Mental retardation is detected. Types of mental retardation in children. The main causes of mental retardation in a child - who is at risk for mental retardation, what factors provoke mental retardation
Delay mental development (ZPR) is a lag in the development of mental processes and immaturity of the emotional-volitional sphere in children, which can potentially be overcome with the help of specially organized training and upbringing. Mental retardation is characterized by an insufficient level of development of motor skills, speech, attention, memory, thinking, regulation and self-regulation of behavior, primitiveness and instability of emotions, and poor school performance. Diagnosis of mental retardation is carried out jointly by a commission consisting of medical specialists, teachers and psychologists. Children with mental retardation need specially organized correctional and developmental education and medical support.
General information
Mental retardation (MDD) is a reversible disorder of the intellectual, emotional and volitional sphere, accompanied by specific learning difficulties. The number of people with mental retardation reaches 15-16% in the child population. ZPR is largely a psychological and pedagogical category, but it may be based on organic disorders, so this condition is also considered by medical disciplines - primarily pediatrics and child neurology. Since the development of various mental functions in children occurs unevenly, usually the conclusion “mental retardation” is established for preschool children no earlier than 4-5 years old, and in practice - more often during schooling.
Causes of mental retardation (MDD)
The etiological basis of mental retardation is biological and socio-psychological factors that lead to a delay in the child’s intellectual and emotional development.
Biological factors (severe organic damage to the central nervous system of a local nature and their residual effects) cause disruption of the maturation of various parts of the brain, which is accompanied by partial disturbances in the mental development and activity of the child. Among the biological causes that act in the perinatal period and cause mental retardation are: highest value have pathology of pregnancy (severe toxicosis, Rh conflict, fetal hypoxia, etc.), intrauterine infections, intracranial birth injuries, prematurity, kernicterus of newborns, fetal alcohol syndrome, etc., leading to the so-called perinatal encephalopathy. In the postnatal period and early childhood, mental retardation can be caused by severe somatic diseases of the child (hypotrophy, influenza, neuroinfections, rickets), traumatic brain injuries, epilepsy and epileptic encephalopathy, etc. Mental retardation sometimes has a hereditary nature and in some families is diagnosed across generations per generation.
Mental retardation can occur under the influence of environmental (social) factors, which, however, does not exclude the presence of an initial organic basis for the disorder. Most often, children with mental retardation grow up in conditions of hypo-care (neglect) or hyper-care, authoritarian upbringing, social deprivation, and lack of communication with peers and adults.
Delayed mental development of a secondary nature can develop with early hearing and vision impairments, speech defects due to a pronounced deficit of sensory information and communication.
Classification of mental development delay (MDD)
The group of children with mental retardation is heterogeneous. In special psychology, many classifications of mental retardation have been proposed. Let's consider the etiopathogenetic classification proposed by K. S. Lebedinskaya, which identifies 4 clinical types of mental retardation.
ZPR of constitutional origin due to slower maturation of the central nervous system. Characterized by harmonious mental and psychophysical infantilism. With mental infantilism, the child behaves like a younger person; with psycho-physical infantilism, the emotional-volitional sphere and physical development suffer. Anthropometric data and behavior of such children do not correspond to their chronological age. They are emotionally labile, spontaneous, and have insufficient attention and memory. Even at school age, their gaming interests predominate.
ZPR of somatogenic origin is caused by severe and long-term somatic diseases of the child at an early age, which inevitably delay the maturation and development of the central nervous system. The history of children with somatogenic mental retardation often includes bronchial asthma, chronic dyspepsia, cardiovascular and renal failure, pneumonia, etc. Usually such children for a long time are treated in hospitals, which in addition causes sensory deprivation. ZPR of somatogenic genesis is manifested by asthenic syndrome, low performance of the child, less memory, superficial attention, poorly developed activity skills, hyperactivity or lethargy due to overwork.
ZPR of psychogenic origin is caused by unfavorable social conditions in which the child lives (neglect, overprotection, abuse). Lack of attention to the child creates mental instability, impulsiveness, and retardation in intellectual development. Excessive care fosters in a child lack of initiative, egocentrism, lack of will, and lack of purposefulness.
ZPR of cerebral-organic origin occurs most often. Caused by primary mild organic damage to the brain. In this case, disorders may affect individual areas of the psyche or manifest themselves mosaically in different mental areas. Delayed mental development of cerebral-organic origin is characterized by immaturity of the emotional-volitional sphere and cognitive activity: lack of liveliness and brightness of emotions, low level of aspirations, pronounced suggestibility, poverty of imagination, motor disinhibition, etc.
Characteristics of children with mental retardation (MDD)
The personal sphere in children with mental retardation is characterized by emotional lability, easy mood swings, suggestibility, lack of initiative, lack of will, and immaturity of the personality as a whole. Affective reactions, aggressiveness, conflict, and increased anxiety may be observed. Children with mental retardation are often withdrawn, prefer to play alone, and do not seek contact with peers. The play activities of children with mental retardation are characterized by monotony and stereotyping, lack of a detailed plot, lack of imagination, and non-compliance with game rules. Features of motor skills include motor clumsiness, lack of coordination, and often hyperkinesis and tics.
A feature of mental retardation is that compensation and reversibility of disorders are possible only under conditions of special training and education.
Diagnosis of mental development delay (MDD)
Mental retardation can only be diagnosed as a result of a comprehensive examination of the child by a psychological-medical-pedagogical commission (PMPC) consisting of a child psychologist, speech therapist, speech pathologist, pediatrician, child neurologist, psychiatrist, etc. At the same time, anamnesis is collected and studied, conditions are analyzed life, neuropsychological testing, diagnostic examination of speech, study of the child’s medical records. It is mandatory to have a conversation with the child, a study of intellectual processes and emotional-volitional qualities.
Based on information about the child’s development, members of the PMPK make a conclusion about the presence of mental retardation and give recommendations on organizing the upbringing and education of the child in special educational institutions.
In order to identify the organic substrate of mental development delay, the child needs to be examined by medical specialists, primarily a pediatrician and a pediatric neurologist. Instrumental diagnostics may include EEG, CT and MRI of the child’s brain, etc. Differential diagnosis of mental retardation should be carried out with mental retardation and autism.
Correction of mental retardation (MDD)
Working with children with mental retardation requires a multidisciplinary approach and active participation pediatricians, child neurologists, child psychologists, psychiatrists, speech therapists, defectologists. Correction of mental retardation should begin in preschool age and be carried out over a long period of time.
Children with mental retardation must attend specialized preschool educational institutions (or groups), Type VII schools or correctional classes in general education schools. Peculiarities of teaching children with mental retardation include the dosage of educational material, reliance on clarity, repeated repetition, frequent change of activities, and the use of health-saving technologies.
When working with such children, special attention is paid to the development of cognitive processes (perception, attention, memory, thinking); emotional, sensory and motor spheres with the help of fairy tale therapy. Correction of speech disorders in mental retardation is carried out by a speech therapist in individual and group lessons. Together with teachers, correctional work on teaching students with mental retardation is carried out by special education teachers, psychologists, and social educators.
Medical care for children with mental retardation includes drug therapy in accordance with identified somatic and cerebral-organic disorders, physiotherapy, exercise therapy, massage, and hydrotherapy.
Forecast and prevention of mental retardation (MDD)
The lag in the rate of mental development of a child from age norms can and must be overcome. Children with mental retardation are teachable, and with properly organized correctional work, positive dynamics are observed in their development. With the help of teachers, they are able to acquire knowledge, skills and abilities that their normally developing peers master on their own. After graduating from school, they can continue their education at vocational schools, colleges and even universities.
Prevention of mental retardation in a child involves careful planning of pregnancy, avoidance of adverse effects on the fetus, prevention of infectious and somatic diseases in young children, and provision of favorable conditions for upbringing and development. If a child is lagging behind in psychomotor development, an immediate examination by specialists and the organization of corrective work are necessary.
The problem of underachievement of a certain part of primary secondary school students has long attracted the attention of teachers, psychologists, doctors and sociologists. They identified a certain group of children who could not be classified as mentally retarded, since within the limits of existing knowledge they showed a sufficient ability to generalize, a wide “zone of proximal development.” These children were classified as a special category - children with mental retardation.
M.S. Pevzner and T.A. Vlasova (1968, 1973) drew attention to the role of emotional development in the formation of the personality of a child with mental retardation, as well as to the significance of neurodynamic disorders (asthenic and cerebrasthenic conditions). Accordingly, mental retardation was identified, arising on the basis of mental and psychophysical infantilism associated with harmful effects on the central nervous system during pregnancy, and the delay that occurs in the early stages of a child’s life as a result of various pathogenic factors leading to asthenic and cerebrasthenic conditions of the body.
As a result of further research work by K.S. Lebedinskaya proposed a classification of types of mental retardation according to the etiopathogenetic principle:
Each of these types can be complicated by a number of painful somatic, encephalopathic, neurological symptoms, and has its own clinical and psychological structure, its own characteristics of emotional immaturity and cognitive impairment, and its own etiology.
Mental retardation (MDD)- syndrome of temporary lag in the development of the psyche as a whole or its individual functions, a slowdown in the rate of realization of the body’s potential capabilities, 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 satiation in intellectual activity
The causes of PPD can be divided into two large groups:
Biological reasons include:
Among the reasons of a socio-psychological nature The following are distinguished:
The basis of ZPR is the interaction of biological and social causes. In the taxonomy of ZPR Vlasova T.A. and Pevzner M.S. There are two main forms:
Infantilism is a violation of the rate of maturation of the most late-forming brain systems. Infantilism can be harmonious (associated with a functional disorder, immaturity of the frontal structures) and disharmonious (due to organic phenomena of the brain);
Asthenia is a sharp weakening of a somatic and neurological nature, caused by functional and dynamic disorders of the central nervous system. Asthenia can be somatic and cerebral-asthenic (increased exhaustion of the nervous system).
Let us describe in more detail each of the types of ZPR.
Mental retardation of constitutional origin – so-called harmonious infantilism (uncomplicated mental and psychophysical infantilism, according to the classification of M.S. Pevzner and T.A. Vlasova), in which the emotional-volitional sphere is, as it were, at an earlier stage of development, largely reminiscent of the normal structure of the emotional makeup of children more younger age. Characterized by the predominance of emotional motivation for behavior, heightened background mood, spontaneity and brightness of emotions with their superficiality and instability, easy suggestibility. Difficulties in learning, often observed in these children in the early grades, are associated with immaturity motivational sphere and the personality in general, the predominance of gaming interests. Harmonic infantilism is, as it were, a nuclear form of mental infantilism, in which the traits of emotional-volitional immaturity appear in their purest form and are often combined with an infantile body type. Such harmony of psychophysical appearance, the presence of family cases, non-pathological mental characteristics suggest a predominantly congenital constitutional etiology of this type of infantilism. However, often the origin of harmonious infantilism can be associated with minor metabolic and trophic disorders in utero or the first years of life. Under favorable conditions, these children show good alignment results.
This group also includes:
Mental retardation of somatogenic origin. This type of developmental anomaly is caused by long-term somatic failure of various origins: chronic infections and allergic conditions, congenital and acquired malformations of the somatic sphere, primarily the heart. In slowing down the rate of mental development of children, a significant role belongs to persistent asthenia* , reducing not only general, but also mental tone. Often there is also a delay in emotional development - somatogenic infantilism, caused by a number of neurotic layers - uncertainty, fearfulness associated with a feeling of physical inferiority, and sometimes caused by a regime of prohibitions and restrictions in which a somatically weakened or sick child is located.
In an asthenic state, a child is not able to cope with the educational load. The following signs of fatigue often appear:
Mental retardation of psychogenic origin associated with unfavorable upbringing conditions that prevent the correct formation of the child’s personality. 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.
This type of mental retardation should be distinguished from the phenomena of pedagogical neglect, which does not represent a pathological phenomenon, and a deficit of knowledge and skills due to a lack of intellectual information.
Mental retardation of psychogenic origin is observed primarily with abnormal personality development according to the type of mental instability, most often caused by the phenomenon hypoprotection – conditions of neglect, under which the child does not develop a sense of duty and responsibility, forms of behavior 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 by type "family idol" caused, on the contrary, overprotective-pampering education. In which the child is not instilled with the traits of independence, initiative, and responsibility. This 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.
A variant of pathological personality development of the neurotic type is more often observed in children whose parents show rudeness, cruelty, despoticism, and aggression towards the child and other family members. The so-called type "Cinderella". In such an environment, a timid, fearful personality is often formed, whose emotional immaturity manifests itself in insufficient independence, indecision, little activity and initiative, and subsequently leads to maladjustment.
Child development in conditions contradictory upbringing. Children are forced to adapt to adults, which leads to a lack of core attitudes and the formation of an unstable personality.
Mental retardation of cerebral-organic origin occurs more often than other described stages and often has great persistence and severity of disturbances both in the emotional-volitional sphere and in cognitive activity and occupies the main place in this developmental anomaly. A study of the anamnesis shows the presence of mild organic insufficiency of the nervous system, often of a residual nature due to the pathology of pregnancy (severe toxicosis, infections, intoxication and trauma, incompatibility of the blood of mother and fetus according to the Rh factor), prematurity, asphyxia and trauma during childbirth, postnatal neuroinfections , toxic-dystrophic diseases of the first years of life.
Anamnestic data often indicate a slowdown in the change of age-related phases of development: a delay in the formation of static functions, walking, speech, neatness skills, and stages of play activity.
In the somatic state, along with frequent signs of delayed physical development (underdevelopment of muscles, insufficiency of muscle and vascular tone, growth retardation), general malnutrition is often observed, which does not allow us to exclude the pathogenetic role of disorders of autonomic regulation; Various types of body dysplasticity may also be observed. In the neurological condition, hydrocephalic and sometimes hypertensive stigmas (local areas with increased intracranial pressure), and the phenomenon of vegetative-vascular dystonia are often encountered.
Cerebral-organic insufficiency primarily 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. Emotional-volitional immaturity is represented organic infantilism. Children do not have the typical healthy child liveliness and brightness of emotions; characterized by weak interest in evaluation and low level of aspirations. Suggestibility has a rough connotation and is often accompanied by a lack of criticism. Gaming activity is characterized by poverty of imagination and creativity, monotony and monotony. The very desire to play often looks like a way to avoid difficulties in classes. Often, activities that require targeted intellectual activity, such as preparing homework, turn into a game.
Depending on the predominance of one or another emotional background, two main types of organic infantilism can be distinguished: unstable – with psychomotor disinhibition, euphoric mood and impulsiveness and braked – with a predominance of low mood, indecision, timidity.
This type of mental retardation is characterized by disturbances in cognitive activity caused by insufficient attention, memory, inertia of mental processes, their slowness and reduced switchability, as well as insufficiency of individual cortical functions.
Psychological and pedagogical research conducted at the Research Institute of Defectology of the Academy of Pedagogical Sciences of the USSR under the leadership of V.I. Lubovsky, state that these children have 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 “right-left”, phenomena of mirroring in writing, and difficulties in distinguishing similar graphemes.
General psychological and pedagogical characteristics of children with delaysmental development
Depending on the origin (cerebral, constitutional, somatogenic, psychogenic), as well as on the time of exposure of the child’s body to harmful factors, mental retardation gives rise to different types of deviations in the emotional-volitional sphere and cognitive activity. As a result of studying the mental processes and learning opportunities of children with mental retardation, a number of specific features were identified in their cognitive, emotional-volitional sphere, behavior and personality in general. The following common features for mental retardation of various etiologies were identified:
Memory: Insufficient development of cognitive processes is often the main reason for the difficulties that children with mental retardation experience when learning at school. As numerous clinical and psychological-pedagogical studies show, memory impairments play a significant role in the structure of mental activity defects in this developmental anomaly.
Observations of teachers and parents of children with mental retardation, as well as special psychological research indicate deficiencies in the development of their involuntary memory. Much of what normally developing children remember easily, as if by themselves, causes significant effort in their lagging peers and requires specially organized work with them.
One of the main reasons for the insufficient productivity of involuntary memory in children with mental retardation is decrease in their cognitive activity. In a study by T.V. Egorova (1969), this problem was subjected to special study. One of the experimental methods used in the work involved the use of a task, the purpose of which was to arrange pictures with images of objects into groups in accordance with the initial letter of the name of these objects. It was found that children with developmental delays not only reproduced verbal material worse, but also spent significantly more time recalling it than their typically developing peers. The main difference was not so much in the extraordinary productivity of the answers, but in the different attitude towards the goal. Children with mental retardation made almost no attempts on their own to achieve more complete recall and rarely used auxiliary techniques for this. In cases where this did happen, a substitution of the purpose of the action was often observed. The auxiliary method was used not to remember the necessary words starting with a certain letter, but to invent new (extraneous) words starting with the same letter.
In the study by N.G. Poddubnaya studied the dependence of the productivity of involuntary memorization on the nature of the material and the characteristics of activity with it in junior schoolchildren with ZPR. The subjects had to establish semantic connections between units of the main and additional sets of words and pictures (in different combinations). Children with mental retardation showed difficulties in assimilating instructions for series that required independent selection of nouns that matched the meaning of the pictures or words presented by the experimenter. Many children did not understand the task, but were eager to quickly receive the experimental material and begin to act. At the same time, they, unlike normally developing preschoolers, could not adequately assess their capabilities and were confident that they knew how to complete the task. Clear differences were revealed both in productivity and in the accuracy and stability of involuntary memorization. The amount of correctly reproduced material was normally 1.2 times higher.
N.G. Poddubnaya notes that visual material is remembered better than verbal material and in the process of reproduction is a more effective support. The author points out that involuntary memory in children with mental retardation does not suffer to the same extent as voluntary memory, therefore it is advisable to teach it widely.4
TA. Vlasova, M.S. Pevzner point to a decrease in voluntary memory in students with mental retardation as one of the main reasons for their difficulties in school learning. These children do not remember texts well: the multiplication tables; they do not keep the goal and conditions of the task in mind. They are characterized by fluctuations in memory productivity and rapid forgetting of what they have learned.
Specific features of the memory of children with mental retardation:
Reduced memory capacity and memorization speed,
Involuntary memorization is less productive than normal,
The memory mechanism is characterized by a decrease in the productivity of the first attempts at memorization, but the time required for complete memorization is close to normal,
The predominance of visual memory over verbal memory,
Reduced random memory.
Mechanical memory impairment.
Attention: Causes of impaired attention:
The asthenic phenomena present in the child have an impact.
Immaturity of the mechanism of voluntariness in children.
Lack of motivation, the child shows good concentration of attention when it is interesting, and when it is necessary to show a different level of motivation - a violation of interest.
Researcher of children with mental retardation L.M. Zharenkova notes the following features of attention characteristic of this disorder:
Low concentration: the child’s inability to concentrate on a task, on any activity, rapid distractibility. In the study by N.G. Poddubnaya clearly demonstrated the peculiarities of attention in children with ZPR: during the execution of the entire experimental task, cases of fluctuations in attention were observed, a large number of distractions, rapid exhaustion and fatigue.
Low level of attention stability. Children cannot engage in the same activity for a long time.
Voluntary attention is more severely impaired. In correctional work with these children, it is necessary to attach great importance to the development of voluntary attention. To do this, use special games and exercises (“Who is more attentive?”, “What’s missing on the table?” and so on). In progress individual work apply techniques such as drawing flags, houses, working according to a model, etc.
Perception. Causes of impaired perception : with mental retardation, the integrative activity of the cerebral cortex and cerebral hemispheres is disrupted and, as a result, the coordinated work of various analyzer systems is disrupted: hearing, vision, and the motor system, which leads to a disruption of the systemic mechanisms of perception.
Disadvantages of perception:
The teacher’s task is to help a child with mental retardation organize the processes of perception and teach him to reproduce the subject purposefully. On the first academic year In teaching, an adult guides the child’s perception during the lesson; at an older age, children are offered a plan for their actions. To develop perception, children are offered material in the form of diagrams and colored chips.
Features of mental activity of children with mental retardation
This problem was studied by U.V. Ulienkova, T.V. Egorova, T.A. Strekalova and others. The thinking of children with mental retardation is more intact than that of mentally retarded children; the ability to generalize, abstract, accept help, and transfer skills to other situations is more preserved.
The development of thinking is influenced by all mental processes:
In children with mental retardation, all these prerequisites for the development of thinking are impaired to one degree or another. Children have difficulty concentrating on a task. These children have impaired perception, they have a rather meager experience in their arsenal - all this determines the thinking characteristics of a child with mental retardation.
That aspect of cognitive processes that is disrupted in a child is associated with a violation of one of the components of thinking.
Children with mental retardation suffer from coherent speech and the ability to plan their activities using speech is impaired; inner speech is impaired - active agent logical thinking child.
General deficiencies in the mental activity of children with mental retardation:
Lack of formation of cognitive, search motivation (a peculiar attitude towards any intellectual tasks). Children tend to avoid any intellectual effort. For them, the moment of overcoming difficulties is unattractive (refusal to perform a difficult task, replacement of an intellectual task with a closer, playful task.). Such a child does not complete the task completely, but only a simpler part of it. Children are not interested in the outcome of the task. This feature of thinking manifests itself at school, when children very quickly lose interest in new subjects.
Lack of a pronounced orientation stage when solving mental problems. Children with mental retardation begin to act immediately, on the fly. This position was confirmed in the experiment of N.G. Poddubny. When presented with instructions for the task, many children did not understand the task, but sought to quickly obtain the experimental material and begin to act. It should be noted that children with mental retardation are more interested in finishing their work as quickly as possible, rather than in the quality of the task. The child does not know how to analyze conditions and does not understand the significance of the orientation stage, which leads to many errors. When a child begins to learn, it is very important to create conditions for him to initially think and analyze the task.
3. Low mental activity, “mindless” style of work (children, due to haste and disorganization, act at random, without fully taking into account the given conditions; there is no directed search for a solution or overcoming difficulties). Children solve a problem on an intuitive level, that is, the child seems to give the answer correctly, but cannot explain it.
4. Stereotypic thinking, its stereotyped nature.
Visual-figurative thinking.
Children with mental retardation find it difficult to act according to a visual model due to violations of analysis operations, violation of integrity, focus, activity of perception - all this leads to the fact that the child finds it difficult to analyze the model, identify the main parts, establish the relationship between parts and reproduce this structure in the course of their own activities.
Logical thinking.
Children with mental retardation have impairments in the most important mental operations, which serve as components of logical thinking:
In all children with mental retardation, the level of logical thinking lags significantly behind the level of a normal schoolchild. By the age of 6-7 years, children with normal mental development They begin to reason, draw independent conclusions, and try to explain everything. Children independently master two types of inferences:
Children with mental retardation experience great difficulty in forming the simplest conclusions. The stage in the development of logical thinking - drawing a conclusion from two premises - is still little accessible to children with mental retardation. In order for children to be able to draw a conclusion, they are given great help by an adult who indicates the direction of thought, highlighting those dependencies between which relationships should be established.7 According to Ulienkova U.V., “children with mental retardation do not know how to reason or draw conclusions; try to avoid such situations. These children, due to their undeveloped logical thinking, give random, thoughtless answers and show an inability to analyze the conditions of the problem. When working with these children, it is necessary to pay special attention to the development of all forms of thinking in them.”
Considering all of the above, these children need a special approach.
Training requirements that take into account the characteristics of children with mental retardation:
Questions for self-control:
Azbukina E.Yu., Mikhailova E.N. Fundamentals of special pedagogy and psychology: Textbook. - Tomsk: Tomsk State Pedagogical University Publishing House, 2006. - 335 p.
The concept of “mental retardation”.
Mental retardation (MDD) - a special type of anomaly, manifested in a disruption of the normal pace of mental development of the child. May be caused by various reasons: defects child's constitution (harmonic infantilism), somatic diseases, organic lesions of the central nervous system (minimal brain dysfunction).
Children with mental retardation find themselves underachieving from the very beginning of their education. However, the insufficiency of their intelligence is more correctly defined not as backwardness, but as lag. In Russian science, mental retardation is understood as syndromes of temporary lag in the development of the psyche as a whole or its individual functions (motor, sensory, speech, emotional-volitional), and a slow pace of realization of the body’s properties encoded in the genotype. Being a consequence of temporary and mild factors (early deprivation, poor care, etc.), mental retardation can be reversible. Constitutional factors, somatic diseases, and organic failure of the nervous system play a role in the etiology of mental retardation.
Classification of ZPR K.S. Lebedinskaya.
The main clinical types of mental retardation are differentiated according to the etiopathogenetic principle: mental retardation of constitutional origin, mental retardation of somatogenic origin, mental retardation of psychogenic origin, mental retardation of cerebral-organic origin.
Each of these types of mental retardation has its own clinical and psychological structure, its own characteristics of emotional immaturity and cognitive impairment, and is often complicated by a number of painful symptoms - somatic, encephalopathic, neurological.
The presented clinical types of the most persistent forms of mental retardation mainly differ from each other precisely in the peculiarity of the structure and the nature of the relationship between the two main components of this developmental anomaly: the structure of infantilism and the nature of neurodynamic disorders.
At ZPR of constitutional origin We are talking about the so-called harmonious infantilism, in which the emotional-volitional sphere is, as it were, at an earlier stage of development, in many ways reminiscent of the normal structure of the emotional makeup of younger children. Characterized by the predominance of emotional motivation for behavior, heightened mood, spontaneity and brightness of emotions with their superficiality and instability, easy suggestibility.
ZPR of somatogenic origin is caused by long-term somatic insufficiency of various origins: chronic infections and allergic conditions, congenital and acquired malformations of the somatic sphere. Often there is a delay in emotional development - somatogenic infantilism, caused by a number of neurotic layers - uncertainty, timidity, capriciousness associated with a feeling of physical inferiority.
ZPR of psychogenic origin is associated with unfavorable upbringing conditions that prevent the correct formation of the child’s personality (the phenomenon of hypoprotection, hypercustody, etc.). Traits of pathological immaturity of the emotional-volitional sphere in the form of affective lability (mood instability with pronounced manifestations of frequently changing emotions), impulsiveness, increased suggestibility, and indecisiveness in these children are often combined with an insufficient level of knowledge and ideas necessary for mastering school subjects.
ZPR of cerebral-organic origin It occurs more often than other types described above, and often has greater persistence and severity of disturbances both in the emotional-volitional sphere and in cognitive activity.
A study of the anamnesis of these children in most cases shows the presence of mild organic failure of the nervous system. Depending on the predominance in the clinical picture of the phenomena of either emotional-volitional immaturity or impaired cognitive activity, mental retardation of cerebral origin can be divided into two main options: 1) organic infantilism; 2) mental retardation with a predominance of functional impairments of cognitive activity.
As a rule, various types of organic infantilism represent a milder form of mental retardation of cerebral-organic origin, in which functional impairments of cognitive activity are caused by emotional-volitional immaturity and mild cerebrasthenic disorders.
In cases of mental retardation with a predominance of functional disorders, there is instability of attention, insufficient development of phonemic hearing, visual and tactile perception, optical-spatial synthesis, motor and sensory aspects of speech, long-term and short-term memory, hand-eye coordination, automation of movements and actions. Poor orientation in “right-left”, phenomena of mirroring in writing, and difficulties in differentiating similar graphemes are often found.
In this case, a certain partiality and mosaic pattern of violations of individual cortical functions is noted. Obviously, in this regard, some of these children experience primary difficulties in mastering reading, others in writing, still others in counting, fourths show the greatest lack of motor coordination, fifths in memory, etc. X. Spionek (1972) emphasizes that such a child does not have a sufficient number of premises on which logical thinking is built.
For those entering school children with mental retardation has a number of specific features. In general, they are not ready for schooling. They have not sufficiently 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 help) to 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 with mental retardation quickly get tired, their performance decreases, and sometimes they simply stop performing the activities they started.
Decreased performance and instability characteristic of these children attention have different forms of individual manifestation. In some children, the maximum tension of attention and the highest performance are detected at the beginning of the task and steadily decrease as the work continues; for others, concentration occurs only after a certain period of activity; Still others experience periodic fluctuations in attention and uneven performance throughout the entire task.
It has been established that many of these children experience difficulties in the process perception . First of all, this manifests itself in the fact that children do not perceive the presented educational material with sufficient completeness. They perceive many things incorrectly. This is important to keep in mind, since it is easy to assume that children who do not have hearing or vision impairments should not experience difficulties in the process of perception.
All children with mental retardation also have disadvantages memory: Moreover, these shortcomings apply to all types of memorization: involuntary and voluntary, short-term and long-term. First of all, as shown in the studies of V.L. Podobed, they have a limited memory capacity and reduced memorization strength. This extends to memorizing both visual and (especially) verbal material, which cannot but affect academic performance.
A significant lag and originality is also revealed in their development. mental activity . Both are most clearly manifested in the process of solving intellectual problems. Thus, when independently analyzing the objects proposed to describe them, children with mental retardation identify significantly fewer features than their normally developing peers.
The most typical mistakes of children with mental retardation are substitution of comparison of one object with all others by pairwise comparison (which does not provide a true basis for generalization) or generalization based on unimportant characteristics. The mistakes that normally developing children make when performing such tasks are only due to insufficiently clear differentiation of concepts.
The fact that after receiving help, the children of the group under consideration are able to perform various tasks proposed to them at a level close to the norm allows us to speak about their qualitative difference from mentally retarded children. Children with mental retardation have much greater potential in terms of their ability to master the educational material offered to them.
One of psychological characteristics children with mental retardation is that they have a delay in the development of all types of thinking. This lag is revealed to the greatest extent when solving problems that involve the use of verbal and logical thinking.
The development of visual and figurative thinking in children lags significantly behind. It is especially difficult for these children to operate in their minds with parts of images (S.K. Sivolapov). Their visual and effective thinking lags least behind in development. Children with mental retardation, studying in special schools or special classes, by the fourth grade begin to solve problems of a visual and effective nature at the level of their normally developing peers. As for tasks related to the use of visual-figurative and verbal-logical thinking, they are solved by the children of the group under consideration at a much lower level.
Different from the norm and speech children with mental retardation. Many of them have pronunciation defects, which naturally leads to difficulties in the process of mastering reading and writing. Children of the group under consideration have a poor vocabulary (especially active ones), and they are poorly formed empirical grammatical generalizations; Therefore, in their speech there are many incorrect grammatical constructions.
They differ significantly in their originality behavior and activities these children. After entering school, they continue to behave like preschoolers. The leading activity remains the game. Children do not have a positive attitude towards school. Educational motivation is absent or extremely weakly expressed. It was suggested that the state of their emotional-volitional sphere corresponds, as it were, to the previous stage of development.
It is very important to note that in the context of a mass school, a child with mental retardation for the first time begins to clearly realize his inadequacy, which is expressed primarily in academic failure. This, on the one hand, leads to a feeling of inferiority, and on the other, to attempts at personal compensation in some other field. Such attempts are sometimes expressed in various behavioral disorders (“antics”).
Under the influence of failures, a child with mental retardation quickly develops a negative attitude towards educational activities. This can and should be avoided. It is necessary to carry out an individual approach to each such child, based on deep knowledge of the peculiarities of the development of his mental processes and personality as a whole. The teacher needs to do everything possible to support the child’s positive attitude towards school at first. One should not emphasize the lack of success in educational activities and criticize for not entirely adequate behavior. Sometimes it is necessary to encourage the child to complete the proposed tasks based on the play motivation of the activity.
If the specified lag and not quite adequate behavior cannot be overcome in a public school, it is necessary, having prepared a detailed psychological and pedagogical description describing all the features of the child’s behavior in classes and in his free time, to refer the child to a medical-pedagogical commission, which will resolve the issue about the advisability of transferring him to a special school for children with mental retardation.
Features of the manifestation of mental retardation
Children with mental retardation are the most difficult to diagnose, especially in the early stages of development.
In children with mental retardation in a somatic state, there are frequent signs of delayed physical development (underdevelopment of muscles, insufficiency of muscle and vascular tone, growth retardation), the formation of walking, speech, neatness skills, and stages of play activity is delayed.
These children have characteristics of the emotional-volitional sphere (its immaturity) and persistent impairments in cognitive activity.
Emotional and volitional immaturity is represented by organic infantilism. Children with mental retardation do not have the liveliness and brightness of emotions typical of a healthy child; they are characterized by weak will and weak interest in evaluating their activities. The game is characterized by a lack of imagination and creativity, monotony, monotony. These children have low performance as a result of increased exhaustion.
In cognitive activity, the following are observed: weak memory, instability of attention, slowness of mental processes and their reduced switchability. A child with mental retardation needs a longer period to receive and process visual, auditory and other impressions.
Researchers call immaturity of the emotional-volitional sphere the most striking sign of mental retardation; 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 attention disturbances inevitably appear: 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).
^ Impaired perception is 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 about the characteristics of memory in children with mental retardation, one pattern has been discovered 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.
Mental retardation is often accompanied by speech problems, primarily related to the pace of its development. Other features of 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 lexical grammatical side.
Children with mental retardation have a delay 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).
Children with mental retardation are characterized by a limited (much poorer than typically developing children of the same age) stock of general information about the environment, insufficiently formed spatial and temporal concepts, a poor vocabulary, and undeveloped intellectual activity skills.
The immaturity of the functional state of the central nervous system is one of the reasons that children with mental retardation are not ready for schooling by the age of 7 years. By this time, as a rule, their basic mental operations have not been formed, they do not know how to navigate tasks, and do not plan their activities. Such a child has difficulty mastering reading and writing skills, often mixes letters that are similar in style, and has difficulty writing text independently.
In a mass school setting, children with mental retardation naturally fall into the category of persistently underperforming students, which further traumatizes their psyche and causes a negative attitude towards learning.
3. Physical exercise for parents.
Teacher: -Let's remember the traffic lights. What does the red light mean? Yellow? Green? Well done, now let's turn into a traffic light. At the same time, we will check your attention. If I say, “Green,” you stamp your feet; “Yellow” - clap your hands; "Red" - silence. And I will be a faulty traffic light and sometimes show the wrong signals.
Ekaterina Morozova
Reading time: 10 minutes
A A
Some mothers and fathers are well acquainted with the abbreviation ZPR, which hides a diagnosis such as mental retardation, which is becoming more common today. Despite the fact that this diagnosis is more of a recommendation than a sentence, for many parents it comes as a bolt from the blue.
What lies behind this diagnosis, who has the right to make it, and what do parents need to know?
What is mental retardation, or mental retardation - classification of retardation
The first thing that moms and dads need to understand is that mental retardation is not an irreversible mental underdevelopment and has nothing to do with mental retardation and other terrible diagnoses.
ZPR (and ZPRR) is just a slowdown in the rate of development, usually detected before school . With a competent approach to solving the problem of ZPR, it simply ceases to be a problem (and in a very short time).
It is also important to note that, unfortunately, today such a diagnosis can be made out of the blue, based only on minimal information and the child’s lack of desire to communicate with specialists.
But the topic of unprofessionalism is not at all in this article. Here we are talking about the fact that the diagnosis of mental retardation is a reason for parents to think and pay more attention to their child, listen to the advice of specialists, and direct their energy in the right direction.
Video: Mental retardation in children
How are mental development disorders classified - the main groups of mental development?
This classification, which is based on etiopathogenetic systematics, was developed in the 80s by K.S. Lebedinskaya.
- ZPR of constitutional origin. Signs: frailty and growth below average, preservation of childish facial features even at school age, instability and severity of expressions of emotions, delay in the development of the emotional sphere, infantilism manifested in all areas. Often, among the causes of this type of mental retardation, a hereditary factor is identified, and quite often this group includes twins whose mothers encountered pathologies during pregnancy. For children with this diagnosis, as a rule, it is recommended to study in correctional school.
- ZPR of somatogenic origin. The list of causes includes severe somatic illnesses that were suffered in early childhood. For example, asthma, problems with the respiratory or cardiovascular system, etc. Children in this group of mental retardation disorders are fearful and unconfident, and are often deprived of communication with peers due to the intrusive guardianship of parents, who for some reason decided that communication is difficult for children. For this type of mental retardation, treatment in special sanatoriums is recommended, and the form of training depends on each specific case.
- ZPR of psychogenic origin. A rather rare type of ZPR, however, as is the case with the previous type. For these two forms of mental retardation to occur, severely unfavorable conditions of a somatic or microsocial nature must be created. The main reason is unfavorable conditions of parental upbringing, which caused certain disturbances in the process of personality formation little man. For example, overprotection or neglect. In the absence of problems with the central nervous system, children from this group of mental retardation quickly overcome the difference in development with other children in a regular school. It is important to distinguish this type of mental retardation from pedagogical neglect.
- ZPR of cerebral-organic origin . The most numerous (according to statistics - up to 90% of all cases of mental retardation) group of mental retardation. And also the most severe and easily diagnosed. Key reasons: birth injuries, central nervous system diseases, intoxication, asphyxia and other situations that arose during pregnancy or directly during childbirth. Among the signs, one can single out bright and clearly observable symptoms of emotional-volitional immaturity and organic failure of the nervous system.
The main causes of mental retardation in a child - who is at risk for mental retardation, what factors provoke mental retardation?
The reasons that provoke ZPR can be divided into 3 groups.
The first group includes problematic pregnancy:
- Chronic diseases of the mother that affect the health of the child (heart disease and diabetes, thyroid disease, etc.).
- Toxoplasmosis.
- Transferred expectant mother infectious diseases (flu and sore throat, mumps and herpes, rubella, etc.).
- Mom's bad habits (nicotine, etc.).
- Incompatibility of Rh factors with the fetus.
- Toxicosis, both early and late.
- Early birth.
The second group includes the reasons that occurred during childbirth:
- Asphyxia. For example, after the umbilical cord wraps around the baby’s neck.
- Birth injuries.
- Or mechanical injuries that occur due to illiteracy and unprofessionalism of health workers.
And the third group are reasons of a social nature:
- Dysfunctional family factor.
- Limited emotional contacts at various stages of baby development.
- Low level of intelligence of parents and other family members.
- Pedagogical neglect.
Risk factors for the development of PPD include:
- Complicated first birth.
- "Old-time" mother.
- Excess weight of the expectant mother.
- The presence of pathologies in previous pregnancies and births.
- The presence of chronic diseases of the mother, including diabetes.
- Stress and depression of the expectant mother.
- Unwanted pregnancy.
Who and when can diagnose a child with mental retardation or mental retardation?
Moms and dads, remember the main thing: A neuropathologist does not have the right to single-handedly make such a diagnosis!
- The diagnosis of mental retardation or mental retardation (approx. – mental and speech development delay) can be made only by decision of the PMPK (approx. – psychological, medical and pedagogical commission).
- The main task of the PMPC is to make or remove the diagnosis of mental retardation or mental retardation”, autism, cerebral palsy, etc., and also determine what educational program the child needs, whether he needs additional classes, etc.
- The commission usually includes several specialists: a defectologist, a speech therapist and a psychiatrist. As well as the teacher, the child’s parents and the administration of the educational institution.
- On what basis does the commission draw conclusions about the presence or absence of ZPR? Specialists communicate with the child, test his skills (including writing and reading), give tasks on logic, mathematics, etc.
As a rule, a similar diagnosis appears in children’s medical records at the age of 5-6 years.
What do parents need to know?
- ZPR is not a sentence, but a recommendation from specialists.
- In most cases, by the age of 10, this diagnosis is canceled.
- The diagnosis cannot be made by 1 person. It is placed only by decision of the commission.
- According to the Federal State Educational Standard, the problem of mastering the material of the general education program 100% (in full) is not a basis for transferring the child to another form of education, to a correctional school, etc. There is no law that obliges parents to transfer children who do not pass the commission to a special class or a special boarding school.
- Members of the commission have no right to put pressure on parents.
- Parents have the right to refuse to undergo this PMPK.
- Members of the commission do not have the right to report diagnoses in the presence of the children themselves.
- When making a diagnosis, one cannot rely only on neurological symptoms.
Signs and symptoms of mental retardation in a child - features of child development, behavior, habits
Parents can recognize mental retardation, or at least take a closer look and pay special attention to the problem, by the following signs:
- The baby is not able to wash his hands and put on his shoes, brush his teeth, etc., although by age he should already be able to do everything himself (or the child knows and can do everything, but just does it slower than other children).
- The child is withdrawn, avoids adults and peers, and rejects groups. This symptom may also indicate autism.
- The child often shows anxiety or aggression, but in most cases remains fearful and indecisive.
- At the age of “baby”, the baby is delayed in the ability to hold his head, pronounce the first syllables, etc.
Video: The emotional sphere of a child with mental retardation
Other signs include symptoms of underdevelopment of the emotional-volitional sphere.
A child with mental retardation...
- Gets tired quickly and has a low level of performance.
- Incapable of mastering the entire volume of work/material.
- Has difficulty analyzing information from the outside and must rely on visual aids to fully perceive it.
- Has difficulties with verbal and logical thinking.
- Has difficulty communicating with other children.
- Unable to play role-playing games.
- Has difficulty organizing his activities.
- Experiences difficulties in mastering the general education curriculum.
Important:
- Children with mental retardation quickly catch up with their peers if they receive corrective and pedagogical assistance in a timely manner.
- Most often, the diagnosis of mental retardation is made in a situation where the main symptom is a low level of memory and attention, as well as the speed and transition of all mental processes.
- It is extremely difficult to diagnose mental retardation in preschool age, and almost impossible at the age of 3 years (unless there are very obvious signs). An accurate diagnosis can only be made after psychological and pedagogical observation of a child at the age of a primary school student.
Each child's mental retardation manifests itself individually, but the main signs for all groups and degrees of retardation are:
- Difficulty in performing (by a child) actions that require specific volitional efforts.
- Problems with building a holistic image.
- Easy memorization of visual material and difficult memorization of verbal material.
- Problems with speech development.
Children with mental retardation certainly require a more delicate and attentive attitude towards themselves.
But it is important to understand and remember that the developmental disability is not an obstacle to learning and mastering school material. Depending on the diagnosis and developmental characteristics of the baby, school course may be only slightly adjusted for a certain period of time.
What to do if a child is diagnosed with mental retardation - instructions for parents
The most important thing that parents of a child who has suddenly been given the “stigma” of mental retardation should do is to calm down and realize that the diagnosis is conditional and approximate, that everything is fine with their child, and he is simply developing at an individual pace, and that everything will definitely work out , because, we repeat, ZPR is not a sentence.
But it is also important to understand that mental retardation is not age-related acne on the face, but mental retardation. That is, it’s still not worth giving up on the diagnosis.
What do parents need to know?
- Mental retardation is not a final diagnosis, but a temporary condition, but one that requires competent and timely correction so that the child can catch up with his peers to a normal state of intelligence and psyche.
- For most children with mental retardation, a correctional school or class will be an excellent opportunity to speed up the process of solving the problem. The correction must be carried out on time, otherwise time will be lost. Therefore, the “I’m in the house” position is not correct here: the problem cannot be ignored, it must be solved.
- When studying in a correctional school, the child already high school, as a rule, ready to return to regular class, and the diagnosis of mental retardation in itself will not affect the child’s future life.
- Accurate diagnosis is extremely important. The diagnosis cannot be made by general practitioners - only by specialists in mental/intellectual disabilities.
- Don't sit still - contact specialists. You will need consultations with a psychologist, speech therapist, neurologist, defectologist and neuropsychiatrist.
- Choose special ones didactic games, according to the child’s abilities, develop memory and logical thinking.
- Attend FEMP classes with your child and teach them to be independent.
