Violation of speech in children. Psychological disorders in children Psychological disorders in children symptoms

Speech disorders in children have become a serious problem in our time. Today, more and more often before the child enters school, parents are informed that their seven-year-old child has not yet learned to pronounce some letters of his native language, and the touching and funny burr for relatives is nothing more than a pathology that will create difficulties during class ... The saddest thing is that there is no downward trend in the number of such problems. On the contrary, every year more and more children need the help of a speech therapist. What is the reason for this phenomenon and what should parents remember? Let's talk about this.

Causes of speech disorders in children

All causes of speech disorders in children are divided into two large categories: organic (provoking disorders in the central or peripheral speech apparatus) and functional (preventing the normal functioning of the speech apparatus).

The group of organic factors includes:

1. Intrauterine pathologies leading to fetal malformations:

• Hypoxia;
• Viral diseases suffered by a woman during gestation;
• Injuries, falls and bruises of a pregnant woman;
• Rhesus conflict between mother and fetus;
• Violation of the timing of gestation - prematurity (up to 38 weeks) or postmaturity (after 40 weeks);
• Smoking, alcohol and drug abuse;
• Using drugsprohibited during pregnancy;
• Unsuccessful termination of a real pregnancy;
• Occupational hazards;
• Stress, emotional overload.

2. Heredity, genetic abnormalities.

3. Harmfulness of the birth period:

• Birth trauma that provoked intracranial hemorrhage;
• Asphyxia;
• Low weight of the newborn (less than 1500 g) with subsequent intensive resuscitation measures;
• Low score on the Apgar scale.

4. Diseases suffered by the child in the first years of life.

Among the functional causes of speech impairment in children are:

1. Unfavorable social and living conditions of life;
2. Somatic weakness;
3. Psychological trauma caused by stress or fear;
4. Imitation of the speech of people around.

Types of speech disorders in children and their symptoms

The main types of speech disorders in children include:

• Alalia is a condition in which the baby does not have hearing problems, but speech is completely or largely absent due to underdevelopment or pathologies of the parts of the brain responsible for the corresponding function. Distinguish between sensory and motor alalia. In the first case, the child is not able to understand someone else's speech: he recognizes sounds, but does not perceive the meaning of what is being said. Children suffering from motor alalia are not capable of learning and using language - they are not given the assimilation of sounds, syllables, grammatical structures;
• Dysarthria is one of the relatively mild manifestations of anarthria (complete absence of speech). It occurs due to disorders of the innervation of the speech apparatus. In babies with such a diagnosis, general disorders of oral speech are noted, namely: fuzzy, blurry pronunciation of sounds; a very low or unnaturally harsh voice; acceleration or deceleration of the rate of speech, lack of fluency; violation of the respiratory rhythm when talking. A characteristic feature of dysarthria is difficulty in chewing. Children suffering from such a deviation refuse solid foods, reluctantly eat meat. In attempts to feed the child with at least something, parents succumb to his whims and transfer to soft food, as a result of which the development of the articulatory apparatus slows down even more;
• Dislalia - colloquially called "tongue-tied", is considered the most common speech disorder in children. A distinctive feature is the problematic pronunciation of one or more consonants. In the medical literature, the varieties of dyslalia are named according to the names of sounds in Greek: rotacism (problems with the pronunciation of "r"), lambdacism (distortion of the sound "l"), tetism (fuzzy pronunciation of all consonants and their combinations, with the exception of "t"), sigma (incorrect reproduction of whistling and hissing sounds);
• Stuttering is a speech disorder known since ancient times, accompanied by disruptions in the tempo and rhythm of pronunciation due to spasms or convulsions that affect various parts of the speech apparatus. A kid suffering from stuttering can hardly pronounce words, is forced to make long pauses, repeats syllables or sounds several times. Most often, stuttering develops between the ages of 2 to 5 years; during this period, it is recommended to pay special attention to the prevention of speech disorders in children. If a child suddenly stops talking and stubbornly remains silent for several days, it is worth consulting a doctor, as this may be the first sign of pathology.

Correction of speech disorders in children

Correction of speech disorders in children requires an integrated approach, in which the use of psychostimulating and vasoactive medications combined with psychotherapeutic and pedagogical methods of influence. In terms of the typicality and persistence of external manifestations of speech disorders, alalia and dysarthria are in the first position; somewhat less pronounced and easier to treat are different types dyslalia and stuttering. 4.7 out of 5 (31 votes)

The speech function, as well as other higher mental functions (memory, thinking, perception, attention, etc.), is formed in the child gradually, starting from the prenatal period, and this process does not always go smoothly.

Deviations in speech development are possible for various reasons. These can be various pathologies during intrauterine development (the most severe speech defects occur when exposed to adverse factors for a period from 4 weeks to 4 months of pregnancy), toxicosis, incompatibility of the blood of the mother and the child by the Rh factor, viral and endocrine diseases, trauma, hereditary factors, etc.

Birth trauma and asphyxia during childbirth, pathological course of childbirth, various diseases in the first years of a child's life (skull injuries accompanied by a concussion, etc.) can become a cause for unrest. Not the last place is taken by unfavorable social and living conditions, leading to pedagogical neglect of children, violations of their emotional-volitional sphere and a deficit in verbal communication.

Parents need to pay attention to the development of the baby's need to speak. Often when communicating with a small child, adults try to understand and fulfill his requests, without waiting for him to try to express them.

Depending on the duration of exposure to adverse factors and on which part of the brain is damaged, speech defects of various types appear. Speech problems can be just one of the manifestations of a general disruption nervous system and be accompanied by intellectual and motor impairment.

Currently, speech disorders are very well studied and many of them are successfully corrected. The main thing is that you need to contact a specialist in time in order to diagnose them in a timely manner and understand: speech impairment is the only problem or is it a consequence of others serious diseases (autism, hearing impairment, work of the central nervous system, deviations in intellectual development, etc.).

It is very difficult for parents who are concerned about a child's delay in speech or its impairment, it is very difficult to understand how serious the problem is with their child, what to do. As a rule, they hope that everything will go away on its own, and they waste valuable time.

The main types of speech disorders

Speech disorders can be divided into four main types:

Violation of sound pronunciation;

Violation of the rhythm and tempo of speech;

Speech disorders associated with hearing impairment;

Underdevelopment of speech or loss of previously existing speech.

Violation of sound pronunciation

The most common violation of sound pronunciation is dyslalia, in which there is either the absence of some sounds (the child misses them in words), or their distortion (the baby pronounces them incorrectly), or the replacement of one sound with another.

Dislalia is functional and mechanical.

With functional dyslalia, there are no violations of the structure of the speech apparatus (jaws, teeth, palate, tongue). It is observed during the period when the process of assimilation of sounds occurs. Functional dyslalia can occur due to the general physical weakness of the child due to various somatic diseases (especially during the period of active speech formation), delay mental development (minimal cerebral dysfunction), delayed speech development, impaired phonemic perception, limited communication, imitation of incorrect speech. In this case, it is necessary to develop the ability to listen to sounds, actively communicate with the child. Gymnastics to strengthen the muscles of the tongue can be effective.

With mechanical dyslalia, a violation of sound pronunciation is caused by anatomical defects in the organs of articulation, such as an incorrect structure of the teeth, the absence of incisors or their anomalies, bite defects, pathological changes in the tongue (tongue too large or too small), shortened frenulum.

Less common are violations of sound pronunciation caused by labial anomalies, since congenital defects (deformities) are corrected surgically in early age... If there are anatomical defects, consultation (and, in some cases, treatment) of a surgeon and orthodontist is necessary.

Dislalia can also develop when communicating with children who have not formed the correct sound pronunciation. Being in a bilingual environment influences, as well as the attitude of adults towards incorrect pronunciation (many of them do not correct the child's speech, believing that after some time he will learn to speak correctly).

Defects in sound pronunciation in children can be caused by underdevelopment of phonemic hearing (it is difficult for a child to distinguish sounds that are similar in acoustic characteristics: w — w, s — z, etc.), decreased physical hearing, and insufficient mental development.

But it is necessary to distinguish complex dyslalia from other similar disorders, in which lateral pronunciation of many phonemes can be observed, the appearance of excessive saliva at the time of speech is noted, it is difficult for the child to hold the tongue in the desired position for a long time, the mobility of the tongue, the strength and accuracy of movements are changed.

A more serious violation of sound pronunciation arising from organic damage to the central nervous system is dysarthria. With dysarthria, not only the pronunciation of individual sounds suffers. These children have limited mobility of the speech and facial muscles. In speech, there is a fuzzy, blurry sound pronunciation, the voice is quiet, weak, and sometimes, on the contrary, harsh; the breathing rhythm is disturbed, speech loses its smoothness, the rate of speech can be accelerated or slowed down.

The causes of dysarthria are various unfavorable factors that can act in utero during pregnancy (viral infections, toxicosis, pathology of the placenta), at the time of birth (protracted or rapid labor, causing hemorrhage in the infant's brain) and at an early age ( infectious diseases brain and meninges: meningitis, meningoencephalitis, etc.).

This disorder can be observed in a severe form (within the framework of children's cerebral palsy), or in a mild, so-called erased form of dysarthria (dysarthric component). Children with this diagnosis receive a comprehensive speech therapy and medical assistance in special institutions. In a milder form, violations of the movements of the organs of the articulatory apparatus, general and fine motor skills, as well as sound pronunciation are traced - speech is understandable to others, but indistinct.

Children with erased forms dysarthria do not always immediately attract attention, but they can be distinguished by some features. They pronounce words illegibly, eat poorly, refuse to chew solid food, as it is difficult for them to do this (such children must be gradually taught to chew solid food - this will contribute to the development of the muscles of the tongue and cheeks). Many skills that require precise movements of various muscle groups are difficult and therefore need to be developed. The child is taught in different directions: the development of motor skills (general, fine, articulatory), the correction of sound pronunciation, the formation of the rhythmic-melodic side of speech and the improvement of diction.

The kid needs to master mouthwash. To do this, you must first learn to puff out your cheeks and hold on to air, and then move it from one cheek to another; retract the cheeks, while the mouth is open and the lips are closed.

It is necessary to develop fine motor skills of the hands using special exercises. It is necessary to teach the child to fasten buttons (first large, then small) on the doll's clothes or on the removed dress, coat. At the same time, an adult not only shows movements, but also helps to produce them with the hands of the child himself. To train the ability to lacing shoes, various aids are used - lacing.

Children with this disorder have difficulty in visual activity. Therefore, it is necessary to teach them how to hold the pencil correctly, regulate the pressure when drawing, and use scissors.

Difficulties in doing physical exercises and dancing are also noted. Children are taught to maintain balance, to stand and jump on one leg, to correlate their movements with the beginning and end of a musical phrase, to change the character of movements in accordance with the beat. Parents need to know that if you do not start corrective work on time, this can lead to reading (dyslexia) and writing (dysgraphia) disorders in the future. For the fastest achievement of results, work should be carried out in conjunction with a speech therapist, consultations of a neuropsychiatrist and a specialist in physiotherapy exercises are also required.

I would like to dwell on one more violation of the sound pronunciation of speech - rhinolalia, the main difference of which is the presence of a nasal tone of voice. Nasal tone of speech (nasal tone) occurs when the stream of exhaled air passes almost completely through the nose. At the same time, sound production is impaired, which depends both on the activity of the muscles of the soft palate, pharynx and tongue, and on deformation of the hard palate (cleft), alveolar ridge, improper position of the teeth (in the presence of a cleft lip), from disruption of the shape of the wing of the nose (nostrils).

The occurrence of clefts is influenced by genetic factors - unfavorable heredity (the presence of clefts in direct or indirect relatives); biological - diseases of the mother during pregnancy (influenza, SARS, mumps, toxoplasmosis); chemical - contact with harmful substances (pesticides, acids); poor state of the environment; the influence of alcohol, nicotine, drugs; uncontrolled intake of drugs, in particular, oversaturation of the fetus with vitamin A and drugs of the cortisone group.

Usually, at an early age, this disorder is corrected with the help of surgical intervention. Basically speech therapy classes start right after plastic surgery palate.

Violation of the rhythm and tempo of speech

Let's dwell on one of the most common types of disturbances in the rhythm and tempo of speech - stuttering. This disorder is characterized by spasm of the speech muscles. It manifests itself in two forms - the so-called developmental stuttering and reactive stuttering.

Development stuttering is usually noted in early childhood, when the child is not yet good at speaking, he has poorly formed articulations of the tongue, lips and cheeks. And if the baby is taught to pronounce difficult words during this period (frying pan, snowman, policeman, etc.), he may start to stutter.

Overexcitation of the speech areas of the brain lies at the heart of the occurrence of such stuttering. Therefore, the first measure aimed at restoring normal speech should be a "silence mode" for 7-10 days. We must try to exclude all types of emotional impact, completely limit the child's speech, communicate in a whisper and reduce conversations with the baby to a minimum. Sometimes it helps, but in some cases the disorder is quite persistent.

As soon as the child has a stutter or something similar to it (it is difficult for a child to start talking, he finds it difficult to pronounce complex words, repeats the same syllable, etc.), you need to contact a speech therapist and strictly follow all his instructions.

Reactive stuttering (develops as a reaction to some kind of strong impact) is most often the result of fright, mental trauma (severe family conflicts), or exhausting long-term illnesses.

Children with a weakened nervous system begin to stutter, who have a predisposition to this speech disorder (stuttering in close relatives). These children often show signs neurotic state: poor appetite, restless sleep, night fears, urinary incontinence, etc.

A stuttering child must be supervised by a neuropathologist. He needs both medical and speech therapy assistance. The main thing is not to fix the baby's attention on this defect, not to mimic him and not repeat incorrectly pronounced words after him. Your task is to teach him to speak more slowly. Most likely, the child is in a hurry not only to speak, so it is necessary to normalize the entire motor regime of the baby, using calm games. The family environment should also be calm and even.

Parents need to remember that if a child is easily aroused, crying, restlessly sleeping, etc., you should not read too much, tell long stories, rush to teach difficult words and complex phrases. This is especially true for children who have speech disorders that are acceptable for a given age. Against the background of unworked articulation, an abundance of new words will easily lead to a "breakdown" nervous activity... In other words, the level of speech development should correspond to the level of development of the baby as a whole. When this does not happen, there is a risk of stuttering.

It should be borne in mind that stuttering may recur after treatment. There are age periods in which the onset or recurrence of the disease is most likely (from 2 to 6 years). The reasons for relapse are the same as the reasons that originally caused stuttering: family conflicts, overwork, and weakening infections. Therefore, resumption of stuttering can be prevented if the people around them try to create a calm environment for the child.

Hearing-related speech disorders

Already in the first year of life, you yourself can draw conclusions about the level of speech development of the child. Attention should be paid to humming. "If at 3-4 months it does not become more complicated and does not turn into babbling, but gradually fades away, this may indicate serious hearing impairment. As soon as possible, it is necessary to examine the child's hearing, consult an otolaryngologist, and make an audiogram.

How to test your child's hearing at home?

The simplest hearing test is to test your hearing using whispering and regular speaking. Being at a distance of 5-6 meters from the baby (he has his back to you), say in a whisper the words he knows well. Children with full hearing usually hear whispers. If the child does not hear at this distance, you should gradually approach him until he can repeat all the words you said.

During the examination, it is necessary to take into account the general condition of the baby: fatigue, attention, readiness to complete the task. A tired child is easily distracted, does not perceive the meaning of the task assigned to him and may give inaccurate answers. In the case when the baby does not yet know oral speech and does not understand verbal instructions, you can use sounding (tambourine, whistle) and sounded (bird, barking dog, etc.) toys.

If the child does not hear a whisper, move away from him at the same distance and say other familiar words to him in a voice at normal conversational volume. In this way, it is possible to establish at what distance the baby hears normal speech. If you suspect that he is hard of hearing, you should consult an otolaryngologist. If a young child hears speech at normal conversational volume at a distance of 3-4 meters (that is, physical hearing is normal), you can help develop his speech at home (19).

With hearing impairment, the greatest positive effect gives early correctional work. If the baby is shown hearing aid, it must be used - with the help of the apparatus, speech can develop quite successfully. You need to talk with your baby slowly, so that he has the opportunity to see your face, facial expressions, articulation while you utter words - this will develop the ability to read lips.

Underdevelopment of speech or loss of previously existing speech

There is a violation of speech activity - alalia, which can occur as a result of late maturation of nerve cells in the speech zone of the left hemisphere or as a result of early damage to these cells during infections, intoxications, birth trauma, soon after birth. There is motor alalia, when the child's speech is poorly developed, and sensory, when the understanding of the speech of other people is impaired. Most often, there is a mixed form of alalia with a predominance of motor or sensory disorders. The speech of children suffering from alalia develops late, the vocabulary is replenished slowly, they do not change words in numbers, cases, there are no bundles of words in a sentence, therefore at 7-8 years old the child speaks like a 2-3-year-old baby ("Katya is walking in the garden" ). They find it difficult to pronounce the sequence of pronunciation of sounds, so they poorly read and understand poorly. In such children, both general motor skills are insufficiently developed (they are inactive, awkward, slow), and the movements of the fingers.

With this diagnosis, logorhythmic classes, exercises for the development of finely coordinated hand movements are very effective (we give examples of such tasks below). In working with such children, not only a speech therapist should take part, but also a psychologist, a defectologist, a neuropsychiatrist and other specialists (exercise therapy, massage).

If speech has already been formed, but it has been lost due to focal lesion of the speech zones of the brain, then we can talk about another speech disorder - aphasia. Even a very severe form of this disorder in children goes away relatively quickly, if the main cause of the speech disorder is eliminated - the brain tumor is removed, the hemorrhage resolved after the injury, etc.

An important part of corrective work with non-speaking children is games and exercises aimed at improving the movements of the organs of the articulatory apparatus, relieving their muscle tension, and developing the ability to feel and control their movements.

In relation to young children (up to 5 years of age) who master speech skills at a later date, specialists often use the diagnosis of RAD (speech delay). This diagnosis can be made both independently and be a sign of some serious disorder. To understand this, you need to have an understanding of age characteristics development of speech, which will be discussed below.

When you need to seek help from specialists

By the end of the first year of life, with preserved hearing, the child begins to develop understanding of speech. If this does not happen, that is, the baby is not involved in the work of imitating the actions and speech of adults, is not active in playing with toys, then one can suspect intellectual underdevelopment.

In this case, the semantic side of speech will suffer more, so the main help should be directed to the development of cognitive interests.

If a child at 2 years old has normal hearing, and speech is not developed, he needs active communication with adults through gestures and any sounds, and then in the near future the baby should have words.

The child is 2 years 7 months old, and he does not speak yet? It is necessary to start special classes in order to form the need for conversation. At this age, if the baby has problems with speech, it must be shown to specialists and examined.

Adults should in no case reproach a child for experiencing certain difficulties in the process of verbal communication, as this can cause fear of the need to speak, fear of making a mistake. The kid should be encouraged and encouraged to make the slightest attempt to use words. It is necessary to specially create such situations in which the baby will be forced to say something.

If, with preserved hearing and normal intelligence, by the age of three, the child does not have phrasal speech or uses incorrect sentences, we can talk about systemic speech disorders (in understanding the meaning of words, changing them, using them).

The speech of such children develops better in the process of any activity, therefore, it is necessary to conduct joint games, involve the baby in housework, read books that are simple in content, comment on everything that the child sees and does. When communicating with a baby, you need to use simple laconic sentences, and words for repetition should be used in different case forms.

If a four-year-old baby's sound pronunciation lags significantly behind the norm, that is, there are numerous substitutions in speech: instead of sibilants, sibilants are pronounced (w — s, w — z, w — s), the sound p is replaced by l, l or d, replacing solid consonants with the corresponding soft, this indicates a violation of phonemic hearing and, accordingly, the need to conduct classes in order to develop it.

Distorted pronunciation of individual consonants may also be noted: p throat; p one-hit (that is, pronounced without vibration of the tip of the tongue); l two-lipped, similar to English w; whistling sounds s, z, c, pronounced with the tip of the tongue sticking between the teeth.

These speech defects are not age-related and will not disappear on their own, so parents do not need to postpone their correction until later, so as not to fix the incorrect pronunciation in speech. To set the sound, you should contact a specialist, and the parents themselves can help the child develop the ability to use the set sound. At first, the baby in some words can pronounce the sound as it should, but in others - still replace it. The role of adults is to correct the baby and ask him to repeat the word correctly. When reinforcing the sound, those words are used that the child pronounces correctly.

By the age of five, undeveloped coherent speech, low speech activity, lack of curiosity, poor vocabulary may indicate mental retardation (PD).

A child with DPD needs to activate cognitive interests, for which he needs to read more books about nature, about animals, and encourage him to retell texts.

Summing up the above, I would like to note that it is necessary to pay attention to problems that may appear already in the early stages of a child's development. If your baby is two years old, and he does not babble, is inactive, does not make contact well, is not very emotional, all this should alert the parents. Such a child should be shown to a neurologist, otolaryngologist, speech therapist, an EEG - electroencephalography of the brain, if necessary - an audiogram to test hearing. It is better to prevent those problems that may arise later than to face them.

It is believed that deviations in the mental development of a child cannot be distinguished at an early age, and any inappropriate behavior is considered as a child's whim. However, today many mental disorders specialists can already notice in a newborn, which allows treatment to begin on time.

Neuropsychological signs of mental disorders in children

Doctors have identified a number of syndromes - mental characteristics children, most often found at different ages. The syndrome of functional deficiency of subcortical formations of the brain develops in the prenatal period. It is characterized by:

• Emotional instability, expressed in frequent mood swings;
• Increased fatigue and associated low working capacity;
• Pathological stubbornness and laziness;
• Sensitivity, moodiness and uncontrollability in behavior;
• Prolonged enuresis (often up to 10-12 years);
• Underdevelopment of fine motor skills;
• Manifestations of psoriasis or allergies;
• Appetite and sleep disorders;
• Delayed formation of graphic activity (drawing, handwriting);
• Tiki, grimacing, screaming, uncontrollable laughter.

The syndrome is quite difficult to correct, because due to the fact that the frontal regions are not formed, most often deviations in the child's mental development are accompanied by intellectual disability.

Dysgenetic syndrome associated with functional deficiency of brain stem formations can manifest itself in childhood up to 1.5 years. Its main features are:

• Disharmonious mental development with a shift in stages;
• Facial asymmetries, abnormal growth of teeth and violation of body formula;
• Difficulty falling asleep
• Abundance of age spots and moles;
• Distortion of motor development;
• Diathesis, allergies and disorders in the endocrine system;
• Problems in developing neatness skills;
• Encopresis or enuresis
• Distorted threshold of pain sensitivity;
• Violations of phonemic analysis, school maladjustment;
• Memory selectivity.

The mental characteristics of children with this syndrome are difficult to correct. Educators and parents must ensure the neurological health of the child and the development of his vestibular-motor coordination. It should also be borne in mind that emotional disorders intensify against the background of fatigue and exhaustion.

The syndrome associated with functional imperfection of the right hemisphere of the brain can manifest itself from 1.5 to 7-8 years. Deviations in the mental development of the child are manifested as:

• Mosaic perception;
• Impaired differentiation of emotions;
• Confabulations (fantasy, fiction);
• Color discrimination disorders;
• Errors in estimating angles, distances and proportions;
• Distorted memories;
• Feeling of multiplicity of limbs;
• Disturbances in staging stress.

To correct the syndrome and reduce the severity of mental disorders in children, it is necessary to ensure the neurological health of the child and pay special attention to the development of visual-figurative and visual-effective thinking, spatial representation, visual perception and memory.

A number of syndromes are also distinguished that develop from 7 to 15 years due to:

• Birth injury to the cervical spinal cord;
• General anesthesia;
• Concussion;
• Emotional stress;
• Intracranial pressure.

To correct deviations in the mental development of a child, a set of measures is needed to develop interhemispheric interaction and ensure the neurological health of the child.

Mental characteristics of children of different ages

The most important thing in the development of a small child under 3 years old is communication with the mother. It is the lack of maternal attention, love and communication that many doctors consider the basis for the development of various mental disorders. Doctors call the second reason genetic predispositiontransmitted to children from parents.

The period of early childhood is called somatic, when the development of mental functions is directly related to movements. The most typical manifestations of mental disorders in children include digestive and sleep disorders, flinching at harsh sounds, monotonous crying. Therefore, if the baby is anxious for a long time, it is necessary to consult a doctor who will help either diagnose the problem or allay the fears of the parents.

Children aged 3-6 years develop quite actively. Psychologists characterize this period as psychomotor, when the reaction to stress can manifest itself in the form of stuttering, tics, nightmaresideas, neurotization, irritability, affective disorders and fears. As a rule, this period is quite stressful, since it is usually at this time that the child begins to attend preschool educational institutions.

The ease of adaptation in a children's team largely depends on psychological, social and intellectual training. Mental abnormalities in children of this age can occur due to increased loads for which they are not prepared. It is quite difficult for hyperactive children to get used to the new rules that require perseverance and concentration.

At the age of 7-12, mental disorders in children can manifest as depressive disorders. Quite often, for self-affirmation, children choose friends with similar problems and ways of expressing themselves. But even more often in our time, children replace real communication with virtual ones on social networks. The impunity and anonymity of such communication contributes to further alienation, and existing disorders can progress rapidly. In addition, prolonged concentration in front of the screen affects the brain and can cause epileptic seizures.

Abnormalities in the mental development of a child at this age, in the absence of a reaction from adults, can lead to rather serious consequences, including sexual development disorders and suicide. It is also important to monitor the behavior of girls, who often begin to be dissatisfied with their appearance during this period. In this case, anorexia nervosa may develop, which is a severe psychosomatic disorder that can irreversibly disrupt metabolic processes in the body.

Also, doctors note that at this time mental abnormalities in children can develop into a manifest period of schizophrenia. If you do not respond in time, pathological fantasies and overvalued hobbies can develop into delusional ideas with hallucinations, changes in thinking and behavior.

Deviations in the mental development of a child can manifest themselves in different ways. In some cases, the parents' fears for their joy are not confirmed, and sometimes the help of a doctor is really needed. Treatment of mental disorders can and should be carried out only by a specialist who has sufficient experience to make a correct diagnosis, and success largely depends not only on the right medicinesbut also from family support.

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Department of Health of the Tyumen Region

State medical institution of the Tyumen region

"Tyumen Regional Clinical Psychiatric Hospital"

State educational institution of higher professional education "Tyumen Medical Academy"

Early manifestations of mental illness

in children and adolescents

medical psychologists

Tyumen - 2010

Early manifestations of mental illness in children and adolescents: guidelines. Tyumen. 2010.

E.V. Rodyashin chief physician of the GLPU TO TOKPB

Raeva T.V. head Department of Psychiatry, Dr. med. Sciences of the State Educational Institution of Higher Professional Education "Tyumen Medical Academy"

Fomushkina M.G. Chief freelance child psychiatrist of the Tyumen Region Health Department

The guidelines provide a brief description of the early manifestations of major mental disorders and mental development disorders in childhood and adolescence. The manual can be used by pediatricians, neurologists, clinical psychologists and other specialists in "childhood medicine" to establish preliminary diagnoses of mental disorders, since the establishment of the final diagnosis is within the competence of the psychiatrist.

Introduction

Neuropathy

Hyperkinetic disorders

Pathological habitual actions

Childhood fears

Pathological fantasy

Organ neuroses: stuttering, tics, enuresis, encopresis

Neurotic sleep disorders

Neurotic appetite disorders (anorexia)

Mental underdevelopment

Mental infantilism

Violation of school skills

Decreased mood background (depression)

Departures and vagrancy

Painful attitude towards an imaginary physical disability

Anorexia nervosa

Early Childhood Autism Syndrome

Conclusion

List of references

application

Scheme of pathopsychological examination of the child

Diagnostics of the presence of fears in children

Introduction

The mental health status of children and adolescents is essential to ensure and support the sustainable development of any society. At the present stage, the effectiveness of rendering psychiatric care the child population is determined by the timeliness of identifying mental disorders. The earlier children with mental disorders are identified and receive appropriate comprehensive medical, psychological and pedagogical assistance, the higher the likelihood of good school adaptation and the lower the risk of maladaptive behavior.

Analysis of the incidence of mental disorders in children and adolescents living in the Tyumen region (without autonomous okrugs), over the past five years, showed that early diagnosis this pathology is not sufficiently organized. In addition, in our society, there is still fear, both of direct contact to a psychiatric service, and of possible condemnation of others, leading to active avoidance of parents from consulting their child by a psychiatrist, even when it is indisputable necessity. Late diagnosis of mental disorders in the child population and untimely initiation of treatment lead to a rapid progression of mental illness, early disability of patients. It is necessary to increase the level of knowledge of pediatricians, neurologists, medical psychologists in the field of the main clinical manifestations of mental illness in children and adolescents, since when any deviations in the health (somatic or mental) of a child appear, his legal representatives turn to these specialists for help first. ...

An important task of the psychiatric service is active prevention neuropsychiatric disorders in children. It should start from the perinatal period. The identification of risk factors when taking anamnesis in a pregnant woman and her relatives is very great importance to determine the likelihood of neuropsychiatric disorders in newborns (hereditary burden of both somatic and neuropsychiatric diseases in families, the age of a man and a woman at the time of conception, the presence of bad habits, especially during pregnancy, etc.). Intrauterine fetal infections are manifested in the postnatal period by perinatal encephalopathy of hypoxic-ischemic origin with varying degrees of damage to the central nervous system. As a result of this process, attention deficit disorder and hyperactivity disorder can occur.

Throughout a child's life, there are so-called "critical periods of age-related vulnerability", during which the structural, physiological and mental balance in the body is disturbed. It is during such periods, when exposed to any negative agent, that the risk of mental disorders in children increases, as well as, in the presence of mental illness, its more severe course. The first critical period is the first weeks of intrauterine life, the second critical period is the first 6 months after birth, then from 2 to 4 years, from 7 to 8 years, from 12 to 15 years. Toxicosis and other harmful effects on the fetus in the first critical period are often the cause of severe congenital malformations, including gross dysplasias of the brain. Mental illnesses such as schizophrenia, epilepsy, occurring between the ages of 2 and 4, differ malignant course with a rapid disintegration of the psyche. The preference for the development of specific age-related psychopathological conditions at a certain age of the child is noted.

Early manifestations of mental illness in children and adolescents

Neuropathy

Neuropathy is a syndrome of congenital childhood "nervousness" that occurs before the age of three. The first manifestations of this syndrome can be diagnosed already in infancy in the form of somatovegetative disorders: sleep inversion (sleepiness during the day and frequent awakenings and anxiety at night), frequent regurgitation, temperature fluctuations to subfebrile, hyperhidrosis. Frequent and prolonged crying, increased moodiness and tearfulness are noted with any change in the situation, change in the regime, conditions of care, placement of the child in a child care institution. A fairly common symptom is the so-called "rolling", when a reaction of dissatisfaction arises to a psychogenic stimulus, associated with resentment and accompanied by a cry, which leads to an affective-respiratory attack: at the height of exhalation, tonic tension of the muscles of the larynx occurs, breathing stops, the face turns pale, then acrocyanosis is manifested. The duration of this state is several tens of seconds, ends with a deep breath.

Children with neuropathy often have an increased tendency to allergic reactions, infectious and colds. With the preservation of neuropathic manifestations in preschool age under the influence of adverse situational influences, infections, injuries, etc. various monosymptomatic neurotic and neurosis-like disorders easily arise: nocturnal enuresis, encopresis, tics, stuttering, night fears, neurotic appetite disorders (anorexia), pathological habitual actions. The syndrome of neuropathy is relatively often included in the structure of residual organic neuropsychiatric disorders resulting from intrauterine and perinatal organic lesions of the brain, accompanied by neurological symptoms, increased intracranial pressure and, often, delayed psychomotor and speech development.

Hyperkinetic disorders.

Hyperkinetic disorders (hyperdynamic syndrome) or psychomotor disinhibition syndrome occurs mainly at the age of 3 to 7 years and is manifested by excessive mobility, restlessness, fussiness, incoherence, leading to impaired adaptation, instability of attention, distraction. This syndrome occurs several times more often in boys than in girls.

The first signs of the syndrome appear in preschool age, but before entering school, they can sometimes be difficult to recognize due to a variety of normal options. At the same time, the behavior of children is characterized by the desire for constant movements, they run, jump, then sit down for a while, then jump up, touch and grab objects that fall into the field of view, ask many questions, often not listening to the answers to them. Due to increased motor activity and general excitability, children easily come into conflicts with their peers, often violate the regime of children's institutions, poorly master the school curriculum. Hyperdynamic syndrome up to 90% occurs with the consequences of early organic brain damage (pathology of intrauterine development, birth trauma, asphyxia at birth, prematurity, meningoencephalitis in the first years of life), is accompanied by diffuse neurological symptoms and, in some cases, a lag in intellectual development.

Pathological habitual actions.

The most common pathological habitual actions in children are thumb sucking, nail biting, masturbation, pulling or plucking hair, rhythmic head and torso rocking. Common features of pathological habits are an arbitrary nature, the ability to stop them for a while by an effort of will, the child's understanding (starting from the end preschool age) as negative and even bad habits in the absence, in most cases, of the desire to overcome them and even active resistance to the attempts of adults to eliminate them.

Thumb or tongue sucking as a pathological habit occurs mainly in young and preschool children. Thumb sucking is most common. Long-term presence of this pathological habit can lead to bite deformation.

Yakation is an arbitrary rhythmic stereotypical rocking of the body or head, observed mainly before falling asleep or upon awakening in young children. As a rule, rocking is accompanied by a feeling of pleasure, and attempts by others to prevent it cause discontent and crying.

Nail biting (onychophagia) is most common during puberty. Often, not only the protruding parts of the nails are bitten off, but partially adjacent areas of the skin, which leads to local inflammation.

Masturbation (masturbation) consists in irritating the genitals with hands, squeezing the legs, rubbing against various objects. In young children, this habit is the result of fixation of playful manipulation of body parts and is often not accompanied by sexual arousal. With neuropathy, masturbation occurs due to increased general excitability. From the age of 8-9 years, irritation of the genitals can be accompanied by sexual arousal with a pronounced autonomic reaction in the form of facial hyperemia, increased sweating, tachycardia. Finally, at puberty, masturbation begins to be accompanied by representations of an erotic nature. Sexual arousal and orgasm contribute to the consolidation of a pathological habit.

Trichotillomania is the urge to pull the hair out of the scalp and eyebrows, often accompanied by a feeling of pleasure. It is observed mainly in girls of school age. Pulling hair sometimes leads to local baldness.

Childhood fears.

The relative ease of occurrence of fears - characteristic feature childhood. Fears under the influence of various external, situational influences arise the easier, the younger the child. In young children, fear can be caused by any new object that suddenly appears. In this regard, an important, although not always easy task is to distinguish between "normal", psychological fears from fears that are pathological in nature. Signs of pathological fears are considered their causelessness or a clear discrepancy between the severity of fears, the intensity of the effect that caused them, the duration of the existence of fears, violation general condition child (sleep, appetite, physical well-being) and the child's behavior under the influence of fears.

All fears can be divided into three main groups: obsessive fears; fears with overvalued content; fears of a delusional nature. Obsessive fears in children are distinguished by the concreteness of the content, a more or less clear connection with the content of the traumatic situation. Most often these are fears of infection, pollution, sharp objects (needles), enclosed spaces, transport, fear of death, fear of oral answers at school, fear of speech in stuttering, etc. Obsessive fears are perceived by children as "superfluous", alien, they fight with them.

Children do not regard fears of overvalued content as alien, painful, convinced of their existence, do not try to overcome them. Among these fears in children of preschool and primary school age, fears of the dark, loneliness, animals (dogs), fear of school, fear of failure, punishment for violation of discipline, fear of a strict teacher prevail. Fear of school can be the reason for persistent refusals to attend it and the phenomenon of school maladjustment.

Fears of delusional content are distinguished by the experience of a latent threat both from people and animals, and from inanimate objects and phenomena, are accompanied by constant worry, alertness, fearfulness, suspicion of others. Young children are afraid of loneliness, shadows, noise, water, a variety of everyday objects (water taps, electric lamps), strangers, characters from children's books, fairy tales. The child treats all these objects and phenomena as hostile, threatening his well-being. Children hide from real or imaginary objects. Delusional fears arise outside the traumatic situation.

Pathological fantasy.

The emergence of pathological fantasizing in children and adolescents is associated with the presence of painfully altered creative imagination (fantasizing). In contrast to the mobile, rapidly changing fantasies of a healthy child closely related to reality, pathological fantasies are persistent, often divorced from reality, bizarre in content, often accompanied by behavioral disturbances, adaptation, and manifest in various forms. The earliest form of pathological daydreaming is game reincarnation. A child temporarily, sometimes for a long time (from several hours to several days), transforms into an animal (wolf, hare, horse, dog), a character from a fairy tale, an invented fantastic creature, an inanimate object. The child's behavior imitates the appearance and actions of the given object.

Another form of pathological play activity is represented by monotonous stereotyped manipulations with objects that have no play value: bottles, pans, nuts, ropes, etc. Such "games" are accompanied by engagement, difficulty in switching, discontent and irritation of the child when trying to tear him away from this activity.

In children of older preschool and primary school age, pathological fantasy usually takes the form of figurative fantasy. Children vividly represent animals, little people, children with whom they mentally play, endow them with names or nicknames, travel with them, getting to unfamiliar countries, beautiful cities, to other planets. Boys' fantasies are often associated with military themes: scenes of battles, troops are presented. Warriors in colorful clothes of the ancient Romans, in the armor of medieval knights. Sometimes (mainly in prepubertal and pubertal age) fantasies have a sadistic content: natural disasters, fires, scenes of violence, executions, torture, murder, etc. are presented.

Pathological fantasizing in adolescents can take the form of self-incrimination and slander. Most often, these are detective-adventure self-incriminations of teenage boys who talk about their alleged participation in robberies, armed attacks, car thefts, and belonging to spy organizations. To prove the truth of all these stories, adolescents write in a changed handwriting and put notes to relatives and friends allegedly from the leaders of gangs, which contain all kinds of demands, threats, obscene expressions. Teenage girls have slanderous rape. Both with self-incrimination and slander, adolescents at times almost believe in the reality of their fantasies. This circumstance, as well as the colorfulness and emotionality of messages about fictional events, often convince others of their veracity, in connection with which, investigations begin, appeals to the police, etc. Pathological fantasy is observed in various mental illnesses.

Organ neuroses (systemic neuroses). Organ neuroses include neurotic stuttering, neurotic tics, neurotic enuresis, and encopresis.

Neurotic stuttering... Stuttering is a violation of the rhythm, tempo and fluidity of speech associated with muscle cramps involved in the speech act. The causes of neurotic stuttering can be both acute and subacute mental trauma (fear, sudden anxiety, separation from parents, a change in the usual life stereotype, for example, placing a child in a preschool child care institution), and long-term psycho-traumatic situations (conflict relationships in the family, wrong education). Contributing internal factors are a family history of speech pathology, primarily stuttering. An important role in the origin of stuttering belongs to a number of external factorsespecially unfavorable "speech climate" in the form of information overload, attempts to speed up the pace of the child's speech development, a sharp change in the requirements for his speech activity, bilingualism in the family, excessive demands of parents on the child's speech. As a rule, increased stuttering occurs in conditions of emotional stress, excitement, increased responsibility, and also, if necessary, come into contact with strangers. At the same time, in the usual home environment, when talking with friends, stuttering may become less noticeable. Neurotic stuttering is almost always combined with other neurotic disorders: fears, mood swings, sleep disorders, tics, enuresis, which often precede the onset of stuttering.

Neurotic tics. Various automatic habitual elementary movements are called neurotic tics: blinking, wrinkling of the forehead, licking of the lips, twitching of the head, shoulders, coughing, "humming", etc.). In the etiology of neurotic tics, the role of causal factors is played by long-term traumatic situations, acute mental trauma accompanied by fright, local irritation (conjunctiva, respiratory tract, skin, etc.) that cause a protective reflex motor reaction, as well as imitation of tics in one of the others. Tics usually arise as a direct or somewhat delayed in time from the action of the psycho-traumatic factor of a neurotic reaction. More often, such a reaction is recorded, there is a tendency to the occurrence of tics of a different localization, other neurotic manifestations join: mood instability, tearfulness, irritability, episodic fears, sleep disturbances, asthenic symptoms.

Neurotic enuresis. The term "enuresis" refers to the state of unconscious loss of urine, mainly during a night's sleep. To neurotic enuresis are those cases in the occurrence of which a causal role belongs to psychogenic factors. Enuresis, as a pathological condition, is spoken of with urinary incontinence in children from the age of 4 years, since at an earlier age it can be physiological, associated with age-related immaturity of the mechanisms of urination regulation and the lack of a strong skill to retain urine.

Depending on the time of occurrence of enuresis, it is divided into "primary" and "secondary". In primary enuresis, urinary incontinence is noted from early childhood without intervals of the formed skill of neatness, characterized by the ability not to retain urine not only during wakefulness, but also during sleep. Primary enuresis (dysontogenetic), in the genesis of which, the delay in the maturation of urinary regulation systems often has a family-hereditary character. Secondary enuresis occurs after a more or less long - at least 1 year period of having the skill of neatness. Neurotic enuresis is always secondary. The clinic of neurotic enuresis is distinguished by a pronounced dependence on the situation and environment in which the child is, from various influences on his emotional sphere. Urinary incontinence, as a rule, sharply increases with an exacerbation of a traumatic situation, for example, in the event of a parental breakup, after another scandal, in connection with physical punishment, etc. On the other hand, the temporary withdrawal of a child from a traumatic situation is often accompanied by a noticeable decrease or cessation of enuresis. Due to the fact that the emergence of neurotic enuresis is facilitated by such character traits as inhibition, timidity, anxiety, fearfulness, impressionability, self-doubt, low self-esteem, children with neurotic enuresis relatively early, already in preschool and primary school age, begin to painfully experience their disadvantage, they are ashamed of it, they have a feeling of inferiority, as well as anxious expectation of a new loss of urine. The latter often leads to impaired sleep and disturbed sleep at night, which, however, does not ensure timely awakening of the child when the urge to urinate occurs during sleep. Neurotic enuresis is never the only neurotic disorder, it is always combined with other neurotic manifestations, such as emotional lability, irritability, tearfulness, moodiness, tics, fears, sleep disturbances, etc.

It is necessary to distinguish neurotic enuresis from neurosis-like. Neurosis-like enuresis occurs in connection with the transferred cerebral-organic or general somatic diseases, is characterized by a greater monotony of the course, the absence of a clear dependence on changes in the situation with a pronounced dependence on somatic diseases, a frequent combination with cerebrasthenic, psychoorganic manifestations, focal neurological and diencephalic-vegetative disorders EEG changes and signs of hydrocephalus on the X-ray of the skull. In neurosis-like enuresis, the personality response to urinary incontinence is often absent until puberty. Children do not pay attention to their defect for a long time, they are not ashamed of it, despite the natural inconvenience.

Neurotic enuresis should also be distinguished from urinary incontinence as one of the forms of passive protest reactions in preschool children. In the latter case, urinary incontinence is observed only during the daytime and occurs mainly in a traumatic situation, for example, in a nursery or kindergarten in case of unwillingness to visit them, in the presence of an unwanted person, etc. In addition, there are manifestations of protesting behavior, dissatisfaction with the situation, and negative reactions.

Neurotic encopresis... Encopresis is the involuntary discharge of feces that occurs in the absence of abnormalities and diseases of the lower intestine or the sphincter of the anal opening. The disease occurs about 10 times less often than enuresis. The cause of encopresis is in most cases chronic traumatic situations in the family, excessively strict requirements of the parents to the child. Contributing factors of the "soil" can be neuropathic conditions and residual organic cerebral insufficiency.

The clinic of neurotic encopresis is characterized by the fact that a child, who had previously had the skills of neatness, periodically in the daytime has a small amount of feces on the linen; more often parents complain that the child only "slightly stains his pants", in rare cases, more abundant bowel movements are found. As a rule, the child does not feel the urge to defecate, at first does not notice the presence of bowel movements and only after a while does he feel bad smell... In most cases, children painfully experience their lack, are ashamed of it, try to hide dirty linen from their parents. A peculiar reaction of the personality to encopresis can be the child's excessive desire for cleanliness and accuracy. In most cases, encopresis is combined with a lowered mood, irritability, and tearfulness.

Neurotic sleep disorders.

The physiologically required duration of sleep varies significantly with age from 16-18 hours per day in a child of the first year of life to 10-11 hours at the age of 7-10 years and 8-9 hours in adolescents 14-16 years old. In addition, with age there is a shift in sleep towards predominantly nighttime, and therefore most of children over 7 years old have no desire to sleep during the daytime.

To establish the presence of a sleep disorder, it is not so much its duration that matters as the depth, determined by the speed of awakening under the influence of external stimuli, as well as the duration of the period of falling asleep. In young children, various traumatic factors that affect the child in the evening hours, shortly before bedtime, are often the direct cause of the onset of sleep disorders: parental quarrels at this time, various reports of adults that frighten the child about any incidents and accidents, watching movies on television, etc.

Clinic neurotic disorders Sleep is characterized by sleep disturbance, sleep depth disorders with nocturnal awakenings, night fears, as well as sleepwalking and sleep-speaking. Sleep disturbance results in a slow transition from wakefulness to sleep. Falling asleep can last up to 1-2 hours and is often combined with various fears and fears (fear of the dark, fear of suffocating in sleep, etc.), pathological habitual actions (thumb sucking, hair curling, masturbation), obsessive actions such as elementary rituals ( repeated wishes of good night, putting certain toys to bed and certain actions with them, etc.). Sleepwalking and sleeping-talk are frequent manifestations of neurotic sleep disorders. As a rule, in this case, they are associated with the content of dreams, reflect individual traumatic experiences.

Nocturnal awakenings of neurotic origin, in contrast to epileptic ones, are devoid of sudden onset and cessation, are much longer, and are not accompanied by a distinct change in consciousness.

Neurotic appetite disorders (anorexia).

This group of neurotic disorders is widespread and includes various eating disorders in children associated with primary loss of appetite. A variety of traumatic moments play a role in the etiology of anorexia: separation of the child from the mother, placement in a child care facility, uneven educational approach, physical punishment, insufficient attention to the child. The immediate reason for the onset of primary neurotic anorexia is often the mother's attempt to force-feed the child when he refuses to eat, overfeeding, accidental coincidence of feeding with any unpleasant impression (sharp cry, fright, quarrel of adults, etc.). The most important contributing intrinsic factor is the neuropathic state (congenital or acquired), which is characterized by a sharply increased autonomic excitability and instability of autonomic regulation. In addition, somatic weakness plays a role. From external factors, the excessive anxiety of parents regarding the nutritional status of the child and the process of his feeding, the use of persuasion, stories and other distractions from eating, as well as improper upbringing with the satisfaction of all the whims and whims of the child, leading to his excessive pampering, matters.

The clinical manifestations of anorexia are fairly similar. The child has no desire to eat any food, or he is very selective in food, refusing many common foods. As a rule, he reluctantly sits down at the table, eats very slowly, “rolls” food in his mouth for a long time. Due to the increased gag reflex, vomiting often occurs during meals. Eating food causes a low mood, moodiness, tearfulness in a child. The course of a neurotic reaction can be short-lived, not exceeding 2-3 weeks. At the same time, in children with neuropathic conditions, as well as spoiled in conditions of improper upbringing, neurotic anorexia can acquire a protracted course with a long persistent refusal to eat. In these cases, a decrease in body weight is possible.

Mental underdevelopment.

Signs mental retardation manifest themselves already for 2-3 years of life, phrasal speech is absent for a long time, the skills of neatness and self-service are slowly developed. Children are not inquisitive, have little interest in the surrounding objects, games are monotonous, there is no liveliness in the game.

At preschool age, attention is drawn to the weak development of self-service skills, phrasal speech is characterized by poverty vocabulary, the lack of detailed phrases, the impossibility of a coherent description of plot pictures, there is an insufficient supply of everyday information. Contact with peers is accompanied by a lack of understanding of their interests, the meaning and rules of games, poor development and undifferentiated higher emotions (sympathy, pity, etc.).

At primary school age, it is noted that it is impossible to understand and master the curriculum of primary grades of a mass school, the lack of basic everyday knowledge (home address, profession of parents, seasons, days of the week, etc.), inability to understand the figurative meaning of proverbs. Kindergarten and school educators can help diagnose this mental disorder.

Mental infantilism.

Mental infantilism is a delayed development of the child's mental functions with a predominant lag in the emotional-volitional sphere (personal immaturity). Emotional-volitional immaturity is expressed in lack of independence, increased suggestibility, the desire for pleasure as the main motivation for behavior, the predominance of playing interests at school age, carelessness, immaturity of a sense of duty and responsibility, a weak ability to subordinate one's behavior to the requirements of the team, school, inability to restrain direct manifestations of feelings , inability to volitional tension, to overcome difficulties.

Immaturity of psychomotor skills is also characteristic, manifested in the insufficiency of fine movements of the hands, difficulty in developing motor school (drawing, writing) and work skills. The listed psychomotor disorders are based on the relative predominance of the activity of the extrapyramidal system over the pyramidal system due to its immaturity. Intellectual deficiency is noted: the predominance of a concrete-shaped type of thinking, increased fatigue of attention, a slight decrease in memory.

The socio-pedagogical consequences of mental infantilism are insufficient "school maturity", lack of interest in learning, and poor performance at school.

School Skills Disorders.

Disorders of school skills are typical for children of primary school age (6-8 years old). Violations in the development of the reading skill (dyslexia) is manifested in the lack of recognition of letters, difficulty or impossibility of correlating the image of letters to the corresponding sounds, replacing some sounds with others when reading. In addition, there is a slow or accelerated reading pace, rearrangement of letters, swallowing of syllables, incorrect placement of stress during reading.

The disorder in the formation of writing skills (dysgraphia) is expressed in violations of the correlation of the sounds of oral speech with their writing, gross disorders of independent writing under dictation and in presentation: the replacement of letters corresponding to sounds similar in pronunciation, omission of letters and syllables, their rearrangement, dismemberment of words and continuous spelling two or more words, replacing graphically similar letters, mirroring letters, fuzzy writing letters, slipping off a line.

Violation of the formation of the skill of counting (dyscalculia) manifests itself in special difficulties in the formation of the concept of number and understanding the structure of numbers. Particular difficulties are caused by digital operations associated with the transition through a dozen. The spelling of multi-digit numbers is difficult. Mirror spelling of numbers and numerical combinations is often noted (21 instead of 12). There are often violations of understanding of spatial relationships (children confuse right and left side), relative position of objects (front, back, above, below, etc.).

Decreased mood background - depression.

In children of early and preschool age, depressive states are manifested in the form of somatovegetative and motor disorders. The most atypical manifestations of depressive conditions in young children (up to 3 years old), they occur during prolonged separation of the child from the mother and are expressed by general lethargy, crying attacks, motor restlessness, refusal to play activities, disturbances in the rhythm of sleep and wakefulness, loss of appetite, weight loss, a tendency to colds and infectious diseases.

In preschool age, in addition to sleep and appetite disorders, enuresis, encopresis, depressive disorders in psychomotor systems are observed: children have a suffering expression on their faces, walk with their heads down, dragging their feet, without moving their hands, speak in a low voice, there may be discomfort or pain in different parts of the body ... In children of primary school age, behavioral changes come to the fore in depressive states: passivity, lethargy, isolation, indifference, loss of interest in toys, difficulties in learning due to impaired attention, slow assimilation of educational material. Some children, especially boys, are dominated by irritability, resentment, a tendency to aggression, as well as leaving school and home. In some cases, there may be a resumption of pathological habits inherent in a younger age: sucking fingers, biting nails, pulling hair, masturbation.

In prepubertal age, a more distinct depressive affect appears in the form of a suppressed, melancholy mood, a kind of feeling of inferiority, ideas of self-deprecation and self-blame. Children say: “I am incapable. I am the weakest among the guys in the class. " For the first time, suicidal thoughts arise (“Why should I live like this?”, “Who needs me like that?”). At puberty, depression is manifested by its characteristic triad of symptoms: depressed mood, intellectual and motor retardation. A large place is occupied by somatovegetative manifestations: sleep disorders, decreased appetite. constipation, complaints of headaches, pains in various parts of the body.

Children fear for their health and life, become anxious, fixated on somatic disorders, fearfully ask their parents if their heart can stop, if they will suffocate in a dream, etc. In connection with persistent somatic complaints (somatized, "masked" depression), children undergo numerous functional and laboratory examinations, examinations of narrow specialists to identify any somatic disease. The survey results are negative. At this age, against the background of a lowered mood, adolescents develop an interest in alcohol and drugs, they join companies of juvenile delinquents, are prone to suicidal attempts and self-harm. Depression in children develops in severe traumatic situations, with schizophrenia.

Departures and vagrancy.

Departures and vagrancy are expressed in repeated leaving home or school, boarding school or other childcare institution, followed by vagrancy, often for many days. Mostly observed in boys. In children and adolescents, leaving can be associated with the experience of resentment, hurt pride, representing a reaction of passive protest, or with fear of punishment or anxiety about any offense. With mental infantilism, there are mainly dropouts from school and absenteeism due to fear of difficulties associated with study. Shoots in adolescents with hysterical character traits are associated with the desire to attract the attention of relatives, to arouse pity and sympathy (demonstrative shoots). Another type of motivation for initial withdrawal is "sensory thirst", i.e. the need for new, ever-changing experiences; and the desire for entertainment.

Departures can be "unmotivated", impulsive, with an irresistible urge to run away. They are called dromomania. Children and adolescents run away together or in a small group, they can go to other cities, spend the night in entrances, in attics, basements, as a rule, they do not return home on their own. They are brought in by police officers, relatives, strangers. Children do not experience fatigue, hunger, thirst for a long time, which indicates that they have pathology of drives. Nursing and vagrancy disrupt the social adaptation of children, reduce school performance, lead to different forms antisocial behavior (hooliganism, theft, alcoholism, substance abuse, drug addiction, early sexual relations).

Painful attitude towards an imaginary physical disability (dysmorphophobia).

The painful idea of \u200b\u200ban imaginary or unreasonably exaggerated physical disability in 80% of cases occurs at puberty, more often occurs in adolescent girls. The very ideas of physical disability can be expressed in the form of thoughts about facial defects (long, ugly nose, large mouth, thick lips, protruding ears), physique (excessive fullness or thinness, narrow shoulders and short stature in boys), insufficient sexual development (small, "Curved" penis) or excessive sexual development (large mammary glands in girls).

A special type of dysmorphophobic experiences is the lack of certain functions: fear of not keeping intestinal gases in the presence of strangers, fear of bad breath or sweat odor, etc. The experiences described above affect the behavior of adolescents who begin to avoid crowded places, friends and acquaintances, try to walk only after dark, change their clothes and hairstyle. More sthenic teenagers try to develop and use various self-medication methods, special physical exercises for a long time, persistently turn to cosmetologists, surgeons and other specialists with the requirement of plastic surgery, special treatment, for example, growth hormones, drugs that reduce appetite. Adolescents often look at themselves in the mirror ("mirror symptom") and also refuse to be photographed. Episodic, transient dysmorphophobic experiences associated with a bias towards real minor physical disabilities are normal in puberty. But if they have a pronounced, persistent, often absurd, pretentious character, determine behavior, disrupt the social adaptation of a teenager, and are based on a low background of mood, then these are already painful experiences that require the help of a psychotherapist or psychiatrist.

Anorexia nervosa.

Anorexia nervosa is characterized by a deliberate, extremely persistent pursuit of qualitative and / or quantitative food abstinence and weight loss. It is much more common in adolescent girls and young women, much less often in boys and children. The leading symptom is the conviction of excess body weight and the desire to correct this physical "deficiency". At the first stages of the state, appetite persists for a long time, and abstinence from food is intermittently interrupted by bouts of overeating (bulimia nervosa). Then the fixed habitual nature of overeating alternates with vomiting, leading to somatic complications. Teenagers tend to eat alone, try to get rid of it imperceptibly, and carefully study the calorie content of foods.

Weight loss occurs in various additional ways: grueling exercise; taking laxatives, enemas; regular artificial induction of vomiting. The feeling of constant hunger can lead to hypercompensatory forms of behavior: feeding the younger brothers and sisters, an increased interest in cooking various foods, as well as the appearance of irritability, increased excitability, and a decrease in the background mood. Signs of somatoendocrine disorders gradually appear and grow: the disappearance of subcutaneous fat, oligo-, then amenorrhea, dystrophic changes from the side internal organs, hair loss, changes in blood biochemical parameters.

Early Childhood Autism Syndrome.

The syndrome of early childhood autism is a group of syndromes of different origins (intrauterine and perinatal organic brain damage - infectious, traumatic, toxic, mixed; hereditary-constitutional), observed in children of early, preschool and primary school age within the framework of different nosological forms. The syndrome of early childhood autism manifests itself most clearly from 2 to 5 years, although some signs of it are noted at an earlier age. So, already in infants, there is a lack of a "revitalization complex" characteristic of healthy children upon contact with a mother, they do not have a smile at the sight of their parents, sometimes there is a lack of an orienting reaction to external stimuli, which can be mistaken for a defect in the sense organs. Children have sleep disorders (intermittent sleep, difficulty falling asleep), persistent appetite disorders with its decrease and special selectivity, lack of hunger. There is a fear of novelty. Any change in the usual environment, for example, in connection with the rearrangement of furniture, the appearance of a new thing, a new toy, often causes dissatisfaction or even violent protest with crying. A similar reaction occurs when changing the order or timing of feeding, walking, washing, and other aspects of the daily routine.

The behavior of children with this syndrome is monotonous. They can spend hours performing the same actions, vaguely reminiscent of a game: pouring water into dishes and pouring out of it, sorting through pieces of paper, matchboxes, cans, strings, arranging them in a certain order, not allowing anyone to remove them. These manipulations, as well as an increased interest in certain objects that usually do not have a game purpose, are an expression of a special obsession, in the origin of which the role of impulse pathology is obvious. Children with autism actively seek loneliness, feeling better when left alone. Psychomotor disorders are typical, manifested in general motor impairment, awkward gait, stereotypes in movements, shaking, rotating the hands, jumping, rotating around its axis, walking and running on tiptoes. As a rule, there is a significant delay in the formation of basic skills of self-service (independent eating, washing, dressing, etc.).

The child's facial expressions are poor, not expressive, characterized by an "empty, expressionless look", as well as a look, as it were, by or "through" the interlocutor. In speech, there are echolalia (repetition of the heard word), pretentious words, neologisms, drawn intonation, the use of pronouns and verbs in the 2nd and 3rd person in relation to themselves. In some children, there is a complete refusal to communicate. The level of development of intelligence is different: normal, exceeding the average norm, there may be a lag in mental development. The syndromes of early childhood autism have different nosological affiliations. Some scientists attribute them to the manifestation of the schizophrenic process, others to the consequences of early organic brain damage, atypical forms of mental retardation.

Conclusion

The establishment of a clinical diagnosis in child psychiatry is based not only on complaints from parents, guardians and children themselves, collecting an anamnesis of the patient's life, but also on observing the child's behavior and analyzing his appearance. When talking with the parents (other legal representatives) of the child, it is necessary to pay attention to the facial expression, facial expressions of the patient, his reaction to your examination, the desire to communicate, the productivity of contact, the ability to comprehend what he heard, follow the instructions given, the volume of vocabulary, the purity of pronunciation of sounds, the development of fine motor skills , excessive mobility or lethargy, slowness, awkwardness in movements, reaction to the mother, toys, children present, the desire to communicate with them, the ability to dress, eat, develop neatness skills, etc. If signs of a mental disorder in a child or adolescent are detected, the parent or guardian should be advised to seek advice from a child psychotherapist, child psychiatrist, or psychiatrists at regional hospitals in rural areas.

Child psychotherapists and child psychiatrists serving the child and adolescent population of Tyumen work in the outpatient department of the Tyumen Regional Clinical psychiatric hospital", Tyumen, st. Herzen, d. 74. Telephone registration of child psychotherapists: 50-66-17; telephone of the registration of child psychiatrists: 50-66-35; helpline: 50-66-43.

List of references

1. Bukhanovsky A.O., Kutyavin Yu.A., Litvan M.E. General psychopathology. - Publishing house "Phoenix", 1998.
2. Kovalev V.V. Child psychiatry. - M .: Medicine, 1979.
3. Kovalev V.V. Semiotics and diagnosis of mental illness in children and adolescents. - M .: Medicine, 1985.
4. Levchenko I.Yu. Pathopsychology: Theory and practice: textbook. - M .: Academy, 2000.
5. Problems of diagnostics, therapy and instrumental research in child psychiatry / Scientific materials of the All-Russian conference. -Volgograd, 2007.
6. Eidemiller E.G. Child psychiatry. SPb .: Peter, 2005.

ATTACHMENT

1. Scheme of pathopsychological examination of a child according to

Contact (speech, gesture, mimicry):

- does not come into contact;

- shows speech negativism;

- formal contact (purely external);

- does not come into contact immediately, with great difficulty;

- does not show interest in contact;

- selective contact;

- easily and quickly establishes contact, shows interest in it, willingly obeys.

Emotional-volitional sphere:

active / passive;

active / inert;

cheerful / lethargic;

motor disinhibition;

aggressiveness;

spoiledness;

mood swings;

conflict;

Hearing condition(norm, hearing loss, deafness).

Vision state(norm, myopia, farsightedness, strabismus, optic atrophy, low vision, blindness).

Motor skills:

1) leading hand (right, left);

2) development of the manipulative function of the hands:

- there is no grabbing;

- sharply limited (cannot manipulate, but there is grabbing);

- limited;

- insufficient, fine motor skills;

- safe;

3) consistency of hand actions:

- missing;

- norm (N);

4) tremor. Hyperkinesis. Impaired coordination of movements

Attention (duration of concentration, steadfastness, switching):

- the child does not concentrate well, has difficulty keeping attention on the object ( low concentration and instability of attention);

- attention is not stable enough, superficial;

- quickly depleted, requires switching to another type of activity;

- poor switching of attention;

- attention is quite stable. The duration of concentration and attention switching is satisfactory.

Reaction to approval:

- adequate (rejoices in approval, waits for it);

- inadequate (does not react to approval, is indifferent to it). Reaction to remark:

- adequate (corrects behavior in accordance with the remark);

Adequate (offended);

- no reaction to the remark;

- negative reaction (doing it out of spite).

Attitude towards failure:

- evaluates failure (notices the incorrectness of his actions, corrects mistakes);

- there is no assessment of failure;

- negative emotional reaction to failure or own mistake.

Workability:

- extremely low;

- reduced;

- sufficient.

Nature of activity:

- lack of motivation for activity;

- works formally;

- the activity is unstable;

- activity is stable, works with interest.

Learning ability, use of help (during the survey):

- there is no learning ability. Help does not use;

- there is no transfer of the shown method of action to similar tasks;

- learning ability is low. Help is underutilized. Knowledge transfer is difficult;

- we teach the child. Uses the help of an adult (moves from a lower way of completing tasks to a higher one). Carries out the transfer of the received method of action to a similar task (N).

Activity development level:

1) showing interest in toys, selectivity of interest:

- persistence of playing interest (whether he is engaged in one toy for a long time or moves from one to the other): does not show interest in toys (does not work with toys. Does not join the joint game with adults. Does not organize independent play);

- shows a superficial, not very persistent interest in toys;

- shows a persistent selective interest in toys;

- performs inappropriate actions with objects (ridiculous, not dictated by the logic of the game or the quality of the object of action);

- uses toys adequately (uses the object in accordance with its intended purpose);

3) the nature of actions with toys:

- nonspecific manipulations (with all objects it acts the same, stereotypically - taps, pulls in the mouth, sucks, throws);

- specific manipulations - takes into account only physical properties items;

- objective actions - uses objects in accordance with their functional purpose;

- procedural actions;

- a chain of game actions;

- game with plot elements;

- a role-playing game.

Stock of general ideas:

- low, limited;

- slightly reduced;

- corresponds to age (N).

Knowledge of body parts and face (visual orientation).

Visual perception:

color perception:

- no idea of \u200b\u200bthe color;

- matches colors;

- distinguishes colors (highlights by word);

- recognizes and names the primary colors (N - at 3 years old);

size perception:

- no idea of \u200b\u200bthe size;

- correlates objects by size; - differentiates objects by size (selection by word);

- names the size (N - at 3 years);

form perception:

- no idea about the form;

- correlates objects in shape;

- distinguishes between geometric shapes (highlights by word); names (planar and volumetric) geometric shapes (N - at 3 years).

Folding nesting dolls (three-piece– from 3 to 4 years old; four-part– from 4 to 5 years; six-part– from 5 years old):

- ways to complete the task:

- action by force;

- enumeration of options;

- targeted tests (N - up to 5 years);

- trying on;

Inclusion in a row (six-piece matryoshka– from 5 years old):

- actions are inadequate / adequate;

- ways to complete the task:

- excluding size;

- targeted tests (N - up to 6 years);

- visual correlation (mandatory from 6 years old).

Folding the pyramid (up to 4 years old - 4 rings; from 4 years old - 5-6 rings):

- actions are inadequate / adequate;

- excluding the size of the rings;

- taking into account the size of the rings:

- trying on;

- visual correlation (N - mandatory from 6 years old).

Insert Cubes(samples, enumeration of options, fitting, visual correlation).

Mailbox (from 3 years old):

- action by force (permissible in N up to 3.5 years);

- enumeration of options;

- trying on;

- visual correlation (N is required from 6 years old).

Paired pictures (from 2 years old; choice according to the sample from two, four, six pictures).

Construction:

1) design from building material (by imitation, by model, by presentation);

2) folding figures from sticks (by imitation, by model, by presentation).

Perception of spatial relationships:

1) orientation in the sides of one's own body and mirroring;

2) differentiation of spatial concepts (higher - lower, further - closer, to the right - to the left, in front - to the back, in the center);

3) a holistic image of the object (folding cut pictures from 2-3-4-5-6 parts; vertical, horizontal, diagonal, broken line cut);

4) understanding and use of logical and grammatical constructions (N from 6 years old).

Temporary views:

- parts of the day (N from 3 years old);

- seasons (N from 4 years old);

- days of the week (N from 5 years old);

- understanding and use of logical and grammatical constructions (N from 6 years old).

Quantitative representations:

— ordinal count (verbally and counting items);

- determination of the number of items;

- allocation of the required quantity from the set;

- correlation of items by quantity;

- the concept of "a lot" - "little", "more" - "less", "equally";

- counting operations.

Memory:

1) mechanical memory (within N, reduced);

2) mediated (verbal-logical) memory (N, decreased). Thinking:

- the level of development of thinking:

- visual and effective;

- visual and figurative;

- elements of abstract logical thinking.

1. Diagnostics of the presence of fears in children.

To diagnose the presence of fears, a conversation is held with the child with a discussion of the following issues: Tell me, please, are you afraid or not afraid:

1. When are you alone?
2. Get sick?
3. Die?
4. Any children?
5. Some of the educators?
6. That they will punish you?
7. Babu Yaga, Kashchei the Immortal, Barmaley, Snake Gorynych?
8. Terrible dreams?
9. Darkness?
10. Wolf, bear, dogs, spiders, snakes?
11. Cars, trains, planes?
12. Storms, thunderstorms, hurricanes, floods?
13. When is it very high?
14. In a small, cramped room, toilet?
15. Water?
16. Fire, fire?
17. Wars?
18. Doctors (other than dentists)?
19. Blood?
20. Injections?
21. Pain?
22. Unexpected sharp sounds (when suddenly something falls, knocks)?

Processing of the methodology "Diagnostics of the presence of fears in children"

On the basis of the received answers to the listed questions, it is concluded that children have fears. The presence of a large number of various fears in a child is an important indicator of a preneurotic state. Such children should be referred to the "risk" group and special (corrective) work should be carried out with them (it is advisable to consult them with a psychotherapist or psychiatrist).

Fears in children can be divided into several groups: medical(pain, injections, doctors, diseases); related to physical damage(unexpected sounds, transport, fire, fire, elements, war); of death(his); animals and fairytale characters; nightmares and darkness; socially mediated(people, children, punishment, lateness, loneliness); "Spatial fears"(height, water, confined spaces). In order to make an unerring conclusion about the emotional characteristics of a child, it is necessary to take into account the peculiarities of the entire life of the child as a whole.

In some cases, it is advisable to use a test that allows you to diagnose anxiety in a child between the ages of four and seven in relation to a number of typical life situations of communication with other people. The authors of the test consider anxiety as a type of emotional state, the purpose of which is to ensure the safety of the subject at the personal level. Elevated level anxiety may indicate insufficient emotional adaptation of the child to certain social situations.

Mental disorders in children or mental dysontogenesis - a deviation from normal behavior, accompanied by a group of disorders that belong to pathological conditions... They arise due to genetic, sociopathic, physiological reasons, sometimes trauma or brain diseases contribute to their formation. Disorders that occur at an early age become the cause of mental disorders and require treatment by a psychiatrist.

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Causes of disorders

The formation of the child's psyche is associated with the biological characteristics of the organism, heredity and constitution, the rate of formation of the brain and parts of the central nervous system, acquired skills. The root of the development of mental disorders in children should always be sought in biological, sociopathic or psychological factors that provoke the occurrence of disorders, often the process is triggered by a set of agents. The main reasons include:

• Genetic predisposition. Assumes initially malfunctioning of the nervous system due to innate characteristics of the body. When close relatives have mental disorders, there is a chance of passing them on to the child.
• Deprivation (inability to meet needs) in early childhood. The bond between mother and baby begins from the first minutes of birth, it sometimes has a major impact on a person's attachments, the depth of emotional feelings in the future. Any type of deprivation (tactile or emotional, psychological) partially or completely affects the mental development of a person, leads to dysontogenesis of the psyche.
• Limitation of mental abilities also refers to a kind of mental disorder and affects physiological development, sometimes it becomes the cause of other disorders.
• Brain injury occurs as a result of severe labor or head bruises, encephalopathy is caused by infections during intrauterine development or after past diseases. For the prevalence of this reason, the leading place belongs to the hereditary factor.
• Bad habits of the mother, the toxicological effects of smoking, alcohol, drugs have a negative effect on the fetus even during the period of gestation. If the father suffers from these ailments, the consequences of intemperance are often reflected on the child's health, affecting the central nervous system and the brain, which negatively affects the psyche.

Family conflicts or an unfavorable situation in the house is a significant factor that traumatizes the forming psyche, aggravating the condition.

Mental disorders in childhood, especially up to one year, have a common feature: the progressive dynamics of mental functions is combined with the development of dysontogenesis associated with a violation of the morphofunctional cerebral systems. The condition occurs due to cerebral disorders, congenital characteristics or social impact.

Relationship between disorders and age

In children, psychophysical development occurs gradually, it is divided into stages:

• early - up to three years;
• preschool - up to the age of six;
• junior school - up to 10 years old;
• school-puberty - up to 17 years.

Critical periods are considered to be time periods during the transition to the next stage, which are characterized by a rapid change in all body functions, including an increase in mental reactivity. At this time, children are most susceptible to nervous disorders or the aggravation of the mental pathologies present. Age crises occur in 3-4 years, 5-7 years, 12-16 years. What features are inherent in each stage:

• Up to one year old, babies develop positive and negative feelings, they form initial ideas about the world around them. In the first months of life, disorders are associated with the needs that the child must receive without fail: food, sleep, comfort and absence of painful sensations. The crisis of 7-8 months is marked by an awareness of the differentiation of feelings, recognition of loved ones and the formation of attachment, so the child needs the attention of the mother and family members. The better parents provide satisfaction of needs, the faster a positive stereotype of behavior is formed. Dissatisfaction causes a negative reaction, the more unfulfilled desires accumulate, the more severe the deprivation, which subsequently leads to aggression.
• In 2-year-old children, active maturation of brain cells continues, behavior motivation appears, orientation towards assessment by adults, identification of positive behavior occurs. With constant control and prohibitions, the impossibility of self-assertion leads to a passive attitude, the development of infantilism. With additional stress, behavior takes on a pathological character.
• Stubbornness and nervous breakdowns, protests are observed at 4 years old, mental disorders can manifest themselves in mood swings, tension, and an internal discomfort. Restrictions cause frustration, the child's mental balance is disturbed due to even a slight negative influence.
• At the age of 5, violations can manifest themselves when mental development is ahead of, accompanied by dysynchrony, that is, a one-sided orientation of interests appears. Also, attention should be paid if the child has lost the skills acquired earlier, has become untidy, limits communication, his vocabulary has decreased, the kid does not play role-playing games.
• In seven-year-olds, the cause of neuroses is school classes; with the beginning of the school year, disorders are manifested in mood instability, tearfulness, fatigue, and headaches. The reactions are based on psychosomatic asthenia (poor sleep and appetite, decreased performance, fears), fatigue. The factor of disruption is the discrepancy between mental abilities and the school curriculum
• In school and adolescence, mental disorders are manifested in anxiety, increased anxiety, melancholy, mood swings. Negativism is combined with conflict, aggression, and internal contradictions. Children react painfully to the assessment of their abilities and appearance by those around them. Sometimes there is increased self-confidence or, conversely, criticality, posturing, disdain for the opinion of the teacher and parents.

Mental disorders must be distinguished from the abnormalities of post-schizophrenic defect and dementia resulting from organic brain disease. In this case, dysontogenesis acts as a symptom of pathology.



Types of pathologies

Children are diagnosed with mental disorders characteristic of adults, but babies also have specific age-related ailments. The symptoms of dysontogenesis are varied, depending on age, stage of development and environment.

The peculiarity of the manifestations is that in babies it is not always easy to distinguish pathology from characteristics of character and development. There are several types of mental disorders in children.



Mental retardation

Pathology refers to acquired or congenital underdevelopment of the psyche with a clear lack of intelligence, when the child's social adaptation is difficult or completely impossible. In sick children, they decrease, sometimes significantly:

• cognitive ability and memory;
• perception and attention;
• speech skills;
• control over instinctive needs.

The vocabulary is poor, the pronunciation is indistinct, the child is emotionally and morally poorly developed, unable to predict the consequences of his actions. It is mildly detected in children with admission to school, the middle and severe stages are diagnosed in the first years of life.

The disease cannot be completely cured, but proper education and training will allow the child to learn communication and self-care skills, with easy stage diseases people are able to adapt in society. In severe cases, caring for a person will be required throughout life.

Impaired mental function

The borderline state between oligophrenia and the norm, disorders are manifested by a delay in the cognitive, motor or emotional, speech sphere. Mental delay sometimes occurs due to the slow development of brain structures. It happens that the state passes without a trace or remains as an underdevelopment of one function, while it is compensated by other, sometimes accelerated abilities.

There are also residual syndromes - hyperactivity, decreased attention, loss of previously acquired skills. The type of pathology can become the basis for the pathocharacterological manifestations of personality in adulthood.

ADD (Attention Deficit Disorder)

A common problem in children of preschool age and up to 12 years old, characterized by neuro-reflex excitability. Shows that the child:

• active, unable to sit still, do one thing for a long time;
• constantly distracted;
• impulsive;
• unrestrained and talkative;
• does not finish what he started.

Neuropathy does not lead to a decrease in intelligence, but if the condition is not corrected, it often becomes the cause of difficulties with learning, adaptation in the social sphere. In the future, the consequence of attention deficit disorder may be incontinence, the formation of drug or alcohol addiction, family problems.

Autism

Congenital mental disorder is accompanied not only by speech and motor disorders, autism is characterized by a violation of contact and social interaction with people. Stereotypical behavior makes it difficult to change the environment, living conditions, changes cause fear and panic. Children tend to perform monotonous movements and actions, repetition of sounds and words.

The disease does not respond well to treatment, but the efforts of doctors and parents can correct the situation and reduce the manifestation of psychopathological symptoms.

Acceleration

Pathology is characterized by the accelerated development of the child in physical or intellectual terms. The reasons include urbanization, improved nutrition, inter-ethnic marriages. Acceleration can manifest itself as harmonious development, when all systems develop evenly, but these cases are rare. With the progress of the physical and mental direction at an early age, somatovegetative deviations are noted, and endocrine problems are revealed in older children.

The mental sphere is also characterized by discord, for example, during the formation of early speech skills, motor skills or social cognition lag behind, and physical maturity is also combined with infantilism. With age, disagreements are smoothed out, so violations usually do not lead to consequences.

Infantilism

With infantilism, the emotional-volitional sphere lags behind in development. Symptoms are revealed at the stage of school and adolescence, when already a large child behaves like a preschooler: he prefers to play, rather than gain knowledge. Does not accept school discipline and requirements, while the level of abstract-logical thinking is not violated. In an unfavorable social environment, simple infantilism tends to progress.

The reasons for the formation of the disorder are often constant control and restriction, unjustified custody, the projection of negative emotions on the child and incontinence, which prompts him to close and adapt.

What to look for?

The manifestations of mental disorders in childhood are varied, sometimes it is difficult to confuse them with a lack of upbringing. Symptoms of these disorders can sometimes appear in healthy children, so only a specialist can diagnose the pathology. A doctor should be consulted if the signs of mental disorders are manifested clearly, expressed in the following behavior:

• Increased cruelty. A child at a young age does not yet understand that dragging a cat by the tail, he hurts the animal. The student is aware of the level of discomfort of the animal, if he likes it, you should pay attention to his behavior.
• Desire to lose weight. The desire to be beautiful arises in every girl in adolescence, when, at normal weight, a schoolgirl considers herself fat and refuses to eat, there is a reason to go to a psychiatrist.
• If the child has high degree anxiety, panic attacks often occur, the situation cannot be ignored.
• Bad mood and blues are sometimes characteristic of people, but the course of depression for more than 2 weeks in a teenager requires increased attention from parents.
• Mood swings indicate the instability of the psyche, the inability to adequately respond to stimuli. If a change in behavior occurs for no reason, it indicates problems that need to be addressed.

When a child is mobile and sometimes inattentive, there is nothing to worry about. But if because of this it is difficult for him to play even outdoor games with his peers, because he is distracted, the state requires correction.

Treatment methods

Timely identification behavioral disorders in children and the creation of a favorable psychological atmosphere allows you to correct the mental disorder in most cases. Some situations require lifelong monitoring and medication. Sometimes it is possible to cope with the problem in a short time, sometimes it takes years to recover, the support of the adults around the child. Therapy depends on the diagnosis, age, reasons for the formation and type of manifestations of disorders, in each case, the method of treatment is selected individually, even when the symptoms vary slightly. Therefore, when visiting a psychotherapist and psychologist, it is important to explain to the doctor the essence of the problem, to provide a complete description of the characteristics of the child's behavior, based on the comparative characteristics before and after the changes.

In the treatment of children are used:

• In simple cases, psychotherapeutic methods are sufficient, when the doctor, in conversations with the child and parents, helps to find the cause of the problem, ways to solve it, and teaches to control behavior.
• Complex of psychotherapeutic measures and reception medications speaks of a more serious development of pathology. For depression, aggressive behavior, mood swings, sedatives, antidepressants, antipsychotics are prescribed. For the treatment of developmental delays, nootropics, psychoneuroregulators are used.
• In case of severe disorders, inpatient treatment is recommended, where the child receives a course of necessary therapy under the supervision of a doctor.

During and after treatment, it is necessary to create a favorable environment in the family, eliminate stress and the negative impact of the environment that affects behavioral reactions.

If the parents have doubts about the adequacy of the child's behavior, it is necessary to consult a psychiatrist, a specialist will conduct an examination and prescribe treatment. It is important to identify pathology at an early stage in order to correct behavior in time, prevent the progression of the disorder and eliminate the problem.