Psychogenic mental retardation. Mental retardation as a form of dysontogenesis. Mental characteristics of children diagnosed with mental retardation, mental retardation and mental retardation
In 1980, K. S. Lebedinskaya proposed a classification of ZPR. This classification is based on etiopathogenetic systematics. There are 4 main types of ZPR:
♦ constitutional nature;
♦ somatogenic nature;
♦ psychogenic in nature;
♦ cerebral-organic nature.
All 4 types have their own characteristics. A distinctive feature of these types is their emotional immaturity and impaired cognitive activity. In addition, complications in the somatic and neurological spheres can often arise, but the main difference is in the features and nature of the relationships between two important components of this developmental anomaly: the structure of infantilism and the characteristics of the development of all mental functions.
ZPR of constitutional origin
With this type of delay mental development The emotional-volitional sphere of the child is at an earlier stage of physical and mental development. There is a predominance of gaming motivation of behavior, superficiality of ideas, and easy suggestibility. Such children, even when studying at a comprehensive school, retain the priority of gaming interests. With this form of mental retardation, harmonious infantilism can be considered the main form of mental infantilism, in which underdevelopment in the emotional-volitional sphere is most pronounced. Scientists note that harmonious infantilism can often be found in twins, this may indicate a connection between this pathology and the development of multiple births. Education of children with this type of mental retardation should take place in a special correctional school.
ZPR of somatogenic origin
The causes of this type of mental development delay are various chronic diseases, infections, childhood neuroses, congenital and acquired malformations of the somatic system. With this form of mental retardation, children may have a persistent asthenic manifestation, which reduces not only the physical status, but also the psychological balance of the child. Children are characterized by fearfulness, shyness, and lack of self-confidence. Children in this category of mental retardation have little contact with their peers due to the guardianship of parents who try to protect their children from what they think is unnecessary communication, so they have a low threshold for interpersonal connections.
With this type of mental retardation, children need treatment in special sanatoriums. The further development and education of these children depends on their health status.
Mental health problems of a psychogenic nature
The central core of this form of mental retardation is family dysfunction (prosperous or single-parent family, various types of mental trauma). If, from an early age, the child’s psyche has been traumatically influenced by unfavorable social conditions, this can lead to a serious disturbance in the child’s neuropsychic activity and, as a consequence, to shifts in autonomic functions, and subsequently mental ones. In this case, we can talk about an anomaly in personality development. This form of mental retardation must be correctly differentiated from pedagogical neglect, which is not characterized by a pathological condition, but arises against the background of a lack of knowledge, skills and intellectual underdevelopment.
In medicine and pedagogy there is no clear differential diagnosis of the problem of ZPR, ZRR and ZPRR. Parents are offered average recommendations, which should be suitable for correcting diagnoses of mental retardation, developmental developmental disorders and mental retardation in all children. But in practice this is far from being the case, and treatment does not always help. What is the cause of mental retardation, developmental retardation and developmental retardation in a child and how it is possible to remove the diagnosis, read in this article.
ZPR, ZPR, ZPRR: what are these diagnoses?
- ZPR. Impaired mental function. It is given to children whose normal development of mental functions is disrupted - thinking, memory, attention, ability to learn and acquire new skills.
- ZRR. Delayed speech development. It is given to children who, by the age of 3-4 years, have small lexicon or no phrasal speech, at a normal pace of mental development.
- ZPRR. Delayed mental and speech development. It combines both a lag in the formation of the psyche and a delay in the development of speech.
Kindergarten teachers may report that the child behaves “strangely,” aggressively, screams, or prefers to be alone. Doesn't complete tasks with everyone else due to restlessness. He may need additional time, new knowledge is not retained in his memory, and he has to repeat everything like the first time. The lag in early childhood, when children are most actively developing, may turn out to be irreparable. In the first grades of school, a child diagnosed with mental retardation, mental retardation and mental retardation is often found to have reading, writing and arithmetic disorders. If the situation is not corrected, the child becomes a candidate for training in a correctional program. Read on to find out how to avoid this.
Diagnosis of mental retardation, developmental retardation and developmental retardation in children
Diagnosis of children with mental retardation, mental retardation and mental retardation includes several stages:
- Study of medical history and living conditions;
- Examination of the child by a pediatrician, neurologist and ENT doctor;
- Examination of the child by a speech therapist, psychologist and psychiatrist.
First, the presence of injuries, infections and other factors that could lead to a disruption in the development of the baby’s nervous system is determined. Information about the child’s behavior and treatment in the family and in kindergarten is also important. Specialist doctors help determine concomitant diseases and the condition of the body as a whole. A diagnosis of mental retardation, mental retardation or mental retardation is made by a medical-pedagogical commission based on the opinions of a speech therapist, psychologist, psychiatrist and speech pathologist.
Delayed speech and mental development is also detected during preventive medical examinations of children of established ages, as well as during a medical examination of a child for admission to school. kindergarten. Methods for diagnosing mental retardation, mental retardation and mental retardation are based on determining whether the child’s level of development corresponds to age standards.
If a child has been diagnosed with mental retardation, mental retardation or mental retardation, this means that special attention needs to be paid to the child’s development.
Causes of ZPR, ZPR and ZPRR in children
The causes of mental retardation, mental retardation and developmental retardation in children are:
- Organic damage to the central nervous system
Brain damage at the physical level can occur when birth trauma, severe hypoxia, infectious diseases of the central nervous system, head injuries and repeated operations under anesthesia.
- Chromosomal, genetic and somatic diseases
Diseases such as Down syndrome, cerebral palsy, congenital sensorineural hearing loss and others carry with them a secondary delay in the development of speech and psyche.
In this article we will talk about those children who do not have obvious signs of brain damage. When pregnancy and childbirth proceeded normally, and the child lags behind in development due to a discrepancy between environmental conditions and his individual mental characteristics. These conditions also include the choice of incorrect methods of education and training.
ZPR, ZPR and ZPRR in children: symptoms and signs
Symptoms of ZPR, ZRR and ZPRR include:
- Poverty or lack of independent speech from 3 years of age;
- The child does not understand well and does not complete simple tasks;
- Slowly acquires new skills;
- Restlessness, attention deficit hyperactivity disorder;
- Neurotic reactions (nocturnal enuresis, tearfulness, fears);
- Closedness, isolation, absence or weak reaction to addressing a child with intact hearing;
- Autistic-like behavior;
A child with mental retardation, developmental retardation or developmental retardation may have individual symptoms or all of the above.
The problem with the classifications of symptoms of mental retardation, mental retardation and mental retardation is that they do not take into account the individual characteristics of the child, equate different children and adjust them to generally accepted norms. What is the reason for the delay in mental and speech development in a certain child? Let's figure this out with the help of system-vector psychology by Yuri Burlan.
Mental characteristics of children diagnosed with mental retardation, mental retardation and mental retardation
According to the system-vector psychology of Yuri Burlan, a person is born with certain vectors. Each vector has its own properties, unlike others, and its own psychophysical characteristics.
Knowing the child’s vectors allows him to develop correctly. After all, what is normal for one may be pathology for another. In children with diagnoses of mental retardation, mental retardation and developmental retardation, the reasons for their appearance lie in developmental disorders in one or more of the following vectors.
A child with a sound vector has a special sensitivity to the sounds and words of other people. These are the children who are silent for a long time, and then immediately begin to speak in sentences. When a child does not turn to adults, has little desire to communicate, does not speak, but understands everything and does what he is told - this may be a baby with a sound vector. If the sounds outside are unpleasant to his sensitive ear, then the psyche defends itself. The child “withdraws into himself”, his interaction with environment. This can happen when there are quarrels, scandals, noises in the family, loud household appliances and the like. A mother’s harsh voice and even unwanted words in a quiet voice that she says casually can be the cause of delayed psycho-speech development in children with a sound vector. When external conditions are too traumatic, such a child may be diagnosed with autistic-like behavior and childhood autism.
This is a severe disorder of communication and behavior with partial or complete loss of the ability to distinguish the meaning of the speech of others while hearing is preserved. The child cannot develop further because his psyche curls up into a ball inside himself. He needs help to “come out.” To do this, the rules of sound ecology at home must be observed. Close people, first of all the mother, need to know the characteristics of such children. A child with a sound vector is not built like everyone else. And the more complex the psyche, the more fragile it is, the easier it is to break it, without even wanting it.
Children with anal vector are slow and thorough. It is vital for them to finish the job they start, whether it’s sitting on the potty or fastening buttons. It is psychologically important for such a child to put an end to any matter.
If you rush him or interrupt him, he begins to become stubborn and offended. As a reaction to stress, stupor may appear - the baby stops and cannot continue what he started. With chronic stress in the anal vector, thinking becomes excessively slow, and begins to get stuck on unimportant details. It is difficult to switch attention, the baby cannot absorb knowledge and does not acquire new skills. Developmental delays in a child with an anal vector appear due to a discrepancy between the pace of his mental activity and the demands of the environment. Stuttering may occur. It is necessary to distinguish the anal vector from others and create optimal conditions for development for the child.
The skin vector is opposite in properties to the anal vector. A child with a skin vector is nimble, flexible, and able to quickly switch from one thing to another. Grasping at several things and not finishing them is about him. If such a child is raised incorrectly, he may experience mental retardation with attention deficit hyperactivity disorder.
Then it is difficult for him to learn and acquire skills due to distractibility and restlessness. Such a child, more than others, needs discipline and an adequate system of prohibitions, because in the skin vector, self-restraint has a special meaning. Parents, irritated by the child’s behavior, begin to sharply grab him, spank him, and scold him. This cannot be done - humiliation, causing pain, beating a baby with a skin vector inhibits its development.
Children with a visual vector have the greatest emotionality and are prone to mood swings. To educate their sensuality is the task of parents. If a child with a visual vector has not been taught empathy for other people, then he may experience fears, throw tantrums, cry and make mountains out of molehills for any reason. When a child develops the habit of receiving emotions in this way, it disrupts his interaction with other people. A fear of communication arises, and then the child who is talkative at home remains silent and is afraid of strangers, and stuttering may appear.
The role of a child’s sense of security and safety in the development of mental retardation, mental retardation and mental retardation
Mom is the closest person to a child, and the most important. She gives him a feeling of security and safety. This is a prerequisite for the development of the baby’s psyche. Mom saves his life and psychological comfort. Then the child is able to develop the properties in his vectors to the maximum.
The loss of a sense of security and safety is fraught with a stop in his development. Then the still immature properties of the vectors begin to appear in the child, some of which are recognized as symptoms and signs of mental retardation, mental retardation and mental retardation.
Until the age of 6-7 years, the child’s unconscious connection with his mother is absolute - he adopts her inner state without words. If the mother is irritated, depressed, upset, and is subject to frequent stress, then the child will not feel protected. When a mother puts her psyche in order, the baby’s condition improves. A calm, balanced mother is able not to make mistakes in parenting, to react correctly to any child’s behavior and not to lash out at him.
When a mother finds out that her child has been diagnosed with mental retardation, mental retardation and mental retardation, she is overcome with a wave of fear for his future. Internal tension and feelings of guilt increase. She strives to give him the best, and if there is no result, despair sets in. This anxious state of the mother affects the child negatively. Mom needs to know what to do, gain confidence in her actions, and increase stress resistance.
Gain knowledge at the training “System-vector psychology” - best advice, which can be given in this situation.
Pedagogical and social neglect is a consequence of ignorance of the rules of education
When a child develops mental retardation, mental retardation or mental retardation due to improper upbringing methods and exposure to unfavorable conditions, such as humiliation, physical and psychological abuse, overprotection or homelessness in the family, lack of education in the emotional sphere, labor, hygiene skills and inability to overcome laziness - speak of a pedagogically neglected child.
Often these are socially disadvantaged families, but even in exemplary families there are educationally neglected children.
When something is applied to a person that is contrary to his nature, when they do not know the peculiarities of his psyche, this is a question of the psychological literacy of the parents.
Everyone is born with certain inclinations, which can be either developed or destroyed. It is easy to involve any child in the activity that is intended for him by nature, if you know what he is inclined to.
The diagnoses of ZPR, ZPR and ZPRR include many conditions, each of which has its own vector-based cause. If a child has been diagnosed with mental retardation, mental retardation or mental retardation, this is not a death sentence. How to remove the diagnosis of SPR - you need to know which child is diagnosed with SPR. Having understood the peculiarities of the child’s psyche, it will be possible to develop him correctly.
If you are the mother of a small son or daughter diagnosed with mental retardation, mental retardation or mental retardation, come to the free online lectures of the training “System-vector psychology” by Yuri Burlan. Watch and read
The works of Klara Samoilovna and Viktor Vasilyevich Lebedinsky (1969) are based on an etiological principle that allows us to distinguish between 4 options for such development:
1. ZPR of constitutional origin;
2. ZPR of somatogenic origin;
3. Mental retardation of psychogenic origin;
4. ZPR of cerebral-organic origin.
In the clinical and psychological structure of each of the listed variants of mental retardation there is a specific combination of immaturity in the emotional and intellectual spheres.
1.ZPR constitutional origin
(HARMONIC, MENTAL and PSYCHOPHYSIOLOGICAL INFANTILISM).
This type of mental retardation is characterized by an infantile body type with childlike plasticity of facial expressions and motor skills. The emotional sphere of these children is, as it were, at an earlier stage of development, corresponding to the mental makeup of the child more younger age: brightness and liveliness of emotions, the predominance of emotional reactions in behavior, gaming interests, suggestibility and lack of independence. These children are tireless in play, in which they show a lot of creativity and invention, and at the same time quickly get fed up with intellectual activity. Therefore, in the first grade of school, they sometimes have difficulties associated with both a lack of focus on long-term intellectual activity (they prefer to play in class) and an inability to obey the rules of discipline.
This “harmony” of mental appearance is sometimes disrupted at school and adulthood, because immaturity of the emotional sphere makes it difficult social adaptation. Unfavorable living conditions can contribute to the pathological formation of an unstable personality.
However, such an “infantile” constitution can also be formed as a result of non-rude, for the most part metabolic and trophic diseases suffered in the first year of life. If at the time of intrauterine development, then this is genetic infantilism. (Lebedinskaya K.S.).
Thus, in this case there is a predominantly congenital constitutional etiology of this type of infantilism.
According to G.P. Bertyn (1970), harmonic infantilism is often found in twins, which may indicate the pathogenetic role of hypotrophic phenomena associated with multiple births.
2. ZPR of somatogenic origin
This type of developmental anomalies is caused by long-term somatic insufficiency (weakness) of various origins: chronic infections and allergic conditions, congenital and acquired malformations of the somatic sphere, primarily the heart, diseases of the digestive system (V.V. Kovalev, 1979).
Long-term dyspepsia during the first year of life inevitably leads to developmental delays. Cardiovascular failure, chronic inflammation lungs, kidney diseases are often found in the history of children with mental retardation of somatogenic origin.
It is clear that a poor somatic condition cannot but affect the development of the central nervous system and delays its maturation. Such children spend months in hospitals, which naturally creates conditions of sensory deprivation and also does not contribute to their development.
Chronic physical and mental asthenia inhibits the development of active forms of activity and contributes to the formation of personality traits such as timidity, timidity, and lack of self-confidence. These same properties are largely determined by the creation of a regime of restrictions and prohibitions for a sick or physically weakened child. Thus, artificial infantilization caused by conditions of overprotection is added to the phenomena caused by the disease.
3. Mental retardation of psychogenic origin
This type is associated with unfavorable upbringing conditions that prevent the correct formation of the child’s personality (incomplete or dysfunctional family, mental trauma).
The social genesis of this developmental anomaly does not exclude its pathological nature. As is known, unfavorable environmental conditions that arise early, have a long-term effect and have a traumatic effect on the child’s psyche can lead to persistent changes in his neuropsychic sphere, disruption first of autonomic functions, and then of mental, primarily emotional, development. In such cases, we are talking about pathological (abnormal) personality development. BUT! This type of mental retardation should be distinguished from the phenomena of pedagogical neglect, which do not represent a pathological phenomenon, but are caused by a deficit of knowledge and skills due to a lack of intellectual information. + (Domestic psychologists do not classify pedagogically neglected children, meaning “pure pedagogical neglect”, in which the lag is caused only by reasons of a social nature. Although it is recognized that a long-term lack of information, the lack of mental stimulation during sensitive periods can lead a child to a decrease in potential opportunities for mental development).
(It must be said that such cases are recorded very rarely, as well as mental retardation of somatogenic origin. There must be very unfavorable somatic or microsocial conditions for mental retardation of these two forms to occur. Much more often we observe a combination of organic failure of the central nervous system with somatic weakness or with the influence unfavorable conditions of family upbringing).
Mental retardation of psychogenic origin is observed, first of all, with abnormal personality development by type of mental instability, most often caused by the phenomena of foster care - conditions of neglect, under which the child does not develop a sense of duty and responsibility, forms of behavior, the development of which is associated with the active inhibition of affect. The development of cognitive activity, intellectual interests and attitudes is not stimulated. Therefore, the features of pathological immaturity of the emotional-volitional sphere in the form of affective lability, impulsiveness, and increased suggestibility in these children are often combined with an insufficient level of knowledge and ideas necessary for mastering school subjects.
Variant of abnormal personality development like a “family idol” caused, on the contrary, by overprotection - incorrect, pampering upbringing, in which the child is not instilled with the traits of independence, initiative, and responsibility. Children with this type of mental retardation, against the background of general somatic weakness, are characterized by a general decrease in cognitive activity, increased fatigue and exhaustion, especially during prolonged physical and intellectual stress. They get tired quickly and take longer to do things. educational assignments. Cognitive and educational activities suffer SECONDARYLY due to a decrease in the overall tone of the body. This type of psychogenic infantilism, along with a low capacity for volitional effort, is characterized by features of egocentrism and selfishness, dislike of work, and an attitude towards constant help and guardianship.
Variant of pathological personality development neurotic type It is more often observed in children in whose families there is rudeness, cruelty, despotism, and aggression towards the child and other family members. In such an environment, a timid, fearful personality is often formed, whose emotional immaturity is manifested in insufficient independence, indecisiveness, low activity and lack of initiative. Unfavorable upbringing conditions also lead to a delay in the development of cognitive activity.
4. ZPR of cerebral-organic origin
This type of developmental disorder occupies the main place in this polymorphic developmental anomaly. It is more common than other types of mental retardation; often has great persistence and severity of disturbances both in the emotional-volitional sphere and in cognitive activity. It is of greatest importance for the clinic and special psychology due to the severity of the manifestations and the need (in most cases) special measures psychological and pedagogical correction.
A study of the anamnesis of these children in most cases shows the presence of mild organic failure of N.S. - RESIDUAL CHARACTER (remaining, preserved).
Abroad, the pathogenesis of this form of delay is associated with “minimal brain damage” (1947), or with “minimal brain dysfunction” (1962) - MMD. → These terms emphasize the UNEXPRESSIVENESS, CERTAIN FUNCTIONALITY OF CEREBRAL DISORDERS.
Pathology of pregnancy and childbirth, infections, intoxication, incompatibility of the blood of mother and fetus according to the Rh factor, prematurity, asphyxia, injuries during childbirth, postnatal neuroinfections, toxic-dystrophic diseases and injuries of the nervous system in the first years of life. - The reasons are to a certain extent similar to the reasons for mental retardation.
COMMON for this form of mental retardation and oligophrenia- is the presence of so-called MILD BRAIN DYSFUNCTION (LMD). ORGANIC DAMAGE TO THE CNS (RETARDATION) AT THE EARLY STAGES OF ONTOGENESIS.
Similar terms: “minimal brain damage”, “mild childhood encephalopathy”, “hyperkinetic chronic brain syndrome”.
Under LDM- is understood as a syndrome reflecting the presence of mild developmental disorders that occur mainly in the perinatal period, characterized by a very varied clinical picture. This term was adopted in 1962 to designate minimal (dysfunctional) brain disorders in childhood.
FEATURE OF ZPR- there is a qualitatively different structure of intellectual disability compared to u/o. Mental development is characterized by UNEVENITY of disturbances of various mental functions; wherein logical thinking M.B. more preserved compared to memory, attention, mental performance.
In children with LIMITED CNS LESION, a multidimensional picture of cerebral insufficiency is much more often observed, associated with immaturity, immaturity and therefore greater vulnerability of various systems, including the vascular and cerebrospinal fluid.
The nature of dynamic disorders in them is more severe and more frequent than in children with mental retardation of other subgroups. Along with persistent dynamic difficulties, there is a primary deficiency of a number of higher cortical functions.
Signs of a slowdown in the rate of maturation are often detected already in early development and concern almost all areas, in a significant part of cases even the somatic one. Thus, according to I.F. Markova (1993), who examined 1000 students junior classes special school for children with mental retardation, a slowdown in the rate of physical development was observed in 32% of children, a delay in the development of locomotor functions - in 69% of children, long delay formation of neatness skills (enuresis) - in 36% of observations.
In tests for visual gnosis, difficulties arose in perceiving complicated versions of object images, as well as letters. In praxis tests, perseverations were often observed when switching from one action to another. When studying spatial praxis, poor orientation in “right” and “left”, specularity in writing letters, and difficulties in differentiating similar graphemes were often noted. When studying speech processes, disorders of speech motor skills and phonemic hearing, auditory-verbal memory, difficulties in constructing an extended phrase, and low speech activity were often discovered.
Special LDM studies have shown that
RISK FACTORS ARE:
Late age of the mother, height and weight of the woman before pregnancy, beyond the age norm, first birth;
Pathological course of previous pregnancies;
Chronic diseases of the mother, especially diabetes, Rh conflict, premature birth, infectious diseases during pregnancy;
Psychosocial factors such as unwanted pregnancy, risk factors of a large city (long daily commute, city noise, etc.)
Presence of mental, neurological and psychosomatic diseases in the family;
Low or, conversely, excessive (more than 4000 kg) weight of the child at birth;
Pathological birth with forceps, caesarean section and so on.
DIFFERENCE FROM U/O:
1. Massiveness of the lesion;
2. Time of defeat. - ZPR is much more often associated with later ones,
exogenous brain damage affecting the period,
when differentiation of the main brain systems is already in
significantly advanced and there is no danger of their rough
underdevelopment. However, some researchers suggest
and the possibility of a genetic etiology.
3. The delay in the formation of functions is qualitatively different than with
oligophrenia. In cases with ZPR, one can observe the presence
temporary regression of acquired skills and their subsequent
instability.
4. Unlike oligophrenia, children with mental retardation do not have inertia
mental processes. They are able not only to accept and
use help, but also transfer learned mental skills
activities in other situations. With the help of an adult they can
carry out the intellectual tasks offered to him at close
normal level.
5. The predominance of later stages of damage determines along with
with symptoms of IMMATURITY almost constant PRESENCE
DAMAGE N.S. → Therefore, unlike oligophrenia, which
often occurs in uncomplicated forms, in the structure of the ZPR
CEREBRAL-ORGANIC GENESIS- almost always available
a set of encephalopathic disorders (cerebroasthenic,
neurosis-like, psychopath-like), indicating
damage to N.S..
CEREBRAL-ORGANIC INSUFFICIENCY first of all, it leaves a typical imprint on the structure of the mental retardation itself - both on the characteristics of emotional-volitional immaturity, and on the nature of cognitive impairment
Data from neuropsychological studies have revealed certain HIERARCHY OF COGNITIVE ACTIVITY DISORDERS in children with mental retardation of CEREBRAL-ORGANIC GENESIS. Yes, in more mild cases it is based on neurodynamic insufficiency, associated primarily with EXHAUSTIBILITY OF MENTAL FUNCTIONS.
With greater severity of organic brain damage, more severe neurodynamic disorders, expressed in the inertia of mental processes, are joined by PRIMARY DEFICITIES OF INDIVIDUAL CORTICO-SUBCORTAL FUNCTIONS: praxis, visual gnosis, memory, speech sensorimotor. + At the same time, a certain PARTIALITY, MOSAICALITY OF THEIR VIOLATIONS is noted. (Therefore, some of these children experience difficulties primarily in mastering reading, others in writing, others in counting, etc.). PARTIAL INSUFFICIENCY OF CORTICAL FUNCTIONS, in turn, leads to underdevelopment of the most complex mental formations, including ARBITRARY REGULATION. Thus, the hierarchy of mental function disorders in mental retardation of cerebral-organic origin is the opposite of that which exists in oligophrenia, where the intellect, and not its prerequisites, is primarily affected.
1. EMOTIONAL-VOLITIONAL IMMATURITY is represented by organic infantilism. With this infantilism, children lack the typical healthy child liveliness and brightness of emotions. Children are characterized by a weak interest in evaluation and a low level of aspirations. There is high suggestibility and non-acceptance of criticism addressed to oneself. Gaming activity is characterized by a lack of imagination and creativity, a certain monotony and originality, and a predominance of the component of motor disinhibition. The very desire to play often looks more like a way of avoiding difficulties in tasks than a primary need: the desire to play arises precisely in situations of the need for purposeful intellectual activity and preparation of lessons.
Depending on the prevailing emotional background, one can distinguish II MAIN TYPES OF ORGANIC INFANTILISM:
1) UNSTABLE - with psychomotor disinhibition, a euphoric tint of mood and impulsiveness, imitating childish cheerfulness and spontaneity. Characterized by a low capacity for volitional effort and systematic activity, a lack of stable attachments with increased suggestibility, and poverty of imagination.
2) INHIBITED - with a predominance of low mood, indecision, lack of initiative, often timidity, which may be a reflection of congenital or acquired functional failure of the autonomic N.S. according to the type of neuropathy. In this case, sleep disturbances, appetite disturbances, dyspeptic symptoms, and vascular lability may be observed. In children with organic infantilism of this type, asthenic and neurosis-like features are accompanied by a feeling of physical weakness, timidity, inability to stand up for themselves, lack of independence, and excessive dependence on loved ones.
2. COGNITIVE DISORDERS.
They are caused by insufficient development of memory processes, attention, inertia of mental processes, their slowness and reduced switchability, as well as deficiency of certain cortical functions. There is instability of attention, insufficient development of phonemic hearing, visual and tactile perception, optical-spatial synthesis, motor and sensory aspects of speech, long-term and short-term memory, hand-eye coordination, automation of movements and actions. Often there is poor orientation in the spatial concepts of “right - left”, the phenomenon of mirroring in writing, and difficulties in differentiating similar graphemes.
Depending on the predominance of either emotional-volitional immaturity or cognitive impairment in the clinical picture ZPR OF CEREBRAL GENESIS can be roughly divided
on II MAIN OPTIONS:
1. organic infantilism
Its various types represent more light form ZPR of cerebral-organic origin, in which functional impairments of cognitive activity are caused by emotional-volitional immaturity and mild cerebrasthenic disorders. Violations of cortical functions are dynamic in nature, due to their insufficient formation and increased exhaustion. Regulatory functions are especially weak at the control level.
2. Mental retardation with a predominance of functional impairments of cognitive activity - in this variant of retardation, symptoms of damage dominate: pronounced cerebrasthenic, neurosis-like, psychopath-like syndromes.
In essence, this form often expresses a state bordering on u/o (of course, the variability of the state in terms of its severity is also possible here).
Neurological data reflect the severity of organic disorders and a significant frequency of focal disorders. Severe neurodynamic disorders and deficits in cortical functions, including local disorders, are also observed. Dysfunction of regulatory structures is manifested in the links of both control and programming. This variant of ZPR is a more complex and severe form of this developmental anomaly.
CONCLUSION: The presented clinical types of the most persistent forms of mental retardation mainly differ from each other precisely in the peculiarities of the structure and the nature of the relationship between the two main components of this developmental anomaly: the structure of infantilism and the characteristics of the development of mental functions.
P.S. It should also be noted that within each of the listed groups of children with mental retardation there are variants that differ in both the degree of severity and the characteristics of individual manifestations of mental activity.
CLASSIFICATION OF ZPR L.I.PERESLENI and E.M. MASTYUKOVA
II TYPE ZPR:
1) Type BENIGN (NON-SPECIFIC) DELAY- is not associated with brain damage and is compensated with age under favorable environmental conditions, even without any special therapeutic measures. This type of mental retardation is caused by a slow rate of maturation of brain structures and their functions in the absence of organic changes in the central nervous system.
Benign (nonspecific) developmental delay manifests itself in some delay in the development of motor and (or) psychomotor functions, which can be detected at any age stage, is relatively quickly compensated and is not combined with pathological neurological and (or) psychopathological symptoms.
This type of mental retardation can be easily corrected through early stimulation of psychomotor development.
It can manifest itself both in the form of a general, total lag in development, and in the form of partial (partial) delays in the formation of certain neuropsychic functions, this especially often applies to a lag in the development of speech.
Benign nonspecific delay can be a familial symptom; it is often observed in somatically weakened and premature children. It can also occur when there is insufficient early pedagogical influence.
2) Type SPECIFIC (or CEREBRAL-ORGANIC) DEVELOPMENTAL DELAY- associated with damage to brain structures and functions.
Specific or cerebral-organic developmental delay is associated with changes in the structural or functional activity of the brain. Its cause may be disturbances in intrauterine brain development, fetal hypoxia and asphyxia of the newborn, intrauterine and postnatal infectious and toxic effects, trauma, metabolic disorders and other factors.
Along with severe diseases of N.S., which cause developmental delays, most children have mild neurological disorders, which are detected only with a special neurological examination. These are the so-called signs of MMD, which usually occur in children with cerebral-organic mental retardation.
Many children with this form of mental retardation exhibit motor disinhibition—hyperactive behavior—already in the first years of life. They are extremely restless, constantly on the move, all their activities are unfocused, and they cannot complete a single task they start. The appearance of such a child always brings anxiety, he runs around, fusses, breaks toys. Many of them are also characterized by increased emotional excitability, pugnacity, aggressiveness, and impulsive behavior. Most children are not capable of playful activities, they do not know how to limit their desires, they react violently to all prohibitions, and they are stubborn.
Many children are characterized by motor clumsiness and their fine differentiated movements of the fingers are poorly developed. Therefore, they have difficulty mastering self-care skills, and for a long time they cannot learn to fasten buttons or lace shoes.
From a practical point of view, differentiating specific and nonspecific developmental delay, i.e. essentially pathological and non-pathological delay, is extremely important in terms of determining the intensity and methods of stimulating age-related development, predicting the effectiveness of treatment, learning and social adaptation.
Delay in the development of certain psychomotor functions SPECIFIC FOR EACH AGE STAGE OF DEVELOPMENT.
So, during the period NEWBORN - such a child long time a clear conditioned reflex is not formed over time. Such a baby does not wake up when he is hungry or wet, and does not fall asleep when he is full and dry; all unconditioned reflexes are weakened and evoked after a long latent period. One of the main sensory reactions of this age - visual fixation or auditory concentration - is weakened or does not appear at all. At the same time, unlike children with damage to the central nervous system, he does not show signs of dysembryogenesis and developmental defects, including those expressed to a minimal extent. He also has no disturbances in crying, sucking, or asymmetric muscle tone.
Aged 1-3 MONTHS in such children, there may be a slight lag in the rate of age-related development, the absence or a weakly expressed tendency to lengthen the period of active wakefulness, a smile when communicating with an adult is absent or appears inconsistently; visual and auditory concentrations are short-term, humming is absent or only isolated rare sounds are observed. Progress in its development begins to be clearly visible by 3 months of life. By this age, he begins to smile and follow a moving object. However, all these functions may not manifest themselves constantly and are characterized by rapid depletion.
At all subsequent stages of development, benign developmental delay manifests itself in the fact that the child in his development goes through stages that are more characteristic of the previous stage. However, mental retardation can appear for the first time at each age stage. For example, a 6-month-old child with this form of developmental delay does not give a differentiated reaction to familiar and unfamiliar people, he may also have delayed development of babbling, and a 9-month-old child may exhibit insufficient activity in communication with adults, he does not imitate gestures, his play contact is poorly developed, babbling is absent or weakly expressed, intonation and melodic imitation of a phrase does not appear, he may have difficulty grasping or not grasping small objects with two fingers at all, or he does not respond clearly enough to verbal instructions. The slow pace of motor development is manifested in the fact that the child can sit, but does not sit down on his own, and if he sits, he makes no attempt to stand up.
Benign developmental delay in age 11-12 MONTHS most often manifests itself in the absence of the first babbling words, weak intonation expressiveness of vocal reactions, and unclear correlation of words with an object or action. Delayed motor development results in the child standing with support but not walking. Retardation in mental development is characterized by weakness in repeated actions and imitative games; the child does not manipulate with both hands confidently enough and does not sufficiently grasp objects with two fingers.
Nonspecific developmental delay in the first THREE YEARS OF LIFE most often manifests itself in the form of a lag in the development of speech, insufficient play activity, a lag in the development of the function of active attention, the regulating function of speech (the child’s behavior is poorly controlled by the instructions of an adult), insufficient differentiation of emotional manifestations, as well as general psychomotor disinhibition. It can also manifest itself as a delay in the development of motor functions. At the same time, IN THE FIRST MONTHS OF LIFE, the rate of normalization of muscle tone, the extinction of unconditioned reflexes, the formation of straightening reactions and balance reactions, sensory-motor coordination, voluntary motor activity and especially fine differentiated movements of the fingers lag behind.
B 4. PSYCHOLOGICAL PARAMETERS OF DPR
Topic: ZPR. Definition, main reasons, their brief description.
Plan:
Introduction.
1. Definition of ZPR
2. Causes of mental retardation and their characteristics.
3. Classification of children with mental retardation.
Bibliography.
Introduction.
There are a significant number of children studying in mass schools who are already in primary school do not cope with the training program and have difficulties in communication. This problem is especially acute for children with mental retardation. The problem of learning difficulties for these children is one of the most pressing psychological and pedagogical problems.
Children entering school with mental retardation have a number of specific characteristics. In general, they have not developed the skills, abilities and knowledge necessary for mastering program material, which normally developing children usually master in the preschool period. In this regard, children are unable (without special assistance) master counting, reading and writing. It is difficult for them to comply with the norms of behavior accepted at school. They experience difficulties in voluntary organization of activities: they do not know how to consistently follow the teacher’s instructions, or switch from one task to another according to his instructions. The difficulties they experience are aggravated by the weakening of their nervous system: students quickly get tired, their performance decreases, and sometimes they simply stop performing the activities they have begun.
The task of a psychologist is to establish the child’s level of development, determine its compliance or non-compliance with age standards, as well as identify pathological features of development. A psychologist, on the one hand, can provide useful diagnostic material to the attending physician, and on the other hand, can select correction methods and give recommendations regarding the child.
Deviations in the mental development of children of primary school age are usually correlated with the concept of “school failure.” To determine deviations in the mental development of underachieving schoolchildren who do not have mental retardation, deep disturbances of sensory systems, lesions of the nervous system, but at the same time they lag behind their peers in learning, we most often use the term “mental retardation”
1. Definition of ZPR
Mental retardation (MDD) is a concept that does not speak of persistent and irreversible mental underdevelopment, but of a slowdown in its pace, which is more often detected upon entering school and is expressed in an insufficient general stock of knowledge, limited ideas, immaturity of thinking, low intellectual focus, predominance of gaming interests, rapid saturation in intellectual activity. Unlike children suffering from mental retardation, these children are quite smart within the limits of their existing knowledge and are much more productive in using help. Moreover, in some cases, a delay in the development of the emotional sphere will come to the fore ( different kinds infantilism), and violations in the intellectual sphere will not be expressed sharply. In other cases, on the contrary, a slowdown in the development of the intellectual sphere will prevail.
Mental retardation (abbr. DPR) is a violation of the normal pace of mental development, when certain mental functions (memory, attention, thinking, emotional-volitional sphere) lag behind in their development the accepted psychological norms for a given age. Mental retardation, as a psychological and pedagogical diagnosis, is made only in preschool and primary school age; if by the end of this period signs of underdevelopment of mental functions remain, then we are talking about constitutional infantilism or mental retardation.
These children had a potential ability for learning and development, but for various reasons it was not realized, and this led to the emergence of new problems in learning, behavior, and health. The range of definitions of mental retardation is quite wide: from “specific learning disability”, “slow learner” to “borderline intellectual disability”. In this regard, one of the tasks of a psychological examination is to distinguish between mental retardation and pedagogical neglect and intellectual disability (mental retardation) .
Pedagogical neglect- this is a condition in the development of a child, which is characterized by a deficit of knowledge and skills due to a lack of intellectual information. Pedagogical neglect is not a pathological phenomenon. It is not associated with a deficiency of the nervous system, but with defects in education.
Mental retardation- This qualitative changes the entire psyche, the entire personality as a whole, resulting from organic damage to the central nervous system. Not only the intellect suffers, but also emotions, will, behavior, and physical development.
A developmental anomaly, defined as mental retardation, occurs much more often than other, more severe disorders of mental development. According to various sources, up to 30% of children in the population have mental retardation to some degree, and their number is increasing. There is also reason to believe that this percentage is higher, especially recently.
With mental retardation, the child’s mental development is characterized by uneven disturbances of various mental functions. At the same time, logical thinking may be more intact compared to memory, attention, and mental performance. In addition, unlike mental retardation, children with mental retardation do not have the inertia of mental processes that is observed with mental retardation. Children with mental retardation are able not only to accept and use help, but also to transfer learned mental skills to other situations. With the help of an adult, they can complete the intellectual tasks offered to them at a level close to the norm.
2. Causes of mental retardation and their characteristics.
The causes of delayed mental development may be severe infectious diseases of the mother during pregnancy, toxicosis of pregnancy, chronic fetal hypoxia due to placental insufficiency, trauma during pregnancy and childbirth, genetic factors, asphyxia, neuroinfections, severe diseases, especially at an early age, nutritional deficiencies and chronic somatic diseases, as well as brain injuries in the early period of a child’s life, an initial low level of functionality as an individual feature of the child’s development (“cerebrasthenic infantilism” - according to V.V. Kovalev), severe emotional disorders of a neurotic nature, associated, as a rule, with extreme unfavorable conditions of early development. As a result of the adverse impact of these factors on the central nervous system In the child, there is a kind of suspension or distorted development of certain structures of the cerebral cortex. The shortcomings of the social environment in which the child is raised are very important, and sometimes even decisive. Here, in the first place are the lack of maternal affection, human attention, and lack of care for the baby. It is for these reasons that mental retardation is so common in children raised in orphanages and 24-hour nurseries. Children left to their own devices, raised in families where parents abuse alcohol and lead a disorderly lifestyle, find themselves in the same difficult situation.
According to the American Brain Injury Association, among children with learning disabilities, up to 50% are children who received a head injury between birth and 3-4 years.
It is known how often young children fall; This often happens when there are no adults nearby, and sometimes even the adults present do not attach much importance to such falls. But as recent research from the American Brain Injury Association has shown, such seemingly minor traumatic brain damage in early childhood can even lead to irreversible consequences. This occurs when there is compression of the brain stem or stretching of nerve fibers, which can occur in more severe cases throughout life.
3. Classification of children with mental retardation.
Let us dwell on the classification of children with mental retardation. Our clinicians distinguish among them (classification by K.S. Lebedinskaya) four groups.
The first group is mental retardation of constitutional origin. This is harmonious mental and psychophysical infantilism. Such children are already different in appearance. They are more delicate, often their height is less than average and their faces retain the features of an earlier age, even when they are already schoolchildren. These children have a particularly pronounced lag in the development of the emotional sphere. They seem to be on more early stage development compared to chronological age. They have a greater expressiveness of emotional manifestations, the brightness of emotions and at the same time their instability and lability; easy transitions from laughter to tears and vice versa are very characteristic of them. Children in this group have very pronounced gaming interests, which prevail even at school age.
Harmonic infantilism is a uniform manifestation of infantilism in all areas. Emotions lag behind in development, delayed and speech development, and development of the intellectual and volitional sphere. In some cases, the physical lag may not be expressed - only mental lag is observed, and sometimes there is a psychophysical lag as a whole. All these forms are combined into one group. Psychophysical infantilism sometimes has a hereditary nature. In some families, it is noted that their parents also had corresponding traits in childhood.
The second group is mental retardation of somatogenic origin, which is associated with long-term severe somatic diseases at an early age. These can be severe allergic diseases (bronchial asthma, for example), diseases of the digestive system. Long-term dyspepsia during the first year of life inevitably leads to developmental delays. Cardiovascular failure, chronic pneumonia, and kidney disease are often found in the history of children with mental retardation of somatogenic origin.
The state of mental retardation is determined by heredity. Children with this type of mental retardation are distinguished by harmonious immaturity of both physique and psyche, which gives grounds to designate such a form of delay as harmonious psychophysical infantilism. In children of this group, there is a significant lag in mental development from normal age, which manifests itself mainly in the emotional-volitional sphere with relatively preserved (albeit slower than normal) cognitive activity.
Such a student attracts attention from the first days of his stay at school; he is curious about everything that happens around him, quickly finds friends and patrons who take care of and protect the “little one”, and enjoys universal love because of his easy-going, cheerful disposition. The main background of his mood is predominantly positive: mood swings are rare, grievances are quickly forgotten. At the same time, the superficiality of emotional reactions is noted. Immaturity of the emotional-volitional sphere leads to unformed educational motivation. Having quickly settled into school, such children do not accept new requirements for behavior: they are constantly late for lessons after recess, get up during class, walk around the classroom, talk loudly with neighbors, and approach the teacher. Restless, talkative, they cannot obey necessity
perform any task without being distracted, turn educational activities in the playroom available to them, forgetting to take the necessary school supplies, they always put toys in their briefcase. They play in class themselves and involve their neighbors in the game. Having written out the elements of the letters, they begin to finish drawing them, turning them into flowers, Christmas trees, houses, and plot drawings appear on the notebook sheet. The child does not differentiate between “good” and “bad” grades. He is pleased by the very fact of their presence in the notebook. The behavior of such a child disorganizes the work of the class.
From the first months of school, a child becomes persistently unsuccessful. There are a number of reasons for this. On the one hand, due to the immaturity of the emotional-volitional sphere, he tends to do only what is directly related to his interests (he cannot organize his behavior in the lesson, but is organized and proactive in playing, listening and reproducing fairy tales and stories, does not write down the elements of letters well , but demonstrates good drawing skills). On the other hand, due to the immaturity of the prerequisites for intellectual development, such children have an insufficient level of formation of mental operations, memory, speech, and a small stock of knowledge and ideas about the surrounding reality for their given age.
Day constitutional ZPR characterized by a favorable prognosis, subject to targeted pedagogical influence in an entertaining and playful form accessible to the child. Identification of such children in preschool age, early start correctional work, training not from 7, but from 8 years old can completely remove the above problems. The child may also be sent, by decision of the school psychological and pedagogical council, to a compensatory education class. If there is no such class at school, duplication of the first class is possible. Repeating a second year does not traumatize children with constitutional mental retardation. They easily join the new team and quickly and painlessly get used to the new teacher. The psychophysical status that has changed during the first year of study and individual psychological and pedagogical support allow such a child to master the program of a mass comprehensive school on an equal basis with other students, and no serious problems are observed in their further education.
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