What is ZPR?

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

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

What suffers

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

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

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

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

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

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

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

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

Who are these children

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

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

It is probably best to take both factors into account.

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

Unfavorable course of pregnancy:

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

Pathology of childbirth:

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

Social factors:

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

Types of Delay

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

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

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

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

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

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

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

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

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

MMD researchers have identified the followingrisk factors for its occurrence:

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

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

About prevention

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

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

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

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

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

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

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

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

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

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

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

Content

This diagnosis is made to children, usually at school or preschool age, when the child first encounters systematic and purposeful learning. This is a type of delay in psychological development that requires correction. With timely diagnosis and proper treatment, and the behavior of parents and children, this disease can be completely eliminated and developmental problems can be overcome.

ZPR - what is it?

The abbreviation stands for mental retardation, according to ICD-10 it has the number F80-F89. ZPR in children is a slow process of improvement of mental functions, for example, the emotional-volitional sphere, thinking, memory, perception of information, memory, which leads to a lag according to generally accepted norms in development for a given specific age.

Pathology is usually detected. at primary school or preschool age. The first manifestations of mental retardation appear during testing, which is carried out before entering school. Specific manifestations include a lack of knowledge, limited ideas, difficult intellectual activity, immaturity of thinking, and the predominance of purely childish and playful interests. The causes of pathology in each case are individual.

Symptoms and signs

Children with mental retardation experience minor problems in the cognitive sphere, but many mental processes are affected, which form the clinical picture. Manifestations of mental retardation in children include the following signs:

1. Experts characterize the level of perception in a child with mental retardation as slow; there is no ability to assemble a holistic image of an object. Hearing is often affected by the disease, so the presentation of material for children with this disease must be accompanied by pictures and visual examples.
2. If the situation requires stability and concentration, then the child will have difficulties, because any external influence distracts him.
3. When diagnosed with mental retardation, hyperactivity is observed against the background of attention deficit disorder. Children remember information selectively, with poor selectivity. The visual-figurative (visual) type of memory works better, the verbal type is not developed enough.
4. There is no imaginative thinking. Children use abstract logical thinking only under the guidance of a teacher.
5. It is difficult for a child to draw any conclusions, compare things, or generalize concepts.
6. Lexicon limited, speech is characterized by distortion of sounds, it is difficult for the patient to construct complete phrases and sentences.
7. In most cases, mental retardation is accompanied by delayed speech development, dysgraphia, dyslalia, and dyslexia.

Before admission to school, specialists must conduct tests to check the child’s level of development. If there is a delay in mental development in children, the teacher will definitely notice it. It is extremely rare that a child with mental retardation does not have any signs of the disease and does not stand out among his peers. Parents should not start treatment on their own; a consultation with a doctor is required. Obvious signs of mental retardation in preschool age include:

• the student cannot at all or has difficulty dressing himself, eating, washing, buttoning his jacket, tying his shoelaces, and performing other daily procedures;
• the student does not want to participate in joint games, treats classmates with danger, clearly shows signs of isolation, does not want to communicate with the team;
• any of his actions are accompanied by aggression and indecision;
• behaves anxiously, is constantly afraid of even the simplest situations.

Differences from mental retardation

Parents do not always understand the difference between these two pathologies, but they exist, and they are very noticeable. If doctors continue to observe all signs of mental retardation in a child after the 4th grade, then a suspicion of mental retardation or constitutional infantilism arises. The main differences between these pathologies are as follows:

1. Mental retardation and intellectual underdevelopment are irreversible. In case of mental retardation, the situation can be corrected if treatment is started in a timely manner, with proper care for the patient.
2. With mental retardation, a student can use the help that a specialist offers him and transfers it to new tasks. This does not happen with mental retardation.
3. Children with mental retardation try to understand what they read; with LD, this desire is absent altogether.

Causes

The classification of mental retardation is carried out according to the factors that provoked the pathology. One of the possible options is local changes in the brain areas that occur even at the stage of intrauterine development. The reason for this is the mother’s illness of a somatic, toxic, infectious form. The same changes occur when a child is asphyxiated while passing through the birth canal.

Another important factor is genetics, which, according to the laws of nature, can reward a child with a natural predisposition to slow maturation of brain systems. Often the pathology has a neurological basis with signs of vascular dystonia, hydrocephalus, and failure of innervation of the cranial area. Encephalography can clearly trace all disorders of brain activity that provoke delayed development. Characteristic manifestations of mental retardation in children include the activity of delta waves and complete attenuation of alpha rhythms.

Emotional and psychological reasons develop if the student was brought up in unacceptable conditions from an early age. Interpersonal, psycho-speech and other problems arise if:

• there is emotional, maternal deprivation (neglect);
• lack of attention from teachers, which led to neglect;
• the baby did not have the necessary incentives for normal development;
• alcoholism of parents, lack of attention from parents in early age;
• there were no conditions to master simple skills;
• indifferent, indifferent attitude on the part of the teacher, individual characteristics were not taken into account;
• frequent, regular scandals in the family, limited contact with peers, instability;
• meager, poor nutrition, which did not provide the growing body with all the necessary vitamins and minerals.

Types of ZPR

This disease is divided into 4 groups. Each type is provoked by certain factors and has its own characteristics of emotional immaturity and impaired cognitive activity. The following types of pathology are distinguished:

ZPR of constitutional origin

This type of pathology is characterized by a pronounced immaturity of the emotional-volitional sphere; it lags several steps behind compared to other children. This is called mental infantilism, it is not a disease, it is considered to be a complex of sharpened character traits, behavioral traits that can significantly affect the daily activities of the child. The child's learning and adaptation ability to new situations suffers more.

With this type of mental retardation, the child is often dependent on his mother, feels helpless without her, and has difficulty adapting to new conditions. A characteristic feature is an elevated background mood, the expression of emotions is violent, but the mood is unstable. Closer to school age, the child still puts games in the foreground, but normally learning motivation should appear.

Without outside help, it is difficult for a child to make decisions, choose something, or make any other volitional effort. Children with mental retardation can behave cheerfully and spontaneously; the developmental delay is not obvious, but in comparison with their peers they always seem younger. Teachers should pay more attention to such students, taking into account their individual characteristics.

Somatogenic origin

Frequently ill and weakened children fall into this group. Chronic infections, long-term illnesses, allergies, and congenital defects provoke mental retardation. This is explained by the fact that under the influence of a long course of the disease, against the background of the weakness of the body, the baby’s mental state suffers. This prevents him from fully developing, which leads to low cognitive activity, dulling of attention, and increased fatigue. These factors lead to a slowdown in the formation of the psyche.

This group also includes schoolchildren from overprotective families. Too much attention to raising a child leads to a lack of development of independence, knowledge of the surrounding world, and the formation of a full-fledged personality when literally one step is not allowed to be taken without control. Overprotection is inherent in families where children are often sick; constant anxiety, pity for the baby, and the desire to make his life as easy as possible ultimately lead to delayed mental development.

ZPR of psychogenic origin

In this case, the main role is given to the social situation during the development of the baby. An unfavorable family environment, mental trauma, and problematic upbringing lead to mental retardation. In the presence of violence, aggression towards the baby or family members, it entails the development of certain traits in the character of your child. This often becomes the cause of lack of independence, indecisiveness, lack of initiative, pathological shyness and timidity.

This type of cause of mental retardation is distinguished by the fact that there is practically no guardianship and insufficient attention to upbringing. A schoolchild grows up in a situation of neglect and pedagogical neglect. This leads to a lack of a formed opinion about the moral and norms of behavior in society, the baby cannot control his own behavior, is unable to be responsible for his actions, and there is a lack of knowledge about the world around him.

ZPR - cerebral-organic origin

The most common type of pathology has an unfavorable prognosis compared to the types described above. The main development of the disease is organic disorders, for example, insufficiency of the nervous system, which develops for the following reasons:

• birth injury;
• pathologies of pregnancy (Rh-conflict, trauma, intoxication, infection, toxicosis);
• prematurity;
• neuroinfections;
• asphyxia.

This type of mental retardation is accompanied by an additional symptom – minimal brain dysfunction (MCD). By this concept we mean a complex of mild developmental deviations that manifest themselves only in certain cases. The signs are very different and can appear in different areas of the baby’s mental activity.

Complications and consequences

ZPR consistently affects the patient’s personal development in future life situations. Significant consequences can only be avoided if timely measures are taken to diagnose deviations, correct behavior, and teach the individual to exist in society. Indifference to the delay only leads to aggravation of existing problems, which will manifest themselves as they grow up.

A typical complication is self-isolation, withdrawal from peers, they begin to be treated as outcasts, which adds a sense of inferiority to one’s own personality and reduces self-esteem. The combination of all factors leads to extremely difficult adaptation and the inability to communicate with the opposite sex. The consequence is a decrease in the level of cognition, assimilation of new information, distortion of speech and writing, difficulty in searching suitable profession, mastering simple working techniques.

To determine developmental delay, it is necessary to conduct a comprehensive examination of the baby, which is carried out by a psychological, medical and pedagogical commission (abbreviated PMPC). The diagnosis of mental retardation is made according to the conclusion of a speech therapist, psychologist, defectologist, child neurologist, pediatrician, or psychiatrist. The specialist collects anamnesis, studies it, and analyzes living conditions. Next, neuropsychological testing is carried out, a study of your child’s medical records, and a diagnostic examination of speech.

A mandatory part of the diagnosis is a conversation with the baby to study intellectual processes, emotional and volitional qualities. This information becomes the basis for determining the baby’s level of development. Members of the PMPC make an opinion on the absence or presence of mental health development, issue recommendations for the further organization of education, training of your child in a school or other special educational institutions. The following instrumental methods can be used:

Correction

Treatment for mental retardation begins immediately after the first symptoms of the disease appear. Early diagnosis is important for an effective correction regimen, which includes A complex approach, the following main treatment methods are used:

1. Reflexology. Electrical impulses are sent to the brain points. The microcurrent technique is effective for developmental delays after cerebral-organic damage.
2. Speech therapy massage, effective methods of memory development, memory training, articulation gymnastics, improving the level of thinking. All these therapeutic measures are carried out by specialists, a defectologist and a speech therapist.
3. Medications are prescribed only after examination by a neurologist. Use on your own is strictly contraindicated; it can harm your baby.
4. At social factors consultation with a psychologist is required. Communication with dolphins, animals, and horses helps a lot. Prosperous couples can help the child develop self-confidence (without developing inflated self-esteem); support should help in personality development.

Also in kindergarten identify children who are different from their peers. They act first, think later, are too impulsive, and cannot concentrate on a specific task. Delayed mental development of a child is characterized by a lag in speaking, concentration, motor skills, thinking, and memory. There is a lag in learning, behavior regulation, and uncontrollable emotional outbursts.

Children with mental retardation need specially organized education with medical support. Psychiatrists attribute such a delay to mild deviations. Mental retardation in children is not a gross disorder of the development of the child’s psyche; the problem is not related to underdevelopment of the motor system and should not be confused with disability.

You can notice symptoms of mental retardation in children by paying attention to some features of the child’s behavior:

• Without the help of adults, schoolchildren do not master the curriculum (writing, reading, counting);
• uncontrollable behavior, restlessness, inattention;
• mental and speech development is delayed;
• it is difficult to express a thought correctly;
• it is not possible to compose a retelling of the text read or told, only individual fragments of the story are built;
• slow thought process;
• noticeable memory loss;
• do not pronounce all letters and sounds;
• such children are naive, straightforward, dependent;
• often conflict with peers;
• find it difficult to perceive and carry out school assignments and instructions;
• some games cause fear;
• poor performance;
• fast fatiguability;
• cannot play in an organized, coherent manner;
• educational material is learned slowly;
• children are not inquisitive enough;
• impulsive, irritable;
• they are focused on minor issues;
• it is difficult to understand the main idea of ​​the task;
• characterized by fussiness, aggressiveness, uncertainty, expressiveness;
• rapid mood changes;
• require constant attention and approval.

Developmental delay is detected in preschool age by the following signs:

• baby 6-8 months does not hold the head independently;
• baby 7-9 months does not turn over;
• after 7 months does not sit by himself;
• by six months the baby does not babble, at one and a half years - does not utter simple words or syllables (pa, na, ma, yes, mom, dad);
• The child constantly walks on tiptoes.

Important! If these symptoms appear, consult a pediatrician or psychiatrist.

Causes of developmental delay

The child has difficulties with learning and social adaptation. Unstable intellectual abilities are observed. Children may be classified as pedagogically neglected cases, indicating that the cause depends on the child’s social status.

Possible causes of mental retardation arising during the mother's pregnancy:

• rubella, chickenpox;
• acute respiratory infections, acute respiratory viral infections, influenza;
• intrauterine infections;
• severe toxicosis;
• consumption of alcoholic beverages;
• smoking;
• maternal contact with pesticides;
• oxygen starvation of the fetus;
• different Rh factor among parents.

Postpartum factors for the manifestation of mental retardation:

• injuries caused to the baby during childbirth;
• asphyxia in infants;
• a premature baby may show signs of mental retardation;
• jaundice;
• umbilical cord entanglement;
• placental abruption.

Other causes of mental retardation:

• attention deficit;
• lack of psychological influence of parents on the baby;
• pedagogical neglect;
• limitation of life activity;
• quarrels, violence, alcoholics in the family;
• excessive care;
• head injury, tumor;
• hydrocephalus;
• rickets;
• meningitis;
• epilepsy;
• delay physical development;
• excess weight, chronic maternal illnesses;
• nervous breakdowns of the expectant mother;
• heredity.

A neuropsychological examination revealed slow formation of the frontal parts of both hemispheres of the brain, which are responsible for behavior, thinking, attention, and memory. It is expressed in the slowness of perception and processing of received information. If the neurologist detects damage, he will prescribe drugs that activate the work of brain cells, coordinating the baby’s excitability.

Modern children are closed in their own world, computer games negatively affect development. Over time, a lack of communication with peers appears, and a fear of making new acquaintances arises. There is a fear of contact with children and adults.

Problems with the baby’s psyche can develop due to hearing, vision, and speech defects. The child feels inferior, withdraws, stops communicating, and becomes irritable.

Classification of ZPR

The cognitive and physical abilities of children with mental retardation are limited. Their intelligence is lower than that of their peers. They are not able to fully comply with the requirements. Games and certain interests come to the fore. Such guys behave differently in different situations.

The somatogenic group includes children with somatic diseases (asthma, heart disease, kidney failure, pneumonia, etc.). Past illnesses affect brain function. Children spend a long time in medical institutions. They are characterized by low ability to work, absent-mindedness, have difficulty remembering material, they have superficial attention, and lethargy. They perceive the new team difficultly, react adequately to the environment, are polite, and do not show initiative.

Constitutional delay depends on heredity. Slow maturation of the central nervous system leads to mental disorders and delayed physical development. The behavior of such children does not correspond to their age. Some behave like kids, others try to show that they are adults. Children are spontaneous, they have insufficient memory, unfocused attention, are not touchy, often good mood. They carry out tasks that are of interest to them.

Mental retardation of a psychogenic nature occurs under unfavorable conditions of a social and somatic nature. This group includes neglect, shortage or lack of parenting, abuse, strong guardianship. Children are characterized by impulsiveness, weak intelligence, and lack of independence. The child becomes neurotic, restless, and is overcome by anxiety. Overprotection leads to lack of will and lack of determination. If there are no problems with the central nervous system, the child will gradually adapt to the school environment and overcome the barrier of communication with classmates.

Cerebral-organic origin is caused by damage or anomaly of the brain and central nervous system, cerebral palsy. Violations affect any area of ​​the psyche, it all depends on the scale and area affected.

Who carries out the diagnosis and when?

A commission diagnoses mental retardation in the child. Composition: psychologist, neurologist, teacher, psychiatrist, speech therapist, defectologist. During the diagnosis, parents, representatives of the kindergarten or school are present. Their task includes:

1. Give a conclusion or reject the diagnosis of mental retardation.
2. The child is tested on his knowledge. They check reading, writing, counting, logic, and the child answers certain tests.
3. Experts study the child’s perception, memory, thinking, attentiveness, and self-awareness.
4. The commission establishes the training program and what specific classes are needed.

Preschoolers up to 6 years old are diagnosed. Additionally, the doctor may prescribe an EEG, MRI, or CT scan of the brain.

Actions of parents in case of mental retardation

Such a diagnosis is not final; the child’s development does not stand still, it simply moves at its own pace. The first years of study are important for the formation of personality. This is the time of laying basic knowledge and relationships with people around you. Help involves psychological and pedagogical correction.

Action for adults:

1. Developmental delay requires competent psychocorrection; you need to start studying on time. You should not rely on someone (school, teacher), you need to take control of the situation.
2. A correctional class will help you get comfortable faster, gradually master the educational material, and make friends with classmates.
3. After the adjustment, the child is cured, ready to return to regular school by 5th - 6th grade, the lag will not be noticeable.
4. You should contact different doctors. Consult a neurologist or psychiatrist several times a year. Take a course of treatment as prescribed.
5. If the school does not have a speech therapist, you will have to find one yourself. Attend specialist classes twice a week and do additional tasks at home.
6. Consultations, classes with a defectologist.
7. Together with the teacher, draw up a plan to make up for the shortcomings of the training sessions.
8. Explain to the child orientation in space (where is left and where is right, seasons, months, days, figure out the clock). Classes will give results if they are carried out in a playful way. Includes motor games and sandbox activities.
9. At first, the lesson lasts 8-15 minutes, writing 5 minutes. Then they switch attention to another lesson. After 40 minutes they take a break: eat, run, jump, look at pictures.
10. If possible, hire tutors.

Advice! There are many educational games and exercises on the Internet for children with mental retardation.

The sooner adults pay attention to the baby’s lag, the faster the recovery will come.

If the doctor considers that drug treatment is necessary, nootropic drugs will be prescribed.

Often parents control every movement of the baby: they collect his schoolbag, do his homework for him, feed him, dress him. Such excessive care deprives their child of independence, instills uncertainty, and makes them irresponsible. Control is needed, but completely independent actions cannot be limited. For example, dad asks: “What lessons were given? What subject will you start teaching? What did you put in your briefcase? Show me the book you read?” Such questions form a sense of responsibility in the child, push him to take independent action, and help him make his own decisions.

Heavy workload reduces the child’s performance, resulting in lethargy, irritation, aggression, and mood swings. It is difficult to carry out increased loads, the child becomes nervous, worries, and loses faith in himself.

Indifference and a permissive attitude are observed in dysfunctional families and where parents are too busy, they do not see the problem. With age, the situation begins to manifest itself, adults frighten with belts, cuffs, and come up with different methods of punishment. In the future, this leads to irreversible consequences.

What to do?

1. No matter how hard it is, you can’t stop, you can’t give up, exercises will give results over time. Praise your child for every successful decision, for small achievements.
2. Help the child if he asks for help.
3. Create a positive microclimate in the family. Spend more time together.
4. Instill confidence in your son (daughter), convince him of success, explain: you just need to make an effort.
5. Create a desire to learn and maintain a daily routine.
6. Avoid overwork.
7. Give more independence: let him eat, dress, fold things, make the bed, wash the dishes.
8. Help.
9. Show on a walk different shapes, colors, count objects. For example: “How much do cars cost? What color are they? Show me a big and a small car?
10. Bodily-emotional contact: hugging, kissing.
11. Observe the baby’s condition from an early age.
12. Consult your pediatrician.

Exercises that the child can handle should be given.

Advice! If there is a correctional educational institution in the city, it is better to send your child there.

The number of students in a correctional class is less than in a regular school, the teacher pays attention to each student. The teachers have experience teaching such children. You have to be patient; you can’t take it out on your child, he’ll close himself off and there will be no way to fix anything.

Mental retardation is a feature of a child’s development in which basic mental functions are formed with a lag behind accepted age norms.

Impaired mental function(ZPR) is a pathology that requires a careful assessment, identification of their causes and determination of ways to eliminate them. It manifests itself in a wide variety of symptoms, which depend on the causes of the disorder, the characteristics of the child and the environment in which the baby develops.

It is important to say that this term only refers to disorders that do not have actively expressed forms and manifest themselves in a child of preschool and primary school age . The main difficulties encountered in children with mental retardation are related toadaptation to the educational process. At a later age, as well as in cases where more complex forms of pathology are identified, we are no longer talking about mental retardation, but about other diagnoses.

Types of pathology

ZPR is divided into 4 groups based on the causes of occurrence and characteristics of the manifestation of symptoms.

Types of ZPR and their characteristics in the table

Diagnosis

According to the list medical diseases the diagnosis of mental retardation refers to psychological developmental characteristics (F80-F89).

In order to identify the causes and characteristic features of mental retardation in a child, a commission of specialist educational psychologists carries out a set of measures aimed at analyzing his personality, his birth history and living conditions. The complex includes:

• communication with the child, conversation with parents;
• taking anamnesis;
• examination and examination by a psychologist;
• expert opinion.

At the examination stage, the baby’s memory, perception, attention, and information processing abilities are studied. His ability to perceive sounds, the meaning of speech, and perform emotional-volitional actions is also assessed.

To diagnose mental retardation, laboratory tests are also prescribed: genetic, molecular and metabolic analyses.

Causes

As can be seen from the list of origins of the disease, mental retardation occurs for both biological and socio-psychological reasons.

Biological Reasons for DPR:

• organic damage to the central nervous system, epilepsy;
• birth and traumatic brain injuries;
• prematurity;
• infections intrauterine and at an early age;
• Rhesus conflict;
• rickets;
• heredity, etc.

In case of defects in the functioning of the sense organs (visual impairment, hearing impairment, speech difficulties, etc.) and in the absence or insufficiency of corrective treatment and rehabilitation, mental retardation develops due to the inability of the baby to fully perceive the world. information block

Socio-psychologicalThe causes of the disease are usually associated with living in dysfunctional families (aggressive environment, authoritarian upbringing, cruelty towards the child and other family members, problems with alcohol, etc.), or with conditions of overprotection, lack of communication with peers, etc.

Causes of developmental delays in preschool children

According to psychologists, about 20% of first-graders in our country have difficulties mastering the school curriculum. Having reached the age of 7 years, such children have not mastered the necessary age-related skills of perception and analysis of information in order to successfully study at school.

The reason for mental retardation is that deviations from norms were not detected in time at an earlier age. By the age of 2-3 years, parents can pay attention to signs that the child is lagging behind in certain indicators. Does not speak, does not know how to hold a spoon or eat independently, does not show active interest in the world around him, cannot fulfill simple playful requests from adults - these and other signs of must

alert parents and become a reason to show their son or daughter to a specialist.

It is easiest to notice signs of mental retardation in children 4-5 years old. It is at this age that they already engage in active, proactive communication with peers, and show their first successes in preschool education, are interested in letters, numbers, spelling words, etc.

But the age of 4-5 years is critical for starting treatment for developmental delays. Much more favorable prognoses for eliminating pathology occur when corrective classes and treatment begin before the age of 3 years.

This is especially important for speech development delays. If speech skills are absent by age 4-5, the likelihood of successful treatment is less than 1%. If there is no speech even by the age of 7, then there is more than a 90% chance that it will not appear.

Symptoms and signs in children

The same mental development disorders in different children differ in time and degree of expression. These manifestations can concern both the psycho-emotional sphere and physical skills.

Emotional-volitional sphere

Emotional-volitional sphere. These are types of mental retardation associated with the child’s inability to control his emotions and make volitional efforts. He cannot stay in one place for a long time, is not focused on the task at hand, and gets tired quickly. Such children violate discipline, have conflicts, and are subject to sudden attacks of causeless aggression or laughter. Gaming activities remain a priority for a long time.

Intellectual development

Intellectual development. Decreased attention and impaired perception. Characterized by a lag in speech skills. The child slowly realizes what is happening, does not recognize familiar objects presented from a new perspective, and is poorly oriented in space. Such a child remembers better information that is received visually. By the beginning of school, insufficient ability to process information (summarize, systematize, etc.) is revealed.

Interpersonal relationships

Interpersonal relationships. The child is unable to build stable relationships with peers or adults and has difficulty conducting dialogues. Inhibited, aggressive, extremely shy, fearful.

Speech

Speech.The pace of development has been reduced. The degree of violation depends on the cause of its occurrence. Usually delays can be easily compensated for by regular exercise.

Thus, the main signs of mental retardation are the following violations:

• memory
• attention
• thinking
• speeches

With various types of mental retardation, all of the listed signs appear in a mild form and are not an obstacle to the child’s full development of the regular school curriculum. Children with such developmental delays only require more careful attention and adjustments to the form of presentation of the material.

Signs of pathology at 2 years

By the age of 2, the baby already has a certain set of skills that allow us to evaluate his learning abilities and the pace of development. Therefore, it is at this age that it becomes possible to identify signs of mental retardation for the first time.

This age is characterized by active actions that imitate the manipulations of close adults. Children willingly imitate their parents in everyday living conditions, and also perform simple play actions following a model after a demonstration (assemble a pyramid, draw a line on paper, etc.). Also, at 2 years old, the child already pronounces not only individual words, but also simple sentences of 3-4 words

How to understand that a child has mental retardation?

There is reason to talk about delayed development of a two-year-old child in cases where the child:

• cannot correlate a three-dimensional shape with the corresponding planar image, does not understand even after being shown how to assemble a simple pyramid or sorter (distribute figured inserts into similar holes).
• does not navigate in a set of 3-4 contrasting colors, cannot find a color from a sample.
• is not able to show (answer) which of the objects presented (after showing) is heavy/light, warm/cold, soft/hard, etc.
• does not perform 2-3 actions in the game (consistently feed and rock the doll).
• does not understand how to build a simple shape from cubes according to a model.
• does not show desire for activity, is apathetic, incurious.
• does not require what is desired.
• does not know the names of the main colors, shapes, objects that surround him.
• cannot distribute objects by size, shape, color, cannot form a pyramid according to a given pattern or picture.
• cannot complete a simple picture (petal of a flower, etc.), does not depict simple shapes and lines on a sheet of paper, does not use imagination in drawing.
• does not take on game roles (“I am a mother, a doctor...”), does not fantasize, and does not emotionally color behavior in the game.
• does not make contact with other children, does not participate in emotional communication.
• does not understand what is “good” and what is “bad” when he has done something shameful and prohibited.
• does not show initiative, does not strive for independence, is incurious.

  If you find a number of the described signs in your child, contact a competent neurologist.

  Mental retardation is not a disease, but a sign that your child needs extra attention. Timely diagnosis of the baby’s condition will allow us to understand the cause in time and take the necessary measures to ensure that the disorders do not subsequently develop into a serious pathology.

The last few years to the problem mental retardation there is increased interest. This is due to the fact that such a deviation in mental development is ambiguous; there are many causes, prerequisites and consequences of its occurrence. Therefore, this phenomenon, so complex in its structure, requires an individual approach in each specific case.

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

This happens because the rate of maturation of the psyche with developmental delay is slowed down. In addition, in each individual child, mental retardation can manifest itself differently and differ both in degree and time of manifestation.

We will try to highlight a number of developmental features that are characteristic of the majority of children with mental retardation.

The most striking sign of mental retardation is immaturity of the emotional-volitional sphere ; that is, it is very difficult for such a child to make a volitional effort on himself, to force himself to do something. These children also experience attention disorders : instability, decreased concentration, increased distractibility. May be present increased motor And speech activity . It is precisely this complex of disorders (impaired attention + increased motor and speech activity) that is currently designated by the term "attention deficit hyperactivity disorder" (ADHD) .

Perception disturbance usually manifests itself in difficulties in constructing a holistic image. For example, it may be difficult for a child to recognize familiar objects from an unfamiliar perspective. This feature of perception is usually the reason for limited knowledge about the world around us. Speed ​​of perception and spatial orientation are also impaired.

Memory Children with mental retardation also have a certain feature: they remember visual (non-verbal) material much better than verbal information.

Development rate speeches with ZPR, as a rule, it is also slowed down. Other features of speech development usually depend on the severity of mental retardation and the nature of the underlying disorder: in some cases there may be only a slight delay or even compliance with the normal level of development, in other cases there is a systemic underdevelopment of speech.

Developmental delay thinking with mental retardation, it is detected primarily during solving problems of a verbal-logical nature. By the beginning of school, children with mental retardation, as a rule, do not fully master all the intellectual operations necessary to complete school assignments (analysis, synthesis, generalization, comparison, abstraction).

At the same time, the developmental disability is not an insurmountable obstacle to mastering the general education curriculum. However, this program must be adjusted in accordance with the developmental characteristics of the child.

Causes of mental retardation

As the reasons leading to mental development delays, domestic specialists M.S. Pevzner and T.A. Vlasov distinguish the following:

Types of ZPR

Mental retardation is usually divided into four groups:

1) ZPR of constitutional origin . This type is characterized by a pronounced immaturity of the emotional-volitional sphere, which is, as it were, at an earlier stage of development. Here we are talking about the so-called mental infantilism. You need to understand that mental infantilism is not a disease, but rather a certain complex of behavioral characteristics.

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

2) ZPR of somatogenic origin - This group includes weakened, often ill children. As a result of a long-term illness, allergies, or congenital malformations, mental retardation may occur. This is explained by the fact that during a long illness, against the background of general weakness of the body, the child’s mental state also suffers, and, therefore, cannot fully develop. Low cognitive activity, increased fatigue, dullness of attention - all this leads to a slowdown in the rate of mental development.

This also usually includes children from families with overprotection - excessive attention to the upbringing of the child. When parents care too much about their child, they don’t let him go a single step, they do everything for him. In such a situation, loved ones prevent the child from demonstrating independence, and therefore from understanding the world around him and forming a full-fledged personality. It should be noted that the situation of overprotection is very common in families with sick children, where pity for the baby and constant worry about his condition, the desire to make his life easier, ultimately negatively affect the development of the child’s psyche.

3) ZPR of psychogenic origin - the cause of this type of mental retardation is dysfunctional situations in the family, problematic upbringing, and mental trauma. If there is aggression and violence in the family towards the child or other family members, this can contribute to the child’s indecisiveness, lack of independence, lack of initiative, timidity and pathological shyness.

Thus, in this case it is observedthe phenomenon of hypocustody, or insufficient attention to raising a child. The consequence of this is the child’s lack of ideas about moral standards of behavior in society, the inability to control his own behavior, irresponsibility and inability to answer for his actions, and an insufficient level of knowledge about the world around him.

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

The reason for the occurrence of this type of PPD isare organic disorders, namely, insufficiency of the nervous system, the causes of which can be: pathology of pregnancy (toxicosis, infections, intoxication and trauma, Rh conflict, etc.), prematurity, asphyxia, birth trauma, neuroinfections. With this form of ZPR there is a so-called minimal brain dysfunction (MMD) - a complex of mild developmental disorders that manifest themselves, depending on the specific case, in a very diverse manner in various areas of mental activity.

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