How to react to parents if the record “delay mental development". Of course, they are scared enough, but do not give up. In the case of CRA, the main thing is to find out the cause of the problem and understand how to deal with it. More details - in our old material.

How to recognize?

Impaired mental function - violation of the established terms of maturation of the emotional-volitional and intellectual spheres of the child, slowing down the pace of development of the psyche.

Can parents themselves suspect the problem? If the baby is three months old absent " " , that is, he does not begin to walk and smile in response to the voice and smile of his parents - it is necessary to go to an appointment with a pediatric neurologist.

What will the doctor pay attention to? There are certain normative terms according to which at 1-2 months the baby must follow the rattle with his eyes, at 6-7 - sit, at 7-8 - crawl, at 9-10 - stand, and by the age of one year old take the first steps. If the development of the child does not correspond to the norms, the neurologist may assume problems. Another factor of concern is if the child suddenly regresses, that is, he stops doing what he already knew or does it much worse than before.

The kid grew up and his parents noticed that he behaving wrong , as his peers, has difficulties with communication, problems with mastering speech, it is difficult for him to concentrate, is he closed or uncoordinated? With all such manifestations, the doctor can state a mental retardation, which means it is time to figure out what led to it and find a way to deal with the disease.

You will have to work in a close team: a pediatrician, a neurologist, parents, sometimes a speech therapist and a child psychiatrist are included. It is important to understand what led to the developmental delay and to find ways in which the child will catch up with his peers.

Voinovskaya Irina Vladimirovna, pediatric neurologist of the Dobrobut Children's Clinic on the Left Bank says: “The reasons for the delay in psychological development can be both biological - pathologies of pregnancy, prematurity, trauma and asphyxiation during childbirth, mother's illness in the early stages of fetal development, genetic conditioning, and social - long-term limitation of the child's life, unfavorable conditions of upbringing, psycho-traumatic situations in life child. If parents notice unstable emotions in a child, a decrease in cognitive activity, problems in the formation of speech activity with a child, you should contact a child neurologist, speech therapist, psychologist or psychiatrist. Experts will develop an individual scheme of pedagogical and medical correction, which, together with the close attention of parents to the development of the baby, will help to partially or even completely overcome the mental retardation. "

How does it manifest

The most striking sign of ZPR doctors call immaturity of the emotional-volitional sphere ... It is quite difficult for a child with such a disease to force himself to do something.

Consequently - attention deficit and decreased concentration ... The kid is often distracted, it is difficult to interest him in any process.

Due to problems with a limited amount of knowledge about the world around them, children diagnosed with IAD may develop difficulties with orientation in space , they find it problematic to recognize even familiar objects from a new perspective.

A feature of children with mental retardation is that they better remember what they see than what they hear, and they also often have problems with the development of speech at different levels.

Lagging is also observed in thinking, for example, children with mental retardation have serious difficulties while solving problems based on synthesis, analysis, comparison and generalization.

Reasons and not only

What is the reason for the violation of normal development in a child?

These are genetic factors, and mild organic brain damage due to an illness (for example, a severe form of flu or), a number of factors associated with the development of a child in infancy (irrational use of large doses of antibiotics), an unfavorable course of pregnancy and childbirth (illness, intoxication, asphyxia during childbirth).

Vaccination of a baby with neurological problems or can also provoke CRA. For example, mental retardation is noted in almost all orphanage children, and those who did not get there directly from the hospital, but were with their mother for a while, regression of previously acquired skills is observed.

Many experts believe that social and pedagogical factors are the cause of DPD: an unfavorable situation in the family, lack of development, difficult living conditions.

Our mom- Anutik tells: “At the age of 3 we had OHR, ZRR, pseudobulbar dysarthria. The EEG showed organic brain damage, without intellectual disruption ... His coordination and setting of the legs when walking was slightly impaired. He spoke 5 words at that time, without verbs. Somewhere 3.5 years of intensive training, the child had other words, then simple sentences, then a story. At 5.5 years old, we began to slowly master reading, and by the age of 6 my child began thorough preparation for entering the 1st grade ... Now we are first graders, in the most ordinary kindergarten school, near the house, studies are good, even Ukrainian we master it, although before school I grew up in a Russian-speaking family ... English is bad for now, but I don't really want to load it with the third language, in fact, for him. The memory is good, we learn poems well ... The child likes the team, they like it when they take everyone out for a walk, play all sorts of games on the street with a crowd, like to stay at the extended day and all drink tea and eat sandwiches together at the table, like to do the lessons in an organized way. ... There remained blurred speech, of course, mild dysarthria, some neurological moments. But while they are small, 1st grade, classmates do not really understand what the matter is, they do not distinguish him on this basis, besides, there are still a lot of ordinary children in the class who still don’t speak "p", hissing. But in 2 years (from 3.5 to 5.5), I can tell you, the child made a HUGE breakthrough in the development of speech ... We underwent treatment at a speech center in Kiev. And there, each course of classes with a speech therapist, massage therapist and other specialists is always supported with medication. How everything will develop further, she herself is in the dark .... Let's see ... "

What to do?

So, what should parents do if doctors have found and confirmed the diagnosis of mental retardation in the baby?

If a diagnosis is made, then specialists should determine the cause , due to which there was a developmental delay. It is also important to understand if the child has any related problems, for example, if the child has difficulty developing speech, it is important to understand that he does not have hearing problems.

If the doctor prescribes the child medicines , which will have a direct impact on his psyche, try to be sure to get an appointment with another specialist in order to listen not one, but two, three or five opinions. Most often, experts are of the opinion that in case of CRA, the correct rehabilitation of competent specialists is sufficient.

Find a child working with children diagnosed with CRD in your city. Working in adaptation groups, mini-kindergartens or independently, the child will be able to cope with the disease faster, and parents will receive qualified consultations and will be able to participate in trainings.

Specialists of the center for helping children with mental retardation will develop individual program rehabilitation baby, which will be aimed directly at stimulating the affected mental processes.

Work with your child according to the developed rehabilitation program under the supervision of the center's specialists, and most importantly - do not lose contact with the child, believe in his development.

Our mother - JuliaL tells: “In my opinion, the most important thing is not to lose contact with the child, not to let HIM move away ... You see, I have two more ordinary children, and for a long time I could not understand what was wrong with my son ... I was already thinking Maybe I really have some kind of coldness, or something ... And then I realized that he was trying to distance himself, withdraw into himself, but you can't let go. Such contact helps us a lot to keep the family in general, sisters, pets - although there are a lot of problems and inconsistencies. It was a great happiness when, after 3 years, he first began to settle down next to me, then he said "mother", at 5 he suddenly began to hug ... lives with us, etc. IMHO - medical specialists-teachers advise what they know, but everything must be applied with an eye to how the mother feels. It is very important that we, our children and they feel good with us, do not break this. Honestly, we have trips, some good, warm events have always made some progress. And when "building" the son does not give progress at all ... This is the simplest and most difficult for me, sorry for the unnecessary emotions ... "

We are sure that if you start working with your baby in a timely manner, you will be able to solve many problems, and over time the child will recover and will not be any different from his peers!

The works of Klara Samoilovna and Viktor Vasilievich Lebedinskikh (1969) are based on the etiological principle, which makes it possible to distinguish 4 variants of such development:

1. CRA of constitutional origin;

2. DPR of somatogenic origin;

3. CRA of psychogenic origin;

4. DPR of cerebral-organic origin.

In the clinical and psychological structure of each of the listed variants of CRA, there is a specific combination of the immaturity of the emotional and intellectual spheres.

1.ZPRconstitutional origin

(HARMONIC, MENTAL and PSYCHOPHYSIOLOGICAL INFANTILISM).

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

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

However, such an "infantile" constitution can be formed as a result of not rude, for the most part metabolic and trophic diseases transferred in the first year of life. If at the time of intrauterine development, then this is genetic infantilism. (Lebedinskaya K.S.).

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

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

2. CRA of somatogenic origin

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

Prolonged dyspepsia during the first year of life inevitably leads to developmental delays. Cardiovascular failure, chronic inflammation of the lungs, and kidney disease are common in the history of children with CRD of somatogenic origin.

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

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

3. CRA of psychogenic origin

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

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

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

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

Option abnormal development personality as "family idol" it is caused, on the contrary, by overprotection - wrong, pampering upbringing, in which the child is not instilled with the features of independence, initiative, responsibility. For children with this type of CRD, against the background of general somatic weakness, a general decrease in cognitive activity, increased fatigue and exhaustion are characteristic, especially with prolonged physical and intellectual exertion. They get tired quickly and take longer to complete any study tasks. Cognitive and educational activities suffer SECONDLY due to a decrease in the general tone of the body. This type of psychogenic infantilism, along with a small capacity for volitional effort, is characterized by features of egocentrism and selfishness, a dislike for work, an attitude toward constant help and care.

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

4.RMD of cerebral organic origin

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

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

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

Pathology of pregnancy and childbirth, infections, intoxication, incompatibility of the blood of the mother and the fetus by the Rh factor, prematurity, asphyxia, trauma during childbirth, postnatal neuroinfections, toxic - dystrophic diseases and trauma of the NA in the first years of life. - The reasons are to a certain extent similar to the causes of oligophrenia.

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

Similar terms: "minimal brain damage", "mild childhood encephalopathy", "hyperkinetic chronic brain syndrome".

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

FEATURE OF ZPR - there is a qualitatively different structure of intellectual disability in comparison with y / o. Mental development is characterized by an UNEQUALITY of violations of various mental functions; while logical thinking m. more intact in comparison with memory, attention, mental performance.

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

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

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

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

Special studies of LDM have shown that

RISK FACTORS ARE:

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

Pathological course of previous pregnancies;

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

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

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

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

Abnormal childbirth with forceps, by caesarean section etc.

DIFFERENCE FROM Y / O:

1. Massive defeat;

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

exogenous brain damage affecting the period

when the differentiation of the main brain systems already in

well advanced and there is no danger of their rude

underdevelopment. However, some researchers suggest

and the possibility of genetic etiology.

3. The delay in the formation of functions is qualitatively different from that for

oligophrenia. In cases with CRD, the presence of

temporary regression of acquired skills and their subsequent

instability.

4. Unlike oligophrenia, children with CRD have no inertia

mental processes. They are capable of not only accepting and

use help, but also transfer the learned skills of mental

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

perform the intellectual tasks offered to them on a close to

norm level.

5. The prevalence of later terms of the defeat determines the side

with the phenomena of UNMATURITY almost constant PRESENCE

DAMAGE TO NS → Therefore, unlike oligophrenia, which

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

CEREBRAL-ORGANIC GENESIS - almost always available

a set of encephalopathic disorders (cerebroasthenic,

neurosis-like, psychopathic), indicating

damage to NS ..

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

The data of neuropsychological studies allowed to identify a certain HIERARCHY OF DISORDERS OF Cognitive PERFORMANCE IN CHILDREN WITH DISEASE OF CEREBRAL ORGANIC GENESIS.So, in more mild cases it is based on neurodynamic insufficiency, associated primarily with the depletion of mental functions.

With a greater severity of organic brain damage, to the more gross neurodynamic disorders, which are expressed in the inertia of mental processes, the PRIMARY DEFICIENCY OF INDIVIDUAL CORK-SUBCORTAL FUNCTIONS: praxis, visual gnosis, memory, speech sensorimotorics is added. + At the same time, a certain PARTIALITY, MOSAIC OF THEIR DISORDERS is noted. (Therefore, some of these children experience difficulties mainly in mastering reading, others in writing, others in counting, etc.). PARTIAL INSUFFICIENCY OF CORKAL FUNCTIONS, in turn, leads to the underdevelopment of the most complex mental neoplasms, including REGULATORY REGULATION. Thus, the hierarchy of mental disorders in cerebral-organic genesis of mental retardation is the opposite of the one that exists in oligophrenia, where the intellect primarily suffers, and not its prerequisites.

1. EMOTIONAL WILLED UNMATURITY is represented by organic infantilism. With this infantilism in children, there is no typical healthy child liveliness and brightness of emotions. Children are characterized by a weak interest in assessment, a low level of claims. There is a high suggestibility and non-perception of criticism. Game activity is characterized by the poverty of imagination and creativity, a certain monotony and originality, the predominance of the component of motor disinhibition. The desire to play itself often looks more like a way of avoiding difficulties in assignments than a primary need: the desire to play arises precisely in situations of the need for purposeful intellectual activity and preparation of lessons.

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

1) UNSTABLE - with psychomotor disinhibition, euphoric mood and impulsiveness, imitating children's cheerfulness and spontaneity. Characterized by a small ability to volitional effort and systematic activity, the absence of persistent attachments with increased suggestibility, poverty of imagination.

2) BRAKED - with a predominance of a low background of mood, indecision, lack of initiative, often fearfulness, which may be a reflection of congenital or acquired functional insufficiency of autonomic NS. by the type of neuropathy. In this case, sleep disturbances, appetite disturbances, dyspeptic symptoms, and vascular lability can be observed. In children with organic infantilism of this type, asthenic and neurosis-like features are accompanied by a feeling of physical weakness, timidity, inability to stand up for oneself, lack of independence, and excessive dependence on loved ones.

2. DISORDERS OF Cognitive PERFORMANCE.

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

Depending on the prevalence in clinical picture phenomena of either emotional-volitional immaturity, or violations of cognitive activity CRP OF CEREBRAL GENESIS can be roughly divided

on II BASIC OPTIONS:

1.organic infantilism

Its various types represent more easy form DPD of cerebral-organic genesis, in which functional disorders of cognitive activity are caused by emotional-volitional immaturity and mild cerebrasthenic disorders. Disturbances of cortical functions are dynamic in nature, due to their insufficient formation and increased exhaustion. Regulatory functions are especially weak in the control link.

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

In essence, this form often expresses a state bordering on y / o (of course, here the variability of the state in terms of its severity is also possible).

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

OUTPUT: The presented clinical types of the most persistent forms of CRD 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 peculiarities of the development of mental functions.

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

CLASSIFICATION OF ZPR by L.I. PERESLENI and E.M. MASTYUKOVA

II TYPE ZPR:

1) Type GOOD (NON-SPECIFIC) DELAY - is not associated with brain damage and is compensated with age under favorable environmental conditions, even without any special therapeutic measures. This view ZPR is caused by a slower rate of maturation of brain structures and their functions in the absence of organic changes in the central nervous system.

Benign (nonspecific) developmental delay is manifested in some delay in the formation of motor and (or) psychomotor functions, which can be detected at any age stage, is relatively quickly compensated for and is not combined with pathological neurological and (or) psychopathological symptoms.

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

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

Benign nonspecific delay can be a familial feature and is often seen in somatically weak and premature infants. It can also take place when there is insufficient early pedagogical influence.

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

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

Along with severe diseases of NS, causing a delay in development, most children have mild neurological disorders, which are detected only with a special neurological examination. These are the so-called signs of MMD, which usually occur in children with cerebral-organic cerebral derangement.

In many children with this form of CRD, motor disinhibition - hyperactive behavior - is found in the first years of life. They are extremely restless, are constantly on the move, all their activities are unfocused, they cannot complete any business they have begun. The appearance of such a child always brings anxiety, he runs, fusses, breaks toys. Many of them are also characterized by increased emotional excitability, pugnaciousness, aggressiveness, and impulsive behavior. Most children are not capable of play activities, they do not know how to limit their desires, they react violently to all prohibitions, and are stubborn.

For many children, motor awkwardness is characteristic, they have poorly developed fine differentiated movements of the fingers. Therefore, they hardly master the skills of self-service, for a long time they cannot learn to fasten buttons, lace up their shoes.

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

Lagging behind in the development of certain psychomotor functions SPECIFICALLY FOR EACH AGE STAGE OF DEVELOPMENT.

So, in the period NEWBORNS - such a child long time a clear conditioned reflex for a time is not formed. Such a baby does not wake up when he is hungry or wet, and does not fall asleep when he is full and dry; all unconditioned reflexes are weakened and are evoked after a long latency period. One of the main sensory reactions of this age is weakened or does not manifest at all - visual fixation or auditory concentration. At the same time, in contrast to children with CNS damage, he does not show signs of dysembryogenesis, malformations, including those expressed to a minimum. He also does not have disturbances in screaming, sucking, or muscle tone assimilation.

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

At all subsequent stages of development, benign developmental delay is manifested in the fact that the child in its development goes through stages that are more characteristic of the previous stage. However, CRD can appear for the first time at each age stage. For example, a child of 6 months with this form of developmental delay does not give a differentiated reaction to acquaintances and strangers, he may also have delayed development of babbling, and a child at 9 months may show insufficient activity in communicating with adults, he does not imitate gestures, he has weak playful contact is developed, babbling is absent or weakly expressed, intonational-melodic imitation of a phrase does not appear, he can hardly grasp or not grasp small objects at all with two fingers or not respond clearly enough to verbal instructions. The slower pace of motor development is manifested in the fact that the child can sit, but not sit down on his own, and if he is sitting, he does not attempt to get up.

Benign developmental delay in age 11-12 MONTHS manifests itself most often in the absence of the first babbling words, weak intonational expressiveness of vocal reactions, indistinctness of the correlation of words with an object or action. The delay in motor development is manifested in the fact that the child stands with support, but does not walk. Lagging in mental development is characterized by weakness of repetitive actions and imitative games, the child does not confidently manipulate with two hands, and does not grasp objects with two fingers.

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

В 4. PSYCHOLOGICAL PARAMETERS OF ZPR

Mental retardation (PDD) - a syndrome of temporary lag in the development of the psyche as a whole or its individual functions, a slowdown in the rate of realization of the body's potential capabilities, is often found when entering school and is expressed in a lack of general stock of knowledge, limited ideas, immaturity of thinking, low intellectual purposefulness, predominance of game interests, rapid oversaturation in intellectual activity.

Causes zpr occurrence can be divided into two large groups:

1. reasons of a biological nature;

2. reasons of a socio-psychological nature.

Biological reasons include:

1) various options for the pathology of pregnancy (severe intoxication,

rh-conflict, etc.);

2) prematurity of the child;

3) birth trauma;

4) various somatic diseases (severe forms of influenza, rickets, chronic diseases - defects of internal organs, tuberculosis, syndrome of impaired gastrointestinal absorption, etc.)

5) non-severe brain injury.

Among the reasons for a socio-psychological nature are:

1) early separation of the child from the mother and upbringing in complete isolation in conditions of social deprivation;

2) a lack of full-fledged, age-appropriate activity: subject, game, communication with adults, etc.

3) distorted conditions for raising a child in a family (hypo-care, hyper-care) or an authoritarian type of upbringing.

At the heart of CRA is the interaction of biological and social causes.

Classification.

According to the systematics of ZPR, Vlasova T.A. and Pevzner M.S. there are two main forms:

1. Infantilism- violation of the rate of maturation of the most late forming brain systems. Infantilism can be harmonic (associated with functional impairment, immaturity of the frontal structures) and disharmonious (due to the phenomena of the organic matter of the brain);

2. Asthenia- a sharp weakening of the somatic and neurological nature, due to functional and dynamic disorders of the central nervous system. Asthenia can be somatic and cerebral-asthenic (increased exhaustion of the nervous system).

Classification of the main types of RPD according to K.S. Lebedinskaya relies on the Vlasova - Pevzner classification, it is based on the etiological principle:

CRA of a constitutional nature (the cause of occurrence is not the maturation of the frontal parts of the brain). This includes children with uncomplicated harmonic infantilism, they retain the features of a younger age, their interest in play prevails, and educational interest does not develop. These children, under favorable conditions, show good results alignment.

CRA of somatogenic origin (the reason is the transfer of a somatic illness by the child). This group includes children with somatic asthenia, the signs of which are exhaustion, weakening of the body, reduced endurance, lethargy, instability of mood, etc.

CRA of psychogenic origin (the reason is unfavorable conditions in the family, distorted conditions of upbringing of the child (overprotection, hypoclosure), etc.

ZPR of cerebral asthenic genesis(the reason is brain dysfunction). This group includes children with cerebral asthenia - increased exhaustion of the nervous system. Children are observed: neurosis-like phenomena; increased psychomotor irritability; affective mood disorders, apathy-dynamic disorder - decreased nutritional activity, general lethargy, motor disinhibition.

In the clinical and psychological structure of each of the listed variants of ZPR, there is a specific combination of immaturity of the emotional and intellectual spheres.

Features of memory, attention, perception with delayed mental development.

Memory:

Lack of formation of cognitive processes is often the main reason for the difficulties that children with mental retardation develop in school. As shown by numerous clinical and psychological-pedagogical studies, a significant place in the structure of a defect in mental activity in this developmental anomaly belongs to memory impairments. Observations of teachers and parents of children with mental retardation, as well as special psychological studies indicate deficiencies in the development of their involuntary memory. Much of what normally developing children

memorize easily, as if by itself, causes significant efforts among their lagging peers and requires specially organized work with them.

One of the main reasons for the insufficient productivity of involuntary memory in children with CRD is decrease in their cognitive activity... In the study of T.V. Egorova (1969), this problem was subjected to a special study. One of the experimental methods used in the work involved the use of a task, the purpose of which was to lay out pictures with images of objects into groups in accordance with initial letter the names of these items. It was found that children with developmental delay not only reproduced verbal material worse, but also spent much more time on recalling it than their normally developing peers. The main difference was not so much in the extraordinary productivity of the answers, but in the different attitude towards the goal. Children with CRD on their own made almost no attempts to achieve more complete recall and rarely used auxiliary techniques for this. In those cases when this did happen, a substitution of the purpose of the action was often observed. The auxiliary method was used not to remember the necessary words starting with a certain letter, but to come up with new (extraneous) words for the same letter.

Specific features of the memory of children with CRD:

Decreased memory size and speed of memorization,

Involuntary memorization is less productive than normal,

The memory mechanism is characterized by a decrease in the productivity of the first attempts to memorize, but the time required for complete memorization is close to normal,

The predominance of visual memory over verbal,

Decrease in random memory.

Mechanical memory impairment .

These three ominous letters are nothing more than a mental retardation. Doesn't sound very nice, right? Unfortunately, today in a child's medical record one can often find such a diagnosis.

These three ominous letters are nothing but impaired mental function... Doesn't sound very nice, right? Unfortunately, today in medical card a child can often find such a diagnosis.

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

What is suffering

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

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

Researchers call the most striking sign of CRD 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 inevitably appear attention disorders: his 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 denoted by the term "attention deficit hyperactivity disorder" (ADHD).

Perceptual impairment expressed in the difficulty of building a holistic image. For example, it may be difficult for a child to recognize objects they know from an unfamiliar perspective. This structured perception is the reason for the lack, limitation, knowledge about the world around. The speed of perception and orientation in space also suffer.

Talking about memory features in children with CRD, one regularity was found here: 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.

CRP is often accompanied by speech problemsassociated 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.

Children with CRD have 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).

At the same time, CRA is not an obstacle to the development of general educational programs of study, which, however, require certain adjustments in accordance with the characteristics of the child's development.

Who are these children

The answers of experts to the question of which children should be ranked in the group with CRD are also very ambiguous. Conventionally, they can be divided into two camps.

The first adhere to humanistic views, believing that the main reasons for the developmental deficiencies are primarily socio-pedagogical in nature (unfavorable family situation, lack of communication and cultural development, difficult living conditions). Children with mental retardation are defined as unadapted, difficult to learn, pedagogically neglected. This view of the problem prevails in Western psychology, and recently it has become widespread in our country. Many researchers cite data that mild forms of intellectual underdevelopment tend to be concentrated in certain social strata, where parents have an intellectual level below the average. It is noted that hereditary factors play a significant role in the genesis of intellectual underdevelopment.

Probably, it is best to take into account both those and other factors.

So, as the reasons leading to mental retardation, domestic experts M.S. Pevzner and T.A. Vlasov, the following are distinguished.

Unfavorable course of pregnancy:

• mother's illness during pregnancy (rubella, mumps, flu);
• chronic maternal diseases (heart disease, diabetes, thyroid disease);
• toxicosis, especially in the second half of pregnancy;
• toxoplasmosis;
• intoxication of the mother's body due to the use of alcohol, nicotine, drugs, chemical and drugs, hormones;
• incompatibility of the blood of the mother and the baby for the Rh factor.

Labor pathology:

• injury due mechanical damage the fetus when using various means of obstetric aid (for example, the application of forceps);
• asphyxia of newborns and its threat.

Social factors:

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

Types of developmental delay in children

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

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

Such a child is often not self-sufficient, it is difficult to adapt to new conditions for him, often strongly attached to his mother and in her absence he feels helpless; it is characterized by an increased background of mood, a violent manifestation of emotions, which are very unstable at the same time. By school age, such a child still has playful interests in the foreground, while normally they should be replaced by educational motivation. It is difficult for him to make any decision without outside help, make a choice or make any other volitional effort over himself. Such a kid can behave cheerfully and directly, his developmental lag is not striking, but when compared with his peers, he always seems a little younger.

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

This also includes children from families with overprotection - excessively increased attention to raising a baby. When parents take too much care of their beloved child, do not let him go, they do everything for him, fearing that the child may harm himself, that he is still small. In such a situation, loved ones, considering their behavior as a model of parental care and guardianship, thereby prevent the child from showing independence, and hence the knowledge of the world around him, the formation of a full-fledged personality. It should be noted that the situation of overprotection is just very common in families with a sick child, where pity for the baby and constant anxiety for his condition, the desire to supposedly make his life easier in the end turn out to be bad helpers.

The next group is CRA of psychogenic origin.... The main role is given to the social situation of the baby's development. Unfavorable situations in the family, problem upbringing, mental trauma become the reason for this type of CRA. If there is aggression and violence in the family towards the child or other family members, this can lead to the predominance in the character of the baby of such traits as indecision, lack of independence, lack of initiative, fearfulness and pathological shyness.

Here, in contrast to the previous type of CRA, there is a phenomenon of hypo-care, or insufficient attention to the upbringing of a child. A child grows up in a situation of neglect, pedagogical neglect. The consequence of this is the lack of ideas about the moral norms of behavior in society, the inability to control their own behavior, irresponsibility and inability to take responsibility for their actions, an insufficient level of knowledge about the world around them.

The fourth and last type of CRA is of cerebral-organic origin... It occurs more often than others, and the prognosis further development for children with this type of CRD, in comparison with the previous three, it is usually the least favorable.

As the name suggests, the basis for the isolation of this group of cerebrovascular accidents are organic disorders, namely, the failure of the nervous system, the causes of which can be: pathology of pregnancy (toxicosis, infections, intoxication and trauma, Rh-conflict, etc.), prematurity, asphyxia, birth trauma, neuroinfection. With this form of CRD, the so-called minimal cerebral dysfunction (MMD) takes place, which is understood as a complex of mild developmental disorders that manifest themselves, depending on the specific case, very diversely in various areas of mental activity.

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

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

Children of this type are distinguished by the weakness of the manifestation of emotions, poverty of imagination, disinterest in evaluating themselves by others.

About prevention

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

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

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

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

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

If you have already visited the appointment, and the doctor considered it necessary to prescribe medications, you should not neglect his recommendations. And if doubts do not give rest, or the doctor does not inspire confidence, show the child to another, third specialist, ask your questions, try to find the maximum amount of information.

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

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

In addition to visiting doctors' offices, there are several points regarding the interaction of parents with children, which are also necessary for the normal and full development of the child. The components of communication with the baby are familiar to every caring mother and are so simple that we do not even think about their colossal effect on the growing body. it body-emotional contact with the baby. Skin contact means any touch to the child, hugs, kiss, stroking the head. Since in the first months after birth, the baby has a very developed tactile sensitivity, bodily contact helps him to navigate in a new environment for him, to feel more confident and calm. The baby must be taken in your arms, caressing him, stroking not only on the head, but all over the body. The touch of tender parental hands to the baby's skin will allow him to form the correct image of his body, to adequately perceive the space around him.

A special place is given to eye contact, which is the main and most effective way transfer of feelings. In particular, of course, this applies to infants who are not yet available other means of communication and expression of emotions. A kind look reduces anxiety in the baby, has a calming effect on him, and gives him a sense of security. And, of course, it is very important to pay all your attention to the baby. Some believe that by indulging a baby's whims, you are spoiling him. This is certainly not the case. After all, the little man feels so insecure in a completely unfamiliar environment that he constantly needs confirmation that he is not alone, he is needed by someone. If the child received less attention in early childhood, this will certainly affect later.

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

Impaired mental function (ZPR) - the temporal lag in the development of mental processes and the immaturity of the emotional-volitional sphere in children, which can potentially be overcome with the help of specially organized training and education. Delayed mental development is characterized by an insufficient level of development of motor skills, speech, attention, memory, thinking, regulation and self-regulation of behavior, primitiveness and instability of emotions, and poor school performance. Diagnosis of cerebrovascular accidents is carried out collectively by a commission of medical specialists, teachers and psychologists. Children with mental retardation need specially organized correctional and developmental education and medical support.

General information

Mental retardation (PDD) is a reversible violation of the intellectual and emotional-volitional sphere, accompanied by specific learning difficulties. The number of persons with mental retardation reaches 15-16% in the child population. DPD is more of a psychological and pedagogical category, but it may be based on organic disorders, therefore this condition is also considered by medical disciplines - primarily pediatrics and pediatric neurology. Since the development of various mental functions in children is uneven, usually the conclusion "mental retardation" is established for preschoolers no earlier than 4-5 years old, but in practice - more often in the process of schooling.

Causes of mental retardation (PDD)

The etiological basis of CRA is formed by biological and socio-psychological factors that lead to a temporal delay in the intellectual and emotional development of the child.

Biological factors (non-gross organic damage to the central nervous system of a local nature and their residual effects) cause a violation of the maturation of various parts of the brain, which is accompanied by partial disorders of the child's mental development and activity. Among the causes of a biological nature that act in the perinatal period and cause mental retardation, the most important are the pathology of pregnancy (severe toxicosis, Rh-conflict, fetal hypoxia, etc.), intrauterine infections, intracranial birth trauma, prematurity, nuclear jaundice of newborns, fetal alcohol syndrome, etc., leading to the so-called perinatal encephalopathy. In the postnatal period and early childhood, mental retardation can be caused by severe somatic diseases of the child (malnutrition, influenza, neuroinfections, rickets), craniocerebral trauma, epilepsy and epileptic encephalopathy, etc. CRD is sometimes hereditary and in some families it is diagnosed from generation to generation a generation.

A delay in mental development can occur under the influence of environmental (social) factors, which, however, does not exclude the presence of an initial organic basis for the disorder. Most often, children with DPD grow up in conditions of hypo-care (neglect) or hyper-care, an authoritarian upbringing, social deprivation, and a lack of communication with peers and adults.

A delay in mental development of a secondary nature can develop with early hearing and vision impairments, speech defects due to a pronounced deficit of sensory information and communication.

Classification of mental retardation (PDD)

The group of children with mental retardation is heterogeneous. In special psychology, many classifications of mental retardation have been proposed. Let us consider the etiopathogenetic classification proposed by K. S. Lebedinskaya, which distinguishes 4 clinical types of CRA.

CRA of constitutional genesis due to a slowdown in the maturation of the central nervous system. It is characterized by harmonious mental and psychophysical infantilism. With mental infantilism, the child behaves like a younger child; with psycho-physical infantilism, the emotional-volitional sphere and physical development suffer. Anthropometric data and behavior of such children do not correspond to chronological age. They are emotionally labile, spontaneous, and lack attention and memory. Even at school age, their interests in play prevail.

CRD of somatogenic genesisdue to severe and prolonged somatic diseases of the child at an early age, inevitably delaying the maturation and development of the central nervous system. The history of children with somatogenic mental retardation often includes bronchial asthma, chronic dyspepsia, cardiovascular and renal failure, pneumonia, etc. Usually, these children are treated for a long time in hospitals, which in addition also causes sensory deprivation. CRD of somatogenic genesis is manifested by asthenic syndrome, low performance of the child, less memory, superficial attention, poorly formed skills of activity, hyperactivity or lethargy with overwork.

CRD of psychogenic genesis caused by the unfavorable social conditions in which the child lives (neglect, overprotection, cruel treatment). Deficit of attention to the child forms mental instability, impulsivity, and lag in intellectual development. Increased care fosters in the child lack of initiative, egocentrism, lack of will, lack of purposefulness.

ZPR of cerebral-organic genesis occurs most often. It is caused by primary non-gross organic brain damage. In this case, violations can affect individual areas of the psyche or manifest themselves in mosaic in various mental areas. The delay in the mental development of cerebral-organic genesis is characterized by the lack of formation of the emotional-volitional sphere and cognitive activity: the lack of vividness and brightness of emotions, a low level of claims, pronounced suggestibility, poor imagination, motor disinhibition, etc.

Characteristics of children with mental retardation (PDD)

The personal sphere in children with mental retardation is characterized by emotional lability, easy mood swings, suggestibility, lack of initiative, lack of will, immaturity of the personality as a whole. There may be affective reactions, aggressiveness, conflict, increased anxiety. Children with mental retardation are often withdrawn, prefer to play alone, do not seek to contact their peers. The play activity of children with DPD is characterized by monotony and stereotype, lack of a detailed plot, poverty of fantasy, non-observance of game rules. Motility features include motor awkwardness, lack of coordination, and often hyperkinesis and tics.

A feature of mental retardation is that compensation and reversibility of violations are possible only in the context of special training and education.

Diagnostics of mental retardation (PDD)

Mental retardation can be diagnosed only as a result of a comprehensive examination of the child by the psychological, medical and pedagogical commission (PMPK) consisting of a child psychologist, speech therapist, defectologist, pediatrician, child neurologist, psychiatrist, etc. In this case, the collection and study of anamnesis, analysis of conditions life, neuropsychological testing, diagnostic examination of speech, study of the child's medical records. A conversation with a child, a study of intellectual processes and emotional-volitional qualities is mandatory.

Based on information about the development of the child, the members of the PMPK make a conclusion about the presence of mental retardation, give recommendations on the organization of the upbringing and education of the child in the conditions of special educational institutions.

In order to identify the organic substrate of mental retardation, the child needs to be examined by medical specialists, first of all, a pediatrician and a pediatric neurologist. Instrumental diagnostics may include EEG, CT and MRI of the child's brain, etc. Differential diagnosis mental retardation should be carried out with oligophrenia and autism.

Correction of mental retardation (PDD)

Working with children with mental retardation requires a multidisciplinary approach and the active participation of pediatricians, child neurologists, child psychologists, psychiatrists, speech therapists, and defectologists. Correction of mental retardation should begin with preschool age and carried out for a long time.

Children with mental retardation should attend specialized preschool educational institutions (or groups), type VII schools or correctional classes of general education schools. The peculiarities of teaching children with mental retardation include the dosage of educational material, reliance on visualization, repeated repetition, frequent change of activities, and the use of health-saving technologies.

When working with such children, special attention is paid to the development cognitive processes (perception, attention, memory, thinking); emotional, sensory and motor spheres with the help of fairy tale therapy,. Correction of speech impairments in DPD is carried out by a speech therapist in the framework of individual and group lessons. Together with teachers, correctional work on teaching students with mental retardation is carried out by teachers-defectologists, psychologists, and social teachers.

Medical care for children with mental retardation includes drug therapy in accordance with the identified somatic and cerebral-organic disorders, physiotherapy, exercise therapy, massage, hydrotherapy.

Prediction and prevention of mental retardation (PDD)

The lag in the pace of the child's mental development from the age norms can and must be overcome. Children with mental retardation are learnable and, if properly organized corrective work positive dynamics is observed in their development. With the help of teachers, they are able to assimilate knowledge, abilities and skills that their normally developing peers master on their own. After leaving school, they can continue their studies at vocational schools, colleges and even universities.

Prevention of mental retardation in a child involves careful planning of pregnancy, avoidance of adverse effects on the fetus, prevention of infectious and somatic diseases in children early age, providing favorable conditions for education and development. If the child lags behind in psychomotor development, an immediate examination by specialists and the organization of correctional work is necessary.