a somatic state have frequent signs delays in physical development (underdevelopment of muscles, lack of muscle and vascular tone, stunted growth), delayed formation of walking, speech, neatness skills, stages of play activity.

These children have peculiarities of the emotional-volitional sphere (its immaturity) and persistent disturbances in cognitive activity.

Emotionally - volitional immaturity is represented by organic infantilism. Children with CRD lack the vividness and vividness of emotions typical for a healthy child; they are characterized by weak will and weak interest in assessing their performance. The game is distinguished by the poverty of imagination and creativity, monotony, monotony. These children have poor performance as a result of increased exhaustion.

In cognitive activity, the following are observed: weak memory, instability of attention, slowness of mental processes and their reduced switchability. A child with CRD needs a longer period to receive and process visual, auditory and other impressions.

Researchers call the most striking sign of DPD the 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, disturbances of attention inevitably appear: its instability, decreased concentration, increased distraction. Attention disorders can be accompanied by increased motor and speech activity. Such a complex of deviations (impaired attention + increased motor and speech activity), not complicated by any other manifestations, is currently referred to as "attention deficit hyperactivity disorder" (ADHD).

^ Violation of perception is expressed in the difficulty of building a holistic image. For example, it may be difficult for a child to recognize objects he knows from an unfamiliar perspective. Such a structured perception is the cause of insufficiency, limitation, knowledge about the world around. The speed of perception and orientation in space also suffer.

If we talk about the peculiarities of memory in children with mental retardation, then one pattern was found: they memorize 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 indicators of children with CRD improved even in comparison with normally developing children.

DPD is often accompanied by speech problems associated primarily with the rate of its development. Other features of speech development in this case may depend on the form of severity of CR and the nature of the underlying disorder: for example, in one case it may be only some delay or even compliance with the normal level of development, while in the other case, there is a systemic underdevelopment of speech - a violation of its vocabulary grammatical side.

In children with CRD, there is a lag in the development of all forms of thinking; it is revealed first of all during the solution of problems on verbal-logical thinking. By the beginning of schooling, children with mental retardation do not fully master all the intellectual operations necessary for completing school assignments (analysis, synthesis, generalization, comparison, abstraction).

Children with CRD are characterized by a limited (much poorer than normally developing children of the same age) supply general information about the environment, insufficiently formed spatial and temporal representations, poor vocabulary, poorly formed skills of intellectual activity.

The immaturity of the functional state of the central nervous system is one of the reasons that children with CRD are not ready for schooling by the age of 7. By this time, as a rule, they have not formed the basic mental operations, they do not know how to navigate in tasks, do not plan their activities. Such a child hardly masters the skills of reading and writing, often mixes letters that are similar in outline, and has difficulty in writing the text on his own.

In a mass school environment, children with CRD naturally fall into the category of consistently poor students, which further traumatizes their psyche and causes a negative attitude towards learning.

3. Physiotherapy for parents.

Teacher: -Let's remember the traffic lights. What does red light mean? Yellow? Green? Well done, now let's turn into a traffic light. We'll check your attention at the same time. If I say "Green", you stamp your feet; "Yellow" - clap your hands; “Red” is silence. And I will be a faulty traffic light and will sometimes show incorrect signals.